What can I do to improve fertility on my own?
As an infertility specialist I frequently get asked “what can I do on my own to improve my chances of getting pregnant”. Ten initiatives to improve fertility:
Age – Start your family sooner versus later. Women are born with all the eggs they will ever have at the time of birth. Every month women lose a cohort of eggs until menopause, which is defined as the last egg released. Because eggs are not replaced, eggs accumulate genetic errors as a function of time due to a multitude of environmental stressors. Fertility decreases significantly after age 35, it decreases markedly after 38. For women over 42 pregnancy rates with the most aggressive therapy, i.e., in vitro fertilization pregnancy rates are likely to be in the single digit range. Because males constantly make new sperm all their life, fertility changes associated with aging are much less striking – there is a slight decrease in fertility after age 50.
Timing – the second part of the menstrual cycle (post ovulation) is consistently around 14 days. Therefore, if a woman’s cycle lasts 28 days then that means she is ovulating on day 14. Conception is greatest when intercourse takes place 1-2 days prior to ovulation or the day of ovulation – the goal is to have sperm onboard before the egg has released. Pregnancy rates are significantly diminished if egg release occurs before sperm are present.
Frequency of intercourse – the goal is to have sperm onboard before the egg is released. Daily intercourse prior to ovulation is associated with the highest chance for pregnancy, followed by every other day intercourse. Couples who have intercourse once per week or less have a markedly decreased chance of conception.
Lubricants – may impair sperms ability to swim up into the cervical mucous. Try to avoid Vaseline, K-Y. Approved lubricants that do not impair sperm motility include PreSeed as well as Astroglide, both available without a prescription.
Weight – extremes of weight, i.e., both obesity and excessively thin women have decreased fertility rates. While the physiologic mechanism is different the common pathway is the same, these individuals do not produce gonadotropins correctly, the hormones responsible for egg development. Normalizing body weight often will result in normal ovulation.
Stress – stress can affect fertility by decreasing gonadotropins, i.e., the two hormones LH and FSH that are responsible for egg production. Decrease in stress often will result in normal physiologic ovulation. If you are having regular 28 day plus or minus 2-3 day cycles you are likely having regular physiologic ovulation.
Smoking – has clearly been associated with decreased fertility as well as increased risk of miscarriage and early onset menopause. Smoking is believed to affect the number and quality of your eggs.
Alcohol – is best totally avoided when trying to get pregnant. There is no safe level of alcohol consumption during pregnancy. The concern here is more in terms of teratogenic effects on the fetus, i.e., fetal alcohol syndrome.
Caffeine – consumption of high levels of caffeine, five cups or more, has been associated with impaired fertility as well as an increased risk of miscarriage. One to two cups of coffee a day is not believed to affect fertility.
Strenuous aerobic activity has been shown to decrease fertility – limit aerobic activity to nothing more strenuous than brisk walking.