Ways to Improve Fertility
Oftentimes with respect to complex issues, even health-related, we like easy, self-help fixes. Just go to any online bookstore (or a bricks and mortar bookstore, if you can find one) and see a myriad of “DIY” titles such as “Three Steps to ______,” “Five Ways to ______,” “Seven Methods for ______.” While there are not 3, 5, or 7 steps to conception, below are ten clinically-based means to boost fertility. Most are pretty simple, and some of these things your grandmother probably told you!
1: Timely intercourse
It is best to have vaginal intercourse every two to three days throughout the cycle, with the most likely days including 3 days prior to ovulation to 3 days following ovulation. Commonly we recommend the usage of an ovulation prediction kit beginning around cycle day 10 of a 28 day cycle, with intercourse the evening that the test suggests ovulation as well as the next evening.
2: Maintain a healthy BMI
What is the right weight to maximize the likelihood of conception? Generally it is a body mass index of between 19-25 kg/m2. If you do not know your BMI you can use this calculator from the National Institutes of Health: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
It is more difficult to conceive if one is overweight or underweight (in fact, more difficult if under than over). The fatty layer beneath the skin is the largest endocrine organ in the body, by far, and it makes hormones that have direct effects on ovulation and other reproductive functions.
3: Maintain sperm health
Approximately 40% of couples who present to an infertility clinic have a male factor related problem as a primary diagnosis. Sperm concentration, motility and structural form are all important determinants of sperm health.
Men should also avoid being over- or underweight, and avoid tobacco, alcohol, excessive heat (tight underwear, hot tubs, saunas, steam rooms), and toxins (e.g. petroleum-based products, household cleaners, pesticides and herbicides).
4: Do not smoke
In addition to known adverse effects on the lungs and cardiovascular health, a couple attempting conception should stop smoking due to the fact that smoking tobacco products increases oxidative stress (oxygen radicals) which damages both egg and sperm DNA. Ask your primary care physician about means to stop smoking (e.g., nicotine replacement therapy, Chantix, Zyban, e-cigarettes, hypnosis).
5: Good lubricants
Although commonly used, water-based lubricants may not promote fertility! In fact, some water-based gels actually stun or kill sperm. Oil-based lubricants such as canola oil, olive oil, baby oil (Not butter!) are all good alternatives.
If you do decide to use a product from the drugstore, please read the label to make sure you are not using something that may be contra-ceptive.
6: Drink alcohol minimally (if at all)
Some recent studies from northern Europe have shown that even five bottles of beer per week can have definite adverse effects on sperm health and reproductive hormones. Excess alcohol in men can lead to decreased testosterone, increased sex hormone binding globulin and increased estrogen, as well as increased visceral fat (“beer belly”) with associated cardiovascular risks. In women, excess alcohol can lead to ovulation dysfunction, can increase testosterone and other androgens and can increase the chances for breast cancer.
In general, men should probably have no more than four bottles of beer, or four 6 oz. pours of wine per week and women should have no more than three of either per week. With respect to mixed drinks, men should probably have no more than two and women no more than one per week.
7: Minimize caffeine intake
Consuming 500 milligrams (about 5 cups) of coffee can affect male and female reproductive health. Animal studies reported in the British Journal of Pharmacology have found that the activity of fallopian tubes, which carry eggs from the ovaries to the uterus, can be undermined by regular caffeine intake, thus negatively affecting fertility.
The recommended daily limit of caffeine is 200-250 milligrams daily while attempting conception and no more than 125 mg during pregnancy. First trimester miscarriage rates increase with greater than 150 mg of caffeine daily.
8: Prevent STDs
Avoiding sexually transmitted diseases (STD) is recommended to protect general health and fertility. Chlamydia and gonorrhea can cause scarring in both women and men and adhesions in the fallopian tubes or vas deferens can lead to sterility. Condoms help as does monogamy! Before having sex with someone, make sure that she or he is verifiably STD-free and has been very recently tested. No proof, no sex.
9: Stop exercising excessively
Daily aerobic exercise, achieving a heart rate of 70-80% of one’s target heart rate for 30 minutes daily is a good general recommendation; however, one should have a medical checkup before engaging in any new physical activities. More than five hours of vigorous exercise per week may lead to ovulation problems due to poor communication between the brain and the ovaries. Sperm production and function can also be impacted negatively by excessive exercise.
10: Beware of toxic chemicals
Household cleaners, herbicides, pesticides, organosolvents, petroleum based products, anesthetic gases and other chemicals can decrease fertility. Certain professions are more likely to be exposed to harmful chemicals than others. These include but are not limited to workers in agricultural, pest-control, domestic cleaning, petroleum industry, hair styling, dentistry, anesthesia, and printing.