Ask The Doctor: Do's and Don'ts for Enhancing Fertility

I have been trying unsuccessfully to get pregnant for the last two years. What can my husband and I do?
By Jacob Teitelbaum, MD

Actually there are a number of things you can do—and certain things you shouldn’t do—to increase your chances of conceiving. First, here’s a list of what you should give up:

• Stop or cut back on drinking coffee. Having more than four cups a day (or quite possibly, any at all) can result in infertility. In fact, some researchers joke that coffee acts as a reasonable form of birth control (I wouldn’t rely on it, though!).

• Stop drinking alcohol, especially if you have trouble ovulating. Even one drink a day can increase infertility by 30 percent; two drinks a day doubles that percentage. The reason? Alcohol increases the hormone prolactin, which inhibits the two hormones necessary for ovulation: FSH and GnRH.

• Don’t take melatonin supplements, which people often use to help them sleep. Melatonin can raise prolactin levels, too, and may result in temporary infertility.

• If you douche, stop. A recent study suggests that douching can also temporarily decrease the probability of getting pregnant by about 30 percent.

• Watch your vitamin C intake. If you are taking 1,000 mg a day or more, decrease that to 500 mg a day.

• Give up caffeinated sodas—even one a day can decrease your ability to conceive by 50 percent.

So what can you do to get pregnant?
• Take vitamins. Start with a good multivitamin with folate and magnesium. Add extra vitamin B6 (approximately 50 mg daily). This is especially helpful if you have irregular—or no—periods.

• Be sure your iron levels are adequate. A blood test (a ferritin level combined with an iron level and iron binding capacity) will tell you this. Although a ferritin level of 9 shows you have enough iron to prevent anemia, you can be infertile with ferritin levels that are less than 40 ng per ml. In a study of women with infertility who had ferritin levels less than 40, half of them quickly became pregnant when put on iron supplements.

• Get your thyroid levels checked. Even if they test within the normal range, if you have a tendency to be constipated, intolerant to cold, have dry skin or thinning hair, and your temperature hovers around 98.2 degrees or less, there’s a good chance that your thyroid is slightly underactive.

What about your husband? Research suggests that sperm counts are dropping throughout the industrialized world. There’s a good possibility this is coming from chemicals, especially pesticides, which mimic estrogen effects in the body. In many countries this has become an area of major concern. It’s interesting to note that, according to studies, sperm counts of organic farmers have increased, whereas farmers using pesticides have seen a decrease in theirs. Much like for women, men should refrain from using melatonin and stop drinking alcohol. If your husband takes any blood pressure or cholesterol medicine, have him talk to his doctor. Medications such as verapamil and nifidipine can cause reversible infertility. Here are some suggestions to increase sperm motility (ability to move):
• Up his intake of vitamin C to 1,000 mg a day (unlike the advice for women), which has a marked effect on sperm count and motility. Taking 500 mg twice a day, for example, can cure infertility in 20 percent of infertile males.

• Take astragalus. One study showed this herb could increase sperm motility by about 50 percent.
• Add higher doses of intramuscular vitamin B12 to increase sperm counts. Intramuscular vitamin B12 is, by definition, given by injection. Although tablets might be helpful, you can only absorb a fraction of the B12 taken this way.

• Take 50 mg of zinc daily for four months. If you have history of Alzheimer’s in your family, decrease your daily allotment to 15 mg.

• Add the amino acids L-carnitine (3 grams a day for 4 months) and L-arginine aspartate (9 grams a day for low motility or 4 grams for low sperm counts).

• Buy a good multivitamin, one that contains selenium (up to 200 mcg a day) and vitamin E (no more than 400 IU a day) to increase fertility.

What can you do as a couple? Doctors used to tell women that frequent intercourse before and during ovulation would decrease their chances of getting pregnant. Luckily, that’s just a myth—make love as often as you like three to four days before ovulation and, of course, during ovulation. Play with newborns. Be around children instead of shying away from them. Let yourself relax, and let the process of getting pregnant be fun instead of a chore or task that requires you to pay attention to every detail. Let go! Once you’ve done the things I’ve suggested above, your work is done; now it’s time to let your body and your mind do their part.