5 things to improve chances of conception:

Diagnosis of unexplained infertility could be very frustrating. Uncertainty is the hardest part to deal with.

While it could be some subtle factors causing infertility in some couple, in others it could be genuine lack of cause. It is better than being diagnosed with something serious. In couples where the women are less than 40 years of age and no known obvious factors for infertility, over 80% will conceive in the first year and over 90% by the end of the second year.

There are many things that can be done to improve the chances of spontaneous conception:

1. Quit smoking: Both active and passive smoking can adversely affect fertility in both male and female. In women, it reduces ovarian function, alters tubal function and the uterine environment leading to non-implantation of the embryo. In men, it impairs the fertilising capacity of sperm by reducing mitochondrial activity and increasing DNA damage. Stopping smoking will not only improve fertility but also general health.

2. Maintain a healthy weight: Both obesity (BMI>30) and being underweight (BMI<19) can impair fertility even in young and regularly ovulating women. Obesity can alter the egg quality, and impair implantation of the embryo. Obesity in men can cause DNA damage in sperm and decreased libido and erectile dysfunction.

3. Cut down on Alcohol: Excessive alcohol (especially binge drinking) can cause infertility. In men, even habitual drinking over 5 units per week has been found to have an adverse effect on sperm quality. Alcohol consumption in women can reduce fertility by decreasing the implantation rate and abnormal embryo development. The recommended allowance for alcohol for women is 1 or 2 units per week and for men 3-4 units per day. Avoid binge drinking.

4. Avoid psychological stress: It is well known that psychological stress can have an immense impact on fertility of both men and women. However, difficulty in conceiving can lead to significant psychological stress. Various methods like relaxation therapy, meditation, yoga, acupuncture, mindfulness, joining a peer support group can help to reduce the stress.

5. Having regular intercourse at the right time of the cycle: While there are various tests to detect ovulation, the presence of a regular menstrual cycle in itself is a fair indicator of regular ovulation. Doing urinary ovulation test adds to unnecessary stress and can be avoided. Ovulation typically occurs 14 days before the periods. Sexual intercourse should be aimed at few days before the ovulation, which can be worked out from individual cycle length.

e.g In a typical 28-day cycle, ovulation occurs on day 14 and the fertile period are between 8 – 14 days, while in a 30-day cycle ovulation occurs on day 16 and fertile period are between 8-16 days. Vaginal intercourse every 2 to 3 days during the fertile period optimises the chances of pregnancy.

Other facts: There is no evidence on the effect of tea, coffee on fertility.

While raised scrotal temperature reduces sperm quality, it is uncertain whether wearing loose-fitting underwear improves fertility.

Women trying to get pregnant should take dietary supplementation with folic acid to prevent neural tube defect in the baby.

Written by Dr Anupa Nandi