Dr Zoe Williams
Dr Williams is a well-known and respected media medic who also has experience in health, fitness and wellbeing, alongside her role as a GP. She is a national advisor to the Office for Health Improvement and Disparities (OHID) GP clinical champion network and also leads on work to promote physical activity and healthy lifestyle with The Royal College of General Practitioners.
I remember being taught in school, in an awkward sex education class, that if you have unprotected sex just once then you would get pregnant — who recalls being told the same thing?
While this can of course happen, the reality is far from this for most and, in fact, one in seven heterosexual couples experience infertility — meaning the failure to achieve a pregnancy after 12 months or more of regular unprotected sex, without contraception.
About 84 per cent of couples will conceive naturally within a year if they have unprotected vaginal sex every two or three days and the woman is under 40. Of those who do not conceive in the first year, about half will do so in the second year — this means that 90 per cent of couples will conceive within two years.
While this is reassuring, for those who are actively trying to conceive, two years is a long time, so there are some additional things you can do to optimise your chances of conception.
1. Have sex at the right time
While the general advice is simply to have sex every two to three days, this might not always work for couples due to busy schedules, or just choice. Once an egg is released from the ovary, which is called ovulation, you have about 24 hours in which it needs to come into contact with live sperm, otherwise it dissolves. Live sperm can survive inside the female body for up to five days. Biologically speaking, ovulation day is the only day you can get pregnant, as this is when the sperm and egg actually meet. So couples trying to conceive should have sex multiple times on the days just before ovulation as well as the day itself. This means that the real key is being in touch with your body and knowing when you ovulate.
Ovulation happens mid-cycle, so in people who have a 28-day cycle, this will be around day 14, with day one being the first day of your period. However, dates alone cannot be relied upon as we are all different, and relying solely on this could mean you miss your window of fertility. The best indicator of ovulation is changes to cervical secretions, or vaginal discharge. Around the time of ovulation it tends to become more wet, transparent and stretchy. It is often described as being like egg white. Other techniques involve taking basal temperatures, alongside apps and devices such as “Natural Cycles, “Daysy” and “Mira” or using ovulation sticks, which can also predict ovulation.
My advice though is never to be fully dependent on these measures, and if you can continue to have sex regularly, at least either side of your probable fertile window, then do so.
2. Fix your diet
You really are what you and eat, and so is your baby, even before he or she is conceived. Which means what you put into your body is already having an impact on another human’s health and wellbeing! A Mediterranean diet is considered a healthy, balanced diet that focuses on plant foods like fruit, vegetables, wholegrains, nuts, seeds, and pulses, like beans, chickpeas and lentils. The diet includes moderate amounts of lean proteins like fish and chicken, some dairy foods only minimal amounts of processed and ultra processed foods. Olive oil is used to replace other oils and fats in the diet. Load up on seasonal and colourful fruit and veg – the darker the skin, the better the antioxidant value and this is a time when it is worth investing in organic food if you can afford to, as it is less likely to be polluted with pesticides and other chemicals. It’s not just about women though, diets rich in fruits, vegetables, wholegrains and fish are linked to better sperm quality so make sure your partner is doing their bit and adjusting their diet too.
3. Supplement your diet
Before you start to try for baby ensure you have a good healthy, balanced diet, and that you are taking the recommended supplements,. The Department of Health recommends a daily supplement of 400µg folic acid from before you're pregnant until you're 12 weeks pregnant. This is to reduce the risk of problems in the baby's development in the early weeks of pregnancy. It is also recommended to take a daily vitamin D supplement.
To cut down on the number of different supplement tablets you take, you might consider a multivitamin supplement that delivers the required amount of folic acid AND includes vitamin D. Also check they include zinc, as this helps support normal fertility and reproduction. Men can also benefit from taking a supplement too to support their diet, including zinc which contributes to normal fertility and reproduction, selenium which contributes to normal spermatogenesis and vitamin C which contributes to the protection of cells from oxidative stress.
Omega 3 essential fatty acids are also an important consideration for both men and women.
4. Get active
The end goal of conception is pregnancy and as anyone who has been through it will testify, pregnancy can be a tough nine months. Whilst trying to conceive is the perfect time to give yourself a head start on how fit you can be throughout your pregnancy and when you give birth.
Not only that, but being active can support fertility as regular exercise helps balance hormones, boosts circulation and reduces stress levels, all of which are linked to improved fertility.
Physical activity is also one of the absolute best things you can do to look after your mental health too. Exercise releases a cocktail of feel-good chemicals in the brain. Serotonin which is known as the ‘happy hormone’, dopamine which stimulates the reward centres in the brain, oxytocin which is the ‘love hormone’ and endorphins which are our natural inbuild pain relievers and also make us feel good.
If you’re just starting out then try different things, to see what you enjoy and remember that anything which gets your heart beating faster, body feeling warmer and gets you a little out of breath counts as well as any muscle strengthening activities – which include hill walking, yoga, climbing stairs as well as resistance workouts or lifting weights. Bedroom exercises count but don’t rely solely on them.
It's important to note that exercising too much, or some extreme types of training, such as ultra marathons can put additional stress on the body and negatively impact fertility in some people.
5. Stay Healthy
Drinking alcohol is linked to fertility problems in both men and women. The current NHS advice if you’re trying to conceive is to drink once or at most twice a week and limit your intake to no more than one or two units each time, a unit is half a pint of weak lager or a small (125ml) glass of wine. Of course, if you can it’s much better to stop drinking completely, especially since after you conceive many doctors believe there is no safe intake in pregnancy, Smoking is an absolute no-no for you both too.
The toxic chemicals in tobacco can cause damage the lining of the womb, the eggs and sperm. Smokers are at higher risk of complications during pregnancy and either of you smoking has a significant impact on the health of your baby too.
Carrying too little or too much fat on the body can also affect fertility.
6. Reduce stress levels
Studies have shown that the stress hormone, cortisol, affects the messaging between the brain and the ovaries and in some cases that can affect ovulation, which in turn can affect fertility. Stress can also increase the risk of high blood pressure, problems with sleep, lowered sex drive and can make us resort to unhealthy lifestyle choices to help us cope with it, such as eating too much sugar for comfort, drinking alcohol, or smoking. Stress alone won’t make anyone infertile but it’s a contributory factor so while it’s easier said than done, if you’re planning to start a family, lowering stress levels is a good idea. Not everyone can change jobs or quit to reduce stress levels so it's about managing what you can. Yoga, meditation, mindfulness and breathing exercises can all help reduce stress levels, and there are free apps which can guide you. We know time spent in green spaces is good for lowering stress levels and sleeping well and being active too. Find what works for you and employ it. Trying to get pregnant can be extremely stressful in itself so it’s important you try to mitigate this added emotional stress as much as possible. beneficial, as they also allow you to explore the emotional and psychological basis behind infertility.
7. It's a team event
If you google ‘how to get pregnant’ you’ll see the majority of resources are aimed at women, but conceiving isn’t a solo affair. It’s down to your partner to make sure their sperm quality is as good as it can be too. Diet, exercise, stress levels, body weight, alcohol, and smoking can all make a difference. It’s also important for men to keep their testicles cool. Testicles are on the outside of the body because they need to be kept slightly cooler than body temperature to produce the best quality sperm. So whilst trying to conceive it’s a good idea to avoid long stints in jacuzzies and saunas and if your job involves working in a hot environment or sitting for prolonged periods, take regular breaks to move around and outside.
8. Get a health check
While fertility tests aren’t available on the NHS unless you’re having NHS funded fertility treatment, there are private clinics across the UK that can offer health checks specifically targeted at fertility but if you don’t have the money to go privately, there are tests you can do at home or at your GP surgery. Most GP surgeries have blood pressure monitors in reception, so take yours a few times over the course of a few weeks and make sure it’s in the normal zone which is between 90/60mmHg and 120/80mmHg. You can work out your BMI using an online calculator, you can also check your hip to waist ratio using an online calculator. You can check your resting heart rate which should be between 60 and 100 beats per minute. All these tests will give you a general indication of health and if anything is concerning you, make an appointment to speak to your GP.
9. Remember to have fun, and connect
Humans are one of the few species who have sex for fun and not just to reproduce. The person you want to get pregnant with is likely the person you can see yourself growing old with, so get some fun between the sheets to take the pressure off it being all about fertility. You can mix things up however works for you, maybe different rooms in the house or maybe a hotel booked for a weekend of fun. It’s important to connect emotionally as well as physically and when you’re trying to get pregnant, the love and passion can be replaced by regimented ovulation checks and windows of time – there’s nothing wrong with that but where you can, try to have sex for the reasons you did in the first place. So be spontaneous and remember to enjoy sex, and orgasm may be helpful in aiding fertilisation too.
This is general information only and does not constitute specific professional medical advice. If you have any medical concerns or issues you're worried about, and before you engage in any new exercise activity, please talk to your own GP or Health Care Professional for advice.