Optimizing Your Fertility

There are several things you can do to at home to help improve your chances at becoming pregnant.  I am going to discuss many topics from when is the best time to have intercourse for pregnancy down to diet and lifestyle.

Usually, the firsts question that comes up from patients is regarding the frequency of intercourse. How often should you have it and what is the “fertile window”? How do you know when you ovulate? Do coital practices increase fertility outcome? Now this is about fertility outcomes and the peek of our fertility, let's say we have a 20 year old woman and her partner is 21 years old and they have intercourse, the chance of getting pregnant month to month is not all that great about 20 - 25 percent. However, over time within the next month or two the chance of you getting pregnant is pretty high in normal fertile couples. We say in about six months 80 percent of the couples will get pregnant. In a year about 85 percent of the couples will get pregnant. Research done back in the early nineteen hundreds tested women at the age of 37 in different populations and countries. For all the women their fertility outcomes dramatically decreased after the age of 37 years old. Therefore, we say if you don't get pregnant after six months and you are over the age of 35 you're not infertile. However, we would advise you to meet with one of our fertility doctors sooner than later, so we can evaluate why you are not getting pregnant.

Now lets discuss, frequency of intercourse, basically how often is often enough that will improve your chances of getting pregnant. Usually we say, if the sperm is normal it will likely stay alive in the productive track for about five days, if not longer. This should mean that if you have intercourse once a week, your chances are pretty good. Well actually, when you study fertile couples, it really is not the case. We see the highest fertility rates from couples that have daily intercourse leading up to ovulation. If this is not possible, every other day is an option and will only decrease your chances by roughly 30 percent. The likelihood for success decreases to 15 percent per cycle when intercourse occurred only once weekly. The “Fertile Window” is best defined as the 6-day interval ending on the day of ovulation. Most people think it starts at time of ovulation, which is not the case, it's a couple of days leading up to ovulation. The way to figure that out is to utilize your cycles if you have clockwork periods every 28 or 30 days or whatever your number is, just subtract 14 days before you have your period and that's pretty much when you ovulate. Then to increase your chances you need to have intercourse about a week leading up to ovulation. Some women have inconsistent periods, if that is the case you would probably benefit from an ovulation predictor kit, or cervical mucus scores to help you find your day of ovulation.

Coital Practices so this is where a lot of the myths come from. There is no scientific evidence that you have to stay laying down for an extended period of time after intercourse, or to avoid showering right away. The reason behind this research is that as soon as ejaculation happens sperm can been found in the fallopian tube trying to meet the egg within two minutes and within 15 minutes the entire sperm is in cervical canal. Another common question is what type of position is best? The answer is any position that is intercourse in the vaginal canal.  The other thing to consider is if you are using lubricants. One of the most common is KY and it is a water-based lubricant. The problem with water-based lubricants is they immobilize sperm, meaning they will not swim. Therefore, if you use an water- based lubricant and are trying to get pregnant you should consider not using them during this time or switch to an oil -based product. Also, be aware that saliva is water- based as well.

Another area of concern is diet and lifestyle. There is no specific diet associated with higher fertility outcomes. However, they have said that in the past fast food and hydrogenated oils have been associated with poor fertility outcomes.  This is a common association, but there is no research to back up the effects of fast food on fertility.  There are a couple of seafood related concerns one being high levels of mercury can cause infertility. However, there was a study published in the Endocrine Society that looked at multiple couples who consumed seafood 2 times a week, 4 ounces each. They all had higher fertility outcomes getting pregnant sooner and at higher rates.  Please note, that not all seafood has high levels of mercury.  If you do like seafood, perhaps consume it twice a week while trying to conceive.

Smoking is definitely associated with poor fertility outcomes. It does not affect sperm as much in men. However, it can cause premature menopause in women because of early aging of ovaries. We will ask you to stop smoking when going through fertility treatments.

There have been conflicting studies on alcohol. We are not going to encourage anyone to drink, but there was a study and the control group drank 1 glass or less a day versus the other group that drank 2 glasses a day, while trying to get pregnant. The research showed that the control group that drank 1 or less a day had a better fertility outcome. It is best to limit alcohol consumption during fertility treatments and especially once you become pregnant. Alcohol can cause birth defects to the fetus.

Caffeine always comes up as a top question and all the coffee drinkers will be happy to hear that 1-2 cups of coffee a day during pregnancy and before pregnancy has shown to have no effect on outcomes.

There are many different environmental factors, and one we are most familiar with is BPA plastic.  Most drinking bottles and baby bottles it has been removed, but not all.  Please do your best to avoid BPA because it has been associated with a higher risk for miscarriage. Illicit drugs should of course be avoided and even over- the -counter medication, you should consult with your physician. One thing you need to do before getting pregnant is to begin taking folic acid, you will need to continue taking folic acid when pregnant as well. We don’t have a lot of data on herbal supplements that might improve fertility. We do sometimes tell patients they can take Coenzyme Q10, it can benefit some women going through fertility treatments. There also haven’t been any studies showing negative effects of Coenzyme Q10.  I hope these tips help you optimize your fertility and if you need our help in this area, we will do everything in our power to help you have a family.

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