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Several studies have shown reduced fertility for women who consume more than 300 mg of caffeine each day. Fortunately, the threshold is high enough that you can still indulge in that morning cup o' joe, since the average 8-ounce cup of coffee only has 100 to 130 mg of caffeine. Don't forget, though, that black tea, green tea, chocolate, and some sodas also contain caffeine.
For women undergoing in vitro fertilization, however, the threshold is much lower: A mere 50 mg of caffeine—the equivalent of one cup of tea—can negatively impact success rates.
Alice Domar, an assistant professor at the Harvard Medical School who also counsels women dealing with infertility, suggests that you may want to further restrict your caffeine intake if you've been trying unsuccessfully to get pregnant, even if you're not doing IVF. Since only limited research has been done on the topic, Domar worries that further research may show that lower amounts of caffeine still impact fertility.
"Fertility is a very time-limited period in a woman's life, so try everything you can now," Domar recommends. "There's no downside to further limiting your caffeine intake, and if further research shows that lower caffeine intakes negatively impact even non-IVF women, you'll know you’ve done everything you could."
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Being extremely overweight can make a woman less likely to get pregnant. Obesity can inhibit ovulation and wreak havoc with hormones. It also puts women at risk for a variety of health problems (such as diabetes, heart disease and high blood pressure) that negatively impact fertility and can create complications during pregnancy. Women who are morbidly obese are also less likely to be successful with fertility treatments.
Part of the problem is the hormonal imbalance that's created by the fat cells themselves. Fat cells produce extra estrogen, says Gerard Letterie, a reproductive endocrinologist at the Northwest Center for Reproductive Sciences. The more fat cells, the more estrogen, so being overweight is very similar to being on birth control pills.
Domar explains that although female fertility peaks with a body mass index in the low- to mid-20s, weight-related fertility problems are most common in women with a BMI greater than 34, which is considered obese. For instance, a woman who is 5 feet, 4 inches tall and weighs 200 pounds isn't just obese; she’s also jeopardizing her fertility.
If you're having trouble losing weight, Letterie recommends a group weight loss program like Jenny Craig or Weight Watchers. "Studies have shown that women participating in group weight loss programs are the most likely to be successful," says Letterie.
You needn't diet down to a size 8 to get pregnant. "Research shows that when obese women lose an average of 10 to 14 pounds, many will get pregnant the natural way, without medical intervention," Domar says.
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A normal, healthy Body Mass Index ranges from 18.5 to 24.9. Anything lower than 18.5 is underweight. For instance, woman who is 5 feet 4 inches tall and weighs 105 pounds has a BMI of 18 and is considered to be underweight.
Being even slightly underweight can dramatically reduce your fertility, as fertility starts to plummet for women with BMIs of 18 or lower.
Women who are underweight are less likely to ovulate. Some will stop menstruating completely. Others will menstruate irregularly. But experiencing a monthly period doesn't necessarily mean you're fertile, since it's possible to menstruate without ovulating.
Sometimes low body weight can be caused by excessive exercise and athletic training, which has also been linked to problems with getting and staying pregnant. For such women, dialing back on the exercise can be enough to gain weight and boost fertility.
For low body weight caused by an eating disorder, it's important to seek professional treatment.
Simply gaining some weight is usually enough for women to begin ovulating again, says Letterie. For those women who don't, Letterie stresses that there are simple treatments to help women ovulate again, but only after they've gained the necessary weight.
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In May 2006, the journal Fertility and Sterility published two studies showing significantly increased pregnancy rates for women receiving acupuncture treatments in conjunction with the embryo transfer stage of in vitro fertilization. In one study, women receiving acupuncture were more than twice as likely to become pregnant. In another, acupuncture prior to embryo transfer increased rate of pregnancy by 50 percent.
Researchers aren't sure why acupuncture may be helpful. Some speculate that acupuncture may positively impact hormonal levels or increase blood flow to the ovaries and uterus. Another theory: Since acupuncture can induce a relaxation response, it may be counteracting the stress that often accompanies infertility. Reducing infertility-related stress and anxiety has been shown to increase success for IVF treatments.
Despite the positive findings, scientists agree that more research needs to prove that acupuncture is truly effective.
Although Domar herself has called for more rigorous testing of acupuncture, specifically to sort out the issue of the placebo effect, that hasn’t stopped her from recommending acupuncture to her infertility patients. "There is some very promising data out there," Domar says. "Acupuncture is a safe, cheap, non-invasive and easy way to potentially increase your chances of getting pregnant."
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Walking just 30 minutes each day is a simple, inexpensive form of exercise that helps ward off problems like heart disease and diabetes, diseases which may impact fertility and can cause complications during pregnancy. In addition, regular exercise helps maintain a normal body weight, which is an important part of maximizing fertility.
Walking may also help boost fertility by increasing circulation to the pelvis and the reproductive organs, since some research has linked decreased blood-flow to the ovaries with ovarian aging and reduced success with in-vitro fertilization.
"Many couples I see have jobs that require them to sit all day in front of the computer. This doesn't do much for circulation to the pelvis and the reproductive organs," says Dr. Susan Carr, a naturopathic physician at Fertile Path in western Washington state. "Exercise is one way to support circulation to these organs."
Daily physical activity is also a great way to improve your mood and help ward off the stress and depression that are common side effects of infertility.
Thirty minutes a day is easy to fit into even the busiest of schedules and can provide a great opportunity to spend quality time with your partner or a good friend.
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While many experts believe that depression doesn't cause infertility, proper treatment for depression can help increase fertility.
Since it's not uncommon for women struggling with infertility to become depressed, try joining a fertility-focused mind-body group. These groups teach techniques to relax and manage the stress and anxiety associated with infertility. Research conducted at the Harvard Medical School found that women undergoing in vitro fertilization who participated in a 10-week mind-body program were more than twice as likely to get pregnant.
If you were seriously depressed before attempting to get pregnant, it's important to seek prompt treatment from a mental health professional. "Women with severe clinical depression are much less likely to eat well, exercise, and otherwise take care of themselves," says Domar. "And women who are less healthy are less likely to get pregnant."
While anti-depressants can be effective in the short term, Letterie encourages women to work with their doctors to get on the lowest dose possible. Ideally, he'd like to see women weaned off of prescriptions before getting pregnant, since taking medication during pregnancy is not without risks.
To learn to manage depression without drugs, Domar recommends that women work with a cognitive behavioral therapist to learn effective ways of dealing with depression. The Association for Behavioral and Cognitive Therapies maintains a database of therapists trained in cognitive behavioral techniques.
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To maximize your chances of conception and a healthy pregnancy, Carr and Domar both recommend eating a healthy, unprocessed diet rich in whole grains, beans, fresh fruit and vegetables, raw nuts and seeds (skip the ones with added oil and salt), healthy oils (like olive oil), lean meat, and cold-water fish like wild salmon that are high in omega-3 fatty acids.
A balanced, whole-foods diet will help you maintain a normal BMI, a critical component in maximizing fertility. In addition, by eating well and minimizing unhealthy fats, white flour, sugar, and salt, you'll reduce your risk of diabetes, heart disease, and high blood pressure—diseases that can decrease your fertility and also cause complications in pregnancy.
To further boost your chances of conception, Carr recommends emphasizing foods that are rich in omega-3 fatty acids, such as wild, cold-water fish, walnuts, and flax seeds. "Omega-3 fatty acids promote fertility, since essential fats are required for hormone balance and healthy cell function," says Carr. "Unfortunately, most diets are deficient."
With just a little extra planning, it's easy to integrate more whole foods into your diet. For breakfast, try a bowl of oatmeal with fresh fruit. For lunch, have a sandwich on whole-grain bread or a colorful salad with olive oil and vinegar. Fresh fruits, as well as raw nuts and seeds, make excellent mid-afternoon snacks. "Just be intelligent about your health," says Domar. "Given a choice between fried dough and an apple, we all know which one to pick."
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Most reproductive experts agree that one or two drinks each week shouldn’t impact a woman's chances of getting pregnant, while excessive drinking is clearly problematic. However, the jury is still out on exactly how much a woman can drink before her fertility is affected.
While a couple of studies have found no link between moderate alcohol (one to two drinks each day) intake and fertility, one Danish study from 2003 found that just seven drinks a week could negatively impact the chances of conceiving for women more than 30 years old. Another Danish study from 1998 found that even moderate drinking (6 to 10 drinks each week) reduced a woman's chances of getting pregnant, with more excessive drinking further decreasing the chances of conceiving.
For women who are heavier drinkers, Letterie recommends that they get their drinking problem under control before they try to conceive, especially since it's critically important that women cut out alcohol completely once pregnant.
Although it's still unclear whether or not moderate drinking will negatively impact fertility, limiting alcohol consumption to only one or two drinks each week surely won't hurt, especially if you’ve been trying unsuccessfully to get pregnant for more than a few months.
In addition, you should stop drinking after you ovulate during any cycle in which you try to conceive. Alcohol consumption after conception can increase the risk of miscarriage and can cause fetal alcohol syndrome.
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More than 100 research studies have consistently linked smoking to decreased fertility and increased problems in carrying a birth to term, says Dr. David Adamson, a reproductive endocrinologist at Advanced Reproductive Care in Palo Alto, Calif.
Smoking damages eggs, reducing the chances of getting pregnant during any given cycle, and smokers may hit menopause several years earlier than their non-smoking peers. Smoking also negatively impacts hormone levels, further reducing fertility.
The problems don't end when a smoker gets pregnant. Smokers are more likely to suffer from miscarriage and complication during their pregnancies, and babies born to smokers are more likely to be underweight.
Although smoking does damage eggs, quitting now can still help boost fertility. Going smoke-free will prevent further reduction in egg quality, help reverse hormonal changes, and increase the chances of carrying a healthy baby to term.
According to the American Society for Reproductive Medicine, it's not enough for just the woman to stop smoking, since second-hand smoke has been shown to be almost as bad for a woman's fertility as actually smoking. Since smoking also reduces fertility in men, it makes sense to make quitting a family affair.
By Lisa Farino for MSN Health & Fitness
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