Female fertility: Why lifestyle choices count

Are you trying to get pregnant? You might wonder whether there's anything you can do to make it easier to conceive. Some things might be beyond your control or need medical help. These include medical issues that affect being able to conceive. But your lifestyle choices can affect fertility too. Here's what you need to know.

What is female fertility?

Female fertility is being able to get pregnant. Have you and your partner been trying to get pregnant by having sex without birth control for at least one year with no success? Not getting pregnant in that time might make you wonder how fertile you are. Anyone can be affected by fertility concerns or problems.

What causes female fertility problems?

Factors that can have an impact on female fertility include:

• Trouble releasing eggs, called ovulating, or trouble with regular periods. Hormone-related conditions can affect the release of eggs from the ovaries. These conditions include polycystic ovary syndrome, high prolactin hormone levels and thyroid conditions. Other conditions that may change ovulation or periods are poorly controlled diabetes and some autoimmune diseases such as lupus.
• Uterine or cervical conditions. This includes growths in the uterus, such as polyps or fibroids.
• Fallopian tube damage or blockage. This can be in one or both tubes through which eggs travel from the ovaries to the uterus. These tubes are the fallopian tubes. Often the cause is pelvic inflammatory disease.
• Having the tissue that lines the inside of the uterus grow outside the uterus. This is called endometriosis.
• Early menopause, also called primary ovarian insufficiency. This happens when the ovaries stop working and periods stop before age 40.
• Bands of scar tissue that bind organs together. These bands are called pelvic or uterine adhesions. They can happen after a pelvic infection, appendicitis, or abdominal or pelvic surgery.
• Aging. Waiting to try to get pregnant can lower the chance of being able to conceive. As you move closer to your 40s, you lose eggs at a faster rate. And the eggs you have are less likely to become fertile.

What can I do to increase my fertility?

Healthy lifestyle choices can help. Take steps to:

• Stay at a healthy weight. Being too overweight or too underweight can keep you from releasing eggs, called ovulation, and having regular cycles.
• Prevent sexually transmitted infections. Infections such as chlamydia and gonorrhea are a leading cause of not being able to conceive.
• Try not to work the night shift. Working the night shift all the time might affect your hormone levels. This can raise the risk of not being fertile. If you do work the night shift, try to get enough sleep when you're not working.

Stress isn't likely to keep you from getting pregnant. But stress isn't good for your health. Think about ways to lower stress. Try meditation, deep breathing, yoga or other activities to lower and manage stress when you try to conceive.

What's off-limits?

To protect your fertility, make these healthy lifestyle choices:

• Don't smoke. Tobacco use is linked with lower fertility. Smoking ages the ovaries, which uses up the egg supply too early. If you smoke, ask your healthcare professional to help you quit.
• Limit or avoid alcohol when trying to conceive. Heavy drinking is linked with an higher risk of problems ovulating. To help when you're trying to get pregnant, stop drinking alcohol. Not drinking is the best choice when you conceive and during pregnancy.
• Limit caffeine. Drinking less than 200 milligrams a day of caffeine doesn't seem to affect being able to conceive. This amount is one or two 6-ounce to 8-ounce cups of coffee a day.
• Don't exercise too hard or too long. For people at a healthy weight, too much hard exercise can affect ovulating and lower levels of the hormone progesterone. If you want to become pregnant soon, think about limiting hard exercise, such as running or fast cycling, to less than five hours a week and less than 60 minutes a day.
• Avoid toxins. There are many toxins in the environment. These include pesticides, dry-cleaning solvents and lead. They can harm fertility. Be aware of these toxins and discuss ways to limit exposure to them with a member of your healthcare team.

What's the bottom line?

If you're thinking about getting pregnant, you might worry that some lifestyle choices can make getting pregnant harder. Talk with your healthcare professional about ways to improve your fertility and raise your chances of getting pregnant.

If you haven't become pregnant after one year of regular sex with no birth control, or if you have medical conditions that might affect getting pregnant, talk with a pregnancy specialist, called an obstetrician.