Dr Michael Eisenberg, twoplus fertility www.twoplusfertility.com
Many couples dream of starting a family, but conceiving naturally isn’t straightforward for everyone. Whilst it may feel overwhelming, fertility issues are more common than you think: 1-in-7 UK couples may have difficulty conceiving (a).
This can be very upsetting, especially if you’ve been trying for a long time. However, there is no one-size-fits-all solution to fertility; each couple has individual circumstances and must be treated holistically.
Fertility issues are generally perceived to be a female health problem. However, male factors such as poor sperm count and motility also affect a couple’s ability to conceive. The average man now carries around half as much sperm compared to 40 years ago (b) and most sperm don’t naturally make it very far into the female reproductive tract (c).
Age is also a factor, women are born with a set number of eggs, which decreases as they age. The quality of these eggs also declines with time (2). Men over 40 are more likely to have trouble conceiving. Although men produce sperm throughout life, the quality decreases with age (3). With couples increasingly focusing on their careers or trying to find financial stability before starting a family, age can become a key consideration.
In some cases, there are physiological problems at play. Some women don’t ovulate due to conditions like polycystic ovarian syndrome (PCOS), diminished ovarian reserve (DOR), hormonal problems, premature menopause, Fallopian tube obstruction, endometriosis, or physical abnormalities in the uterus (2).
Male infertility can be due to a lack of sperm, sperm abnormalities, or sperm movement issues. Problems in the testicles due to an injury, cancer, surgery, blockage, or infection can also influence the semen quality. Some men may also experience ejaculation problems or they don’t produce enough hormones to make sperm (4). Certain genetic conditions like Klinefelter’s syndrome or Y-chromosome defects may also decrease sperm production (2).
Assuming there are no physiological problems, lifestyle factors can have an impact on fertility. Being overweight, stressed, sleeping poorly, and overeating junk food can affect your overall health and wellbeing, including your chances of getting pregnant. Excessive drinking and smoking are also risk factors (2).
Talk to your GP if you’re going through any medical treatment or taking regular medication. Exposure to certain medications, hormones, radiation, and environmental toxins can cause changes in your body that lead to infertility (2).
If you have been trying for a baby for more than six months, it might be time to get help, but before seeing a fertility doctor, you may want to consider how to maximise your chances of natural conception at home:
Diet
Avoiding fast food is a good idea if you’re trying to have a baby. One study showed that trans-fat intake was associated with lower fecundity (5). Other studies show that a diet rich in omega-3 polyunsaturated fatty acids, protein from vegetables, whole grains, low-glycemic carbohydrates, dairy food, and iron is associated with a higher chance of getting pregnant (5).
Men should also follow a healthy diet since some nutrients are essential for the health of the sperm, such as omega-3, vitamin E, vitamin C, β-carotene, selenium, zinc, vitamin D, and folate (5).
Regular Sex
The pressure to get pregnant can make a couple stressed and affect their sexual relationship. However, studies show that couples who have sex every other day have more chances of conceiving than those who have sex less often (once a week) (6). Avoid making sexual activity an obligation and try to make it pleasurable, rather than a chore.
Timing is another thing to consider. The peak of fertility can vary even in women with regular cycles (6). One way of predicting ovulation is through vaginal secretion analysis. When it’s slippery and clear, the probability of conception is highest. Ovulation predictor kits or cycle tracking can also help (6).
Moderate Alcohol and Caffeine Intake. Avoid Tobacco
Women trying to get pregnant should avoid drinking more than two drinks a day (10 g of alcohol) (6).
High levels of caffeine consumption (more than 5 cups of coffee per day) have also been associated with decreased fertility (6). Finally, people who smoke are more likely to have fertility issues (6).
Vaginal Lubricants
Some water-based vaginal lubricants may decrease sperm movements due to the chemical composition. Specialists recommend using mineral oil, canola oil, or hydroxyethyl cellulose-based lubricants when necessary (6).
Maximising Sperm Transport to the Egg
It is a common misconception that only a single sperm is needed to reach the egg for fertilisation to occur. In fact, successful fertilisation requires many sperm to prepare the way for the final ‘survivor.’
For that to happen, a few million sperm need to reach the uterus. However, most sperm that remain in the vaginal tract after sex can’t survive in the vagina’s acidic environment.
The twoplus Sperm Guide aims to increase the chances of natural conception by avoiding semen leakage during sex. This small, comfortable device used during sex helps sperm get to the right place. The device mimics cervical cap insemination, preventing leakage of sperm after sex, while also increasing the amount of sperm which reaches the cervical mucus. Without intervention, less than 1% of sperm reach the egg. The sperm guide has been shown in in-vitro testing to increase the effective sperm count by approximately eight times.
Finally, the most important thing to remember is if you have been trying to conceive without success try not to get too stressed or anxious – stress itself can contribute to the problem.
References
- NHS data https://www.nhs.uk/conditions/infertility/
- H. Levine et al., “Temporal trends in sperm count: a systematic review and meta-regression analysis,” Human Reproduction Update, vol. 23, no. 6, pp. 646-659, 2017.).
- reference-S. S. Suarez and A. A. Pacey, “Sperm transport in the female reproductive tract,” Human Reproduction Update, vol. 12, no. 1, pp. 23-37, 2005.
1. How common is infertility? NIH. [Internet]. [cited 2021 Apr 8]. Available from: https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common
2. Fertility. CDC [Internet]. [cited 2021 Apr 8]. Available from: https://www.cdc.gov/reproductivehealth/infertility/index.htm#:~:text=About 6%25 of married women, to term (impaired fecundity).
3. Collodel G, Ferretti F, Masini M, Gualtieri G, Moretti E. Influence of age on sperm characteristics evaluated by light and electron microscopies. Sci Rep. 2021 Mar;11(1):4989.
4. Public Health England N. Infertility causes [Internet]. [cited 2021 Apr 8]. Available from: https://www.nhs.uk/conditions/infertility/causes/
5. Carvalho BR de, Barcelos IDES, Medeiros SF de, Benetti-Pinto CL, Yela DA, Nácul AP, et al. Increasing the Chances of Natural Conception: Opinion Statement from the the Brazilian Federation of Gynecology and Obstetrics Associations-FEBRASGO Committee of Gynecological Endocrinology. Rev Bras Ginecol e Obs. 2019;41:183–90.
6. Pfeifer S, Butts S, Fossum G, Gracia C, La Barbera A, Mersereau J, et al. Optimizing natural fertility: a committee opinion. Fertil Steril. 2017;107(1):52–8.
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