Optimizing Natural Fertility

There are many myths and misconceptions surrounding natural ways of optimizing fertility. Always ask your doctor before starting any supplements or treatments not prescribed by a physician. Here are the answers to some commonly asked questions about natural fertility:

1. What is the best time to have sex if I want to get pregnant?
   The “fertile window” is generally defined as the six days prior to and ending on the day of ovulation. With regular 28-day menstrual cycle intervals, ovulation usually occurs on or around day 14 of the cycle. The first day of menses counts as day 1 of the menstrual cycle.
2. How can I track my ovulation?
   There are a number of different ways to track your ovulation day. Commercially-available ovulation predictor kits can be purchased at most local pharmacies. Other natural methods are available as well. One inexpensive and effective way to monitor ovulation during a natural cycle involves monitoring vaginal secretions. The probability of getting pregnant is highest when the secretions are slippery and clear. Unfortunately, many of the available ovulation tracking ‘apps’ have proven to be inaccurate.
3. How often should I have sex, and does position matter?
   A common misconception is that having sex too frequently decreases the chances of getting pregnant. Having sex every day or every other day during the fertile window increases the probability of pregnancy. As long as sperm is deposited into the vagina, position does not impact fertility.
4. Can I use lubricants during sex if I am trying to get pregnant?
   Many couples prefer to use lubricants during sexual intercourse. Unfortunately, many lubricants, including saliva, can inhibit sperm and therefore may decrease your chances of getting pregnant. Mineral oil and canola oil do not appear to impact sperm. There are also some commercially-available hydroxyethylcellulose-based lubricants such as Pre-Seed (INGfertility) and ConceivEase (Reproductive Laboratory) which do not impact sperm.
5. Can my lifestyle impact my fertility?
   In general, a healthy lifestyle may help improve fertility, especially in women with ovulatory dysfunction. All women attempting to conceive should take a folic acid supplement (or a prenatal vitamin with folic acid in it) of at least 400mcg daily. The following factors have been shown to impact fertility:
   • Smoking- Smoking has been shown to negatively impact fertility and may also increase the risk of miscarriage
   • Alcohol- Heavy alcohol consumption (> 2 drinks per day) in women may negatively impact fertility.
   • Caffeine- High levels of caffeine intake in women (> 2 cups of coffee per day or the equivalent in other caffeinated beverages) may negatively impact fertility. During pregnancy, drinking more than 200-300mg (2-3 cups of coffee per day) may increase the risk of miscarriage.
   • Body mass index- Being overweight or underweight may negatively impact fertility.