What Affects Your Fertility (and How to Boost It) Part Ⅰ
Fertility isn’t usually something women think about much. You expect your reproductive system to produce babies, just as you expect your heart to pump blood and your lungs to breathe air. But if you don’t get pregnant after a few months of trying, fertility becomes all you might think about—and you’re not alone. About 11 percent of women of reproductive age in the US have trouble conceiving, which is why many doctors these days are having fertility discussions earlier with patients.
While the internet will try to convince you otherwise, there aren’t any magic fertility foods, fertility pills or ancient rituals that have been proven to jumpstart conception. The truth is, while some of your lifestyle choices affect your chances of conceiving, you largely have limited control over your fertility, and the best thing you can do (assuming there’s no underlying medical condition) is to keep trying. “The biggest predictor of success in conceiving with or without assistance is persistence,” says Ginny Ryan, MD, division chief for reproductive endocrinology and infertility at UW Medicine’s department of obstetrics and gynecology. Still, a few factors may lower your risks for fertility issues, and burgeoning research shows there might be small things you can try to boost your chances of conceiving.
What Is Fertility?
Simply put, fertility is a body’s capacity for producing babies. The clinical definition of _in_fertility is not being able to become pregnant after 12 months of having regular, unprotected sex. (By regular, we mean every other day within your fertility window—more on that later.) Research suggests that after one year of unprotected sex, 12 to 15 percent of couples are unable to conceive, and after two years, 10 percent of couples still haven’t given birth to a live-born baby.
Because conception requires an egg, sperm and a viable place for them to meet, fertility depends just as much on your partner’s body—or wherever the sperm is coming from—as it does on yours. According to the National Institute of Child Health and Human Development, in one-third of infertile couples, the issue lies with the man; in another third the issue is with the woman and with the last third, the problem is with both the man and woman or can’t be identified.
And yet, as Ryan points out, “women are often very quick to take on the burden of the fertility issue, to assume it’s their problem. [But] you have to resolve that kind of distress and sense of control that women have.”
What Factors Affect Fertility?
While few factors have been proven to boost fertility without a doubt, there are several that can put a damper on it. If you’re having a hard time conceiving, consider taking a closer look at the following:
Fertility declines with age in both men and women, but its implications are much greater in women, who are born with all the eggs they’ll ever have. “It’s the most obvious factor affecting fertility,” says Mark Crider, MD, an infertility researcher and ob-gyn in academic practice at AdventHealth Medical Group in Orlando. Women in their 20s have better odds of getting pregnant since they have more eggs and a higher ratio of genetically normal ones. In their 30s, women are about half as fertile. A woman’s chance of conception declines significantly after age 35. Male fertility also declines with age—especially after age 40—but more gradually. It seems incredibly unfair, but that’s why having discussions with your doctor about fertility—even before you’re thinking about starting a family—may help you plan accordingly.
Certain health issues or genetic disorders can affect fertility. Sometimes the condition itself will have a direct impact, as in the case of endometriosis, fallopian tube blockage, hyperthyroidism, and polycystic ovarian syndrome. Other times, it’s the medication used to treat the condition that may interfere with conception, as is the case with certain drugs for diabetes and thyroid conditions.
A healthy BMI is between 19 and 25. As your BMI increases beyond that, fertility decreases, and that drop accelerates even more when you’re morbidly obese, which is defined as having a BMI of 40 or higher. As R. Stan Williams, MD, professor of reproductive medicine at the University of Florida, notes, the added weight correlates with more hormones disrupting a woman’s system. Many women might stop ovulating regularly as they get heavier. Chronic inflammation that comes with being obese might also hinder conception, he says. At the same time, being _under_weight can affect fertility too. Many women with less than 17 percent body fat have problems ovulating, though there aren’t good data to explain why.
While there are limited data on how to increase fertility by eating specific foods, doctors generally agree that eating nutritiously and exercising moderately will at least keep you from decreasing your baseline chances of getting pregnant. However, exercising too vigorously or having an eating disorder can impinge on your fertility. Both can “disrupt the feedback systems between the brain and ovaries, which can disrupt ovulation,” Williams says.
Of course, smoking and excessive alcohol consumption should be off-limits. “Any alcohol intake in the months a woman is trying to conceive will reduce her chances of conceiving that month, and anything above moderate drinking will have an impact on the pregnancy itself,” Williams says.
There’s no doubt that emotions play a role in your fertility, but there aren’t any hard and fast rules as to how. One study from The Ohio State University Wexner Medical Center suggests that preconception stress might play a role in infertility. “Infertility can be a big existential crisis for some people, and studies have shown that it can be just as distressing as or more stressing than a cancer diagnosis,” Ryan says.
There is emerging research suggesting links between infertility and environmental toxins, including chemicals found around our homes, personal care products and cleaning solutions—but the impact of daily exposure to these things isn’t fully understood. Williams calls this “a gray area.” “As a general rule,” he says, “you want to avoid toxic exposure, but what is a toxin, exactly? Certainly if you’re a farmer or a worker dealing with pesticide management, you don’t want to be around that stuff.”