Fertility and Natural Conception

 

We are commonly asked about general lifestyle and health advice to optimise pregnancy chances. There is also a lot of information available about optimal sexual practices that are best for conception, but unfortunately, a lot of this information is based on very little evidence. 

It is important to first understand that the chance of conception in normally fertile couples is fairly low. For women under 30, it is approximately 25% per month, going down to 20% in women under 35. However, 80% of normally fertile couples will be pregnant after 6 months of trying. The time to conception tends to increase as women get older. If you are looking to create a fertile life and improve your chances of falling pregnant naturally, these are the best natural ways to boost fertility

Diet and fertility

Maintaining a healthy weight with a balanced diet has been shown to normalise menstrual cycles and increase the chances of falling pregnant. Evidence suggests that overweight women may take approximately double the time to conceive when they are trying than is normal, while underweight women may have a four-fold increase in time.

A fertility diet plan should include a healthy amount of protein, particularly plant-based proteins like those found in beans and lentils, as well as complex carbohydrates like wholegrains. Women should make sure to consume whole-fat dairy every day, which is rich in vitamins and calcium. We also recommend consuming foods rich in iron and using supplements for fertility like folate.

Lifestyle

It should be no surprise that smoking, use of illicit drugs and increased alcohol intake all have a negative effect on pregnancy chances. We recommend minimising these as much as possible while trying to conceive, and ideally cutting them out entirely. We also recommend reducing your caffeine intake while trying to conceive.

Increasing your activity and exercise while trying to conceive can also have a positive effect on your fertility, though only in moderation. Doing too much high intensity exercise may have a negative effect instead. Half an hour of moderate activity every day can be a good start, but your fertility specialist will be able to help you create a tailored exercise plan for your needs.

Ovulation

Ovulation commonly occurs in the middle of a menstrual cycle, on or around day 14 of a 28-day cycle. Unfortunately, a lot of women don't have a 28-day cycle, making it harder to pick the day of ovulation. If a diary is kept for the first day of menstrual bleeding, ovulation would occur 14 days before the next first day.  For example, if a woman's period starts 30 days after her last period then she likely ovulated on day 16 of her cycle.

Ovulation testing such as cervical mucus consistency, basal body temperature and urine dipstick testing is quite popular but not always very accurate. Regular intercourse around calculated ovulation day is as effective as ovulation testing in a woman with regular cycles.

How long is the fertile window?

Once an egg is ovulated it will only survive approximately 24 hours, so it is important to have sperm available during this time. Thankfully, sperm can live for up to 4 days so sex does not have to be highly timed for the day of ovulation and a fertile window can be used. This would include the 4 days before and up to 48 hours after estimated ovulation. It is important to have regular sex during the fertile window. The chance of conception each month is the same whether couples have sex everyday or every second day during the fertile window.

Sexual position has not been shown to increase pregnancy chances and although staying prone after sex may reduce semen leaking from the vagina it has been shown that sperm is present in the cervical canal within seconds of ejaculation and in the fallopian tube within 15 minutes.

Sexual position has not been shown to increase pregnancy chances and although staying prone after sex may reduce semen leaking from the vagina it has been shown that sperm is present in the cervical canal within seconds of ejaculation and in the fallopian tube within 15 minutes.

Lubricants

Some commonly used lubricants — such as KY jelly, olive oil and saliva — have been shown to negatively affect sperm motility, though this hasn't really been shown to reduce pregnancy chances in normally fertile couples. It is generally recommended that if lubricants are needed for sex that couples trying to conceive should preferentially use lubricants such as mineral oil or canola oil.

How to improve egg quality

Unlike sperm which is made in a 3-monthly cycle, eggs are created in a female foetus and no new eggs are then formed throughout a woman's life.  This effect of egg ageing as a woman gets older has a significant effect on the chance of conception after the age of 35 and the chance of conception is much lower for a woman in her 40s.

Over time there is increasing DNA damage inside eggs and this damage is very difficult for the body to repair.  This leads to an increased chance of poor-quality eggs being released as a woman gets older.

Improving egg quality is a major issue for older women trying to conceive, and there has been a lot of work around trying to improve this with supplements, including coenzyme Q10, Vitamin D, DHEAS and melatonin. These egg quality supplements are safe for use by women wishing to conceive at an older age but there is little robust evidence of their effectiveness.

If you would like more advice about complementary medicines that might help improve your chances to get pregnant naturally, please ask your fertility specialist.

When to see a fertility specialist

Advice from a fertility specialist does not have to be about IVF or other treatments, but can include just improving lifestyle measures and other natural ways to increase fertility. Advice can be sought at any time.

If you have been trying to conceive for more than 6 months regardless of your age, I would encourage you to raise this question with your family doctor and ask for a referral to a fertility specialist.  This would be particularly important if you are over 35 years old.

It would be highly recommended to seek specialist advice if there is a known fertility issue or if you have been trying to conceive for more than 12 months.

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