Patients ask me on a regular basis what they can do at home to improve their fertility naturally without taking medicine. While there have been some notable discoveries in the world of reproductive medicine that point to ways to optimize fertility, there is no “magic bullet” that routinely improves the odds for all couples. Still, if you are struggling to find answers and are willing to make a few lifestyle changes, the hassles may be far outweighed by the benefits.

Weight and Fertility

We know that women who are very thin and those who are overweight are both at greater risk for fertility problems. Your body mass index, or BMI, gives a gauge of your weight in proportion to your height. Normal is considered to be 18.5 to 25. General fertility and even in-vitro fertilization success is clearly diminished in patients with a BMI over 30. The good news is, research has shown that women in this category can significantly improve their chances of becoming pregnant with as little as 5% weight loss.

Women with a BMI of less than 20 may have low levels of leptin, a hormone made by fat cells that signals the brain that you have enough stored energy to meet the metabolic demands of pregnancy. For these women, gaining weight may be a key factor in improving fertility. Sometimes this means cutting back on exercise or changing the way you exercise—for example, changing from running to yoga.

Diet and Fertility

One of the most respected studies about diet and fertility was done at the Harvard School of Public Health, where researchers examined data from the Nurses’ Health Study. This study followed over 200,000 nurses for several decades with health questionnaires every two years. The authors concluded that avoiding trans fats and using unsaturated vegetable oils like olive oil and canola oil help fertility. Fats in general were not frowned upon in foods like whole milk or yogurt.

When it comes to carbs, “good carbs” like those found in oatmeal, beans and vegetables were fine. Simple carbs—foods that are processed and contain a lot of sugar—were found to be bad. As a general rule, if it comes in a wrapper or has more than one ingredient, think twice before you eat it. Protein intake was important, but relying on red meat alone was a no-no. Although red meat is high in iron—an important part of a successful diet—other sources or even supplements were better.

Hydration and Fertility

When it comes to what we should be drinking to improve fertility, the answer is simple: more water. Drinking soft drinks, whether they are sweetened or sugar-free, seems to decrease one’s overall chances of conceiving. Caffeine is not necessarily a bad thing. Drinking two or fewer cups of coffee daily does not seem to be harmful, but be careful what you put in it. Are the 410 calories in a mocha frappuccino really worth it, considering the 65 grams of simple carbs that it contains? A good rule of thumb to is to go 80/20: if you can maintain a healthy diet 80% of the time, mild sinning the other 20% of the time is acceptable. With coffee drinks, that may mean getting the smaller size and limiting the number of times you have one.

Alcohol and Fertility

Is alcohol completely off the list of personal indulgences? The short answer is no, but again, the mantra should be moderation. We do know that moderate to heavy drinking (more than two drinks per night) leads to hormonal changes in men and women and can impact fertility. Binge drinking (think football tailgating) seems to be especially detrimental. Since we do not fully know the impact of alcohol on fertility, most couples would be safest to drop it completely or limit themselves to just a few drinks a week during social gatherings.

Exercise and Fertility

I have heard more moaning and groaning about exercise than any other lifestyle factor modification that I have ever suggested to a patient. Do you have to exercise five times a week and get back down to the size you were in high school? No. But exercise helps our bodies break down fat, which both manufactures and stores hormones, so we are altering our hormone environment. Even if you’re not losing weight, you still reap benefits when you exercise for this reason.

Of course, there is also the other extreme, where women exercise too much and have very little body fat, and therefore little stored energy. Thin women who are avid exercisers, even when they are still having periods, quite often have relatively low ovarian hormone production and may be infertile because of it. While an unhealthy lifestyle is never encouraged, these women would do well to avoid the repetitive physiological stress that comes with strenuous exercise.

Vitamins and Supplements and Fertility

When it comes to supplements that are touted as “fertility boosters,” most have very little science to back up their claims. The other issue is that all nutraceuticals are exempt from inspection by the U.S. Food and Drug Administration, so you never know about the quality control or purity of the product you are buying.

Prenatal vitamins are always a good idea, especially those with iron and at least 1 milligram of folic acid. Folic acid should be taken before you try to conceive to help with cellular metabolism and avoid nervous system problems in developing fetuses. Other supplements for which there is at least some evidence for improving fertility are vitamin D, vitamin E, and CoQ10 or ubiquinol.

Most prenatal vitamins contain 400-800 units of vitamin D3, but most experts would agree that taking at least 3,000 units per day is helpful. This is especially true for women who may suffer with polycystic ovaries (PCO). Vitamin E at a dose of 400 mg per day can improve uterine blood flow and CoQ10 at 200 mg per day improves cellular metabolism and energy. Although the research on these last two is spotty, there is very little downside to taking them, and the potential upside is tremendous.

While it is possible to get pregnant without making healthy lifestyle changes, that does not mean that you should not optimize your chances. Your efforts may not fully correct your fertility problem, but they are apt to make your fertility treatment more effective.

For more answers to questions about infertility, sign up to attend Infertility: What You Need to Know, a brunch-and-learn event taking place from 9-11 a.m. Saturday, April 28 at the Courtyard Marriott Downtown. Find out more about Fertility Center of the Carolinas on their web page.

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