Watch Your Weight
Aside from the other risks it poses to your health, excess body fat can lead to an overproduction of certain hormones that disrupt ovulation. Your cycles may be less regular, you may ovulate less often, and you lower your chances of getting pregnant. On the flip side, too little body fat means your body may not produce enough hormones to ovulate each month or to sustain a pregnancy if you do conceive. Exercise can help you maintain a healthy weight. Just don't overdo it, says Christopher Williams, MD, a reproductive endocrinologist at the University of Virginia, in Charlottesville, and author of The Fastest Way to Get Pregnant Naturally (Hyperion). Women who exercise intensely (like long-distance runners or competitive athletes) may stop ovulating or ovulate less frequently. Overexercising also raises miscarriage risk. Talk to your doctor or midwife about your workout routine before trying to get pregnant.
Staying well nourished boosts your odds of conceiving. Make sure to include enough protein, iron, zinc, and vitamin C, because deficiencies in these nutrients have been linked to lengthened menstrual cycles (and therefore less frequent ovulation) and a higher risk of early miscarriage. Women athletes are prone to being deficient in zinc, Dr. Williams says. "Oysters are a rich source, but it's probably easier for most women to get zinc -- plus all other essential vitamins and minerals -- from a daily multivitamin supplement." Also include protein-rich foods in your diet, such as meat, fish, low-fat dairy products, eggs, and beans. Vegetarians can get their complete amino acids by including flavorful combinations of protein-containing foods, such as rice and beans or stir-fry with tofu.
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Kick Butt (Cigarettes, That Is)
As if you needed another reason to quit smoking: Cigarette toxins not only damage a woman's eggs, interfering with the fertilization and implantation process, but also cause the ovaries to age. That means that the ovaries of a 35-year-old smoker function as if they belong to a 42-year-old and are therefore less fertile, says Robert Barbieri, MD, head of obstetrics and gynecology at Brigham and Women's Hospital, in Boston, and coauthor of 6 Steps to Increased Fertility (Simon & Schuster). "Smoking does permanent damage to your fertility, but when you cut out cigarettes, you get some ovarian function back."
Know Your Cycle
A normal menstrual cycle lasts about 25 to 35 days (start counting on the first day of your period). If your cycle is noticeably longer -- say, 42 days -- you can assume you're ovulating less often and may want to see your ob-gyn or midwife, says Michael Soules, MD, past president of the American Society for Reproductive Medicine and managing partner of Seattle Reproductive Medicine, a fertility clinic in Seattle, Washington. When you're ready to conceive, find your "fertile window," during which you should have intercourse regularly. A woman's fertile days are usually the day of ovulation and the four of five days before, not after. But don't assume that you automatically ovulate on day 14 of your cycle: A study from the National Institute of Environmental Health Sciences found that ovulation varies dramatically from woman to woman, occurring as early as day 6 and as late as day 21 of a cycle. How can you determine when you're ovulating? You can try an ovulation test kit, which checks for certain hormones in your urine, or note daily changes in your basal body temperature and cervical mucus.
Stress and depression may hamper your fertility. A Danish study, which followed 393 couples who were trying to get pregnant, found that women were less likely to conceive during months when they reported psychological distress. Experts suspect that stress, like heavy exercise, may throw off your body's hormone production, making your menstrual cycle less reliable. But learning to manage stress through relaxation techniques (such as mindfulness meditation or yoga) or support from a counselor or a group, can get your hormones back on track, Dr. Barbieri says.
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Think Before Drinking
A growing body of research has linked alcohol consumption with a decreased ability to get pregnant (not to mention the harm it can cause to a developing fetus). Alcohol alters estrogen levels, which may interfere with egg implantation, although pouring an occasional glass of Pinot with your dinner is unlikely to harm fertility. You should also consider cutting back on caffeine while you try to conceive and during your pregnancy. A recent study published in the American Journal of Obstetrics and Gynecology found that women who drank the equivalent found in two cups of coffee were twice as likely to miscarry as those who didn't consume any. The bottom line: If you're thinking about getting pregnant, be a teetotaler and limit your daily java fix.
Get Busy in the Bedroom
If the demands of your hectic life have dampened your sex drive, it's a good idea to start having sex more often. Some research suggests that women who engage in regular (at least weekly) intercourse are more likely to have predictable menstrual cycles and normal ovulation than women who have sporadic sex. One theory: Your husband emits sex hormones that influence your reproductive system. Weekly sex may also make you produce more estrogen. And there's no question that frequent sex helps when you're actually trying to conceive. Having sex every 36 to 48 hours in the few days before ovulation will make the most of your fertile window, Dr. Williams says. But because mandatory sex on certain days can become a chore, you might also try making love every few days all month long.
This can wipe out normal, protective bacteria in the vagina, shifting the balance and putting you at risk for bacterial vaginosis, a common but often overlooked vaginal infection. A fishy odor and grayish discharge are often the only signs. Untreated BV has been linked to preterm labor and may be associated with higher risk of miscarriage and infertility. See your healthcare provider if you notice any new vaginal symptoms (itchiness, burning, unusual discharge, or sores). A reproductive-tract infection is unlikely, but it's best to be safe when your fertility is at stake.
Protect It with the Pill
Yes, the birth-control pill may actually enhance your fertility. "I suspect that oral contraceptives, which halt ovulation, quiet down your reproductive system, protecting your ovaries from aging," Dr. Barbieri says. For some women, the pill can be critical in preserving fertility because it keeps two common conditions, endometriosis and uterine fibroids, under control by slowing uterine-tissue growth. (With endometriosis, uterine tissue grows outside the uterus, causing painful cramps and often harming the fallopian tubes or other organs. Uterine fibroids are benign growth that can make pregnancy difficult or impossible.) Once you go off birth-control pills, your cycle will return to its pre-pill pattern in about a month.
Don't Overlook His Health
The same things that harm your fertility can do a number on your husband's reproductive health too. Cigarettes, alcohol, a poor diet -- any of these can contribute to lower sperm production or motility (ability to swim). Studies have also traced chromosomal damage in sperm to cigarette smoke and heavy alcohol intake. Getting enough nutrients every day -- particularly vitamins E and C and the mineral selenium -- will help him produce healthy sperm. Taking a daily multivitamin is a good step, Dr. Williams says. "It takes almost three months for a man to make new sperm, so he needs to think ahead too."
Used with permission from the November 2001 issue of Parents magazine. Updated March 2008.
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