Have you been trying to get pregnant with no success? I've been there. You are not alone.
Infertility affects more and more couples each year. According to the Centers for Disease Control, as of 2010 about 6.7 million American women suffer from infertility. Infertility is defined as as the inability to conceive after one year of well-timed, unprotected intercourse (or after six months if the woman is over 35) or the inability to carry a viable pregnancy to live birth. It's important to remember that having infertility isn't just about not being able to conceive, but it also represents the inability to stay pregnant as well. Infertility isn't only about women, either. About 4 million males ages 25-44 in the U.S. experience some form of infertility.
So, what do you do now? Many fertility doctors will recommend treatments, but fertility treatments can be cost-prohibitive for many couples. Assisted reproductive technologies like IVF are used in less than 3 percent of infertility cases. IVF costs an average of $12,000-$15,000 per cycle, and associated medications may add as much as $3,000-$5,000 more. And generally, two or more IVF cycles are necessary to achieve pregnancy. Cost isn't the only factor -- there are the emotional costs, invasive procedures and time intensive treatment regimens to take into account as well.
Here's what you may not know: If you're struggling to get pregnant and you don't have a specific type of infertility where IVF is required, there are many factors completely in your control to help you improve your fertility.
I always knew I should eat and drink healthier, exercise daily and live as stress-free as possible. But I never understood the startling connection between these run-of-the-mill healthy lifestyle recommendations and their dramatic effect on my fertility.
I interviewed Conceivable founder Kirsten Karchmer, who shared recommendations based on her experience helping 7,000 couples improve their fertility. Kirsten is a renowned fertility expert and pioneer in integrative fertility. Her personalized fertility program helps women identify, understand and address specific, underlying health factors that may be limiting their natural fertility.
Karchmer is a voracious reader and total research nut. "It's important to me to make recommendations to women that are evidence based," says Karchmer as she shows me a huge stack of research she pulled for this article. "Empowering women with education is a huge part of my job. When I'm giving someone tips, I need it to be more than my opinion -- I'm interested in fertility facts."
Here are her top five tips to improving your fertility:
1. Reduce Animal Proteins and Increase Whole Foods in Your Diet
"One of the easiest ways to improve your fertility is to improve the quality of the fuel you put into your body," Karchmer tells me. "Women who are struggling to get pregnant often feel powerless, but even something as simple as increasing the amount of vegetables you eat can dramatically improve your overall health and fertility. Remember, what you eat forms the building blocks for a healthy uterine lining and optimal egg development; both are essential for conception and a healthy pregnancy."
In a large-scale study of women who had difficulty conceiving, scientists found that increasing the intake of animal protein, even by as little as one serving a day, resulted in a 32 percent higher likelihood of ovulatory infertility. Furthermore, researchers found that women who consumed plant proteins for as little as 5 percent of their total daily calories had a 50 percent decrease in their risk of ovulatory infertility.
Whole foods also play an important role. A low glycemic load, such as that created by low-carbohydrate and whole grain diets, appears to protect fertility. Women with high glycemic loads, the result of a diet high in processed and refined foods, were demonstrated to have nearly twice the risk of ovulatory infertility as women with low glycemic loads.
The RIGHT fats are key too. In a recent study, every 2 percent increase in calories consumed via unhealthy trans-fats increased the risk of ovulatory infertility by more than 70 percent. This was especially true when these trans-fats replaced fertility-friendly monounsaturated fats.
2. Drink, Drink, Drink... Water
Just as important as the foods you eat are the drinks you drink. Not drinking enough water -- or drinking too many unhealthy beverages like sodas, coffee or alcohol -- can lead to dehydration and negative effects upon your fertility.
"The more hydrated your cervical mucus is, the easier sperm can travel through it. Studies have found that sperm had the highest difficulty traveling through thick cervical mucus with low water content. So to give yourself the best chances of conception, we recommend decreasing your intake of dehydrating sodas and coffees and exchange hydrating smoothies, teas and most importantly, water," Karchmer explains.
If you're not a big water drinker, here's a suggestion that I found helpful when we were trying to get pregnant. Fill up a big cup of water every morning. Then set an alarm on your phone to go off every two hours during the day. When it beeps or buzzes, or sings (whatever you have your alarm ringtone set to), that means it's time to refill your water glass. Still full from the last time you filled it? Drink up!
3. Sleep Well
Are you getting enough sleep? "Sleep is essential for hormone regulation, which is a cornerstone of a healthy reproductive cycle," Kirsten explains. "Sleeping less than seven to eight hours per night has been associated with depressed leptin levels throughout the following day. Leptin is important because it controls a whole cascade of hormones -- GnRH, FSH, LH -- that regulate your menstrual cycle." Disturbances in leptin concentrations have also been linked with poor egg quality.
A lack of sleep also affects our stress levels. People with acute or prolonged sleep deprivation experience higher levels of stress and associated stress hormones, like cortisol, the following day. Higher cortisol levels are linked to more negative feelings of stress throughout the day and can reduce the chances of successful embryo implantation. Elevated cortisol has also been associated with higher levels of very early pregnancy loss. In a 2009 published by the National Academy of Sciences, pregnancies exposed to higher levels of cortisol were found to be 2.7 times more likely to end in miscarriage.
4. Exercise Moderately, But Don't Overdo It
"One of the questions I get asked the most in my clinic," says Karchmer, "is how much should I be exercising? People always want to know if they should join a boot camp, train for a marathon or get a membership to the new CrossFit gym down the street. Unfortunately, many of the solutions that are sold as 'good for us' can actually do more harm than good. You need to get moving, but dang, don't go out and punish yourself, sister. This is not the time to try to get back to what you weighed in high school."
Karchmer's solution? Get your body moving, but don't overdo it. Between one to five hours of moderate exercise per week is associated with an 18 percent average increase in women's fecundability, regardless of their initial weight, though overweight and obese women experience more benefit. However, over-exercising has also been linked to infertility. Lean women who exercised at high intensity five or more days a week were shown to be 2.3 times more likely to develop fertility difficulties than those who did not.
When we were struggling to conceive, I gave up hot yoga and soccer just in case they were too intensive for my body. Instead, I doubled the amount of time I walked each day.
5. Improve Your Mental Health
Multiple studies have shown how unregulated stress and anxiety may be extremely detrimental to one's fertility:
- The presence of stress significantly reduces the probability of conception during every day of the fertile window. Furthermore, as stress levels increase, the likelihood of fertilization decreases.
- Higher levels of mental stress are associated with a longer time-to-pregnancy, increasing one's risk of infertility.
- Maintaining positive moods and outlooks have been correlated with increased chances of delivering a live baby.
Meditation, yoga, massage, time with friends? Find whatever works to decrease your stress levels and stick to it.
These are just five small changes that could change your life. All of this is really good news for women who are struggling to conceive. Karchmer explains,
In my clinical experience, I saw that infertility was rarely caused by just a single factor. More often, it is a combination of many factors like exhaustion, poor nutrition, stress and sub-par menstrual cycles that create a kind of sub-clinical syndrome that has no name other than "unexplained infertility. The good news is that each and every one of those factors are completely correctable. It just takes a bit of detective work to identify which areas can be improved, and a plan with simple, repeatable steps, to address those factors. A little effort -- just the smallest baby steps, really -- can go a long, long way.
If I had to do it all over again, I would work on getting my body more fertility-friendly as soon as we started trying to get pregnant.