Everything to Know About Fertility
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Medically reviewed by Cordelia Nwankwo, MD
Fertility is all about the ability to conceive (get pregnant). Fertility can decline with age in both males and females. If you have been trying to conceive a child and it hasn't happened, you may be thinking about your fertility and any influencing factors that may or may not be important in increasing your odds.
This article will detail what affects fertility, how to increase fertility in females, how to increase fertility in males, and what you need to know about tracking fertility with ovulation. You'll also be directed to resources including clinics and support options for evaluating your fertility.
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Related: At-Home Fertility Tests to Help With Your Reproductive Health
What Affects Your Fertility?
Many factors can affect fertility. Experts say fertility challenges affect males and females equally, and it's just as likely that a combination of factors from both persons causes them. Some factors depend on biological sex and others are environmental causes.
What Is Sex and Gender?
Sex and gender are different. Sex is a biological and physiological designation whereas gender is a social construct. Sex is often referred to as male, female, or intersex, and gender exists on a spectrum ranging from male and female to non-binary, gender fluid, and gender non-conforming.
Causes of infertility for females include:
Menstrual cycle irregularities or lack of ovulation
Reproductive structure differences
Infections, including sexually transmitted infections (STIs)
Primary ovary insufficiency (POI)
Autoimmunity and Fertility
Autoimmune disorders such as rheumatoid arthritis or lupus, genetic disorders, and health conditions like diabetes and obesity can impact fertility in anyone.
Causes of infertility in males include a variety of health conditions that affect sperm health and transport which include:
Chromosome disorder
Hormone irregularities including sensitivity to testosterone
Thyroid-related or pituitary gland conditions
Testicle injury or structural difference
Varicocele
Varicocele creates blood flow problems in the testes which increases the temperature and negatively impacts sperm health. It's estimated some 15 out of every 100 males have varicoceles and that this does have some impact on sperm health and movement. However, experts also add that some 8 out of 10 males with a varicocele do not have fertility problems.
Other factors influencing fertility include:
Age (fertility declines as age increases)
Nutrition and exercise
Physical or mental stress
Smoking tobacco or cannabis
Cocaine or heroin use
Certain medications and body-building products that affect testosterone
Environmental pollution, organic pollutants
Cancer treatment (radiation and chemotherapy)
Related: What to Know About Cervical Cancer and Pregnancy
How to Increase Fertility in Females
There are many changes a person can make the help support their fertility. Increasing fertility is possible, but there are some unexplainable causes of infertility (i.e., the cause is not obvious or known).
Along with reducing physical and mental stress, experts suggest nutrition can significantly increase fertility. One 2021 literature review on the effect of nutrition on female fertility suggests following a Mediterranean diet may be a way to increase fertility and live birth rates.
Med Diet for Fertility?
The Mediterranean diet is filled with omega-3s, zinc, iron, lycopene, vitamin C, vitamin D, coenzyme Q10 and other nutrients from vegetables, fruits, olive oil, low-fait dairy and poultry, fish, with low consumption of red meat and refined sugars. Experts say these foods can help reduce the risk of conditions that affect fertility in both sexes, such as insulin resistance diabetes or obesity.
Certain supplements with antioxidant effects can also help support female fertility, specifically. They include:
Acetyl L-Carnitine
Folic acid
Other nutrients like vitamins B1, B2 (riboflavin), B3, B5, and B6 have been linked to female (and male) fertility and often appear in fertility supplements. However, one review of these particular B vitamins found no evidence to support claims of increasing fertility.
Female infertility can be treated with medication, surgery, intrauterine insemination (IU), and assisted reproductive technology (ART).
Related: IUI vs. IVF: Deciding Which Is Right for You
How to Increase Fertility in Males
The same healthy lifestyle recommended to females trying to conceive is also suggested for males. There are also specific recommendations for males you may have heard, including avoiding hot tubs that create an unfavorable environment for sperm in the testes which are outside of the body.
Certain supplements help reduce the risk of male infertility, although research results can be limited and inconsistent across studies. These nutritional and dietary supplements associated with male infertility include:
D-aspartic acid (D-AA): A form of amino acid found in glands such as testes. One controlled study, for example, found three grams daily of D-AA for two weeks increased male testosterone levels by 42%.
Calcium: Calcium deficiency has been shown to affect male sperm motility and health, which can impact male fertility.
Avoid soy products: Soy foods have been associated with reduced semen quality due to their rich isoflavone content.
Treatment for male infertility includes medicine if you have a hormone disorder causing infertility, surgery to remove any blockages in the genital tract, or structural challenges contributing to infertility.
What Is IVF?
IVF, or in vitro fertilization, is the most common method of assisted reproductive technology used to help someone conceive. It involves fertilizing an egg outside of the uterus in a lab setting. IVF success rates can be estimated by using the Centers for Disease Control and Prevention (CDC) IVF Success Estimator tool.
Related: An Overview of the Male Reproductive System
Tracking Fertility With Ovulation
People with a menstrual cycles can use a calendar method for tracking fertility with ovulation.
Calendar Method for Tracking Fertility
It's typical to ovulate some 12 to 14 days before a new menstrual cycle starts. The "fertile window" is said to be in the five days leading up to ovulation (plus the day of and the day after ovulation). This usually adds up to about a seven-day fertility window of a greater chance of conceiving each cycle.
It is advised to tacking your menstrual cycle for six months in order to collect enough data to determine your average length between menstruation and ovulation.
Related: When Are You the Most Fertile?
Clinics, Support, and Resources to Evaluate Your Fertility
You can find the success rate for fertility clinics around the country on the CDC's website. Bear in mind that numerous factors impact any individual clinic's record of success (including which couples they select to work with or how many clients they have helped over the years). Many deeply personal factors also play significant and overlapping roles in any person and any couple's fertility.
There are some tools online like that from Univfy you can use to get a general sense of your fertility based on your age, height, IVF history, and more. The best indicator of potential fertility treatment success is going to be an honest conversation with your healthcare provider. With your full health history, they are better equipped to give insight, and even then some things are still unexplainable when it comes to fertility and pregnancy.
Related: 9 Best Fertility Clinics of 2023
Summary
Fertility is about whether or not someone can conceive. Fertility is relevant to males and females trying to get pregnant. Many factors play into someone's fertility, including age, health condition, lifestyle, and more. There are ways to increase fertility, although not all are proven. The methods of improving fertility mentioned in this article include focusing on dietary means of increasing fertility. You can also track fertility with ovulation and consult with clinics and tools to evaluate your fertility.
