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Pregnancy
      Woman checking pregnancy test

      Fertility

      So, you want to have a baby and you are sure there are loads of things you’re supposed to know? Here is your pocket guide to everything you need to start your journey to becoming a parent.

      What is the meaning of being fertile?

      Being fertile means that a person or a couple can have a child through regular sexual activity within a year of trying to conceive1. Conception depends on a single sperm being able to fertilise an egg, which implants as an embryo in the uterus, grows into a foetus and is born as a baby. A simple enough process you may think, but actually it is an extraordinarily complex process, this making of another human being!

      When are woman & men most fertile?

      Lifestyle changes that positively affect all your health also improve your fertility, eggs and sperm need tender, loving care too! For example, stopping smoking6, reducing alcohol and caffeine, losing weight if you need to, doing exercise and getting enough sleep can all make a huge difference. Testicles don’t like being hot so men should try to wear loose fitting trousers and boxers and take showers rather than hot baths. Working out and exercise is great for both female and male fertility.

      Diet and fertility

      Think colour; the more the better. Fresh vegetables, berries, nuts and seeds, fish, eggs, olive oil, pulses and wholegrains are all stuffed full of nutrients that make healthy sperm and eggs. In general, try to follow the NHS EatWell Guide for a healthy, balanced diet.

      Balanced diet platter

      Vitamins for fertility

      As soon as you consider having a baby, women should take 400mcg of folic acid or folate which helps to prevent certain birth defects. It could be some time before you realise you are pregnant, and these early weeks can be critical. Vitamin D is important for both partners, especially if you have darker skin. And avoid vitamin A in supplements. Men need nutrients too, like zinc, selenium, folic acid, vitamin C and E. So, if you find it hard to always eat healthily, or you have any dietary restrictions, are vegan or vegetarian, it’s a good idea to take an all-round pre-conception multivitamin11

      Infertility

      Infertility is diagnosed if a couple have failed to conceive after one year of regular, unprotected (no contraception) vaginal intercourse12.

      Causes of infertility

      Infertility affects men and women equally. Older age, conditions like endometriosis, polycystic ovarian syndrome (PCOS), fibroids, blocked fallopian tubes, irregular cycles, hormonal abnormalities, being severely overweight or underweight may affect women’s fertility.

      For men, low sperm counts, immotile or abnormally shaped sperm, low testosterone levels, undescended testes, varicocele (varicose vein) on the testicle and obesity all affect fertility.

      For both, infection, poor diet and lifestyle and stress, either in your life generally or as a result of infertility, doesn’t help and sometimes couples are just not having enough sex13.

      Happy couple with results of pregnancy test

      Fertility options

      Investigation is absolutely key, so first see your GP. Hormone tests for both, a pelvic scan, a semen analysis and testicle examination are key. You may be a referred to a fertility clinic for further investigations. And then you just may need a little more help from assisted conception.

      Assisted conception

      IUI

      Intra Uterine Insemination (IUI) involves sperm that has been ‘washed’ to find the best quality and injected directly into the uterus when ovulation is about to occur14. IUI is the least invasive option, but also the least successful and women often have to undergo multiple cycles so it can be quite difficult to have on the NHS and you may have to go privately.

      IVF

      In-Vitro Fertilisation (IVF) involves women taking drugs that stimulate the ovaries to produce multiple eggs, which are removed and mixed with sperm that will hopefully fertilise them, and transferred into the uterus, supported by hormonal drugs15. Intra Cytoplasmic Sperm Injection (ICSI) is used for cases of severe male factor infertility; the best-looking sperm is actually injected into the egg16. IVF is quite an invasive procedure and the success rate is unfortunately low; about 28%, increasing the more cycles you have and the younger you are.

      Take home tips

      • If you are conceiving naturally, have plenty of sex.
      • Eat a healthy, balanced diet, take exercise, and have good sleep.
      • Give up smoking, reduce alcohol and caffeine.
      • Get help after one year, or six months if you are a women over 35.
      • There are other assisted conception options available.

      Melanie Brown

      Melanie Brown is a nutritional therapist with a special interest in the diagnosis and treatment of male infertility, endometriosis and recurrent miscarriage, as well as how the reproductive system microbiome affects these conditions.


      Read more

      1. World Health Organization (WHO) (2020) Fertility. https://www.who.int/news-room/fact-sheets/detail/infertility
      2. Chamani IJ, Keefe DL (2019) Epigenetics and Female Reproductive Ageing. Frontiers in Endocrinology 10:473 doi: 10.3389/fendo.2019.00473
      3. Sharma R. et al (2015) Effects of increased paternal age on sperm quality, reproductive outcome and associated epigenetic risks to offspring. Reproductive Biology and Endocrinology 13:35
      4. Steiner AZ, Long DL, Tanner C, Herring AH Effects of Vaginal Lubricants on Natural Fertility Obstetrics & Gynecology 120(1) 44-51 
      5. Watson LJ (2018) What’s the best time of day for sex? https://www.psychologytoday.com/gb/blog/married-and-still-doing-it/201809/whats-the-best-time-day-sex
      6. Budani MC, Tiboni GM (2017) Ovotoxicity of cigarette smoke: A systematic review of the literature. Reproductive Toxicology 72 164-181
      7. Scrott R, Murphy SK (2020) Cannabis use and the sperm epigenome: a budding concern? Environmental Epigenetics 1-10.
      8. Frisch RE. (1988) Fatness and Fertility. Scientific American 1;258(3):88-95.
      9. Karayiannis D et al (2017) Association between adherence to the Mediterranean Diet and semen quality parameters in male partners of couples attempting fertility. Human Reproduction 32(1)215-222
      10. Chiu YH, Chavarro JE, Souter I (2018) Diet and female fertility: Doctor, what should I eat? Fertility and Sterility 110(4) 560-569.
      11. NHS (UK) (2020) Vitamins and supplements for pregnancy. Start 4 Life. https://www.nhs.uk/start4life/pregnancy/vitamins-and-supplements-pregnancy/
      12. World Health Organization (WHO) (2020) Infertility. https://www.who.int/news-room/fact-sheets/detail/infertility
      13. NHS (2020) Infertility: Causes, Diagnosis, Treatment. Https://www.nhs.uk/conditions/infertility/
      14. Human Fertilisation and Embryology Authority (HFEA) (2020) IUI https://www.hfea.gov.uk/treatments/explore-all-treatments/intrauterine-insemination-iui/
      15. IVF. Overview (2020) https://www.nhs.uk/conditions/ivf/[ME1]

      Read more

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