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Eight Tips on How to Boost Your Fertility

The month of October is National Infertility Awareness Month. Of course, we appreciate the opportunity to educate the public about issues and current developments in this field. The 2009 annual meeting of the American Society for Reproductive Medicine will be held in Atlanta on October 18-21. You can follow along on Twitter to see some of the things that will be discussed by entering #ASRM09 on those days!

I would like to share some tips on how to improve your fertility. This issue affects approximately 7.3 million women and men in the United States, representing 15% of couples in their prime reproductive years.

AGE

I want to start with age, because it’s one of the big ones. Women are born with 1-2 million eggs and by the age of 37 they have 25,000 left. How well you reproduce depends on a number of factors, but one of the most important is the age factor. The quality of these eggs starts to deteriorate after 30, and more significantly after 35, due to poor egg quality. There is no way to change egg quality. Consider trying to start your family sooner rather than later. If this is not possible, staying on birth control pills could extend the viability of the eggs in a woman’s ovaries by resting the ovaries. Seek help for infertility problems early instead of putting it off. If you’re over 35, make a well-defined, aggressive treatment plan with a set timeline. Don’t let your doctor reassure you that “everything is fine and you just need to wait for it to happen.” Basically, I advise my patients over 35 years of age, if no pregnancy after 6 months, see a fertility specialist for a complete and thorough evaluation (which should only take 1-2 months to complete), create a treatment plan in a given time and get moving. through that plan successively. For example, if you start with ovulation induction and intercourse, use that for 4-6 months, then move to IUI only for 4 attempts, then move to IVF. As time goes by, your chances only decrease, even with IVF.

HEALTH

The key ingredient here is good health and exercise in the years before trying to conceive. Exercising for at least 5 hours each week is recommended. Good habits start early, but it’s never too late to start! Weight can also affect your ability to get pregnant, in some cases, and being too much above or below your ideal BMI (body mass index) can be harmful. See the National Institutes of Health website to calculate your BMI: http://www.nhlbisupport.com/bmi/. Aim to be at an ideal BMI, however do not delay pregnancy for weight loss if you are over 35.

DIET

A good diet before starting your efforts to conceive is also important. It makes sense to eat lots of fruits and vegetables, but did you know that dairy products and yogurt have been found to be just as important? A Harvard Medical School study suggests that whole milk products, not skim, are responsible for protection against ovulatory infertility. Another interesting finding was that folic acid improves ovulation in women, and in men, sperm quality! It can be taken as a multi-vitamin and found in foods such as oranges. Eliminating trans fats in women who have diabetes seems to help as well. Moderate intake of caffeine and alcohol is important as well. Again, an ideal weight is useful. No matter what anyone says, there are no diets or foods that “improve” fertility, but a healthy diet can help overall.

TEMPORARY SEXUAL ACTIVITY

Many couples try to conceive using contactless ovulation kits. There are a few things to consider though. Most women ovulate 14 days before their next period. For example: If your cycles are 25 days, then you most likely ovulate around cycle day #11. Your fertile period would then be CD# 9-13. Those are the days I would recommend intercourse. You should stop intercourse on CD#7 and wait until CD#9 to start. Have sex once a day in those five days, only one ejaculation a day. Start using your ovulation kit on CD #9 (counting 16 days from the end of your average cycle). Remember, once the egg is released from the ovary, it is only receptive to sperm and can be fertilized for about 12 hours. If you have irregular cycles, you may have another problem and you need to see a specialist to determine what is going on. But the absolute bottom line with time is this, make it fun NOT scientific!! You husband will become a reluctant participant if it is forced. Don’t tell him, “Honey it’s my fertile time again we have to have sex”, rather, he shouldn’t even know. You should just set the stage for him to be interested, excited and “horny”. That way you’ll both enjoy the experience, and trying won’t be a chore.

KICK THE SMOKING HABIT

Almost all studies show that smoking impairs fertility. In women, 10 or more cigarettes a day reduce egg quality. Post-conception smoking has been linked to miscarriages and ectopic pregnancies. In men who smoke, there is a problem of lower sperm count and lower sperm motility as well, which means lower sperm functionality. Even worse is smoking marijuana. Any chemical that goes into your body goes into your bloodstream, into your cells and into your sperm and/or eggs. This is an absolute no no! Same with other forms of recreational drugs including large amounts of alcohol. My rule of thumb is if it affects your brain cells then it also affects your reproductive cells.

RELAX

Couples trying to conceive can become stressed, especially if they have been trying for more than a few years. Yoga, acupuncture, massage and meditation tapes made expressly for infertility patients all help. My patients are encouraged to use relaxation techniques. It helps them through the emotional ups and downs of the IVF process. The patients approach the day of the procedure in a much calmer, relaxed way and it can make a difference in how well the retrieval and transfer goes. Going to a therapist for massage therapy or meditation therapy may also be covered by insurance if it can be shown that an anxiety disorder exists. As mentioned above, make it fun and enjoyable, not homework.

Scrutinize your doctor

You want a doctor who knows fertility through and through. Most of these types of doctors will be able to offer ALL levels of infertility treatment. Just like you don’t want a doctor who only does Clomid, you don’t want a doctor who only does IVF. You will be pushed into the only thing they can do for you, Clomid or IVF. It is easy to screen for this. . . simply ask, “what levels and types of treatment can you perform for me?” Most importantly, infertility should be diagnosed and treated by a Medical Specialist, not general practitioners, nurse practitioners, PAs or medical assistants.

IF ALL ELSE FAILS…

If your fertility journey is running into too many roadblocks, then you may need to explore other options. Remember that if you fail to achieve pregnancy naturally, it is NOT the end of the road. I advise my patients, “Nowadays, we can get pregnant with almost anyone, it just depends on what I have to do to achieve the pregnancy”. There are many reasons why a woman or man can be infertile and a visit to a good fertility specialist will certainly narrow down or actually pinpoint where the problem lies. Treatment often varies from person to person so don’t expect to find the answer on a forum or chat! Clogged fallopian tubes, high FSH levels, abnormal sperm count or low motility, all these and more are responsible for infertility problems in many couples.

A doctor’s diagnosis is necessary to effectively identify the best course of action for the couple trying to conceive. But, don’t let your doctor just put you on Clomid without a good reason. Clomid is NOT a miracle drug. It has a specific purpose, which is to stimulate ovulation in women who do not ovulate. If you have regular cycles, this is a sign that you are ovulating. That means the problem is something else and Clomid won’t change that. Make sure the treatment you are receiving addresses a specific problem. Ask your doctor to explain his/her strategy, why they use the treatment they recommend, and what they treat. Treatment without a specific reason is a waste of time and money, as is treatment without completing a complete infertility evaluation. I can’t tell you how many patients I’ve seen who have been on multiple cycles of Clomid or IUI only to find out her tubes are blocked!

Above all, stay positive, we are here to help!

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