This information is not meant to diagnose or prescribe. Please seek appropriate advice from your health-care provider.

Fertility-Enhancing Tips for Couples

Many years ago I was teaching an herbal class. In it, we were discussing fertility and pregnancy. I was teaching much of the information in this article. Afterward, a female student, who was a medical lab technician in her early 30s, thanked me for the class. She said that she and her husband had been trying to conceive for several months with no luck, and now she understood why. They had been timing their intimate encounters at exactly the wrong times of the month because she did not understand fertility at all.

Even with all the information that is available on the internet, I find that many couples do not understand fertility, how their lifestyle affects it, and what they can do to enhance it.

Female Fertility

Women have obvious indicators of their ability to reproduce. The first and last menstrual cycles bookend the female reproductive years, although the presence of menstrual cycles does not guarantee fertility. Nor does the absence of menstrual cycles preclude fertility, although it usually suggests significantly lower fertility.

The menstrual cycles bring with them a myriad of symptoms that can often be easily grouped into fertile and non-fertile phases. This information can prove invaluable in helping fertile couples plan their families, less fertile couples achieve pregnancy, and infertile couples see where their challenges may be.

Predicting Ovulation

The first day of menstrual flow is considered to be the first day of the cycle. In a ‘typical’ (is there really such a thing?) 28-day cycle there will be three to five days of menstrual flow, followed by a few days with very little vaginal moisture or lubrication. Once the flow is finished, the lining of the uterus begins to rebuild to accommodate and nourish an embryo if fertilization occurs later on in the cycle.

Generally, by about day ten, a woman will notice a vaginal discharge. It begins as a ‘tacky’ substance. The consistency changes over the next few days to become much more slippery, much more abundant, and very stretchy, like an egg white. When the mucus stretches ten cm (four inches), fertility is at its peak. To optimize the chance of conception, intercourse should happen every 36 to 48 hours during these ‘wet’ or ‘mucusy’ days.

Then, quite suddenly, the mucus will be gone (although this is much less obvious if semen is present), and the fertile time is over. The take-away here is: vaginal mucus predicts impending ovulation.

How to Tell if You've Ovulated

Basal metabolic temperature can be used to confirm that ovulation has happened. Basal temperature is the lowest temperature the body reaches in a 24-hour period. Typically, this is just shortly before waking up.

Using a basal metabolic thermometer (available at most larger drug stores), which has been prepared the night before and left on the bedside table, the temperature is taken upon waking and before getting out of bed or engaging in any activity at all - including but not limited to rolling over to kiss your sweetheart good morning. The thermometer stays in place for five minutes.

It is important to take the temperature within a half-hour of the same time each day. If you normally arise at 6:00 AM, your temperature-taking window is 5:45 – 6:15 AM, even on weekends, but you are free to go back to sleep afterward if you like!

It is important to note the difference between a basal metabolic thermometer and a standard fever thermometer. The basal thermometer spans only a few degrees, marked in tenths of a degree. This is very precise! A fever thermometer covers several degrees, marked in fifths of a degree. In temperature charting for conception, variations smaller than tenths of a degree can be important. Having the right kind of thermometer makes analyzing your data so much more accurate and easy.

Taking the temperature vaginally is the most accurate way. The temperature may then be recorded on graph paper or on a website like I prefer fluid-filled thermometers (even though they are getting harder to find) to digital ones. If the batteries in the digital thermometer get weak, the readings may not be accurate.

Over the course of a menstrual cycle, the temperature in an ovulating woman does a predictable dance. Before ovulation, the temperature will be comparatively lower than after ovulation. After ovulation, the temperature will rise and will stay high. When there have been three consecutive high temperatures, ovulation has passed and the non-fertile phase has begun. The chart below shows an example of the temperature fluctuations in a normal cycle, as well as how to accurately record mucus and other symptoms. Temperature patterns that differ from this can suggest a variety of hormone imbalances that may affect fertility.

In order for an embryo to implant in the uterine lining, the woman ideally needs to have 12 - 16 consecutive high temperatures after ovulation. The high temperatures are caused by the balance between estrogen and progesterone. Progesterone, specifically, plays an important role in maintaining pregnancies.

Cycles that regularly have less than 10 high temperatures generally do not have enough progesterone to allow the embryo to implant well in the uterine lining, which means even if fertilization happens, pregnancy will not. There are herbs that can help to increase progesterone and may assist in maintaining a pregnancy in a woman who has lower than optimal progesterone levels.

Cervical Signs of Fertility

The position and firmness of the cervix can help to predict and confirm ovulation, also. The cervix can be checked by inserting one or two fingers fully into the vagina. Normally, with the pads of the fingers facing toward the front of the body, the cervix will be felt against the pads of the fingers as a fairly firm (like the tip of one’s nose) ring of tissue with a dimple in the middle.

As ovulation approaches, the cervix will rise higher in the vagina, and the angle will also shift so as to be felt with the tips of the fingers instead of the pads. It may rise so high that it is difficult to reach. I’ve fielded a few panicky phone calls of “I can’t find my cervix! Where did it go?”

The cervix will also soften to feel more like one’s lips. The ‘dimple’ will open. When ovulation is over, the cervix will return to its original lower position in the vagina, become firm again, and close.

Low Fertility

Some women have very little vaginal mucus, or the temperature shift is delicate. I have found this usually to be an indication that the hormones are either low or not properly balanced. Regardless of blood test results from the doctor, if the vaginal mucus is not copious, and/or if the temperature pattern is not obvious, I help my client correct them with herbs and diet. I have seen basal temperature charts that indicated very low fertility correct to become ‘textbook perfect’ within a few months by implementing the proper diet and supplement protocol.

Variable-Length or Longer Cycles

Ovulation does not always happen on day 14. In a ‘textbook’ cycle of 28 days it can happen anytime from 12 to 16 days before the next menstrual flow. It is the time before ovulation that is the most variable. If a woman has long cycles, ovulation will happen later in the cycle. A 35-day cycle, for instance, will often show ovulation at day 19 - 23. This is why it is so important for a couple who is trying to conceive to understand vaginal mucus and basal temperature, at the very least.

Cycles that average less than 25 days or more than 42 days are usually not fertile.

To recap: vaginal mucus starts before ovulation, is most copious and stretchy at ovulation, and disappears after ovulation. The cervix rises, opens, and gets softer at ovulation then drops, closes, and firms up when ovulation is complete. The first three consecutive high temperatures confirm that ovulation is over and the woman is no longer fertile in this cycle.

Enhancing Female Fertility

Here are the top six things, beyond dietary corrections (and that’s a topic for another post), that a woman can do to boost her fertility.

  1. Optimize your weight. Being underweight or overweight can delay the time it takes a woman to conceive. One study found that overweight women took twice as long to get pregnant. Being underweight quadrupled the time it took to conceive.
  2. Consuming coffee and/or alcohol can reduce fertility. Drinking two alcoholic beverages per day reduces fertility by up to 60%. Most sources recommend keeping caffeine to less than 200 mg per day, although some women are so sensitive that even just ½ cup of coffee or 50 mg of caffeine per day reduces their fertility.
  3. Stop smoking - including cigarettes and marijuana. Smoking affects how receptive the uterus is to the fertilized egg. It also can mess up the DNA in the egg and increases the risk of miscarriage.
  4. Choose personal lubricants wisely. While the vast majority of lubricants don’t kill sperm, they may not make it easier for sperm to get into the uterus. Products like Astroglide, KY Jelly, and Touch may inhibit sperm motility by 60 - 100%. Some doctors recommend using vegetable oil or coconut oil if lubrication is needed.
  5. Avoid harmful chemicals. Both prospective parents need to be aware of, and limit, exposure to chemicals. Farming, yard maintenance, household maintenance/cleaning, printing, dry cleaning, and art materials are just a few things to be aware of as potential places to be exposed to harmful chemicals. Many of these have actions that mimic human hormones and can alter both the female and male hormonal balance.
    6. Avoid getting overheated and avoid overexercising. Getting too warm, either from hot tubs, steam rooms, saunas, or exercise can reduce ovarian function. Women who exercise more than seven hours per week have a higher incidence of reduced fertility. For women who are undergoing treatment for in vitro fertilization, the limit on exercise is four hours per week.

If conception is not happening in spite of properly timed intercourse, or if the temperature and mucus are not behaving properly, the hormones are out of balance. Herbs and nutrition can be used to stabilize and support hormonal optimization. This is where it can be helpful to work with a practitioner who is well-versed in herbs and nutrition.

Enhancing Male Fertility

Because infertility challenges can originate with the male partner, he should have his sperm checked as a matter of course.

Slow or poorly formed sperm can often be corrected with nutrition and supplements, but remember, it takes 90 days to make sperm, so the following steps need to be long-term changes.

Here are the top eight things, in addition to food, that men need to do to enhance and protect their own fertility.

  1. Stop smoking cigarettes or marijuana. Smoking tobacco has been linked to low sperm counts and sluggish motility. Long-term use of marijuana can result in low sperm count and abnormally developed sperm.
  2. Decrease your drinking. Alcohol can reduce the production of the normally-formed sperm needed for a successful pregnancy.
  3. Watch your weight. Both overweight and underweight men can have fertility problems. With too much weight, there can be hormonal disturbances, and when a man is too lean, he can have decreased sperm count and functionality.
  4. Exercise in moderation. Excessive exercise could lower your sperm count indirectly by lowering the amount of testosterone in your body. And as you might have guessed, stay off the steroids -- they can cause testicular shrinkage, resulting in infertility.
  5. Value your vitamins. Low levels of vitamin C and zinc can cause sperm to clump together. Vitamin E can counteract excess free-oxygen radicals, which can also affect sperm quality.
  6. Eliminate coffee/caffeine consumption. The jury is still out on the question of if or how caffeine affects sperm count, morphology, and motility. Because there are conflicting reports, it may be prudent to eliminate coffee and caffeine, just in case the studies that report negative impacts are proven to be correct.
  7. Don’t delay sex to try to ‘save up’ the sperm. Going more than a week without sex allows the sperm count to increase but slows down their motility. A few studies show the best success rates with daily intercourse, but that may create its own unique stress as well. Intimacy every 36 - 48 hours during the woman’s fertile days tends to be a good balance for most couples.
  8. Avoid overheating of the testicles. Studies show that even as little as one-third of a degree Fahrenheit, regardless of the source of the heat, can harm the sperm count. 

If you would like support in working to enhance your fertility, give Judith Cobb a call at 403-850-5503 or use this link to schedule an appointment.