When you’re trying for a pregnancy, your first two-week wait can feel like an eternity. Every twinge, tickle, and pinch could be a sign of pregnancy. You may find yourself endlessly scouring the Internet to understand your odds and improve your fertility. And in those first few months of trying, you might wonder how people who struggle with infertility manage to cope with endless two-week waits.
Trying for a baby, whether you’re in your first month or your 15th, teaches you patience -- whether you like it or not. Ultimately, whether you get pregnant is a unique product of timing, luck, and overall health. People who struggle with infertility learn to get comfortable with the notion that they can’t control everything. Embracing the lack of control can even help you manage the stress of waiting.
But did you know there are things you can do to improve your fertility right now? Whether you're merely contemplating a baby, in the two-week wait already, or rounding the corner on a year or more of trying, your lifestyle matters. Here’s how to maximize your chances of fertility.
Get a Check-Up Before You Start
Panicking about your fertility will do you no good, but you do need to understand the reality: fertility is a time-sensitive matter. It begins to decline for both men and women as early as the late twenties, and definitely by the mid-thirties. This means that each year you spend trying without success could be deducting years from your fertility life.
Most couples will get pregnant eventually, and almost all will be able to get pregnant with the right help. But what if there is something wrong that you don’t know about? Would you rather spend the next year trying for a pregnancy that cannot happen, only to learn that there’s a serious problem you must address? Or would you rather spend that time addressing the problem?
A fertility check-up before you begin trying can identify obvious problems. For example, if the woman has a very long or very short menstrual cycle, this could be a clue to an underlying issue. Likewise, a history of STDs/STIs, infections, and other health problems might indicate a problem. Schedule a checkup with your gynecologist or primary care provider. Your partner needs to see their doctor, too.
If you uncover any issues, don’t waste time. See a fertility specialist right away. Working with a fertility specialist optimizes your chances of a successful pregnancy. Your primary care provider may not know about recent research, and will not have the cutting-edge training of a fertility specialist. So ask for a referral early in the process.
Improve Your Health
Fertility issues are often connected to other health issues. This means that people with chronic illnesses, such as diabetes, rheumatoid arthritis, and multiple sclerosis, are more vulnerable to fertility issues. Likewise, people with conditions that can compromise fertility, such as an STD or polycystic ovarian syndrome (PCOS) may cause other symptoms.
This means that you should take steps to manage any illnesses you have. You should also seek diagnosis and treatment for any unexplained symptoms. For instance, if you have unexplained weight gain or a history of chronic pain, now is the time to figure out why. Treating these issues may improve your fertility. Perhaps even more important, tending to your overall health -- and not just your fertility -- can mean a longer, happier, healthier life. That’s something every potential parent should aim for, because every child deserves to know their parent will be with them for a long time.
While there’s no guarantee that a slightly healthier lifestyle will improve fertility, taking additional measures to improve your health could address underlying health issues, thereby improving fertility.
Try some of the following strategies:
- Aim for at least 30 minutes of exercise most days of the week.
- Become more active. A sedentary lifestyle that consists primarily of sitting behind a desk is never healthy.
- Manage your stress. Stress alone won’t cause infertility, but it can make the wait worse. And severe, chronic stress is bad for your health, and therefore bad for your fertility. Your mental health matters.
- Get plenty of sleep. Exhaustion only increases stress and reduces your chances of a successful pregnancy.
Maintain a Healthy Body Weight
Having a healthy body mass index (BMI) -- weighing neither too much nor too little -- is one of the more straightforward ways to boost fertility. One study found that being overweight or obese doubled the time it took to get pregnant, even absent other fertility issues. Weighing too much can also complicate pre-existing medical issues. For example, women with PCOS may improve their fertility by losing weight. A low-carb, low-sugar diet can help with symptoms of diabetes, and may also lead to weight loss.
But if you’re addicted to being thin, don’t get too smug. Being underweight is also a risk factor -- though it’s something your doctor might overlook, since obesity is more common than being too thin. Women who are very thin may have unusually long menstrual cycles, or might not ovulate at all. If they do get pregnant, their bodies can struggle to nourish the developing baby. Gaining just a few extra pounds on a healthy, protein-rich diet can make a world of difference.
Monitor and Chart Your Cycles
It’s easy to feel like what’s happening inside your body is a mystery. Eggs? Fallopian tubes? Implantation? What does it all mean?
Fertility happens with or without your knowledge, but a little education can go a long way. Understanding your cycles can help you identify your most fertile window.
Charting your cycles can also help you identify common issues such as:
- An abnormally long luteal phase that could mean a very early miscarriage.
- An abnormally short luteal phase that doesn’t give an egg long enough to implant in the uterine wall.
- Not ovulating, or ovulating very late in the cycle.
Charting may also help you detect early signs of a potential pregnancy, such as implantation bleeding. It can even help you correctly time a pregnancy test, and if you get pregnant, can help you more accurately estimate your due date.
A number of charting apps can help you track your period and predict ovulation. For even more accurate information, try taking your basal body temperature each morning. Following ovulation, the temperature of your body in the early morning increases slightly. This is a highly accurate way to prove that you have ovulated -- more accurate than home ovulation tests -- particularly if you are not being monitored by a doctor for ovulation. You’ll need to take your temperature each and every day around the same time, and to plot the temperatures on a graph.
Other measures of fertility -- such as fertile cervical fluid, home ovulation tests, and other symptoms -- may also help you pinpoint the time of ovulation. Consider investing in a book about charting, such as Toni Weschler’s classic Taking Charge of Your Fertility.
If you are already under the care of a doctor for fertility issues, your doctor might want you to monitor specific fertility signs. So ask your doctor whether it would be helpful to track specific fertility clues.
Choose the ‘Fertile Window’
You’re only fertile for a few days each month. This means you could try for years and still not get pregnant if you time intercourse incorrectly. The “fertile window” is shrouded in myth and secrecy. For instance, some couples mistakenly believe that the woman is most fertile after ovulation. This isn’t true.
It can take several hours, and sometimes even longer, for the sperm to travel to the egg. Once in the reproductive tract, the sperm can survive for several days. This means that the most fertile window is immediately before ovulation. Intercourse a day or two before ovulation gives the sperm time to travel to the egg, and fertile cervical fluid keeps them alive as they make their journey.
You might be thinking that the best way to hit the fertile window is to have sex everyday. For most couples, this isn’t sustainable. Exhaustion will soon set in, and intercourse can begin feeling like a chore. That’s not good for your body, and it’s not good for your relationship. What’s more, it may not be good for your fertility.
Over time, ejaculating too frequently can lower a man’s sperm count. Allowing 48 hours for the sperm to replenish works better. So to optimize fertility, have sex every other day, particularly in the period leading up to and immediately following ovulation. During this period, encourage your partner to abstain from masturbation to maximize fertility.
Choose Lubricants Wisely
No one wants sex to be a chore, but let’s face it: when you’re trying to get pregnant, you’re not going to willingly miss a fertile window. This means some women have sex while trying to conceive when they’re not really in the mood. Others are eager to have sex, but desire a little less friction. In either scenario, lubricants can make sex a vastly more pleasurable experience.
We encourage couples to use lubricants to make sex enjoyable and to foster intimacy. Because when sex feels like a chore, the relationship can suffer. That’s particularly true for couples struggling from infertility. You and your partner need one another, and you need to feel good about your sexual relationship.
There’s a small problem, though: Many lubricants kill sperm, or make it harder for sperm to move in the reproductive tract. Does this mean you have to resign yourself to uncomfortable sex? Hardly. A number of lubricants are designed for couples trying to conceive. Not only do these lubricants protect sperm; they may also make it easier for the sperm to travel in the reproductive tract. Your doctor can recommend the right brand for you. One popular brand is Pre-Seed.
Get a Semen Analysis
Hundreds of years ago, when a couple couldn’t get pregnant, folklore blamed the woman -- and often insisted that her “sinfulness” was to blame. Witness the story of Abraham and Sarai in the Bible. While we now know that both men and women play a role in fertility, popular myths still make their way into our unconscious mind. That’s why many couples treat fertility as a female-only issue. They spend time and money investigating and improving the woman’s health. But they never think about the man’s role.
A semen analysis is a simple, noninvasive procedure that tells you much about your partner’s fertility. It only takes a few minutes, and is normally inexpensive. If you feel anxious about trying for a baby, consider a semen analysis before you even begin the process. If you already know you have fertility issues, make a semen analysis the first thing on your fertility to-do list.
Couples tend to treat eggs as precious objects. After all, there’s only one each month. Sperm are plentiful and easily replaced, right?
Maybe not. Research shows that lifestyle choices can affect sperm quality and sperm count. A few very simple strategies can protect sperm. Little research has proven a link between heat and sperm death, but anecdotal evidence -- and some small trials -- suggest that allowing sperm to overheat could damage them. So to be on the safe side, try the following:
- Switch to boxers, instead of briefs. Briefs can cause the sperm to overheat.
- Avoid very hot showers, saunas, and hot tubs.
- Avoid putting your cell phone near the genitals, or using other devices near the genitals that can cause them to heat up.
Limit Alcohol and Drugs
Alcohol can affect a developing baby well before the mother knows she is pregnant. So consider abstaining from alcohol while you try for a pregnancy. Eliminating or limiting other drugs -- including caffeine, nicotine, and recreational drugs such as marijuana -- can also help. Particularly early in development, these drugs can negatively affect a baby. This can cause a miscarriage before you even know you’re pregnant. Drugs can also compromise fertility.
If you take any prescription drugs, talk to your provider about how they might affect your fertility. Sometimes a more fertility-friendly option is available. In other cases, you might not even need the medication any more. View any medication skeptically, and weigh the risks and benefits under your doctor’s guidance. But never stop a drug without talking to your doctor first, since untreated medical conditions definitely undermine fertility.
Eat a Balanced, Healthy Diet
No specific food can definitively improve fertility, though highly preliminary research suggests some foods may be better for fertility than others. Here’s what we do know: eating a varied diet rich in vegetables is good for your health, and therefore good for your fertility. Developing babies also depend on protein to feed their brains and nurture cell growth, so vegetarians and vegans need to ensure they eat enough of this vital nutrient.
Take a long, hard look at your diet and consider whether specific tweaks might help. If you have PCOS, diabetes, or are overweight, consider eliminating refined sugars and excess carbs. Doing so can help you lose weight, and may improve your chances of getting pregnant.
Consider a Supplement
No supplement will get you pregnant, but there is some limited evidence that deficits in some vitamins and minerals can undermine fertility. Talk to your doctor about the benefits and risks of a fertility supplement. These multivitamins can make up for any holes in your diet, potentially boosting fertility.
You absolutely should be taking a prenatal vitamin/folic acid supplement. These vitamins can prevent neural tube defects. Because the neural tube begins developing before you know you’re pregnant, it’s important to take a supplement before you get pregnant, not after you get a positive test. Your folic acid supplement should have 600 micrograms of folic acid, and you’ll need to begin taking it six months before trying for a baby for the best results.
Note that if you have some genetic anomalies, such as the MTHFR mutation, your body might not properly metabolize folic acid. You might need a folate supplement instead.
Know When to Seek Help
If you’re not getting pregnant, continually trying and failing can be demoralizing. It also wastes precious time. Know when to seek help -- and where to seek it. Follow these two simple guidelines:
- If you are under 35, with no serious medical issues and no history of fertility issues, seek help after 12 months of unsuccessfully trying to conceive -- or if you have had multiple miscarriages in that time.
- If you are over 35, have a history of medical issues, or have an abnormal menstrual cycle, seek help after 6 months of unsuccessfully trying to conceive -- or if you have had multiple miscarriages in that time.
If you know you have a fertility issue, seek help before you begin trying. Your search for answers can begin with your gynecologist or primary care provider. Going this route can also ensure that insurance covers some testing. But if you need further testing or treatment, you’ll need to seek the expert care of a fertility expert.
The Center of Reproductive Medicine offers compassionate, expert care for every step toward parenthood. Let us become your fertility partner. We’re here to help. We listen. We care. And we know what works.