How to Reach – and Hang on to – Your Reproductive Prime
Some people will instruct you, “Just relax.” Others will give you tips on coital position, recipes for ancient herbal potions or slip you the feng shui guide to interior design for fertility. Once they get wind of your efforts to conceive, family, friends, mere acquaintances and near-strangers will freely dispense their (usually) unsolicited advice on the “sure-fire” way to get pregnant.
And you may be tempted to try one or two of these well-intentioned but off-the-wall suggestions. Especially when pregnancy isn’t happening as fast as you think it should and you’d swear that every other couple at the mall is expecting.
Resist that temptation. There’s no evidence that hanging from gravity boots for an hour after intercourse or chomping Saw Palmetto (alleged to promote male potency) increase the odds of pregnancy. There is evidence, though, that something less exotic, maybe even mundane, does work: A sensible, healthy lifestyle.
It is a fact of reproductive life that what you eat, how much you weigh, the exercise you do, the colas and coffee you slug and the cigarettes you light up - just to name a few things - can profoundly affect your ability to make a baby.
While lip service about the high road to health comes easy, getting there typically isn’t. You need discipline, support and, above all, the desire. Moreover, the steps to that good-for-your-fertility lifestyle aren’t always obvious. Most of us could use a good road map that keeps us on the path. So here’s one to help you figure out where you are and how to get where you need to go.
Living La Vida Healthy: Max Out Your Pregnancy Potential
To a greater degree than most people imagine, you can manage your reproductive destiny. Start with a candid assessment of the way you live day-to-day, your physical and psychological self. Unless you’re flawless (and who can make that claim and be called sane?), there’s a good chance you’ll have to make at least a few changes. Some are simple adjustments. Others are a test of will even for the strongest. Be prepared.
You can be too thin. Or too fat. It is one of nature’s crueler quirks that weight will affect a woman’s reproductive capacity more than a man’s. The female body is at it’s baby-making best when it is within 15% the ideal weight. Ideal, in this context, is not about Hollywood aesthetics. It is about the weight at which your body and its hormonal systems run as smoothly as a well-oiled Mercedes. Although it’s a highly individualized matter, many women begin experiencing problems when they’re less than 95% or more than 125% of that weight.
- BMI and the Ideal. What you’re looking for is a body mass index (BMI), the standardized measure of the ratio of height to weight, of between 24 and 30. To calculate your BMI, multiply your weight by 703 and divide that by the square of your height in inches. Not the complicated calculus it first appears. Really. Say you’re 66 inches tall and weigh 155 pounds. The equation looks like this:
155 x 703 = 108,965 66 x 66 = 4,356 108,965/4,356 = 25.01That won’t get you the cover of Vogue, but it’s smack in the middle of the “ideal” weight range.
- The Thin Risk. This is a hard one, for men as well as women, because we’ve lost all perspective. And, okay, it’s not the most common problem. But five minutes watching an episode of “Friends,” and we’re all checking ourselves for excess flesh. Skinny comes with a high cost. Underweight women can stop ovulating, having regular periods or any periods at all. Men with a BMI below 18 often can’t find their libidos, their sperm are less active and have shorter lives than men in normal BMI range.
- Overweight and Overwhelmed. This is the biggie, the problem that afflicts most people. Indeed, between 4%-to-5% of women of reproductive age have Polycystic Ovarian Syndrome, a common cause of female infertility, which is exacerbated by obesity. It’s not known exactly how excess poundage interferes with conception, but it is associated with long gaps between menstrual periods and an overabundance of certain hormones that inhibit ovulation. Too much body fat contributes to insulin resistance and may also indicate underlying problems such as Polycystic Ovarian Syndrome.
Should you find yourself at either weight extreme, consult your doctor and a nutritionist. Not to belabor the obvious, but avoid crash or fad diets to gain or lose girth. It’s not only about achieving a pregnancy, but sustaining a healthy one as well.
Feeding Your Desires: Feast for Fertility
It’s simple. Eat all the things you know you should but probably don’t. That’s right. Lots of fruits, vegetables and low-fat protein. Make sure to have at least three nutrient-laden meals daily and treat yourself to snacks. Not a bowl of ice cream. Something more along the lines of cottage cheese with a few crackers or fruit. If you’re trying to shed a few pounds, don’t skip meals, limit portion size and take time to savor the tastes.
Vegetarians need to take extra care to get sufficient protein when trying to boost fertility. Without it, estrogen metabolizes into inactive (products) more rapidly and menstrual cycles become longer.
Despite your best intentions, it’s sometimes impossible to get all the vitamins and minerals from food alone. Both partners should take a good multivitamin and mineral supplement. A women’s supplement should contain 400 units micrograms of folic acid which helps prevent birth defects of the brain and spinal chord that occur within 30 days of fertilization. Zinc may be especially important for men to produce healthy sperm and for normal testicular function.
Whatever you do, avoid vitamin megadoses, especially A and D. The body doesn’t quickly excrete these fat-soluble vitamins allowing them to build to toxic levels.
And no herbs. These are unregulated substances, mostly untested and unregulated. And there is evidence some can cause problems. St. John’s Wort, a commonly used remedy for depression, for example, has an adverse affect on male fertility. The solution – stay away.
Limit caffeine and alcohol intake. One cup of coffee a day should suffice. A glass of wine might not hurt, but moderate to heavy drinking takes its toll on male (sperm shape and motility) and female (ovulatory dysfunction) fertility and has a deleterious effect on embryos and fetuses.
Exercising Your Rights
All right. You’ve got the good-eating thing knocked. The next part of your reproductive plan is to bend, stretch, run, lift weights, take yoga and maybe a bit of Pilates for good measure. You can overdo it.
Exercise devotees and serious athletes who train hard may find their fertility plummeting. Among women who log more than 30 or 40 miles a week running, the risks are high for amenorrhea (no periods). Even when periods seem normal (not too light or far apart), heavy exercise can diminish progesterone levels so that an embryo might not be able to implant.
Men are less vulnerable to the side effects of uber-workouts. But not immune. Those who do endurance training may find a drop in sex drive, testosterone levels and sperm health. Dedicated cyclists risk flattening the artery that brings blood to the penis without a bike saddle that’s got a cutout in the middle. Give up bicycle shorts, or any snug pants, for that matter. Heat is bad for sperm and testosterone production. That also means limiting hot showers, Jacuzzis, saunas, steam rooms.
Up In Smoke
There is no wiggle room on this. Smoking will stunt your procreative capabilities. Stop it. Now. It poisons gonads and increases susceptibility to sexually transmitted diseases in both men and women. Smoking ups the likelihood of a tubal pregnancies, cervical cancer and pelvic infections. Some studies show that in vitro fertilization, the leading assisted reproductive technology, has a lower success rate among smokers than non-smokers.
Let your lawn go weedy. If you’re rebuilding your deck, give it a rest. Pesticides, weedkillers, paint thinners and the like can have a deleterious effect on male sexual function and sperm production. Women working with chemical solvents, nitrous oxide, vinyl chloride, for instance, may be at risk for early miscarriage. Wear protective gear when working with these substances, particularly if there’s regular exposure at your workplace.
The Drug Bazaar: A Stone Drag On Your Fertility
At first blush, this appears to be a no-brainer. Yes, of course, marijuana and cocaine are trouble. And those body-bulking anabolic steroids interfere with sperm production. But there’s a subtler, more difficult drug use to confront. These drugs are legal and are found in some of the best-known treatments for a variety of diseases or conditions.
- Sulfasalazine, a component of some medications for irritable bowel syndrome, colitis or Crohn’s disease, has a negative impact on sperm development.
- Cimetidine, the key ingredient in some ulcer drugs, is linked to impotence and semen abnormalities.
- Spironolactone, found in many hypertension prescriptions, may interfere with testosterone and sperm production.
- Non-prescription anti-inflammatory drugs taken at the time of ovulation can stymie embryo implantation.
- Prescription psychotropics can interfere with ovulation.
In many instances there are prescription alternatives, so check your meds and consult with your doctor as soon as you’re thinking of having a baby.
Stress and, Um, More Stress: The Stuff That Makes You Nuts
There’s no doubt that attempting to create a new life adds a hefty amount of anxiety to yours. It’s ironic how many people who’ve spent their entire adulthoods trying to avoid pregnancy are suddenly reading how-to manuals. If conception doesn’t happen in the first month or two, they worry that they’re inept, or their bodies or brains have failed them.
Achieving a pregnancy typically takes some time. Unless there’s a known medical condition that may compromise fertility, or you’ve been having unprotected intercourse for a year without conceiving (6 months if you’re 35 or older) there’s no real reason for concern.
Sure, you’ll be regaled with stories about how sex in the back seat of a ’57 Chevy is the ultimate fertility enhancer. Or that instant conception is a mystical byproduct of giving up and going the adoption route. Don’t believe any of it. The only proven result of these shopworn tales is a dose of “what’s wrong with us” angst, which you don’t need. There are enough social pressures.
If you’re in the prime childbearing years, there’s a good chance people in your circle are either pregnant or dealing with babies and toddlers of their own. Tell your friends and family that you’re in family-building mode, and brace yourself for the onslaught of suggestions. Including the proposal that you take their kids for a weekend if you think parenthood is so great. Unintentionally hurtful and utterly bone-headed.
Also be prepared for their palpable discomfort if conception takes longer than you—or they—think it should. Aspiring parents–to–be report that baby shower and infant birthday party invitations come less frequently—a double–edged knife, and that family gatherings become touchy and difficult affairs.
On the other hand, keeping your decision private is not always a simple proposition. It’s surprising how uninhibited your own parents, siblings or associates can be about asking why there are no children or when you’re planning to get on the stick.
Regardless of your choice, the most important stress buffer is your partner. Keep your shared goal—a biological child—in mind and approach this as an unwavering, mutually supportive collaboration. Seek reassurance from health care professionals or patient advocacy groups. Nothing soothes like the balm of clear-headed, objective information. That’s why The American Fertility Association is here. Please call for support and informationt toll free at (888) 917-3777. We’ve been there and we know.
By Michael Steinkampf, M.D. and Karen Hammond, M.S.N., C.R.N.P.
With The American Fertility Association
This fact sheet was funded by an unrestricted educational grant from
Unipath Diagnostics Co.