Are you trying to conceive but finding it difficult? Here are some tips and possible reasons why…

1. Trying to conceive at the wrong time – I see so many couples who are either not having enough conceptions attempts per cycle or are trying the wrong time. Most women will ovulate around 14 days before their next period which is easy to calculate if you have a regular cycle but not so easy if you don’t! If you know when you are ovulating, start trying every second day from four days before ovulation to one day after. For those who are not sure when they ovulate, check your cervical mucus daily and start trying when it turns from thick and sticky or white and pasty to a thinner, clearer and more watery or slippery texture. Keep trying every second day until it changes back to thick and white. (Hint: check mucus late in the day to avoid confusion with residual semen from attempts the night before!)

2. Underlying autoimmune conditions – Auto-immune conditions are those in which the body mounts an immune response against its own tissue. These conditions may be specific such as Hashimoto’s Thyroiditis or non-specific or even asymptomatic, such as having elevated levels of anti-nuclear antibodies (ANAs) or anti-phospholipid antibodies. The lifestyle and dietary aims are to reduce inflammation, support digestive health and support the immune system. Try gluten free to reduce inflammation and improve fertility. Gluten antibodies often cross-react with other antibodies making autoimmune conditions worse.

3. Trying to conceive whilst suffering excess stress – excessive cortisol production from long term or acute stress can affect fertility. This includes people who may not feel “stressed out” but are always on the go and have little downtime. If this is you, make time to slow down and relax. Try a mindfulness meditation before bed and switch some of your high intensity exercise sessions for gentle walking or yoga.

4. Sperm quality – around 30% of subfertility cases or problems trying to conceive, are caused from male factor issues alone. Sperm can be tested for its quality which can be dramatically improved by making diet and lifestyle changes alone. If the male partner is over 35 or you have suffered miscarriages, always test the DNA fragmentation of the sperm in addition to the usual semen analysis.

5. Thyroid is underfunctioning – Good thyroid health and function is essential for good hormonal health (and especially for conception and pregnancy maintenance). Your TSH (thyroid stimulating hormone) should ideally be under 2.0 – if it is higher, you may be hypothyroid or sub-clinically hypothyroid (still ‘in range’ but certainly not optimal for hormonal health). Get your thyroid checked if you are having trouble conceiving or have a family history of thyroid problems.

6. Poor diet and / or nutrient deficiencies – eating nutrient poor foods can lead to deficiency of nutrients and minerals which are essential for good fertility. Load up on plenty of protein, good fats and vegetables and minimize grains, sugar and processed foods. The quality of food you eat is as important as the types of food you eat. Organic food is recommended as much for what it does not contain as what it does contain. The avoidance of herbicides and pesticides is considered essential for preconception health as well as during pregnancy and beyond.

7. Low body weight – body fat is essential for adequate hormone production. A low body fat percentage can cause anovulatory cycles (even when the period is regular). Studies have shown that many women with a BMI of 18-19 may still have periods but not be fertile. For these women it is important to reduce cardio exercise and increase intake of healthy fats such as avocado, salmon, olive oil, coconut oil and full fat pasture-raised dairy products.

8. Reproductive health issues – conditions such as endometriosis, polycystic ovarian syndrome, fibroids, adhesions and ovulation disorders can contribute hormonal imbalances, inflammation and structural issues affecting conception. These issues may be improved with a combination if diet, lifestyle, prescribed supplementation and medical treatment / surgery (if required).

9. Inadequate progesterone production – Many reproductive issues (including subfertility) are associated with low progesterone levels. Progesterone is an important hormone and is responsible for supporting the luteal phase of your cycle and maintaining an early pregnancy. Low progesterone might be an issue if you if you experience spotting before your period, tender and swollen breasts, PMS or short cycles. Low progesterone can contribute to a short luteal phase (less than 12 days) which impacts fertility, Progesterone levels are peaking a week after ovulation and can be tested with a blood test at this time.

10. MTHFR Mutations – People with these mutations have difficulty metabolizing or absorbing folic acid (which is the synthetic version of folate – ALL folic acid is synthetic). This means that folate is not able to easily enter the cells to be utilized and used to protect DNA, among many its many other roles. There are several types of MTHFR mutations and the more severe forms may contribute to a huge range of negative health effects including miscarriage and difficulty conceiving.

11. Low ovarian reserve and advanced maternal age – Some women will have a lowered ovarian reserve (measured by FSH, AMH orantral follicle count) – this means it may be harder to conceive and there may be an increased risk of miscarriage. This will happen naturally as women age but some women have a low reserve at a younger age. There is still no definitive test for ovarian reserve. A diet rich in antioxidants in addition to specific supplementation can be helpful. You only need one good egg (and one good sperm!) but it may take a little longer to find it!

About the author

Belinda Kirkpatrick is an expert Nutritionist and Naturopath in Sydney. She specialises in natural fertility, family and women's health care. She is the author of Healthy Hormones (a practical guide to balancing your hormones) and is the founder of the SEED Concept and also Seed App for iPhone.

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