Optimizing Your Natural Fertility
From the Show: RSC NJ - Fertility Talk
Summary:
Air Date: 11/16/22
Duration: 10 Minutes
When you're trying to have a baby, getting pregnant can be all that you think about. Kelly Curtis discusses different things you can do to increase your ability to conceive and optimize your natural fertility.
Transcription:
Melanie Cole, MS: When you're trying to have a baby, getting pregnant can be all you think about. But for both men and women, there are some things you can do to increase your ability to conceive.
The Reproductive Science Center of New Jersey combines a commitment to sensitive care with a state-of-the-art program. We proudly present Fertility Talk with RSCNJ. Here's Melanie Cole
Melanie Cole, MS: Welcome to Fertility Talk with RSCNJ, the Reproductive Science Center of New Jersey. I'm Melanie Cole. And we're talking today with Kelly Curtis. She's a physician assistant with RSCNJ, and she's here to tell us about optimizing your natural fertility.
Kelly, I'm so glad to have you with us. As we talk about boosting our natural fertility, one of the things that comes to mind is keeping track of our cycles, our ovulation. Tell us a little bit about the fertile window and keeping track of our cycles and tracking our ovulation.
Kelly Curtis: Yeah. Thanks for having me. I do think it's important to note that this is mainly applicable for those who have regular cycles. if you are a patient that has irregular cycles, those that are not within one to two days each month or if you have a lot of pain with your periods or pain with intercourse, then this is something that I would recommend coming to see a, fertility specialists or possibly your OB-GYN sooner. this will apply to those who do have regular cycles.
that being said, what do we know? That 80% of couples will conceive within the first six months of attempting, okay? The highest likelihood is within the first three months of unprotected intercourse. the important thing is to understand your cycles and how to track ovulation.
there's a few different ways to do this. I'm sure everybody has at least heard of one of them. We will start with the calendar method. this is the app on your phone. This will tell you when to start your cycle tracking on the first day of your period. So in this setting, we count first day of your period as full flow, not spotting, but full flow. And you will track this each month and it'll give you the interval or number of days in between cycles. The typical period is 28 days in length. So, you'll hear that a lot and I'll just refer to that as the normal cycle. So, with the calendar method, we know that the second part of the cycle or the luteal phase is about 14 days. So if you have 28 days, you subtract the luteal phase, which occurs at the day of ovulation. So, you will ovulate typically around day 14. If you have 30-day cycles, your ovulation day would then be day 16 and so on and so forth. The typical cycle is considered normal if between 21 days and 35 days. So if you have your menstrual cycle every 21 days, that is normal for you. But know that your window might be much sooner than somebody who has it at 28 or 35.
Another common one is cervical mucus monitoring. So this, you'll actually monitor your cervical mucus the days leading up to ovulation. And then, we know that we have our peak fertility in close to ovulation when the cervical mucus becomes slippery and wet and egg white consistency. So, this is your day for intercourse. This is the max day of ovulation. This one is a little bit limited in that you have to be very in tune with your body to understand the slight differences in the mucus.
Basal body temperature is also another way to track. Again, this one is limited because you have to have a specific thermometer to track basal body temperature. And you have to take your temperature every morning before getting out of bed, no eating or drinking. And this will tell you when you ovulated, so it doesn't tell you the day before. It's the progesterone rise that occurs after ovulation that causes the increase in your body temperature. So, just something to keep in mind when picking one of these methods.
And then last, I know this is a lot of information, but the last way to track your ovulation that we use a lot in our practice is what are called the ovulation predictor kits or the urine sticks. So, these typically measure the LH surge. So, the LH surge is present about 24 hours before ovulation. So, these, we recommend starting on cycle day 10 so you don't miss that window. And you will track to see when the LH surge occurs, and then you can expect to ovulate the next day. So, this is a very good tool for those who may not have the ability to have intercourse during the fertile window, which I'm not sure if I defined that, but the fertile window is the five days leading up to ovulation and the day of ovulation. So, we want to have as much intercourse and sperm exposure in these six days. But we can really target down our peak days using the ovulation predictor kits when we get the LH surge.
Melanie Cole, MS: Wow, that was such a comprehensive answer, Kelly. Really amazing. You're very good. So, tell us about how often. You said, to have a lot of sex at that time and in that fertile window. What does that mean and does that diminish at all the men's ability? I mean, we are talking about the couples here and so does that diminish the ability of the strength of the sperm? How does that work if they have a lot of sex during that time?
Kelly Curtis: Yeah. So, this is actually a big misconception. So, men do not essentially like run out of sperm. There have been studies that in males who have a normal semen analysis that we know of, that the frequent ejaculations do not affect the concentration or motility. Actually, the opposite. If you have infrequent ejaculations, so more than five days, we know that this can actually hinder sperm counts and motility. So, there's no limit as to how much intercourse you can have during the window. That being said, that can be a lot, especially if you are not a couple that is having intercourse daily. We do recommend every other day, should be sufficient during this six-day period. But obviously, the more exposure, the better. If you are very burnt out with intercourse and you are looking to just have sex during the fertile window one or two times, study shown that within the two days of ovulation is the best time to have intercourse. So, we can time it with sperm and egg when they meet. Sperm can live up to five days in the female reproductive tract, and the egg only lives for 24 hours. So, we need to make sure that our timelines are crossing over here.
Melanie Cole, MS: Kelly, this is such great information. So, for the couple, where does weight and body composition come into play when someone is trying to get pregnant? Does our weight affect our natural ability to get pregnant?
Kelly Curtis: Yeah. So, we don't want extremes of weight, okay? So, this could be obesity or being too thin. This can interfere with our hormones and how they're secreted. And we know this kind of translates over into activity and exercise. So, those who have a healthy weight but are working out very aggressively, multiple times a day or throughout the week, this can also put a strain on your body as well as the portion of the brain that secretes these hormones that you're in a constant state of stress. While it is a good stress, it can actually have an effect on your hormones. And that's where you'll hear of people not having a period that are very active, such as marathon runners and things like that. So, that does pose an issue as well as with obesity. And we know that having excess fats can interfere with the amount of estrogen and the way our body metabolizes these hormones.
Melanie Cole, MS: So while we don't have enough time, and you and I have discussed this a little bit, that we should really be doing a series on optimizing our natural fertility. But I'd like you to just briefly touch on lifestyle and food that includes caffeine and alcohol, smoking, any of these things that could decrease our ability to get pregnant.
Kelly Curtis: Sure. So. We'll start with caffeine because, you know, multiple people, everyone wakes up, gets their coffee in the morning. One cup is okay. Two or three seems to be okay. It is when we are doing the extremes of 500 milligrams of caffeine or the equivalent. So, if you like energy drinks or tea, the accumulation of all of these throughout the day may have an effect on our fertility. And we know once we do become pregnant, that we should limit our caffeine to less than 200 to 300 milligrams as this may cause miscarriage.
Other things that are very commonly used, alcohol. There's been limited evidence to indicate that moderate alcohol use has any effect. But we have seen that in women who drink two or more alcoholic beverages in a day, there is a drop in their fertility. So, men also have to be conscious of this as well. Men who have heavy alcohol consumption, you know, that are drinking more than two drinks a day, this has also been seen to affect sperm quality as well as fertility for males.
Smoking is not good at all for anybody. But if women do smoke, we recommend stopping as soon as possible, especially if you're looking to conceive as this may have an effect. We also know that women who smoke, menopause occurs on average one to four years sooner. So, this tells us that there might have an effect on the follicular depletion or the number of eggs that you have available.
Melanie Cole, MS: Oh, that's interesting.
Kelly Curtis: Yeah. Yeah, it's very interesting. Smoking is not great for not only fertility, but multiple other health reasons. So, this is your sign to stop smoking. And diet, I just wanted to touch on what we do, is decreasing red meat and replacing it with more fish has actually been shown to help with the decreasing oxidative stress with the body. So, that would be some advice if you're looking to adjust things from your daily living to try to increase your fertility. That being said, just keep in mind that mercury has decreased fertility as well, so make sure that the fish you're eating are not high in mercury.
Melanie Cole, MS: Wow. This is a lot of information to process. And as I said, we are going to do more of these, you and I, to really get into some of these things a little bit more in detail. Just give us your best advice as couples are looking to optimize their fertility naturally, what would you tell them or what do you tell them every single day?
Kelly Curtis: Healthy lifestyle is a great place to start. So, the right amount of exercise and good diets and then timing your ovulation and understanding your menstrual cycle will go a long way. So, we want to make sure that you're targeting your fertility window here. And then, there is another caveat that when you are having intercourse, that there is no position or laying down or anything like that, that are going to increase your chances. So, we just want as much intercourse as possible during the fertile window.
Melanie Cole, MS: Thank you so much, Kelly, for joining us today and giving us a lot to think about and so many good ideas. Thank you again. And for more information, you can visit fertilitynj.com to get connected with one of our providers. That concludes this episode of Fertility Talk with RSCNJ, the Reproductive Science Center of New Jersey. I'm Melanie Cole.
Melanie Cole, MS: When you're trying to have a baby, getting pregnant can be all you think about. But for both men and women, there are some things you can do to increase your ability to conceive.
The Reproductive Science Center of New Jersey combines a commitment to sensitive care with a state-of-the-art program. We proudly present Fertility Talk with RSCNJ. Here's Melanie Cole
Melanie Cole, MS: Welcome to Fertility Talk with RSCNJ, the Reproductive Science Center of New Jersey. I'm Melanie Cole. And we're talking today with Kelly Curtis. She's a physician assistant with RSCNJ, and she's here to tell us about optimizing your natural fertility.
Kelly, I'm so glad to have you with us. As we talk about boosting our natural fertility, one of the things that comes to mind is keeping track of our cycles, our ovulation. Tell us a little bit about the fertile window and keeping track of our cycles and tracking our ovulation.
Kelly Curtis: Yeah. Thanks for having me. I do think it's important to note that this is mainly applicable for those who have regular cycles. if you are a patient that has irregular cycles, those that are not within one to two days each month or if you have a lot of pain with your periods or pain with intercourse, then this is something that I would recommend coming to see a, fertility specialists or possibly your OB-GYN sooner. this will apply to those who do have regular cycles.
that being said, what do we know? That 80% of couples will conceive within the first six months of attempting, okay? The highest likelihood is within the first three months of unprotected intercourse. the important thing is to understand your cycles and how to track ovulation.
there's a few different ways to do this. I'm sure everybody has at least heard of one of them. We will start with the calendar method. this is the app on your phone. This will tell you when to start your cycle tracking on the first day of your period. So in this setting, we count first day of your period as full flow, not spotting, but full flow. And you will track this each month and it'll give you the interval or number of days in between cycles. The typical period is 28 days in length. So, you'll hear that a lot and I'll just refer to that as the normal cycle. So, with the calendar method, we know that the second part of the cycle or the luteal phase is about 14 days. So if you have 28 days, you subtract the luteal phase, which occurs at the day of ovulation. So, you will ovulate typically around day 14. If you have 30-day cycles, your ovulation day would then be day 16 and so on and so forth. The typical cycle is considered normal if between 21 days and 35 days. So if you have your menstrual cycle every 21 days, that is normal for you. But know that your window might be much sooner than somebody who has it at 28 or 35.
Another common one is cervical mucus monitoring. So this, you'll actually monitor your cervical mucus the days leading up to ovulation. And then, we know that we have our peak fertility in close to ovulation when the cervical mucus becomes slippery and wet and egg white consistency. So, this is your day for intercourse. This is the max day of ovulation. This one is a little bit limited in that you have to be very in tune with your body to understand the slight differences in the mucus.
Basal body temperature is also another way to track. Again, this one is limited because you have to have a specific thermometer to track basal body temperature. And you have to take your temperature every morning before getting out of bed, no eating or drinking. And this will tell you when you ovulated, so it doesn't tell you the day before. It's the progesterone rise that occurs after ovulation that causes the increase in your body temperature. So, just something to keep in mind when picking one of these methods.
And then last, I know this is a lot of information, but the last way to track your ovulation that we use a lot in our practice is what are called the ovulation predictor kits or the urine sticks. So, these typically measure the LH surge. So, the LH surge is present about 24 hours before ovulation. So, these, we recommend starting on cycle day 10 so you don't miss that window. And you will track to see when the LH surge occurs, and then you can expect to ovulate the next day. So, this is a very good tool for those who may not have the ability to have intercourse during the fertile window, which I'm not sure if I defined that, but the fertile window is the five days leading up to ovulation and the day of ovulation. So, we want to have as much intercourse and sperm exposure in these six days. But we can really target down our peak days using the ovulation predictor kits when we get the LH surge.
Melanie Cole, MS: Wow, that was such a comprehensive answer, Kelly. Really amazing. You're very good. So, tell us about how often. You said, to have a lot of sex at that time and in that fertile window. What does that mean and does that diminish at all the men's ability? I mean, we are talking about the couples here and so does that diminish the ability of the strength of the sperm? How does that work if they have a lot of sex during that time?
Kelly Curtis: Yeah. So, this is actually a big misconception. So, men do not essentially like run out of sperm. There have been studies that in males who have a normal semen analysis that we know of, that the frequent ejaculations do not affect the concentration or motility. Actually, the opposite. If you have infrequent ejaculations, so more than five days, we know that this can actually hinder sperm counts and motility. So, there's no limit as to how much intercourse you can have during the window. That being said, that can be a lot, especially if you are not a couple that is having intercourse daily. We do recommend every other day, should be sufficient during this six-day period. But obviously, the more exposure, the better. If you are very burnt out with intercourse and you are looking to just have sex during the fertile window one or two times, study shown that within the two days of ovulation is the best time to have intercourse. So, we can time it with sperm and egg when they meet. Sperm can live up to five days in the female reproductive tract, and the egg only lives for 24 hours. So, we need to make sure that our timelines are crossing over here.
Melanie Cole, MS: Kelly, this is such great information. So, for the couple, where does weight and body composition come into play when someone is trying to get pregnant? Does our weight affect our natural ability to get pregnant?
Kelly Curtis: Yeah. So, we don't want extremes of weight, okay? So, this could be obesity or being too thin. This can interfere with our hormones and how they're secreted. And we know this kind of translates over into activity and exercise. So, those who have a healthy weight but are working out very aggressively, multiple times a day or throughout the week, this can also put a strain on your body as well as the portion of the brain that secretes these hormones that you're in a constant state of stress. While it is a good stress, it can actually have an effect on your hormones. And that's where you'll hear of people not having a period that are very active, such as marathon runners and things like that. So, that does pose an issue as well as with obesity. And we know that having excess fats can interfere with the amount of estrogen and the way our body metabolizes these hormones.
Melanie Cole, MS: So while we don't have enough time, and you and I have discussed this a little bit, that we should really be doing a series on optimizing our natural fertility. But I'd like you to just briefly touch on lifestyle and food that includes caffeine and alcohol, smoking, any of these things that could decrease our ability to get pregnant.
Kelly Curtis: Sure. So. We'll start with caffeine because, you know, multiple people, everyone wakes up, gets their coffee in the morning. One cup is okay. Two or three seems to be okay. It is when we are doing the extremes of 500 milligrams of caffeine or the equivalent. So, if you like energy drinks or tea, the accumulation of all of these throughout the day may have an effect on our fertility. And we know once we do become pregnant, that we should limit our caffeine to less than 200 to 300 milligrams as this may cause miscarriage.
Other things that are very commonly used, alcohol. There's been limited evidence to indicate that moderate alcohol use has any effect. But we have seen that in women who drink two or more alcoholic beverages in a day, there is a drop in their fertility. So, men also have to be conscious of this as well. Men who have heavy alcohol consumption, you know, that are drinking more than two drinks a day, this has also been seen to affect sperm quality as well as fertility for males.
Smoking is not good at all for anybody. But if women do smoke, we recommend stopping as soon as possible, especially if you're looking to conceive as this may have an effect. We also know that women who smoke, menopause occurs on average one to four years sooner. So, this tells us that there might have an effect on the follicular depletion or the number of eggs that you have available.
Melanie Cole, MS: Oh, that's interesting.
Kelly Curtis: Yeah. Yeah, it's very interesting. Smoking is not great for not only fertility, but multiple other health reasons. So, this is your sign to stop smoking. And diet, I just wanted to touch on what we do, is decreasing red meat and replacing it with more fish has actually been shown to help with the decreasing oxidative stress with the body. So, that would be some advice if you're looking to adjust things from your daily living to try to increase your fertility. That being said, just keep in mind that mercury has decreased fertility as well, so make sure that the fish you're eating are not high in mercury.
Melanie Cole, MS: Wow. This is a lot of information to process. And as I said, we are going to do more of these, you and I, to really get into some of these things a little bit more in detail. Just give us your best advice as couples are looking to optimize their fertility naturally, what would you tell them or what do you tell them every single day?
Kelly Curtis: Healthy lifestyle is a great place to start. So, the right amount of exercise and good diets and then timing your ovulation and understanding your menstrual cycle will go a long way. So, we want to make sure that you're targeting your fertility window here. And then, there is another caveat that when you are having intercourse, that there is no position or laying down or anything like that, that are going to increase your chances. So, we just want as much intercourse as possible during the fertile window.
Melanie Cole, MS: Thank you so much, Kelly, for joining us today and giving us a lot to think about and so many good ideas. Thank you again. And for more information, you can visit fertilitynj.com to get connected with one of our providers. That concludes this episode of Fertility Talk with RSCNJ, the Reproductive Science Center of New Jersey. I'm Melanie Cole.