Improving Women's Fertility

Conceiving a child and starting a family can be a stressful process, especially when you've been trying with no results. Even if you've been tracking your ovulation cycles and having sex when you should, the road to parenthood can be long, difficult and complicated by many factors. Understanding your fertility and the lifestyle choices that affect it can help you make changes to improve your chances of conception.

An overview of women's fertility

Fertility refers to a woman's ability to conceive a biological child. Men and women first become fertile in their teens, just after puberty. Fertility peaks sometime in the 20s and decreases with time. For women, the first signs of fertility are the first appearance of ovulation and menstruation.

Ovulation is when a mature egg is released from the ovary and passes into the fallopian tube to await fertilization. Typically, a woman is most fertile in the three days leading up to and during ovulation, but pregnancy is possible within five days before ovulation. It should also be noted that sperm can live inside the female reproductive tract for up to five days if the conditions allow. Approximately 12 to 24 hours after ovulation, a woman is no longer able to get pregnant during that menstrual cycle because the egg is no longer in the fallopian tube. The egg can only survive 24 hours.

If you're not on a typical 28-day menstrual cycle, a menstrual calendar allows you to find the midpoint of your cycle and determine the most appropriate time for conception. Other signs of ovulation are a change in vaginal secretions and a slightly increased temperature.

Women usually remain fertile until five to 10 years before menopause. If you're having trouble conceiving, you're not alone. The Mayo Clinic estimates that 10 to 18 percent of couples have trouble conceiving after a year of frequent sex. Many factors contribute to a woman's ability to conceive a child: dietary choices, weight, exercise, alcohol consumption, age, medical issues and previous surgeries. Outwardly, it's impossible to tell if a woman is infertile, but some signs you aren't ovulating might be a menstrual cycle that is too long (more than 35 days), too short (fewer than 21 days), irregular or absent.

Natural treatments and lifestyle choices for fertility

If you're thinking about starting a family, you might also be thinking about how to improve your fertility and increase your chances of conception. Thankfully, some lifestyle choices can help to optimize your fertility.

Maintain a healthy weight

Women who are well above or below normal weight are at higher risk for disorders with ovulation. Body mass index (BMI) is a measure of body fat based on height and weight. Women with a BMI under 17.5 may have difficulty with their cycle and ovulation, so consulting a physician to optimize reproductive health is recommended. Women with a BMI higher than 30 fall into the obese range and should discuss healthy weight-loss methods with their doctor.

Reduce alcohol consumption

Avoiding alcohol will decrease the amount of time it takes to get pregnant and maintain regularity with ovulation. Women who consume seven or more drinks a week on average will likely face issues with regular ovulation and fertility.

Quit smoking

Women who smoke and are planning to get pregnant can experience a rapid increase in the loss rate of their eggs. Since eggs cannot grow back or regenerate, this means smokers typically experience menopause one to four years earlier than nonsmokers. Women who smoke are less likely to conceive; the infertility rate is nearly double in women who smoke compared to nonsmokers.

Reduce stress

While no conclusive studies have explicitly linked stress to an inability to conceive, the stress of infertility can lead to the aggressive pursuit of infertility treatments or self-isolation. For a variety of factors, it's recommended that you try to reduce the amount of stress in your life before attempting to get pregnant.

Avoid STIs

The Centers for Disease Control and Prevention (CDC) recommends regular screening for chlamydia and gonorrhea for all women younger than 25. Chlamydia and gonorrhea are the two most common types of bacterial sexually transmitted infections (STIs) in the United States but often show no symptoms in women. Untreated, these STIs can lead to pelvic inflammatory disease (PID) and infertility; fortunately, both are easily treatable once diagnosed.

Eat a healthy diet

A Harvard University study recommends a diet that includes whole milk, slowly digested carbohydrates, multivitamins, vegetable protein and unsaturated vegetable oils and excludes trans fat. This can be a side-effect-free option to improve the chances of ovulatory fertility. However, the diet won't help anyone who experiences infertility from a preexisting medical condition.

Have regular checkups

Checking in with your OB-GYN after you start having sex is good general advice for any sexually active person. Regular checkups will help ensure that you're in good health and everything is working the way it should.

Medical treatments for infertility

Infertility can occur for many different reasons, and treatment options vary widely depending on age, the length of infertility, preexisting medical conditions and personal preference. Infertility treatment is often expensive, time-consuming and emotionally and physically taxing.

Restoring fertility is possible through two main kinds of treatment: medication and surgery.

Fertility drugs are the most common type of treatment for women whose infertility stems from ovulation disorder; they work similarly to natural hormones to induce ovulation. One of the most common of these drugs is clomiphene citrate, which is usually given early in the cycle after menstruation begins or used in a woman who is anovulatory (not having a period).

Another fertility drug is gonadotropins, which are used in intrauterine insemination (IUI) or in vitro fertilization (IVF). Gonadotropins are used early in the menstrual cycle to cause multiple eggs to grow to mature size. The risk is that gonadotropins increase your odds of conceiving multiple fetuses or having a premature delivery. They are also typically only used by subspecialists and require intensive monitoring. These drugs can be very expensive

Women who are pregnant with twins or more are at higher risk for miscarrying and should monitor their pregnancy closely with ultrasounds.

Less common fertility drugs include metformin, a drug typically used to treat type-2 diabetes but which can also treat infertility caused by insulin resistance. In rare cases, metformin can cause a serious, life-threatening condition known as lactic acidosis. If you suffer from kidney disease, your doctor will probably advise you against metformin. Bromocriptine is a dopamine agonist used when there are high levels of prolactin in the body (hyperprolactinemia), which results in a lack of menstrual periods, infertility and discharge from the nipples.

Injection of fertility drugs is generally a safe practice, but there is a chance these drugs may cause ovarian hyperstimulation syndrome (OHSS), a condition that causes swollen and painful ovaries. Symptoms include mild bloating, nausea, vomiting and diarrhea, but this condition typically goes away without treatment. If you become pregnant, however, these symptoms may last several weeks and you may be at risk for developing a more severe form of OHSS that can cause rapid weight gain, enlarged ovaries, shortness of breath and fluid in the abdomen.

Surgical options to improve fertility include laparoscopic or hysteroscopic surgeries, which can fix abnormalities that might decrease your chances of getting pregnant. These procedures can include fixing an abnormal uterine shape and removing endometrial polyps and pelvic adhesions. Your doctor might also consider tubal surgeries, though these cases are rare because chances of pregnancy are higher with reproductive assistance such as Intrauterine Insemination (IUI) or In Vitro Fertilization (IVF).

Outlook

Infertility is a complex issue with several contributing factors. In most cases, it's treatable by drugs or surgery, and the outlook is generally positive. Of course, everyone's situation is different, and the chances of fertility come down to your specific circumstances and factors.

Maintaining a healthy lifestyle, diet and weight, monitoring your menstrual cycle and having frequent intercourse will increase your likelihood of conception. But if more than a year has passed or six months if you're older than 35, then consulting your doctor, undergoing tests and discussing treatment options are the only ways to determine which one will work best for you.

If pregnancy is not an option, alternatives include adoption or using a sperm or egg donor. Keeping these in mind when you're trying to start a family can reduce stress and anxiety and help you avoid disappointment if other treatment options aren't viable.