When we spend so much of our lives trying to avoid getting pregnant, it’s natural to assume that conceiving is a piece of cake. Often it can be. But sometimes it isn’t, as is evident by the one in six couples who today experience fertility problems.
The good news is that we now know if you get yourself ready by following some basic steps, you’ll dramatically increase your chances of getting pregnant when you want to, with a healthy baby to show for it.
For a woman, what you do in the month leading up to conception, when you are maturing that auspicious egg, is the most critical. For the man, it takes up to four months to make new sperm from scratch, so they have to be good for a little longer!
Fertility and the speed of conception depend on many factors – some psychological, some physical, some nutritional and some environmental. For example, conceptions are more likely during holidays, with less stress and more time to relax.
Knowing how to time sex to coincide with ovulation (where the female egg is released to be fertilised by the sperm) also greatly increases your chance of conceiving. But most of all, your nutrition, especially your vitamin and mineral status, plays a crucial role.
It has been estimated that only one in twenty people in Britain genuinely receives adequate amounts of all vitamins and minerals to meet the European ‘recommended daily allowance’ (RDA). And I don’t even consider these ‘RDA’ levels to be optimum.
But while a diet lacking in all you need may not actually make you infertile, it could make you ‘sub-fertile’ and reduce your chances of getting pregnant. A marginally fertile woman trying to have a baby with a man with a low sperm count, for example, may not be able to conceive.
So anything that can be done on either side to improve fertility increases your chances of getting pregnant when you want to and also increases your chances of having a super healthy baby. You don’t just need to be fertile. You need maximum fertility.
The mineral zinc is absolutely vital for reproductive health. Infertility, low sex drive and period problems have all been linked to inadequate levels. Together with vitamin B6, zinc affects every part of the female sexual cycle.
Working in partnership, these two nutrients ensure that adequate levels of sex hormones are produced. For example, one hormone called Luteinising Hormone Releasing Hormone (LHRH) causes your pituitary gland to stimulate the development of an egg (or ovum) that causes ovulation. A deficiency in either zinc or B6 can cause a deficiency in LHRH, so your fertility decreases.
Adequate levels of zinc and B6 can also increase your desire for sex (which is why zinc-rich oysters are called an aphrodisiac) and alleviate pre-menstrual problems. Women who suffer from premenstrual syndrome (PMS) are often zinc deficient [1].
After conception, zinc and B6 ease pregnancy sickness and post natal depression, as well as increasing the chances of having a healthy baby.
Oysters, lamb, nuts, egg yolks, rye and oats are all rich in zinc, while B6 is found in cauliflower, watercress, bananas and broccoli. The optimum daily intake is 20mg of zinc and 60mg of B6, which you can achieve with a diet that includes these foods plus a good multivitamin and mineral supplement.
Knowing how to time sex to coincide with ovulation (where the female egg is released to be fertilised by the sperm) also greatly increases your chance of conceiving. But most of all, your nutrition, especially your vitamin and mineral status, plays a crucial role.
It has been estimated that only one in twenty people in Britain genuinely receives adequate amounts of all vitamins and minerals to meet the European ‘recommended daily allowance’ (RDA). And I don’t even consider these ‘RDA’ levels to be optimum.
But while a diet lacking in all you need may not actually make you infertile, it could make you ‘sub-fertile’ and reduce your chances of getting pregnant. A marginally fertile woman trying to have a baby with a man with a low sperm count, for example, may not be able to conceive.
So anything that can be done on either side to improve fertility increases your chances of getting pregnant when you want to and also increases your chances of having a super healthy baby. You don’t just need to be fertile. You need maximum fertility.
Fat is an essential part of our diet. But while the wrong kinds of saturated fats – found in processed foods, meat and dairy products – are rich in most people’s diets, the right kinds of fats are normally lacking.
Oily fish such as mackerel, herring, sardines and salmon are rich sources of one kind of essential fat called Omega 3. Nuts and seeds are rich in the other kind – Omega 6.
Like zinc and B6, Omega 3 and 6 fats are needed for healthy hormone functioning, so a deficiency is likely to effect your menstrual cycle and therefore your fertility.
To make sure you get enough essential fats, aim to have a portion of oily fish two to three times a week and eat a handful of fresh, unsalted seeds every day. Seeds are also rich sources of minerals (including zinc) and protein, so they make a perfect snack.
Although oxygen is essential to life, it also causes damage – and reproductive organs are particularly sensitive.
When oxygen is broken down in our bodies, highly reactive molecules called free radicals are formed, and these harm, or oxidise, other molecules which can start a chain reaction of damage. For example when an apple is cut and comes into contact with oxygen in the air, it gradually turns brown on the outside then begins to rot.
The same would happen inside our bodies were it not for a complex repair system that minimises damage. However, this system is dependent on a good source of ‘anti-oxidant’ nutrients from our diet. If these are lacking, then we age faster, are more prone to developing disease and can become less fertile.
So to keep your body young, you need a good intake of antioxidants. The main antioxidant nutrients are vitamins A (both the animal form retinol and the plant form beta-carotene), C, and E, plus the minerals zinc and selenium.
However, a word of caution. While the betacarotene version of vitamin A is perfectly safe, too much of the animal form, retinol (found in fish and animal liver), can cause problems in pregnancy, so aim to get the lion’s share of your intake from vegetable sources.
Phytonutrients are a recently discovered class of antioxidants – bioflavonoids and lypocene are two you may have heard of. These enhance our absorption and utilisation of other antioxidant nutrients as well as having protective qualities themselves, and are often responsible for giving a plant its colour, which is why eating a ‘rainbow’ selection of fruit and vegetables ensures you get a good variety of phytonutrients.
Essentially, antioxidants all work together to project your body and especially your reproductive organs.
Studies have shown that both vitamin C and vitamin E, for example, boost fertility in women and men [2], while vitamin A is needed for your ova to grow and develop before ovulation.
Anti-nutrients are substances that deplete your body of vital resources while contributing nothing nutritionally themselves.
Refined sugar can be classed as such because it contains no nutrients of its own yet uses up stores of vitamins and minerals as your body processes (or metabolises) it.
But anti-nutrients that have a greater impact on your fertility are those that actually damage your body – alcohol, cigarettes, drugs and environmental toxins.
Alcohol: When you are preparing to conceive, drinking any alcohol at all can reduce your fertility by half – and the more you drink, the less likely you are to conceive [3]. One study showed that women who drank less than five units of alcohol (ie fewer than three glasses of wine or 2.5 pints of beer) a week were twice as likely to conceive within six months compared with those who drank more [4].
Tobacco: Unsurprisingly, smoking hampers fertility too. In a study at the Institute for Reproductive Medicine in Germany, researchers found that smoking damages the quality of eggs in ovaries, reducing the number capable of producing a baby.
Coffee: Sadly, you can’t even seek solace with a cup of coffee. Research has shown that caffeine – also found in tea, chocolate and cola drinks – decreases fertility. Just one cup of coffee a day can halve your chances of conceiving [5].
The increased number of chemicals and pollutants in the environment is also a factor. And toxic metals such as lead and mercury can play havoc with your fertility as well as damaging a developing baby. These are outlined in more detail in my book Optimum Nutrition Before, During and After Pregnancy. [Insert link to Books page]
Infertility rates go up in times of food shortage – because without sufficient nutrients, a woman’s menstrual cycle will stop. But in our resource-rich Western world, thankfully this doesn’t happen – unless the food shortage is self-imposed.
Slimmers and underweight women run the risk of becoming infertile if they don’t eat enough to maintain a regular menstrual cycle. Swedish research has revealed that the ‘average’ woman (ie 5’ 4” of medium build) will stop having periods at 8st 3lb (52 kg) [6].
But even if you are underweight and still have periods, your diet can affect your fertility. I’ve seen women who’ve become infertile as the result of combining a low-fat diet with constant exercise – even though they are having regular periods and ‘appear’ perfectly healthy.
As a result of extensive research, fertility expert and Harvard professor Rose Frisch maintains that only 10% of women are fertile with a body mass index of 18. (To work out your BMI, follow this formula: your weight in kilograms ÷ the square of your height in meters, eg 62kg ÷ (1.7 x 1.7) = 21.5)
Frisch says: “Many women who maintain body shape made popular on the catwalks throughout the world are completely infertile”. This is because your body needs a sufficient intake of fat (albeit the right kind) to produce the hormones required for ovulation.
Likewise, if you are overweight, your fertility can be reduced. Even moderate obesity – classified as a body mass index of 25-30 – reduces your chances of conception and increases the risk of miscarriage [7].
So for maximum fertility, you need to eat enough of the right kind of fats and be neither under nor over weight. As each of us has individual bone structures and body shapes, there is no definitive answer to what your normal weight should be, but the body mass index is a useful guide.
Stress is an everyday fact of life in the twenty-first century. But when you’re trying to conceive, too much can reduce your fertility and play havoc with your health.
Our reaction to stressful situations is the same today as it was in early stages of our evolution, when we had to be primed to ‘fight or flight’ to ensure survival. If we came face to face with a fierce predator, all our energies would be diverted into running away or protecting ourselves rather than producing reproductive hormones or digesting the food in our gut.
Although we are unlikely to face such dangers today, we still respond in the same way when we have a pressing work deadline, get stuck in traffic or have to juggle too many responsibilities. And as these sorts of events occur daily, sometimes hourly, bodily systems like reproduction and digestion can become neglected.
Stress also uses up stores of nutrients – especially B vitamins – which are crucial for a multitude of functions including fertility.
We know that being relaxed boosts fertility because holidays are a common time to conceive. But for most of us, taking time off is limited to a few times a year.
The rest of the time, if you find it hard to relax, get irritable, are unable to ‘shut off’ from the events of the day or have trouble sleeping, stress is having a negative effect on your health – and this could reduce your fertility.
Shakespeare had a point when he wrote: ‘There is nothing good or bad but thinking makes it so’ (Hamlet, Act 2, Scene 2). Unless your house burns down or someone dies, most stresses are not disasters. Thinking they are, however, can easily overwhelm you.
Eating a wholefood diet and supplementing a good multi will also provide all the nutrients you need to help your body cope better with stress.
So if you feel you need help to address the way you react to stress, check out the section on HeartMath techniques [insert link to HeartMath section] and read my latest book, The Stress Cure.
Homocysteine is a protein-like substance naturally found in our blood. However, a diet lacking in sufficient nutrients or a genetic impairment can mean that levels of homocysteine are higher than they should be, and this can contribute to all sorts of health problems, including infertility.
So significant is homocysteine that I advise you test yourself before you get pregnant and, if necessary, reduce a high level (below 6 is optimum) with the right supplements and dietary measures before you conceive. Not only can it boost your fertility, it will also help you avoid many of the problems that can occur during pregnancy.
Reducing your homocysteine may also benefit other disorders that can reduce fertility. For example, researchers from Italy have found that women suffering with PCOS are much more likely to have high homocysteine levels [8].
Getting your partner tested may also increase his fertility. In men, high homocysteine is strongly associated with low sperm motility. Motility is the ‘swimming power’ of sperm, which determines whether they can make it to the egg and penetrate it, or run out of puff.
In one study, high homocysteine was associated with 57 per cent less motility [9]. This may be because the chemical process our bodies use to convert homocysteine to beneficial substances – a process called ‘methylation’ – is absolutely vital for healthy sperm production.
For more information on how to test your homocysteine and what to do if it’s high, read Optimum Nutrition Before, During and After Pregnancy.
More women are deciding to have babies later than ever before – in the past 25 years, the percentage giving birth age 30 and over in England and Wales has doubled. Men too are leaving it later. And while there are many psychological advantages to being an older parent, physically it can be much more demanding.
To begin with, getting pregnant is more difficult – after the age of 30, the viability of your eggs starts to decline and you are likely to have fewer cycles in which you ovulate. A 35-year old woman takes, on average, twice as long to conceive than a 25 year old.
Male fertility – previously thought to be unaffected by age – also starts to reduce after the age of 24. Researchers at the University Division of Obstetrics and Gynaecology at St Michael’s Hospital in Bristol studied 8,500 couples and found that the older a man is, the longer it is likely to take his partner to conceive, irrespective of her age.
The odds of conceiving within six months of trying decrease by 2% for every year that the man is over the age of 24. “It tells us that to some degree men as well as women have a biological clock that starts ticking as they get into their thirties,” says Dr Chris Ford, who led the study.
Older parents also have a greater risk of conceiving a baby with genetic abnormalities such as Down’s Syndrome. For example, the risk of a chromosomal abnormality in a woman age 20 years is 1/500, increasing to 1/20 by age 45.
But this is partly because your body has had more exposure to an unhealthy lifestyle (nutrient-deficient diet, smoking, drinking etc), stress and pollutants. So taking care pre-conceptually and throughout your pregnancy can greatly increase your chances of having a healthy baby.
In fact, research has shown that under ideal conditions – that is if you are in good health with perfect nutrition, good antioxidant protection and limited exposure to pollutants (ie the programme outlined in the Optimum Nutrition Before, During and After Pregnancy) – the effect of age on the chance of achieving a successful pregnancy may be less than previous studies show [10].
Certainly, I find many older couples have healthy babies after adopting the optimum nutrition approach I recommend.
During your cycle – which can vary from 23 to 35 days – there is only one day in which an egg is available for fertilisation. However, sperm usually live for three days and under excellent conditions can survive for five. Therefore, if you know when you ovulate, having frequent sex in this five-day window dramatically increases your chances of conception. So, how do you find out when ovulation occurs?
The discovery that a different type of mucus is produced just before ovulation led to the development of the simplest and safest method of birth control. Unlike normal vaginal mucus, fertile mucus is sticky and thread-like – a bit like egg white. It’s designed to both nourish and protect the sperm, providing it with channels to move along, thereby greatly increasing its chances of reaching the egg.
In a World Health Organisation study, 90% of women could identify their fertile mucus within the first month of learning what to look for.
Another way to tell is by monitoring your resting temperature (ie as you wake up in the morning) – this will drop then rise very slightly as you ovulate. There are also ovulation predicator kits that you can buy without prescription from chemists and large supermarkets. For more details, read the book The Manual of Natural Family Planning by Anna Flynn and Melissa Brooks (Thorsons/HarperCollins).
Once you’re ready to get pregnant, being in good health at the expected time and shortly after conception is especially important. Catching the flu or a virus in the early stages of pregnancy can harm your baby and increase your risk of miscarriage, so if you become unwell while trying to conceive, abstain until you have fully recovered.
You can reduce the risk of getting ill in the first place by supporting your immune system. For more on this, read Optimum Nutrition Before During and After Pregnancy or Optimum Nutrition Made Easy.
If, after following this advice, you still have problems conceiving, I recommend you see a nutritional therapist specialising in fertility (see Consultations for an appointment with me, or visit the BANT website to find details of someone in your area). A personalised consultation can help you and your partner identify any underlying problems such as polycystic ovarian syndrome (PCOS), hormonal insufficiency, parasite or bacterial infections, heavy metal toxicity or food allergies, and then develop a bespoke programme to help resolve any issues.
And if you’re planning to try conventional fertility treatment such as IVF, a tailor-made nutritional programme can also help you to maximise the chances of it working successfully.
That said, research from preconceptual care charity Foresight shows that a more holistic treatment gets the best results. While just 21% of IVF treatments result in a birth, following a nutritional protocol achieves around a 78% success rate.
Optimum Nutrition Before, During and After Pregnancy provides more information, and also looks in more detail at what men can do to increase their fertility.
1. C. J. Chuong and E. B. Dawson, ‘Zinc and copper levels in premenstrual syndrome’, Fertility and Sterility, vol. 62 (1994), pp. 313-21.
2. R. Bayer, ‘Treatment of infertility with vitamin E’, International Journal of Infertility, vol. 5 (1960), pp. 430-4.
3. R. Hakim et al., ‘Alcohol and caffeine consumption and decreased fertility’, Fertility and Sterility, vol. 70, no. 4 (1988), pp. 632-7.
4. T. Jensen et al., ‘Does moderate alcohol consumption affect fertility? Follow-up study among couples planning first pregnancy’, British Medical Journal, vol. 317 (1998), pp. 505-10.
5. A. Wilcox et al., ‘Caffeinated beverages and decreased fertility’, Lancet, vol. 2 (1988), pp.1453-5.
6. N. Holmberg, Acta Obstetricica & Gynecologica, Scandinavica, vol. 50 (1971), pp. 241-6.
7. D. Hamilton-Fairley et al., ‘Association of moderate obesity with a poor pregnancy outcome in women with polycystic ovary syndrome treated with low dose gonadotrophin’, British Journal of Obstetic Gynaecology, vol. 99 (1992), pp. 128-131.
8. G. Loverro, ‘The plasma homocysteine levels are increased in polycystic ovary syndrome’, Gynecology & Obstetrics Investigation, vol. 53 (2002), pp. 157-162.
9. B. V. Sastry and V. E. Janson, ‘Depression of human sperm motility by inhibition of enzymatic methylation’, Biochemical Pharmacology, vol. 32 (1983), pp. 1423-1432.
10. C. P. West, ‘Age and infertility’, British Medical Journal vol 294 (1987), pp. 853.