The basics of making a baby might seem simple, but the intricacies of fertility can be complex. We’re breaking it down and explaining the key aspects of fertility, plus simple steps you can take to support fertility.
Understanding the Menstrual Cycle
The menstrual cycle is a series of changes in hormone production that make pregnancy possible. It consists of four phases - menstruation (your period), the follicular phase, ovulation and the luteal phase.
Your menstrual cycle begins on the first day of your period and starts over when your next period begins. A typical menstrual cycle is 28 days, but cycles can range anywhere from 21 to 35 days.
The first part of the menstrual cycle is the follicular phase. About halfway through your cycle, one of your ovaries releases a mature egg. This is ovulation.
During the second part of the menstrual cycle (the luteal phase) the lining of your uterus thickens while the egg goes into one of your fallopian tubes where it waits to be fertilized by sperm.
If you get pregnant, the egg implants into the side of your uterus and you don’t get your period. If you don't get pregnant, the uterine lining sheds - this is your period.
How Does Conception Work?
For conception to happen, sperm must meet an egg inside the uterus. This means that sperm must be present in the uterus during the 12-24-hour period after ovulation. Timing sex to align with the fertile window (described below) is key!
If sperm and egg meet, the egg can become fertilized. The fertilized egg must then travel down the fallopian tube into the uterus and implant into the lining of the uterus where it continues to grow.
What is the Fertile Window?
The “fertile window” refers to the week during the menstrual cycle when conception is most likely to occur. This period of time includes the five days leading up to ovulation, the day of ovulation, and the day after ovulation.
This might feel like a long time, but sperm can live in your uterus for up to five days after ejaculation. So while there may not be an egg in your uterus yet, it is beneficial to have sperm waiting in the uterus when an egg is released. In addition to having sex before ovulation, it is also beneficial to have sex during ovulation, as well as the day after ovulation, since an egg can live in your uterus for 24 hours.
How do I Know When I am Ovulating?
Because the fertile window is defined by the period of time surrounding ovulation, it is important to know when you’re ovulating.
You can take a urine test to detect ovulation, and you can also keep an eye out for signs of ovulation in your body. These may include the following:
- Changes in cervical mucus
- Increased basal body temperature
- Pelvic cramping and pain
- Increased libido
- Vulva changes
- Breast tenderness
- Bloating and fluid retention
- Mood changes
- Appetite changes
- Heightened sense of smell
You can learn more about these signs of ovulation here.
Tips to Maximize Your Fertility
Eat a balanced diet
In general, a diet that includes primarily whole, unprocessed foods is ideal for supporting overall health and fertility. Some examples of specific foods to include in your diet can be found here.
Consider supplementation
Optimal nutrient intake is helpful at all stages of life, but it is especially during the nutritionally demanding perinatal phase, from fertility to postpartum.
Life can be busy and diets aren’t always perfect, but even the best diets require support. The amount of certain nutrients needed for optimal fertility health aren’t always available through food alone. In addition, our soil and the food it is grown in has become depleted of nutrients over time. This is where supplementation is so helpful.
A prenatal vitamin for women or a comprehensive multivitamin for men can help support your body with the vitamins, minerals, and antioxidants needed for optimal fertility.
Stress
Constant or chronic moderate or severe stress can negatively affect fertility. Learn more about the link between stress and fertility here.
Maintain a normal weight
Being both underweight or overweight can have a negative effect on fertility. Both male and female reproductive systems rely on an important balance of hormones to function properly, and body weight that is higher or lower than optimal can disrupt hormonal function.
Women who are obese or underweight have been shown to have a higher rate of infertility and a lower IVF pregnancy rate. Weight loss before pregnancy has shown some improved time to pregnancy in studies.
Obesity in men has been shown to negatively impact male fertility as it relates to sperm count and sperm motility (the rate at which sperm move). Insulin resistance and diabetes can complicate this even more.
What to Limit or Avoid if You’re Trying to Conceive
What you exclude from your diet and lifestyle is just as important as what you include when you are trying to conceive. Here are a few things to limit or avoid if you are trying to conceive.
Smoking / vaping
Smoking is associated with a greater risk of infertility. Vaping is newer and has been the subject of less research than smoking, but that which exists suggests it is also harmful to fertility, as well as general health.
Alcohol
A good rule of thumb when trying to get pregnant is to act like you’re already pregnant. This includes alcohol consumption. Research has suggested a link between decreased fertility and alcohol consumption.
Caffeine
Research is mixed on the effects of caffeine on fertility. Some research suggests that high amounts of caffeine may impact fertility in both men and women. Aim to keep caffeine consumption to a level that is safe in pregnancy - 200 mg or less per day. This is about one 12-ounce cup of coffee each day.
Diet Drinks
Research shows that aspartame, the sweetener used in most diet sodas, is linked with lower sperm count and can contribute to sperm DNA damage.
In women, research suggests that aspartame can suppress antioxidative activities and result in higher oxidative stress in the ovaries, and may alter fertility by reserving fewer follicles in the ovary and disrupting steroidogenesis in ovarian cells.
Endocrine Disrupting Chemicals
Chemicals found in many of our everyday household cleaning and personal care products can be detrimental to both male and female fertility.
Organizations like the Environmental Working Group have resources to help you identify potentially harmful chemicals in household and personal products.
Understanding Infertility
Studies suggest that 40% to 60% of couples younger than age 30 who are generally healthy are able to conceive in the first 3 months of trying.
Infertility is defined as not being able to become pregnant after having regular unprotected sex without birth control after one year (or after six months if a woman is 35 or older).
In the United States, About 9% of men and about 11% of women of reproductive age in the United States have experienced fertility problems.
About one-third of infertility cases are caused by fertility problems in women and another one-third of infertility cases are due to fertility problems in men. The other cases are caused by a mixture of male and female problems or by problems that cannot be determined.
Infertility in Women
Most cases of female infertility are caused by problems with ovulation. There are several reasons why a woman may have disrupted ovulation, including hormonal imbalances, polycystic ovarian syndrome (PCOS), hypothalamic dysfunction, and more.
Other less common causes of fertility problems in women can include physical problems with the uterus, fallopian tubes, or cervix.
Infertility in Men
There are many different causes of male infertility. This article discusses them in detail.
In some cases, for both men and women, the cause of infertility is never found. This is called unexplained fertility. A combination of several minor factors in both partners could cause unexplained fertility problems.
When to Talk to a Doctor
Fertility experts generally recommend fertility testing if you are under 35 and have been trying to conceive for at least a year, or over 35 and have been trying for at least six months.
However, certain circumstances may warrant seeing a fertility specialist sooner. Reach out to your healthcare provider when you decide to start trying to conceive if you or your partner has a history of any of the following:
- Irregular periods
- Pelvic inflammatory disease
- Repeated miscarriages
- Thyroid problems
- Cystic fibrosis
- Ectopic pregnancy
- Injury or trauma to the scrotum and testes
- Erectile dysfunction
- Problems ejaculating
