There’s an art and science in increasing fertility
By Deborah Jeanne Sergeant
About 9% of men and 11% of women of childbearing age in the U.S. have experienced fertility issues, according to National Health Statistic Reports.
When a couple has trouble conceiving a child, approximately one-third of the time, it stems from issues with the mother; another third relates to the man and the remaining one-third is a mix of both or an unknown cause. To give themselves the best chance for fertility, couples who regularly have sex should try to target what Rob Kiltz calls “the fertile window.”
“To effectively calculate when your body is most fertile, it is important to understand your menstrual cycle as no two women’s menstrual cycles are exactly the same,” said Kiltz, who is the founder of CNY Fertility in Rochester. “Your fertile window depends on the duration of your individual cycle.”
He explained that the first day of the cycle begins the first day of the menstrual period. For the next two weeks, during the follicular phase, the woman’s body focuses on egg growth and maturation and preparing the uterus for a potential pregnancy. For women with a typical 28-day cycle, the body ovulates — releases an egg — around the 14th day and she remains fertile for five days or so.
The cervical mucous becomes “clear, slippery, plentiful and the consistency of egg whites,” Kiltz said.
An at-home ovulation tester can also help pinpoint fertile days.
Once the egg is released, fertilization must take place within 12 to 48 hours. Having intercourse 72 hours before ovulation “gives sperm the best chance of successfully reaching the egg and fertilizing it in time,” Kiltz said.
Sperm can live in a woman’s body for up to five days.
If this strategy isn’t helpful, a few lifestyle changes can help improve fertility naturally.
“Inflammation is a major cause of infertility and diet, exercise and other lifestyle choices all play a role in improving or impairing fertility in both men and women,” Kiltz said.
He elaborated that inflammation kicks off an immune response that may damage sperm, egg, embryo and even a developing fetus. Managing stress regularly — not just waiting for an annual vacation — is key for controlling this response.
While carrying too much fat is deleterious to good health, sufficient dietary fat is necessary to achieve pregnancy.
“It provides essential building blocks for our cells and helps synthesize vital reproductive hormones,” Kiltz said. “Dietary fat provides the body with energy and essential fatty acids that it can’t produce on its own. The fatty acids from animal meat assist with blood clotting and increase brain function. Fat also enables the body to absorb essential vitamins like A, D and E, which have all been shown to support fertility. The most important benefit of eating fat for fertility is that it helps to reduce inflammation.”
Foods containing omega-3 fatty acids, such as olive oil, walnuts and fatty fish such as salmon may help reduce inflammation. Kiltz also recommends eating more saturated fat, moderate protein and low to no carbohydrates to keep the lymphatic system running.
“Eating fat lubricates the lymphatics and helps filter out harmful pathogens, protecting the body from invaders that can cause illness. The lymphatic system is part of the circulatory and immune systems and is critical to maintaining optimal health,” Kilts said.
Nutrients known to support female fertility include zinc, choline, selenium, vitamin A and vitamin D. Sufficient calcium improves sperm production in men.
Kiltz warned against highly processed and fried foods as they’re typically high in trans fats.
“Trans fats that are high in omega-6 are the most damaging and they are formed when common cooking oils — vegetable, canola, soybean and corn — are chemically altered to remain stable at room temperature,” Kiltz said. “Research has shown that trans fats are associated with ovulatory problems and other fertility issues.”
Limit caffeine, as too much can negatively affect fertility. Kiltz warned about eating too much fiber as a small study indicated that doing so may negatively affect hormones in women.
Soy products such as edamame, tofu meat alternatives and soy-based milk alternatives can reduce sperm concentration in men and affect women’s hormones.
Although exercise is important to maintain good health and the proper weight, Kiltz warned against over exercise for men and women, as it can affect hormones negatively.
“The good news for heavy exercisers is that research has shown that decreases in natural fertility likely only last as long as the hard training,” he added.
A couple wanting to conceive should avoid tobacco. Kiltz said that in addition to harming health in many other ways, smoking “can significantly impact both male and female natural fertility” and excessive alcohol can also impair fertility. Although the research is clearer on female fertility, men should also consider cutting back to help improve their overall health which boosts their fertility.
Too little or too much sleep also affects fertility in women, as it can affect menstruation, conception and pregnancy complications. In men, it can reduce sperm counts, motility and survival rates. Kiltz added that using hot tubs has also been shown to reduce sperm motility and increase the percent of sperm with defects.
He recommended mitigating the effects of stress — another fertility buster — and trying modalities such as acupuncture to help promote the ability to conceive.
In addition to leading a healthy lifestyle of minimal alcohol, a healthful diet and regular physical activity, physician Leslie James said that it may help to control environmental factors.
“Endocrine disruptors are chemicals found a lot of times in plastic,” she said.
BPA is one example. Heating food in a non-approved container such as a plastic deli tub or single-use container instead of a glass container worsens the effect.
“Try to avoid those as much as possible,” she said. “Some are hard to avoid and it can create a lot of stress. Obviously, we can reduce our plastic use, but it’s ubiquitous. As much as possible, decrease it.”
“If you are trying to get pregnant but not having monthly periods or nearly monthly, this could be a sign that you are not ovulating regularly and there can be a variety of reasons for that,” said physician Jordana Gilman, an instructor of clinical obstetrics and gynecology at Highland Hospital and attending physician at Highland Women’s Health. “Talk to your OB-GYN for more information on your specific situation.”
For some women, engaging in aerobic exercise like walking 20 minutes a day and even 5% modest weight loss can kickstart ovulating again. To supplement egg health, Gilman recommends trying supplementation with coenzyme Q10.
Talking with a healthcare provider can help zero in on what’s going on and provide targeted resources for improving fertility.