Knowledge | Improving Fertility Health: From Lifestyle Changes to Medical Treatment
How can couples improve their chances of conception? Medical treatment and natural approaches may help both partners support their reproductive health and increase the likelihood of pregnancy.
1. What Is Reproductive Health?
Each year, millions of adults have difficulty conceiving. About 85% of couples conceive within one year, many within a few months. The remaining 15% do not, often because of reproductive health or fertility problems. About half of these couples conceive within two years.
"Couples generally come to my clinic after trying on their own for six months to a year. If the woman is over 35, she should see a reproductive endocrinologist or fertility specialist after six months," said Dr. Ruben Alvero, professor of obstetrics and gynecology at Stanford School of Medicine.
In general, see a fertility specialist after one year of trying, or sooner if the woman is over 35. Before the visit, over-the-counter ovulation tests can track ovulation, which often occurs around day 14. Intercourse every other day beginning on day 10 is suggested because a mature egg survives in the fallopian tube for only about 12 hours.
2. Causes of Fertility Problems
Age is the most common cause for women, but many other factors can make natural conception difficult. "In about 65% of couples with fertility problems, we can identify a physical cause and treat it according to the circumstances," Dr. Alvero said.
Common causes include blocked fallopian tubes, uterine fibroids, low egg quantity or quality, irregular ovulation, and low sperm quality or count. Chronic conditions such as diabetes, celiac disease, lupus, and thyroid disorders may also reduce fertility.
"Obesity also has a major effect on fertility," Dr. Alvero added. "Being underweight can also adversely affect women. If you are overweight or obese, losing 5%–10% of your weight can significantly improve the chance of conception and support a healthier pregnancy." In men, obesity may reduce sperm production or motility.
3. Environmental and Lifestyle Effects
People trying to conceive should consider workplace or everyday exposure to harmful substances such as lead and cigarette smoke, which may reduce sperm quality. Chemicals can also affect female fertility. Dr. Jaclyn Chasse, a licensed naturopathic doctor at Perfect Fertility in Boston, said environmental chemicals—including ingredients in some beauty products, pesticides in food, and BPA in plastic bottles—may harm reproductive health.
Simple dietary and lifestyle changes may improve the chance of conception. Dr. Chasse starts with diet, sleep quality, and stress, and recommends stopping smoking, limiting alcohol, reducing caffeine, and maintaining a healthy weight.
4. Medical Treatment
If lifestyle changes are insufficient, medical treatment is available. A doctor may prescribe fertility medication such as clomiphene citrate (Clomid) to improve ovulation in women or increase testosterone levels in men.
If medication is unsuccessful, intrauterine insemination (IUI) or in vitro fertilization (IVF) may be recommended. IVF is the most common assisted reproductive technology: the ovaries are stimulated, eggs are retrieved and fertilized with sperm in a laboratory, and an embryo is transferred to the uterus.
Fertility treatments and assisted reproductive technologies may not be covered by insurance, which can delay care. Dr. Alvero said his reproductive endocrinology and infertility society was advocating for legislation to expand coverage.
Above all, do not give up on the goal of building a family. Dr. Chasse said, "Helping couples conceive is one of my greatest honors. It is deeply meaningful."
Knowledge | Improving Fertility Health: From Lifestyle Changes to Medical Treatment
Knowledge | Improving Fertility Health: From Lifestyle Changes to Medical Treatment
How can couples improve their chances of conception? Medical treatment and natural approaches may help both partners support their reproductive health and increase the likelihood of pregnancy.
1. What Is Reproductive Health?
Each year, millions of adults have difficulty conceiving. About 85% of couples conceive within one year, many within a few months. The remaining 15% do not, often because of reproductive health or fertility problems. About half of these couples conceive within two years.
"Couples generally come to my clinic after trying on their own for six months to a year. If the woman is over 35, she should see a reproductive endocrinologist or fertility specialist after six months," said Dr. Ruben Alvero, professor of obstetrics and gynecology at Stanford School of Medicine.
In general, see a fertility specialist after one year of trying, or sooner if the woman is over 35. Before the visit, over-the-counter ovulation tests can track ovulation, which often occurs around day 14. Intercourse every other day beginning on day 10 is suggested because a mature egg survives in the fallopian tube for only about 12 hours.
2. Causes of Fertility Problems
Age is the most common cause for women, but many other factors can make natural conception difficult. "In about 65% of couples with fertility problems, we can identify a physical cause and treat it according to the circumstances," Dr. Alvero said.
Common causes include blocked fallopian tubes, uterine fibroids, low egg quantity or quality, irregular ovulation, and low sperm quality or count. Chronic conditions such as diabetes, celiac disease, lupus, and thyroid disorders may also reduce fertility.
"Obesity also has a major effect on fertility," Dr. Alvero added. "Being underweight can also adversely affect women. If you are overweight or obese, losing 5%–10% of your weight can significantly improve the chance of conception and support a healthier pregnancy." In men, obesity may reduce sperm production or motility.
3. Environmental and Lifestyle Effects
People trying to conceive should consider workplace or everyday exposure to harmful substances such as lead and cigarette smoke, which may reduce sperm quality. Chemicals can also affect female fertility. Dr. Jaclyn Chasse, a licensed naturopathic doctor at Perfect Fertility in Boston, said environmental chemicals—including ingredients in some beauty products, pesticides in food, and BPA in plastic bottles—may harm reproductive health.
Simple dietary and lifestyle changes may improve the chance of conception. Dr. Chasse starts with diet, sleep quality, and stress, and recommends stopping smoking, limiting alcohol, reducing caffeine, and maintaining a healthy weight.
4. Medical Treatment
If lifestyle changes are insufficient, medical treatment is available. A doctor may prescribe fertility medication such as clomiphene citrate (Clomid) to improve ovulation in women or increase testosterone levels in men.
If medication is unsuccessful, intrauterine insemination (IUI) or in vitro fertilization (IVF) may be recommended. IVF is the most common assisted reproductive technology: the ovaries are stimulated, eggs are retrieved and fertilized with sperm in a laboratory, and an embryo is transferred to the uterus.
Fertility treatments and assisted reproductive technologies may not be covered by insurance, which can delay care. Dr. Alvero said his reproductive endocrinology and infertility society was advocating for legislation to expand coverage.
Above all, do not give up on the goal of building a family. Dr. Chasse said, "Helping couples conceive is one of my greatest honors. It is deeply meaningful."
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Collected online