What Is Fertility?
A woman’s fertility is often taken for granted but 1 in 7 women who try to conceive have trouble. If you are trying to have a baby you probably want to know how to boost your fertility and increase your odds of conception. Some fertility factors are known and within your control but many are unknown and uncontrollable. If you do have difficulty conceiving, don’t beat yourself up – be as healthy as possible but remember too that you have limited control over your own fertility.
What Factors Affect Fertility?
Age A woman’s fertility starts to gradually decline around age 27 and drops off dramatically after age 35. Women in their twenties have a 20 to 25 percent chance of pregnancy each month. At 30, the chance of becoming pregnant in a given month drops to around 15 percent and by 35, the likelihood is less than 10 percent in a given month. A woman is born with all of the eggs she will ever have so as she ages, she has fewer eggs and the percentage of genetically normal eggs declines. Women in their twenties have greater pregnancy odds since they have more eggs and a higher ratio of genetically normal eggs.
Weight Twelve percent of all infertility can be linked to weighing too much or too little. What is the ideal weight for optimal fertility? According to Harvard researcher and The Fertility Diet co-author, Dr. Jorge E. Chavarro, “The ideal BMI is between 20 and 22. Women who are overweight or obese (BMI of higher than 25, and higher than 30, respectively) are at an increased risk for infertility due to anovuation. Even women who are at the higher end of the normal BMI range tend to have a slightly higher risk of infertility. On the other hand being too lean can also lead to lack of ovulation and infertility."
A severely underweight woman (with less than 17 percent body fat) may have irregular ovulation, reducing their odds of conception. This is most common in women who are athletes or have an eating disorder. Maintaining a healthy BMI will help you achieve your optimal fertility.
Environment In recent decades, the number of infertile women has risen dramatically. It’s tempting to chalk this up to more women having children later but a US National Survey of Family Growth found that the rate of “impaired fecundity” (difficulty conceiving or carrying a child to term) rose significantly for all ages and the biggest rate increase occurred in women under 25 years old. This indicates that environmental causes may be a factor. There are over 80,000 synthetic chemicals used in everyday products – they permeate our air, water, food, and homes but most of them are untested. Some of these compounds are known to impair fertility in humans and animals - such as perchloroethylene (dry cleaning fluid), phthalates (found in cosmetics, personal care products, and packaging) and BPA (found in plastic bottles, cans, and receipt paper). The impact of our daily exposure to these chemicals is not fully understood but emerging studies suggest a link between environmental toxins and infertility.
Nutrition and Lifestyle It’s not a surprise but poor nutrition, smoking, and alcohol consumption take a toll on women’s (and men’s) fertility. The Nurses' Health Study, an eight-year study of more than 18,000 women, examined the effect of nutrition on a woman’s fertility. What it found was that eating lots of easily digestible carbs (like white bread, potatoes, soda) increases the odds of ovulatory infertility, while choosing slowly digestible carbs that are rich in fiber can improve fertility. The study also concluded that getting more protein from plants and less from animals lowers the risk of ovulatory infertility, and that the higher the consumption of trans-fats, the greater the likelihood of infertility.
Smoking can also delay the time it takes a woman to conceive and increase her risk for miscarriage. And exposure to second-hand smoke can impact infertility just as much as smoking does. For a man, excessive alcohol consumption (two to four drinks per day for over two months) can diminish fertility and for a woman, even moderate drinking can make it harder to get pregnant. Caffeine consumption may also increase the time it takes to conceive - one study showed that women who drank more than one cup of coffee a day were half as likely to become pregnant per cycle compared to women who consumed less.
Emotional Factors Stress can interfere with a woman’s ability to get pregnant. It is conventional wisdom but it’s also backed up by research – a recent Ohio State University Medical Center and National Institutes of Health study examined the impact of stress on fertility. It found that 25 percent of women who had the highest levels of the stress biomarker alpha-amylase had about a 12 percent decrease in the chance of becoming pregnant during each menstrual cycle, as compared with women who had the lowest levels of the stress marker.
A study conducted by the Domar Center at Boston IVF looked at the effect of stress-reduction on fertility. It found that infertile women who underwent a 10-session relaxation training and stress management program had increased pregnancy rates. Fifty five percent of women who participated in the stress-reduction program conceived within one year while only 20 percent of a control group conceived during the same time period.
Alice Domar, author of Conquering Infertility and executive director of the Domar Center, was a co-author of the study. Domar says that stress, anxiety and depression hinder fertility. “Women who are depressed take longer to get pregnant.” she says. “If you’ve been trying for a while to get pregnant and you’re not, I would say look at your stress level, your anxiety level, and possible depression. Check in with yourself. Most women have a pretty good sense of how they are doing.” She suggests learning stress management skills and potentially seeking the help of a therapist to help treat the anxiety, stress, and/or depression that could hamper your fertility.
Boosting Your Fertility
Maintain a healthy weight. According to the Nurses’ Health Study, a BMI of 20 to 24 puts you in the “fertility zone”, the ideal weight for getting pregnant.
Eat a fertility-boosting diet. Chavarro offers these dietary guidelines for optimizing fertility:
• Take a multivitamin that contains folic acid and iron. Folic acid will decrease the risk of birth defects and may influence ovulation and help women get pregnant faster.
• Avoid trans-fats, found in fast food and commercial products.
• Eat more vegetable protein (like beans and nuts) and less animal protein.
• Drink a glass of whole milk or having a small dish of ice cream or full-fat yogurt every day; temporarily trading in skim milk and low or no-fat dairy products for their full-fat versions.
A healthier diet is also proven to increase sperm quality and motility (ability of sperm to move) so get your partner on board with a healthy diet too. Find out the best fertility-boosting foods.
Make healthy lifestyle choices. Exercise, get enough sleep, don’t smoke, and limit your intake of alcohol and caffeine.
Reduce your stress. Domar suggests that women who are having difficulty conceiving take concrete steps to lower their stress levels, “Pick up a cognitive behavior book which will teach you some stress management skills, see a therapist, or ask your primary care physician for a cognitive behavioral therapist. Get a relaxation CD and listen to it every day. There are a lot of things you can do on your own to reduce your stress.”
Get treatment for depression and/or anxiety. Depression and anxiety are known to hinder fertility. If you are suffering from either of these conditions, talk to your primary care physician to get a referral for treatment.
Reduce your exposure to toxins. Follow these guidelines from RESOLVE: The National Infertility Association, to cut down on potential harmful chemicals in your diet and home that may hinder your fertility.
• Avoid fish that contain high levels of mercury, dioxin and PCBs (like swordfish and albacore tuna)
• If possible, eat organic. Wash and peel conventional produce before eating to remove pesticides.
• If necessary, filter water at home.
• Reduce or stop using pesticides and herbicides for home, lawn, garden, and pet care. Try non-toxic alternatives.
• Avoid sports/water bottles and other products that contain BPA (Bisphenol A).
• Don’t microwave foods in plastic.
• Use personal care products that are free of phthalates and other harsh chemicals.
• Use a “green” dry cleaning service. If that’s not an option, air out dry-cleaned clothes before bringing them into your car or home.
• Rid your home of indoor air pollutants. Keep your home ventilated, especially when vacuuming, cleaning, painting, or doing anything that stirs up toxins.
• Avoid use of synthetic air fresheners, fabric softeners, and fragrances.
Get a preconception checkup. Meet with your OB/GYN to get an assessment of your overall health and see if she can help you identify lifestyle changes that could improve your chances of getting pregnant and maintaining a healthy pregnancy. Ask these questions on your visit.
Increasing your chances of conception
Upping your odds of getting pregnant requires optimizing your fertility and getting the timing of your um, efforts right. If you were daydreaming in 10th grade bio, brush up on your ovulation basics. It will also help to learn the signs of ovulation.
There are lots of tools that can help you track your ovulation. Use our ovulation calendar to find your most fertile days and the best time to TTC (try to conceive), and our fertility chart to track the signs of ovulation including your basal body temperature and cervical mucus . If you want to step up your efforts, think about getting an ovulation predictor kit and read up on our tips for getting pregnant.
When to Seek Treatment
The recommendation from both the American Congress of Obestetricians and Gynecologists (ACOG) and the American Society for Reproductive Medicine (ASRM) is that women under age 30 try to conceive for 12 months before seeking treatment, and that women over age 30 try for six months before seeking help from a fertility specialist.
However, a new study shows that the majority of women who have not conceived in six months are not likely to conceive by simply trying for another six months. By the end of six months, 56 percent of participants were pregnant. By the end of 12 months, 8 percent were pregnant. Only 15 percent of women got pregnant by trying to conceive for an additional six months. If you have been trying for six months, no matter what your age, it could not hurt to check-in with your OB or a reproductive endocrinologist.
You and your partner should visit a fertility specialist together. Your doctor can give you and your partner a fertility workup, which will start the process of figuring out if either of you has an infertility problem. If a couple is struggling to get pregnant, often the woman assumes that the problem is hers but infertility is an equal opportunity offender — one-third of infertility issues are attributed to women, one-third are attributed to men, and one-third is attributed to a combination of factors.
There are dozens of effective fertility treatments available and assisted reproductive technology (ART) is always improving. Although 1 in 7 couples have difficulty conceiving, two-thirds of couples that are treated for infertility go on to have babies.
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