Natural Ways to Boost Fertility
The journey to parenthood is an exciting experience. You read books, watch videos, listen to podcasts, and talk with friends and family that have experienced the joy of pregnancy-all in anticipation that you will join them in the ranks of being a mom or dad. The stories you hear can give you feelings of happiness, fear, uncertainty, and elation. The plethora of information at your disposal offers fascinating facts you never knew happened in your body, but you can also be exposed to contradicting information of the best ways to do everything and anything in preparation to conceive.
When the decision to start trying to conceive (TTC) has been made, preconception healthcare should be on the top of any couple’s list. Preconception health refers to the health of a baby’s mother and father before the woman gets pregnant. It is important for both men and women to be healthy before conceiving a baby. Improving one’s health before becoming pregnant improves the health outcomes for both mom and baby. Preconception care should start three to four months before actively TTC. This seems like a long time for many, but taking this time prior to actively TTC, can improve the overall chances of conception and decrease potential pregnancy complications that could be prevented if addressed prior to becoming pregnant.
Why are 3-4 months of preconception healthcare suggested?
The oocyte, female egg, that will eventually be fertilized by a single sperm starts to develop months prior to being selected as the primary follicle to be release out of the ovary. Allowing 3-4 months of preconception care will give enough time to positively affect oocytes being recruited as the primary follicle. Improving the egg health prior to primary follicular selection will improve chances of conception, the health of mom, and the health of the baby.
Sperm take arguably from 60-120 days to undergo all stages of development. The final stages occurring in the epididymis allow the sperm to become motile. The process of sperm production includes repeated oxidation reactions. During these times of oxidative stress, sperm is essentially left without intracellular defense mechanisms against oxidative damage. Only enzymatic and non-enzymatic antioxidants in seminal plasma provide cellular protection. If high oxidative damage occurs without adequate antioxidants in the body, this can damage the developing sperm to not be forward progressing, but maybe instead swim in circles or not move at all. During preconception time is when male patients receive antioxidant therapy to improve sperm motility. This is a time when work can be done to improve the overall health of the sperm and male partner.
Balancing hormones for optimal fertility needs three months time to allow for proper signaling and homeostasis to be established between the sex organs, ovaries and testes, and the brain. Although powerful drugs like the oral contraception pill (OCP) can shut down reproduction immediately, new forms of male OCP need 2 months to show effect in a semen analysis. Regaining proper signaling between the brain and sex organs can take time and varies from person to person. Your health today is directly influencing the quality of the recruited follicles and sperm that are preparing to be chosen three months from now as the potential egg and sperm that will develop into your baby. The neuroendocrine system is vital in fertility and needs to be in balance. For example, recruited follicles are bathed in cortisol with high cortisol concentrations present in the pre-ovulatory follicles just prior to ovulation. It has been suggested that cortisol may function to reduce the inflammatory-like reactions occurring in connection with ovulation, though too high levels of cortisol are problematic to healthy functioning fertility. One study involving IVF patients showed follicular fluid from unfertilized eggs had levels of cortisol significantly higher than the levels in follicular fluid from follicles containing successfully fertilized eggs. This suggests that glucocorticoids (cortisol) may antagonize (work against) egg maturation when present at elevated levels.
Giving yourself a preconception time period can help to lower negative stressors in your life that may be contributing to high levels of cortisol. These high levels of cortisol can interfering with fertility health and mental wellbeing. A preconception period allows time to get priorities in order before a baby is on the way, change unhealthy habits, set boundaries to achieve a more relaxed mind-set, improve sleep, and greatly improve the chances of conceiving.
The take away point is to boost fertility prior to trying to become pregnant not 6 months to a year after TTC.
What can you do if you have been TTC for longer than one year, or 6 months for woman over 35, and are still not pregnant?
First you should consider what type of treatments you are open to exploring on your journey to parenthood. When deciding what treatment options are right for your family consider the following, according to the Center of Disease Control, infertility can be treated with “medicine, surgery, intrauterine insemination, or assisted reproductive technology.” These treatment options seem limited in scope and do not address the underlying cause of infertility, in my opinion. Yes, some patients need advanced treatment options, and through a fertility assessment these couples can be identified and referred accordingly. For other patients, giving a 3 month preconception healthcare period, where TTC is put on hold, can greatly benefit overall fertility and well-being for many couples.
First line therapy for fertility struggles should always include:
Body weight management: women with obesity have a 2 fold increased time to conception, while underweight women have a 4-fold increase time to conception. The Center for Disease Control has noted “energy-rich, nutrient-poor foods comprise an estimated 27% of daily caloric intake in the American diet. Many Americans are exceeding energy (caloric) needs but not meeting micronutrient (vitamin and nutritionally essential mineral) requirements,” which can ultimately effect Americans’ overall health and well-being, including fertility health.
Alcohol reduction or complete avoidance: consumption for women >2drinks/day had 60% relative risk to infertility. The CDC also noted that alcohol constitutes an additional 4% of daily caloric intake in the American diet.
Smoking needs to stop! There is a 60% increased infertility risk with smoking.
Caffeine reduction: consumption of >250mg/day decreased the probability of becoming pregnant within one menstrual cycle by 45%. Overall 1-2 cups of coffee per day has no apparent adverse effect on fertility.
Chemical toxins and pollutant removal/avoidance: solvents like those used in dry cleaning or printing industries, were shown to increase relative risk of infertility by 40% in women exposed to them. Numerous studies have shown detriment to sperm health from chemical and environmental toxin exposure.
Proper timing of intercourse: determining when ovulation occurs isn’t something most first timers TTC think much about, though according to an Albert Einstein College of Medicine 2019 study, only 20% of women knew they were fertile 3-6 days out of a month’s cycle, and 16% of woman in the study believed they were most fertile during their menses. A woman is typically most fertile for a 3-6 day window, approximately 14 days after start of flow in a regular 28 day cycle.
Well timed intercourse often needs to be taught to couples TTC. Learning a woman’s fertile window is imperative for decreasing time to conception. Women are not typically taught the signs to identify the fertile window in a their cycle.
How can a woman tell if she’s fertile?
The first sign a woman is fertile is by having a health, symptom free, regular cycle. Once unwelcome symptoms start to be experienced, there is a chance fertility is not optimal. Symptoms indicate hormone imbalances, and imbalanced hormones can affect fertility. The second way patients can check their fertility, and fertile window, is by using what I call the “body’s ovulation prediction kit.”
Cervical position: high in the vaginal vault with an open cervical os indicates ovulation.
Cervical fluid: noticeable egg-white in texture and slippery discharge, not having any cervical fluid changes throughout the month indicate support is needed. Cervical fluid is the superhighway in which sperm use to travel to the egg for fertilization. No changes, thick or dry fluid does not allow for sperm to travel easily if at all to fallopian tubes.
Basal Body Temperature(BBT): Although this morning temperature reading does not tell you when you will ovulate, after a few months of mapping BBT, you will be able to identify the fertile window within a few days. This simple reading can give much insight concerning the health of the woman.
The body’s ovulation prediction kit can help couples know when to have intercourse more frequently to increase chances to conception. Teaching couples how to identify a fertile window, often reveals fertility problems when cervical fluid or BBT have unexpected patterns. Women that map BBT often learn they are pregnant prior to taking a test, since these readings don’t drop at the typical time before menses if fertilization has occurs.
As simple as some of these suggestions to boosting fertility seem, it is the simple things that are often the most impactful, long lasting, and least invasive. It is often easy to excuse some of the above lifestyle habits when many people who eat poorly, drink heavily, smoke, and work with chemicals daily, to name a few detriments towards fertility, are able to conceive without any trouble. Genetics can explain some of the discrepancy seen when fertility struggles occur in otherwise healthy individuals but not in otherwise seemingly unhealthy individuals. This is why it is most important to be evaluated as a whole person, at a functional medicine level, and with great consideration on how your lifestyle, dietary practices, and mental resilience impact You and Your partner.
Dr. Nicole Kerr, ND, LAc is the owner of an all-natural fertility clinic in Wallingford CT, Fertility Oasis. At Fertility Oasis, Dr. Kerr teaches her patients the importance of preconception care and about all treatment options available to couples wanting and/or struggling to conceive. Male and female infertility factors are addressed to offer comprehensive fertility care for her patients.
Fertility Oasis, 857 N Main St Ext Suite 1, Wallingford CT, 203.265.0459 www.fertilityoasis.com