Infertility affects approximately 15% of couples. (1) It can be a massive stress on the relationship and even lead to breakups. In the beginning, you feel so happy, but as time passes, you become frustrated, sad and angry. You become emotional when you see babies everywhere you go, and relatives/friends drive you mad by asking, “When are you going to have a baby?” Sounds familiar? Coping with tremendous pressure can make it even harder to conceive. You are thinking: “Why am I not getting pregnant?” You are not alone!

There are many causes of infertility, both in women and men. It is very important to check with your healthcare provider to rule out any underlying causes of your infertility if you are trying for longer than a year with no luck. 

Your cycles can tell you a lot about your reproductive health. Irregular periods or no periods, spotting before your period, lack of ovulation, painful, heavy periods, and previous miscarriage can all be signs of hormonal imbalance. The following tips will help you balance hormones, reduce stress and increase your chances of becoming pregnant. 

However, if you suffer from

• polycystic ovarian syndrome (PCOS)
• endometriosis
• hyperprolactinemia
• or your symptoms don’t improve with diet and lifestyle changes

work with your general practitioner and a nutritional therapist/dietician to get the best support. 

You can do a lot with a simple diet and lifestyle changes. A study showed that most infertility cases due to ovulation disorders/hormonal imbalance might be preventable through modifications to diet and lifestyle. The diet is referred to as a “Fertility diet”.(2)

• Eat complex carbohydrates instead of simple carbohydrates – Complex carbs are found in whole, unprocessed foods and are richer in fibre, minerals, vitamins and essential nutrients. Examples of complex carbs: Wholegrains (whole wheat, quinoa, brown rice, oats etc.), fruit (apples, berries etc.), vegetables (broccoli, green leafy greens etc.) and legumes (beans, chickpeas etc.)
• Protein – make sure you eat adequate protein a day. A correct balance of proteins, carbohydrates, and healthy fats can reduce the risk of infertility. (3) Protein such as fish, eggs, legumes and occasionally red meat. If you eat meat, choose organic, grass-fed meat and free-range chicken.   
• Increase your fibre – Fibre keeps you regular, helps your body get rid of excess hormones, controls blood sugar, and helps maintain a healthy weight. (4) Examples of fibre-rich fruits and vegetables: broccoli, beets, brussels sprouts, raspberries, pear, apples etc. Legumes are also a good source of fibre.
• Avoid sugar – processed food, sweets/chocolate, and bottled sugary drinks (even fruit juices) are high in sugar. They can cause high blood sugar, leading to type 2 diabetes and weight gain. Sugar can interfere with reproductive hormones and damage sperm and egg quality. Boston University found that even one sugary drink a day caused decreased fertility. (5)
• Choose healthy fats– say no to trans fats. Instead, eat nuts, seeds, salmon, mackerel, sardines, olives, avocado, and olive oil. Examples of trans fats are commercial baked goods, such as cakes, cookies and pies, fried foods, and margarine. 
• Eat antioxidant reach foods- A study shows that increased antioxidant intake is positively associated with female fertility. (6) Examples of these foods: are broccoli, blueberries, raspberries, spinach, ginger, turmeric, sweet potato, avocadoes, beetroot etc. 
• Go organic with your fruit and veggies – to reduce pesticide exposure. A study has shown that women who eat more fruit and veggies with more pesticides are linked to decreased fertility. (7)
• Avoid microwave foods and plastic bottles – They contain hormone-disrupting chemicals. Oestrogen and testosterone are affected (amongst many other hormones), which are critical in reproduction. Phthalates mimic testosterone, making the body think there is enough so that it will produce less. Low testosterone is associated with low sperm count. For women increased risk of premature ovarian failure and miscarriage. Another disruptor is bisphenol A (BPA); it has an oestrogenic effect and can lead to oestrogen dominance in females, decreased sperm count, and erectile dysfunction in men. (8) (9)
• Check your ferritin – Ferritin is your iron storage and a good indicator of iron status. Researchers have found that women with low iron stores are more likely to experience cycles with missed ovulation. (10) Adjust your diet accordingly. Iron-rich foods: turkey, chicken, liver, spinach, beets, broccoli, strawberries, beans, and lentils. Foods high in vitamin C can also help with iron absorption (e.g., citrus fruits and red, yellow and orange peppers).

• Reduce stress– RELAX! As mentioned above, even pre-conception-related stress can halt conception or lead to infertility. (11) Stress is debated to cause infertility, but more and more studies show a connection between stress and infertility. Pre-conception-related stress can lead to anxiety and depression. (12) Try meditation, walking in nature, and deep breathing. 
• Improve sleep – sleep deprivation impairs the secretion of sexual hormones, leading to decreased testosterone levels and reduced sperm motility. In women, lack of sleep (also shift working) can cause reduced melatonin production, leading to failing embryo implantation. (13) Try to achieve 8 hours of uninterrupted sleep each night! Practice sleep hygiene. Try completely removing any source of light or phones in the bedroom. The emission of blue light suppresses melatonin production (a hormone that aids sleep, helps maintain a proper circadian rhythm and promotes restorative sleep).
• Stop smoking- Smoking is associated with reduced sperm count in men (14),  loss of follicles, and early menopause in women. (15) 
• Reduce alcohol consumption and eliminate recreational drugs -Alcohol and drug use have adverse effects on embryos, such as developmental delay and some degree of intellectual impairment. It also can lead to stillbirth. (16)
•  Get moving -Achieve a healthy BMI (body mass index) of 20-25. However, make sure you are not overexercising. Women with High BMI are at higher risk of menstrual dysfunction, anovulation and complications during pregnancy. (17)

• Folate (folic acid) – Take a multivitamin like Immunity; it has 200 mcg of folic acid and other essential vitamins and minerals. Once pregnant, switch to a prenatal multivitamin, a minimum dose of 400mcg daily, and an increase in folate-rich foods to prevent the risk of spina bifida and other neural tube defects. Folate-rich foods include dark green leafy veggies, peanuts, legumes etc. (18) 
• Fish oil/omega3 – may positively affect semen quality (19); omega 3 is crucial for the developing baby’s growth, brain and eye health. (20)
• B6–low B6 status can contribute to miscarriage (21)
• Vitamin A – is required for foetal tissue growth and maintenance. It plays an essential role in cell differentiation. (22)
• Zinc and selenium – some studies suggest these minerals increase sperm count. – supplementations with selenium for men with low selenium have been shown to improve sperm motility. (23)  Adequate zinc level is essential for men’s reproductive health, normal sperm function and fertilisation. (24) However, on the other hand, highly toxic zinc content negatively affects sperm quality.  
• Co-enzyme Q10 (ubiquinol) – The natural medicine journal published a randomised study where participants took 200 mg CoQ10 per day for 26 weeks, and the results showed a significant increase in sperm concentration, motility and morphology (25)
• Vitamin C- improves sperm motility, quality and count. (26) Improves luteal phase defect in some women. (27)

Lastly, communication is crucial with your partner; talking about your feelings can bring you closer. Be open and understanding; this is the best way to support each other through this beautiful but sometimes challenging life experience. 

Be healthy and happy 😊