14 Simple Changes That Enhance Fertility

Whether you’re having trouble conceiving or just want to get pregnant pronto, here are some simple steps you can take to boost your baby-making power.

Get Regular Exercise

Women who reported doing plenty of vigorous activity in the years before trying to conceive were less likely to experience ovulatory infertility, according to a study by Janet Rich-Edwards, M.P.H., Sc.D., director of developmental epidemiology at the Connor’s Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital in Boston. In fact, for every hour of vigorous activity per week there was a 7 percent reduction in risk, with the lowest risk being among women who exercised vigorously for at least five hours each week. Keep in mind that Rich-Edwards was looking at women’s exercise habits before they started trying. The take-home message: Start exercising now.

Avoid Artificial Lubricants

A study at the University of Texas Southwestern Medical Center at Dallas found that a number of non-contraceptive commercial lubricants (Replens, Astroglide) were as toxic to sperm as products containing the spermicide nonoxynol-9. If you need a little help, you can use canola oil, which has no effect on sperm. Or try one of several “sperm-friendly” lubricants now on the market.

Lose or Gain if You Need To

If you’re over- or underweight, losing or gaining just a little can step up your chances of conceiving, according to Paul B. Miller, M.D., a reproductive endocrinologist at University Medical Group in Greenville, South Carolina. He studied 372 women undergoing IVF (in vitro fertilization) and found that those who were under- or overweight were about half as likely to get pregnant as normal-weight women. Why? Overweight women overproduce androgens (male-type hormones), estrogen, and insulin, all of which prevent the ovaries from releasing an egg each month and negatively affect the quality of eggs that do manage to make it out. On the other hand, very thin women have low levels of leptin, an appetite- and weight-regulation hormone. When levels get too low, they tell the brain that the body does not have enough fat available for reproduction, halting ovulation, says Dr. Miller. If you’re overweight, losing just 5 percent of your body weight can improve ovulatory function. For a 250-pound woman, that’s only 12.5 pounds. Dr. Miller advises a low-carbohydrate diet with multiple small meals spread out throughout the day, and participation in modest exercise, such as walking or weight training. Too thin? Gaining as little as five pounds may be enough. Dr. Miller advises enjoying an extra dessert now and then, and avoiding strenuous exercise. “We usually ask our avid exercisers to switch from running or aerobics over to yoga and/or strength training to avoid any calorie drain on their bodies.” And men, you’re not off the hook when it comes to weight. Both overweight and underweight men tend to have problems with sperm quality.

Don’t Forget the Folate

A few studies have shown that a higher intake of folic acid (the synthetic form of folate, which occurs naturally in foods like oranges) may improve ovulation. It’s important that all women of reproductive age take between 400 and 800 mcg each day. And men who get higher doses of folate make healthier sperm, potentially reducing the chances of miscarriage or genetic problems in their babies. Researchers at the University of California Berkeley’s School of Public Health surveyed 97 non-smoking men who had no prior history of fertility problems and found that men who had the highest intake of the vitamin had nearly a 20 percent reduction in the number of abnormal sperm compared to men with low folate intake. Study co-author Brenda Eskenazi, Ph.D., director of the Center for Children’s Environmental Health Research at Berkeley, suggests that men considering fatherhood should take a daily multivitamin and mineral supplement and make sure to get their five servings of fruits and veggies a day.

Have a Bowl of Full-Fat Ice Cream

Yup, you read that right. Findings from the Nurses’ Health Study found that one or (at most) two daily servings of whole milk or whole milk products like yogurt and cheese protect against ovulatory infertility, while skim and low-fat milk, surprisingly, do the opposite, says Jorge E. Chavarro, M.D., Sc.D., instructor in medicine, Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, and co-author of The Fertility Diet (McGraw-Hill, 2007). Experts don’t know why this is, though Dr. Chavarro theorizes that removing the fat from milk changes its balance of sex hormones, which in turn hinders ovulation. But don’t go overboard with tubs of Häagen-Dazs just yet. Dr. Chavarro suggests replacing one low-fat milk item a day with a full-fat one…and cutting calories elsewhere in your diet to compensate.

Do it On the Right Days

Counting day one of your period as day one of your cycle, most women ovulate about 14 days before the next period, says John R. Sussman, M.D., assistant clinical professor of obstetrics and gynecology at the University of Connecticut School of Medicine in Farmington. So if your cycle varies between 24 and 30 days, that means you’ll likely ovulate somewhere between day 10 and day 16. You’ve got the best chance of conception if you and your partner get busy in the five days before you ovulate, or on the day you ovulate, says Dr. Sussman. Why? Once the egg is released from the ovary, it’s only receptive to sperm and able to be fertilized for about 12 to 24 hours. Sperm, however, have a much longer life-span. “Sperm can remain viable for up to five days after intercourse,” says Philip E. Chenette, M.D., a reproductive endocrinologist at Pacific Fertility Center in San Francisco, California. A good guideline for timing baby-making sex is to do it early and often, he recommends. Maximize your chances even more with an over-the-counter ovulation predictor kit, which measures the surge of luteinizing hormone (LH) right before ovulation.

Eliminate Trans Fats

In analyzing different types of fats, Dr. Chavarro found that trans fats were associated with a high risk of infertility. Trans fats decrease the body’s ability to react to insulin, and women who have insulin resistance or diabetes are more prone to irregular ovulation. Trans fats often appear in packaged foods as hydrogenated or partially hydrogenated oils, or as shortening or vegetable shortening. Read labels carefully and avoid trans fats altogether if you can.

Kick the Butts

Virtually all scientific studies have found that smoking impairs fertility in both men and women. Some studies have found that smoking 10 or more cigarettes a day has a negative effect on egg production. Cigarette toxins have been shown to interfere with the ability of the cells in the ovary to make estrogen and to cause a woman’s eggs to be more prone to genetic abnormalities. Smoking also causes the ovaries to age, which can advance menopause by several years. If that’s not enough to make you quit, smoking is also strongly associated with an increased risk of miscarriage and ectopic pregnancies. Men who smoke cigarettes have lower sperm counts, lower motility, and more abnormally shaped sperm.

Relax!

A study from Harvard University Medical School found that group therapy more than doubled the conception rate for women who had had trouble getting pregnant. Researcher Alice D. Domar, Ph.D., executive director of the Domar Center for Mind/Body Health at Boston IVF in Waltham, Massachusetts, recommends trying one (or all) of these relaxation techniques, 10 to 20 minutes a day, twice a day:

Meditation: Sit in a quiet room and concentrate on the in and out of your breath. If your mind won’t stop chattering, focus on a word or phrase (like “om”). Whenever you feel your thoughts wandering, gently bring your focus back to the breath, word, or phrase.

Autogenic training: This technique teaches your body to respond to verbal cues in order to achieve deep relaxation. For example, repeat the phrase, “My left arm is heavy and warm,” then “My legs are heavy and warm,” then “My heartbeat is calm and regular.” Visit domarcenter.com for books and tapes that teach this relaxation method.

Progressive relaxation: While sitting or lying down, concentrate on squeezing and relaxing each of your muscles, beginning with the top of your head and ending with the tips of your toes. For each muscle, squeeze as hard as you can for about eight seconds, and then relax, letting the tension leave you through that part of your body.

Keep It Cool (for men only)

Sperm production requires a lower-than-body temperature, so keep things cool down there, suggests Dr. Chenette. Tight-fitting clothing (especially underwear), prolonged bicycle riding, hot tubs and hot baths, or holding a laptop computer on your lap rather than on a pillow or desktop, can increase scrotal temperature. In fact, one study published in the Journal of the Brazilian Society of Urology found that after men who regularly spent half an hour or more in a bath or Jacuzzi gave it up for three months, half of them had an almost fivefold improvement in sperm production.

Cut Down on Caffeine and Alcohol

Although plenty of research has been done on the effects of moderate amounts of caffeine and alcohol on reproduction, the jury is still out, says Serena H. Chen, M.D., director of the division of reproductive endocrinology and infertility at Saint Barnabas Medical Center in Livingston, New Jersey. Results may be contradictory because every woman metabolizes caffeine and alcohol differently, depending on her own body and even where she is in her menstrual cycle. Another problem may be that different studies have different research methodology—some studies have looked at diet before the outcome, other studies have had women report on their own diet afterward. Of the studies that have looked at diet before the outcome (which are generally more accurate, says Dr. Chen) only about half have found that the drinks are problematic.

If you’re going through assisted reproductive technology, the stakes may be higher. A study in Fertility and Sterility found that drinking alcohol, even a month or longer before IVF, can affect egg retrieval, pregnancy rates, and miscarriage rates. The same study found that men’s drinking caused an increased risk of miscarriage in their partner’s IVF pregnancies, too.

As a cautionary measure, Dr. Chen advises that women trying to conceive abstain from alcohol altogether, and limit daily caffeine to the equivalent of one small cup of coffee, or two small cups of tea, or two small soft drinks. Men should limit alcohol to one-half to one glass of wine or beer per day.

Choose Vegetable Sources of Protein

Researchers at Harvard School of Public Health looked at nearly 19,000 female nurses who were actively trying to get pregnant and found that after factoring out smoking, fat intake, and weight, women who ate the most protein were 41 percent more likely to have reported problems with ovulatory function than women who ate the lowest amount. But when they looked at animal protein intake separately from plant protein, the story changed: Infertility was 39 percent more likely in women with the highest intake of animal protein, whereas women who ate a lot of plant protein were substantially less likely to have had ovulatory infertility. The lesson? Limit your intake of animal protein to no more than one or two servings per day, and up your intake of plant proteins. Replace steak or chicken with beans, tofu, or nuts. Throw beans into a soup, try a side of lentils instead of potatoes, and snack on roasted almonds instead of chips midday.

Don’t Douche!

Researchers at the National Institute of Environmental Health Sciences found that among women who wanted to become pregnant, those who douched more than once a week had the lowest pregnancy rate: 27 percent were not pregnant after a year. In contrast, only 10 percent of those who never or rarely douched were still not pregnant after a year of trying.

Assume the Right Position

There may be little research to back it up, but having sex in a position that keeps the sperm inside the vagina for as long as possible certainly couldn’t hurt. The missionary (man on top) position will get the sperm closest to where it’s supposed to be, at the top of the vagina. “The vagina naturally tilts toward the back, so lying on the back allows the semen to pool in the proper location,” says Dr. Chenette. Putting your knees up accentuates this position, and placing your feet on the wall with your hips on a small pillow does so even more, he says. “The longer you can keep the seminal fluid near the cervix, the more sperm will be in the proper location,” he says. That means you might want to do what men often do, and just roll over and go to sleep after sex. Gravity will hold the sperm in place while you sleep.