Answer from: Wael Saab, MRCOG, Bsc
When we mentioned fertility treatment it’s not always about fertility treatment going to a clinic and having fertility treatments, taking drugs and medications. There are lots of parameters, lots of lifestyle issues that both men and women can follow to boost their fertility naturally.
I’ll start by giving my advice to ladies before shifting to give my advice to men. For ladies, always ladies when it comes to trying for a child there is some basic advice to stop alcohol intake, stop smoking and limit caffeine intake to the bare minimum. Although they sound like basic advice, this has been shown by lots of studies to affect the quality of the sperm and if followed to improve the odds of natural conception. Other parameters as well is to lead a healthy lifestyle by healthy lifestyle I start by mentioning having a well-balanced diet with five a day of fruits and veggies, make sure that you are keeping to the right BMI or to keep as healthy BMI as possible, make sure to indulge yourself in at least three sessions of exercise per week and make sure to specifically in countries that where it’s not that sunny like the United Kingdom specifically during the months of winter, we advise ladies to start taking some vitamin D supplements.There are lots of other supplements that you can get hold over the counter, they don’t require a prescription, you will hear of like something called coenzyme Q10, Myo-inositol – you can discuss those with your doctor during the appointment but lots of supplements that are present over the counter might help in boosting fertility as well. Another thing that we keep on forgetting is avoiding stress and having a decent amount of sleep or having a good sleeping pattern of having seven to eight hours per day of uninterrupted sleep. All of these factors will affect fertility treatment or even trying naturally positively.
When it comes to men, the same thing we advise women is the same when it comes to alcohol, when it comes to caffeine, when it comes to smoking, keeping a good BMI, and exercise. In men, there is additional advice for example anything that increases testicular temperature has been shown to lower fertility. So, we advise men for instance to avoid wearing tight underwear, to avoid saunas, jacuzzis ,cycling for long or any activity that might increase testicular temperature. We also advise men to make sure that their diet includes high levels of antioxidants like vitamin C and some elements like selenium and zinc and most of what I’m mentioning right now, there are supplements that you can take over the counter without a prescription. I also failed to mention obviously that ladies coming as starting fertility treatment or even trying naturally they want to make sure that they are taking the required dose of folic acid which is mainly present in any of the multivitamin formulas for pregnancy that is present over the counter.
Answer from: Stephen Davies, BSc MBBS DCH DRCOG
Another commonly asked question. Probably asked more often within the primary care setting. I think there are some things that can be done and I think that a lot of those relate to lifestyle factors. Unfortunately there is an epidemic of obesity in the western world and I think that is an independent factor which is very often not helpful for getting pregnant. Now it may well be that is something that some ladies find much more difficult to lose weight than others in the context of underlying hormonal issues but I think regardless of that it’s always helpful to try and improve your general health and as part of that, to try and either modify your diet and or increase your exercise and in terms of dietary modification, these days, I think most clinicians would be very much more for the kind of diet that is on the low carbohydrate side and higher protein and that’s helpful for ladies who have a degree of insulin resistance which is is part of the spectrum of problems that occur within Polycystic Ovarian Syndromes. So, I think that’s very useful advice to have. I think weight loss often by itself can reverse ladies who have problems with oligomenorrhoea so, I’ve seen many ladies over the years who have erratic cycles who have perhaps have a starting BMI of 32 or 33 over a period of maybe six months if they lose a significant amount of weight and their BMI comes into the normal range under 30, that will often see the return of regular cycles and with that, the return of spontaneous regular ovulation in which case, if the only issue was ovulation, they will often very quickly get pregnant and I think again, rather than rushing forward into over investigating and over analyzing things particularly in a younger lady, make that the focus, make that the focus of lifestyle. I think, again, if you look at the demographics of ladies who are pregnant now versus 20 or 30 years ago, the mean BMI now is hugely increased throughout the whole of western Europe and the States and Canada and that’s not a helpful thing – not only during pregnancy but if you look at risks during labor and childbirth, the risks are directly associated with increased BMI. So, I think above and beyond the fertility area, is a big thing that I’ve made an issue out of in terms of trying to persuade ladies that it’s a really good time to focus on weight loss for general health but also alongside that increasing their chance of spontaneous fertility. So, alongside that you have advice on diet and again it’s not rocket science – healthy diet involves fresh, fresh vegetables, fruit, meat and fish, try and limit the processed foods that are quick and convenient but generally not particularly good for you. Have all kinds of additives and preservatives and things, try and steer back towards that sort of diet where you’re using fresh produce and thinking about what you’re eating. If you do that it’s rare that you’re actually deficient in important vitamins and minerals with the possible exception of vitamin D which certainly in the northern part of Europe it’s difficult to get enough vitamin D in your diet and there’s rarely enough sunshine to actually generate vitamin D in the skin. So, I think as we’ve understood and started measuring vitamin D and the general population in northern Europe anyway I would advise all ladies of reproductive age alongside taking their preconception folic acid, to takes low-dose vitamin D approximately a thousand units per day which you can buy over the counter in the whole of Europe and that might be in the context of a broader nutritional supplement but as long as those two key features are within it the folic acid and vitamin D that they are I think just their their standard recommendations that all ladies should be thinking about. There may be more specific advice that might be relevant in people who are perhaps vegans or whatever but that’s something they perhaps should talk to their clinician about just to make sure there might not be other elements that might need to be supplemented or for example, ladies who’ve had obesity related surgery but they also should be aware of the kind of supplementation they need to take. I think one of the other issues is that people should try to make sure that just their general lifestyle is good and that they do things to help alleviate stress which is part of everyday life these days but I encourage people. It doesn’t matter whether it’s yoga or dancing or swimming or horse riding or whatever but doing things, might be cooking, it might be painting. I think things that allow people to escape from the stress of day-to-day life. We know stress by itself can switch off the menstrual cycle and if you switch off the menstrual cycle you won’t ovulate, you will not get pregnant. Excessive weight loss, ladies with eating disorders, anorexia, bulimia etc that will switch off the hypothalamic pituitary axis, you will stop ovulating. So, not just being overweight, being underweight can be a significant thing and some of those things might also point to underlying other issues, for example, thyroid disease or whatever diabetes perhaps so, opportunities to get those things checked and make sure that it isn’t just a case of infertility per se but there are other underlying medical issues that absolutely need addressing and correcting and optimizing prior to perhaps getting pregnant in that context.
Answer from: James Nicopoullos, MD
If you’re trying to get pregnant naturally, the key is really making sure that everything that needs to be done is happening: are the tubes open, so get those checked; if you’re trying to get pregnant naturally with a partner: is your partner sperm count okay, are you ovulating and ready to confirm that are your cycles regular and check your progesterone levels a week after you think you’re ovulating – if all of those things are happening, you’re kind of optimizing your chances and then when you are ovulating, then the most fertile time is probably just before ovulation, just making sure you are having timed intercourse at the right times of the cycle and thereafter, it goes back to make sure, you’re not doing anything you shouldn’t in terms of any other social factors.
What are natural ways of increasing fertility and how successful they can be?
Most experts agree that the best you can do for your fertility is to have a healthy lifestyle. If there are no conditions that need medical intervention, best is to reach for help from the fertility advisor, dietician and adapt healthy tips according to your needs.