What Affects Fertility
This is a very common but also complex question. There are likely hundreds of factors when it comes to fertility. When you think about all of the hormonal reactions and stars that must align when conceiving a child, it really is a miracle! It’s also pretty cool. Our bodies are incredibly smart and complex. If one hormone does not do its job properly, our body may protect us by not allowing the pregnancy to occur. On the other hand, when our body feels safe enough, conception may come fairly easily for some.
For women, the primary process that needs to occur in order to be “fertile” or have good fertility is ovulation. Ovulatory dysfunction is the most common cause of female infertility. This is a topic I wish was discussed more with younger women. Most women I know, including myself, did not learn enough about our reproductive systems growing up! Ovulation is the process in which a mature egg is released from the ovary. It is required in order to conceive naturally. The released egg can be fertilized for about 12 to 24 hours, which makes knowing when you are ovulating so important if you are trying to become pregnant or are trying to avoid pregnancy. This does not mean you only have one day to worry about, though. In the right conditions, sperm can live inside the female reproductive tract up to five days after sex.
We read in most books that the average menstrual cycle is 28 days long, and that ovulation typically occurs around day 14. It is very rare that I meet women with consistent 28 day cycles! A regular or “normal” cycle for an adult can be anywhere from 21-35 days. In most women with regular cycles, ovulation may occur in the four days before or after the midpoint of your period. If, like many women, you don't have a perfect 28-day menstrual cycle, you are not alone! I recommend tracking your cycle. You can find more information about this here.
Because you need to ovulate in order to have good fertility, let’s dive into the main factors that affect ovulation.
Medical conditions that affect your hormones - I mentioned above that hormones play an important role in fertility. Hormones such as estrogen, progesterone, LH, FSH, and many more must rise and fall at specific times in order for ovulation to occur. It really is like an orchestra! Each hormone plays its own part, and they come together to make a beautiful symphony. Medical conditions that may disrupt hormonal balance and flow include thyroid conditions, polycystic ovarian syndrome (PCOS), endometriosis, autoimmune diseases, fibroids, other endocrine disorders, or structural abnormalities. PCOS is one of the most common causes of infertility in women.
Stress and inflammation - These go hand-in-hand and both significantly affect your hormones. They can often lead to missing or delayed periods and ovulation. Stress and/or inflammation can come from many different places, and it is important to determine your biggest stressors. Stress can come from personal life and relationships, work, socioeconomic factors, financial stress, trauma, not eating enough, dieting and weight cycling, over-exercising, and poor body image.
Blood sugar imbalances - This will often come from our eating patterns but can also be caused by stress! Chronic dieting, restricting and binging, under-eating carbohydrates, or fasting can all affect blood sugar. Lows and highs in glucose levels may lead to increased insulin levels which can impair ovulation. I do not believe that anyone has to follow a low carb, paleo, or ketogenic diet for fertility. There are so many ways to balance your blood sugar WITHOUT going on a diet. See the blog post I wrote on Gentle Nutrition for PCOS for balanced meal tips.
Gut issues - Issues with digestion may affect fertility in a couple of ways. Conditions like Small Intestinal Bacterial Overgrowth (SIBO), dysbiosis, and low stomach acid affect the body’s ability to absorb nutrients from food. If our bodies are not digesting and absorbing food well, we may be deficient in necessary nutrients for the flow of hormones. Going to the bathroom regularly also plays a role in hormonal balance. Our gut determines how much estrogen is absorbed and how much is eliminated. Not to mention, digestive issues usually cause stress and discomfort, which can play a role in decreased libido or desire to be intimate with your partner.
Other considerations: What about environmental toxins or a poor diet? These can also have an effect on fertility, however I recommend working on the 4 factors above first. What about age? Science says that women are born with all the eggs they will ever have and as they age, they have fewer eggs in their ovaries, and their ability to get pregnant decreases. This is true, but I also believe that we are living longer than ever before. Worrying about age is actually a stressor that may worsen fertility. We at Nourishing Minds Nutrition believe mindset plays a big role in our health! There is also research that women with PCOS have greater fertility later in life!
I hope that this blog post has given you an idea of what could be affecting your fertility or what to look out for when determining if you are fertile. If you are not trying to conceive at this point in time, it could still be a good idea to make sure these factors are addressed for improved period health and PMS symptoms. If you are trying to conceive, please don’t forget about male fertility! Fertility issues don’t only affect women, and in fact, most fertility specialists will examine both partners when making an assessment. I also recommend incorporating stress management into your routine if you are working to improve your fertility, but ruling out or identifying any medical issues is incredibly helpful! Learning about your fertility can feel a little scary or lonely, but it can also be empowering! You always have a safe space here!
