Can You Do Anything To Boost Your Fertility?

Comprehensive, high-quality studies to address the links between lifestyle and fertility are few and far between. Still, we do know that physical and mental health can influence the health of your reproductive system. That’s why we offer advice like that below. It’s based on the best data we have so far, plus a dash or two of medical common sense.

It may be possible to boost fertility with dietary supplementation, but this is not very easy to prove, especially since there is such a wide array of influences in our diets. Still, the large U.S. Nurses’ Health Study, among others, has shown a link between ovulation problems and dietary factors such as:

• Protein intake
• Dietary fats
• Carbohydrates
• Alcohol
• Caffeine
• Dairy¹

For example, eating vegetable sources of protein results in a lower risk of ovulation problems than eating animal sources of protein. Also, foods with a higher glycemic index, such as white bread and desserts, make your blood sugar shoot up and affect your insulin system, which is linked to infertility.¹ A strict low-fat diet may be great for your physique, but has been associated with ovulation disorders. And trans-fats may decrease fertility while healthy fats may improve ovulation, so a reasonable amount of healthy fat in your diet may be a good thing for your fertility.²

Mediterranean diet. When it comes to diets, one size certainly doesn’t fit all. But the Mediterranean diet has shown some positive influences on fertility. This diet emphasizes foods such as fish, fruits, vegetables, beans, whole grains, nuts, and olive oil. It limits meat, cheese, and sweets.

A study in the Netherlands examined the diets of women undergoing in vitro fertilization (IVF) and found that women whose dietary patterns consistently followed the Mediterranean diet increased their chances of pregnancy. One explanation is increased blood levels of vitamin B6. Research has shown that giving vitamin B6 to subfertile women increases the chances of conception by 40 percent and lowers the risk of miscarriage early in pregnancy by 30 percent.³

It may make good sense for the male partner to also pursue a Mediterranean diet because it is associated with better semen quality. Results of a recent study suggest that sticking with this diet leads to much higher sperm concentration, total sperm count, and sperm motility. However, we don’t yet know whether this translates into better outcomes.⁴

Antioxidants. A recent review of several studies found that antioxidant supplements—especially a combination of antioxidants such as vitamin C, vitamin E, and CoQ10—can improve the number, motility, morphology, and sometimes the DNA integrity of sperm in infertile men.⁵ Interestingly, administration of CoQ10 in mice can prevent age-related decline in follicle number and litter size.⁶ A small study in women undergoing IVF showed that those taking CoQ10 had lower numbers of poor-quality eggs but the study was too small to show statistical significance.⁷

Caffeine. So what about caffeine? Do you have to give it up altogether? The data with regards to caffeine consumption and fertility is very limited. But in women, high consumption of caffeine—more than 500 mg daily—is linked to an increased time to pregnancy of more than 9.5 months.² Also, studies in women who are pregnant have suggested that heavy caffeine consumers (equivalent to 5–6 coffee servings per day) have been found to have higher rates of miscarriage.⁸ Use common sense here. A cup of coffee a day probably has no adverse impact on pregnancy. Higher levels of coffee consumption increase stress and could be a problem.

Alcohol. Women who drink more than 2 or 3 drinks per week may have lower pregnancy rates. Alcohol is also very dehydrating, which is not conducive to conception. And, studies have tied alcohol consumption during pregnancy to an increased risk for stillbirth and first trimester miscarriage.⁸

It’s also important for men to avoid excessive alcohol intake, which can inhibit erectile function. Long-term heavy alcohol use also raises estrogen levels in men, which can lead to smaller testicular volume and lowered sperm production. There is no problem with occasionally imbibing—1 or 2 drinks a week probably has no adverse effect on fertility.⁹

Several studies in the recent past have found that extra weight can hurt your chances of becoming pregnant. Researchers aren’t entirely sure why. The interplay between obesity and infertility is complex, including changes in hormones, ovulation, and the menstrual cycle.¹⁰

Not only does obesity decrease the likelihood of ovulation, it also significantly reduces the chance for pregnancy in women who ovulate regularly. One way it may do this is by influencing the quality of the eggs at the molecular level.¹

Extra weight also influences your body’s biochemical milieu. It alters the metabolism of carbohydrates and fats, for example, which can lead to insulin resistance—a condition that makes it harder for glucose to enter cells. Changes like these may create a uterine environment that’s less “friendly” for eggs or embryos, making healthy development more challenging.^4,11

What does all this mean in terms of your ability to become pregnant? Three studies reported on in 2015 consistently point to a reduction in fertility with increasing body mass index (BMI).

• A study of 4,000 egg donor recipients looked at cases where donors’ eggs went to recipients with different BMIs. Controlling for other factors, those with higher BMIs had lower birth rates. A BMI greater than 35 translated to a 21 percent lower birth rate.
• A second study used data from the Society for Assisted Reproductive Technologies (SART) reporting system from 2008 to 2010. In egg donor recipients with a BMI less than 25, the live birth rate was more than 50 percent. That rate dropped by 10 percent in those with a BMI between 40 and 45.
• A third study reviewed IVF cycles in women using their own eggs. Birth rates ranged from 31 percent in patients who had a BMI under 25 to 21 percent in those with a BMI over 50. ¹¹

There is also some evidence that sperm motility is reduced in men with an increased BMI.¹²

Although obesity is more often the challenge in our society, it’s important to note that being underweight is also linked to ovarian dysfunction and infertility. Women with eating disorders are at high risk for infertility. ²

“All things in moderation” doesn’t really apply to everything. But when it comes to exercise and fertility, it may be the best advice. Fitness is great. Pregnancy outcomes are improved in women who have an exercise routine in pregnancy. Three to 4 hours per week of moderate aerobic exercise for women attempting pregnancy may be just about right—and it can be a great stress reliever. Intense exercise (long duration, frequent intervals, high intensity) can be a source of stress that could increase the risk of ovulation problems.^2,9 While attempting pregnancy, steer clear of extreme events like marathons and avoid lifting weights over 40 pounds. ⁶

Moderate physical activity is also a good idea for men attempting conception with their partners. Exercising at least an hour, 3 times a week, translates into better sperm parameters. Avoid bicycling more than 5 hours a week; bicycle saddles can affect testicular function in men who are frequent riders.²

The connection between environmental factors and fertility is complex but we do know a few things.

Cigarettes. Cigarette smoke contains more than 4,000 chemicals and is linked to a wide range of health problems. More research is needed to confirm its link to infertility. However, female smokers experience reductions in fertility—possibly due to accelerated loss of eggs, or a more hostile uterine environment. If you’re a man, cigarettes can also reduce sperm production and damage DNA.²

Chemicals and radiation. There is a growing body of research on environmental toxin exposures and reproductive health. According to the International Federation of Gynecology and Obstetrics (FIGO), miscarriage and stillbirth, impaired fetal growth, and congenital malformations are among the list of poor health outcomes linked to chemicals such as pesticides, air pollutants, plastics, and solvents. You do not have control over all these, but you can at least take steps to limit exposures to plastics and chemicals found in hair and skin products.¹³

If you’re a man, it may also be wise to carry your cell phone in a pocket away from your genitals. Data is limited, but one study showed a small decrease in sperm counts associated with cell phone usage.²

Stress. Managing stress is important for anyone’s well being, especially when undergoing fertility treatment and preparing for pregnancy. At PFC, we understand that infertility can bring on stress and feelings of isolation, and we want to support our patients on this journey.

Acupuncture is performed by inserting fine needles into carefully selected points that correspond to energy meridians that run through the body.

How it works. TCM theory explains that channels of energy run in regular patterns through meridians in the body like water flowing through an aqueduct. According to TCM theory, acupuncture and other TCM modalities can influence blocked energy in meridians, reestablish proper flow, and promote good health. That’s the theory. It may also be that acupuncture redirects stress, away from your fertility and toward those little needles that are placed in key locations.

What it treats. Acupuncture is used to treat a variety of fertility disorders, including spasmed tubes, repeated pregnancy loss, unexplained infertility, luteal phase defect, polycystic ovarian syndrome (PCOS), and male factor infertility.¹⁴ Some practitioners recommend herbal therapy. While herbs and scents may provide a way to re-direct stress, we remain concerned about using herbs as medications. There is little safety and efficacy data for most supplements and no supervising FDA to protect against adverse side effects.

Fertility research. The research on acupuncture is not perfect but some studies suggest that acupuncture improves ovulation rates, increases blood flow to the uterus (which improves chances of implantation), and results in overall better pregnancy outcomes. A small recent study also suggested that electroacupuncture, which uses needles and a mild electric current, may improve the ovarian reserve of patients in which it is diminished.¹⁵

More research still needs to be done to verify if acupuncture truly does improve fertility, and if so, by how much. In the meantime, we believe that acupuncture is safe for patients attempting to conceive.¹⁶

Sources:

1. Shaum KM and Polotsky AJ. Maturitis. 2013;74(4):309–312.
2. Sharma R et al. Reprod Biol Endocrinol. 2013;11(66).
3. Vujkovic M et al. Fertility and Sterility. 2010;94(6):2096–2101
4. Karayiannis D et al. Human Reproduction. 2016;32(1):215–222.
5. Ahmadi S. et al. Int J Reprouc Biomed (Yazd). 2016;14(12):729–736.
6. Özcan P et al. J Assist Reprod Genet. 2016;33(9):1223–1230.
7. Bentov Y et al. Clin Med Insights Reprod Health.2014;8:31–36.
8. PFC website: “What We Tell Our Patients about Alcohol, Caffeine and Exercise.”
9. PFC website: “Nutrition, Exercise and More.”
10. Mitchell A and Fantasia HC. Nurs Womens Health. 2016;20(4):368–376.
11. PFC website: “Increased Weight Decreases Success of IVF.”
12. Tang WH et al. Turk J Med Sci. 2015;45(6):1300–1305.
13. PFC website: “Prenatal Self-Care: Sorting Fact from Fiction.”
14. PFC website: “Acupuncture.”
15. Wang Y et al. Acupunct Med. 2016;34(5):386–391.
16. PFC website: “Acupuncture FAQs.”

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