optimising your fertility

Optimising and Preserving your Fertility

Infertility facts and figures

It is estimated that about 1 in 9 Australian couples of reproductive age have difficulty conceiving, about 40 percent of infertility is due to a male factor, and about 40 percent due to a female factor, and about 20 percent from a combination of factors or unknown reason. In women under 40 more than eight out of 10 couples will conceive within one year if they are having regular intercourse and 9 out of 10 will be pregnant within 2 years.

Chinese Medicine, Health Preservation and Fertility

Chinese Medicine has a rich tradition of improving overall health and reducing factors that contribute to infertility such as stress, anxiety, and poor nutrition.

Modern practitioners of Chinese Medicine frequently see well informed patients who are seeking to optimise and prolong their fertility. Modern life easily damages the vitality of the mind and body. Inappropriate diet, irregular eating patterns, lack of sleep, overwork, exposure to external pathogenic factors and constitutional factors can all adversely affect fertility. Couples are increasingly leaving starting a family until later in life, when according to Chinese Medicine their Qi and Jing essence is not optimal for conception. Furthermore, the emotional stress experienced by couples who are having problems conceiving can damage health, fertility, and relationships. Chinese Medicine may aid patients’ decision making and bring benefits to their overall health, wellbeing, and fertility.

Ageing and Fertility

The age at which people start trying for a family has been rising year on year, and in Australia in 2021, one in 22 babies were born to women aged 40 and over. In 2021, more 60 percent of babies were born to women over 30 and 65% to men aged 30 or older.

The average age of first-time mothers in Australia in 2021 has risen to 29.7 compared with 28.4 in 2011. Fertility declines with age; female fertility peaks in the twenties and begins to decline rapidly from around the age of 35. At 30 years the chance of conceiving each month is about 20 percent and at 40 years it has reduced to just 5 percent also the quality and number of eggs declines.

When treating infertility due to age and current health, Chinese Medicine practitioners look to improve egg and sperm quality through reducing stress and improving circulation of energy and blood, which is lacking in Western Medicine.

Sexual Behaviour

Sexuality and fertility are connected as sexual problems can be involved in an inability to conceive and vice versa. Increased frequency of sex has been found to increase the chances of conception. In a regular 28-day cycle intercourse every one to three days has been found to be optimal, in addition regular sex during IVF cycles may also improve pregnancy rates since exposure to semen has been shown to promote embryo development and implantation in animals.

Another factor is erectile dysfunction in men and low libido in both men and women. Vaginal lubricants and other substances to aid dryness and prevent pain during intercourse may be detrimental to sperm and cause motility issues. Trying to time intercourse with ovulation, although helpful can be another factor affecting sexual performance as it can increase anxiety.

Alcohol

Excessive alcohol consumption has been found to be associated with Infertility. Negative effects include increased time to conception, anovulation, luteal phase dysfunction, poor or abnormal embryo development.

In men heavy alcohol consumption can negatively impact libido, sperm quality and motility.

Smoking

Research consistently demonstrates that smoking negatively impacts both male and female fertility, increasing the risk of miscarriage and ectopic pregnancy, and affecting semen quality and count, and reducing the chances of successful IVF.

Caffeine

Studies suggest that there is an increase in average time to conception of 9.5 months in women who drink caffeinated beverages. Current studies suggest women who are trying to conceive reduce caffeine consumption to less than 200 milligrams a day but there are no specific guidelines.

Diet and Supplementation

Fertility can be adversely affected in both women and men by excess intake of protein, fat, carbohydrate, and dairy; a diet with a high glycaemic load is associated with an increased risk of infertility.

Studies have reported that a diet high in foods rich in antioxidants – ideally including fruits, vegetables, grass-fed meats, nuts, seeds, and seafood – may protect against oxidative stress. Supplementation of dehydroepiandrosterone (DHEA) has been proposed to benefit women with diminished ovarian reserve by increasing egg quality and availability.

Body Weight and Body Mass Index (BMI)

Women with a low BMI are likely to experience amenorrhoea and are more likely to miscarry or give birth pre-term, while the chances of miscarriage are increased and the risk of still birth doubled in women with a BMI of over 30.

Underweight men have lower sperm concentrations, while obesity is linked to erectile dysfunction, and poor semen quality and quantity.

Exercise

Regular and moderate exercise has been shown to improve blood flow and reduce oxidative stress which may improve fertility. Women with a high BMI see improvement in their fertility with moderate exercise.

Recreational Drugs

The use of recreational drugs is associated with subfertility in both men and women.

Stress and Overwork

The likelihood of natural conception is reduced when stress levels are high, a recent American study of 501 couples over 12 months found a 29 percent reduction in fertility and a two-fold increase in the risk of infertility in couples demonstrating high levels of stress. Timing of IVF treatment when stress levels are minimal is therefore advisable.

Conclusion

To maximise the chances of healthy conception, pregnancy and birth, here is a summary of patient recommendations:

  1. Where possible and appropriate, attempt conception prior to 30 years of age in women and prior to 35 years in men.
  2. Reduce alcohol consumption, especially prior to and during IVF, but allow for the occasional drink.
  3. Give up smoking.
  4. Eat a plant-based diet high in good fats and antioxidants such as a Mediterranean diet. Avoid low-fat dairy foods in favour of the full–fat variety. Spend time outside to increase vitamin D levels. Take a folic acid supplement (women) and a good multivitamin.
  5. Exercise moderately and not to the point of exhaustion.
  6. Men should keep mobile phones and laptops away from their testicles and try to keep their testicles cool by wearing loose-fitting cotton underwear.
  7. Reduce stress levels by introducing simple and enjoyable activities that are effective and easily achievable – meditation, yoga and qi gong are ideal.
  8. Avoid overwork and take regular holidays.
  9. Reduce exposure to soft plastics, pesticides, hormones, and fertilisers by choosing organic food and avoiding processed and packaged foods. Use less toxic cleaning products. Replace plastic food containers with glass or BPA–free containers.
  10. Check your BMI as being under- or overweight adversely affects both male and female fertility, the optimal BMI for fertility is 20–25.
Posted in TCM.