If you struggle with fertility issues, you’re not alone. Approximately 11 percent of women and nine percent of men of reproductive age in North America are affected by infertility. While certain non-modifiable issues, such as autoimmune disorders and structural issues of the reproductive system, can negatively impact fertility, research has shown that making certain lifestyle modifications can improve your chances of conceiving. (31) Continue reading to learn more about the evidence-based lifestyle changes to improve fertility.

What is infertility?

The American Society of Reproductive Medicine (ASRM) defines infertility as the failure to conceive after one or more years of attempts to conceive. (32) Infertility is certainly not an exclusively female issue; approximately one-third of couples have trouble getting pregnant due to male infertility. (25)

Fertility declines with age in both men and women, however, this effect is much more pronounced in women. Women are approximately half as fertile in their 30s compared to their early 20s, and the chance of getting pregnant significantly declines after age 35. (25)

Image of couple.

Fertility issues affect both men and women.

What affects fertility?

A number of issues may contribute to female infertility, including:

  • Autoimmune disorders (e.g., lupus, Hashimoto’s thyroiditis, rheumatoid arthritis)
  • Diminished ovarian reserve
  • Health conditions affecting reproductive organs (e.g., endometriosis, uterine fibroids, polyps, polycystic ovary syndrome (PCOS), primary ovarian insufficiency)
  • Structural problems of the reproductive system (e.g., misshapen uterus, uterus scarring from previous injuries or infections) (22)

Some non-modifiable causes of male infertility include:

  • Cryptorchidism (undescended testicle)
  • Hyperprolactinemia (overproduction of prolactin hormone)
  • Testicle injury
  • Testicle swelling resulting from an infection such as mumps, gonorrhea, or chlamydia
  • Varicocele (enlarged veins in the scrotum) (23)

Certain lifestyle and environmental factors may also play a role in male and female infertility, including:

  • Being underweight
  • Chemotherapy and radiation therapy
  • Exposure to certain chemicals (e.g., herbicides, pesticides, pollutants, and endocrine-disrupting chemicals)
  • Hypertension
  • Obesity
  • Poor diet
  • Strenuous physical activity and excessive exercise
  • Substance use (e.g., tobacco, illicit drugs, alcohol) (24)

Did you know? According to the World Health Organization (WHO), up to 80 million women worldwide are affected by infertility, with an even greater prevalence in developing countries. (32)

How to improve fertility

Addressing certain modifiable risk factors can help improve fertility in both men and women.

Maintain a healthy weight

One study found that 96.5% of men with metabolic syndrome experience erectile dysfunction. Obese men are also three times more likely to have lower semen quality than men with a normal body mass index (BMI). (14)

Research has indicated that women with a BMI over 30, classified as obese, may take longer to conceive than women with BMIs between 20 and 25. (17) Furthermore, one systematic review found that miscarriage rates in obese women were 13.6% compared to 10.7% in women of a healthy weight. Obese women are also more likely to experience repeated, early miscarriages than women with a normal BMI. (4)

Being underweight is also a risk factor for infertility issues. Women who are underweight experience a higher risk of ovulatory disorder infertility, and men with low BMIs have been shown to have lower sperm quality than men of normal weight. (11)(26)

The best way to maintain or achieve a healthy weight is to engage in regular physical activity, eat a varied diet rich in nutrient-dense foods, and be mindful of portion sizes. (19)(21)

Note: Some medical conditions may have a direct impact on weight gain or weight loss, in which case it is critical to work with a qualified practitioner to address existing conditions first.

Follow a healthy diet

Dietary patterns may influence male and female fertility. Following a diet similar to the recommendations outlined by the U.S. Dietary Guidelines for Americans, which promotes the consumption of fruits, vegetables, whole grains, healthy monounsaturated and polyunsaturated fats, lean animal proteins, and seafood, has been associated with improved male and female fertility. (32)

Some studies have also suggested that men who follow the Mediterranean diet have better quality sperm than men who follow a dietary pattern similar to the Standard American diet, which is rich in processed meat, sugar-sweetened beverages, and desserts. (30)

Minimize caffeine and alcohol consumption

One study demonstrated an association between daily consumption of over 500 mg of caffeine (equivalent to about four cups of coffee) and delayed conception in women. (3) Results from research examining the connection between caffeine intake and male infertility have been inconclusive, however, one study proposed that caffeine intake may diminish reproductive function, likely through sperm DNA damage. (29)

Several studies have also found a link between alcohol consumption and impaired fertility. A meta-analysis of 57 studies found a link between alcohol consumption and decreased sperm volume. (13) Furthermore, alcohol has been associated with testicular atrophy, decreased libido, and lower sperm count. (7)(16) Heavy alcohol use may negatively impact ovarian reserve and fecundability, which is the probability of conception within one menstrual cycle. (34) One study of young women found that regular binge drinking significantly reduces anti-Müllerian hormone (AMH) levels, a hormone produced in ovary follicles and an indicator of ovarian reserve, compared to women who drink but abstain from binge drinking. (12) Additional research suggests that women who suffer from alcoholism may enter menopause earlier than non-alcoholics, therefore reducing their number of reproductive years. (33)(34)

Manage stress

Researchers have identified a connection between stress and fertility. In men, stress is associated with decreased sperm concentration and motility. One study of 950 men concluded that stress, such as stress experienced as a result of their job or life events, significantly diminished sperm density and total sperm count. (13)

Stress also negatively impacts female fertility. Research has indicated an association between increased stress and decreased likelihood of egg fertilization. The exact cause of this effect is not well understood, however, it’s believed to be a result of increased levels of stress hormones. (31) One study found that women who worked more than 32 hours per week took longer to conceive than women who worked between 16 and 32 hours weekly, likely attributed to work-induced stress. (17)

Stress can be managed in numerous ways, including engaging in regular physical activity, practicing meditation and yoga, staying connected with friends and loved ones, and speaking with a trusted mental health professional. (18)(20)

Managing your weight and keeping stress levels in check are two of the best lifestyle changes for fertility.

Minimize exposure to environmental toxins

Long-term exposure to certain harmful chemicals, such as organic solvents, heavy metals, pesticides, and herbicides, has been shown to negatively impact male and female fertility, and has been associated with recurrent miscarriages. (32) Avoiding all toxic chemicals is nearly impossible, however, taking intentional steps to minimize your exposure whenever possible can help. (32)

One measure to minimize exposure to herbicides and pesticides is to consume organically grown produce or select your produce using the 2020 Environmental Working Group’s (EWG) dirty dozen and clean fifteen recommendations. EWG’s guidelines provide a helpful list that identifies fruits and vegetables with the highest and lowest pesticide residue. (27)(8)

Use the EWG’s dirty dozen and clean fifteen recommendations to guide your purchasing decisions. (8)

To further minimize toxin exposure, use a high-quality water filter to remove heavy metals commonly found in the water supply, consider an air filter to combat indoor air pollution, and choose non-toxic personal care products and cleaning supplies. (1)(36)(2)(10) Limit the use of plastic containers and lined cans, which often contain bisphenol A (BPA), an endocrine-disrupting chemical known to have adverse effects on male and female reproductive function. (6)

Did you know? BPA, a chemical with the potential to diminish fertility, is found in receipt paper (thermal receipts). To limit exposure, opt for digital receipts at stores or avoid touching the printed side of the paper. (6)

Avoid cigarettes

Several studies have found that men who smoke before and while trying to conceive have lower semen volume, as well as total sperm count, motility, and density compared to non-smokers. (13)(5)(15) Smoking cessation has been shown to significantly improve physiological and sexual health in men. (9) One study also demonstrated that sperm quality significantly improved within three months of quitting smoking. (28)

Women who smoke have a significantly higher risk of experiencing infertility compared to non-smoking women. It’s suggested that smoking impairs ovarian function and reduces ovarian reserves. (31) The good news is that quitting smoking can improve your odds of conceiving. (35)

If you currently smoke and are seeking help to quit, consult your practitioner for guidance or find a smoking cessation program that suits your needs.

The bottom line

An extensive body of research has identified a clear connection between lifestyle and fertility. Male and female fertility is affected by numerous lifestyle habits, including maintaining a normal weight, following a healthy diet, and practicing stress management techniques. If you’re having trouble conceiving, consult your practitioner or a fertility specialist for a proper evaluation.

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