What are the methods to enhance fertility?

From the Guidelines

To enhance fertility, it is crucial to maintain a healthy lifestyle, address underlying medical conditions, and consider evidence-based medical interventions, as supported by the most recent and highest quality study 1.

Key Recommendations

• Achieve a healthy weight through balanced nutrition and regular exercise to optimize reproductive hormones.
• Consume a diet rich in antioxidants, including fruits, vegetables, nuts, and grains, while limiting processed foods, alcohol, and caffeine.
• For women, take a prenatal vitamin containing 400-800 mcg of folic acid daily.
• Men should consider supplements containing zinc, selenium, and vitamins C and E to improve sperm quality, although the evidence for antioxidant supplementation is of low quality 1.
• Manage stress through meditation, yoga, or counseling, as chronic stress can disrupt hormone balance.
• Avoid smoking and recreational drugs, which significantly impair fertility.
• Track ovulation using basal body temperature measurements, ovulation predictor kits, or fertility awareness apps to time intercourse appropriately—typically every 2-3 days during the fertile window.
• For men, avoid hot baths, saunas, and tight underwear as excessive heat can reduce sperm production.
• If trying to conceive for 12 months without success (or 6 months if over 35), consult a reproductive endocrinologist who may recommend treatments like Clomiphene citrate, intrauterine insemination, or in vitro fertilization depending on the specific fertility issues identified through testing 1.

Medical Interventions

• For infertile men with low serum testosterone, consider aromatase inhibitors (AIs), human chorionic gonadotropin (hCG), selective estrogen receptor modulators (SERMs), or a combination thereof 1.
• For men with idiopathic infertility, consider treatment using a Follicle-Stimulating Hormone (FSH) analogue to improve sperm concentration, pregnancy rate, and live birth rate 1.
• Assisted reproductive technologies (ART) such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) may be effective for couples with male infertility, especially when natural pregnancy has not previously occurred 1.

From the FDA Drug Label

Clomiphene citrate is indicated for the treatment of ovulatory dysfunction in women desiring pregnancy. Properly timed coitus in relationship to ovulation is important A basal body temperature graph or other appropriate tests may help the patient and her physician determine if ovulation occurred.

The methods to enhance fertility include:

• Ovulation induction with clomiphene citrate in women with ovulatory dysfunction
• Properly timed coitus in relation to ovulation
• Using a basal body temperature graph or other tests to determine if ovulation has occurred 2 Note that the second drug label does not provide information on methods to enhance fertility, but rather provides dosage information for human chorionic gonadotropin.

From the Research

Methods to Enhance Fertility

There are several methods to enhance fertility, including:

• Nutritional changes, such as maintaining a healthy weight, following a balanced diet, and avoiding endocrine-disrupting chemicals 3
• Lifestyle modifications, such as quitting smoking, reducing alcohol consumption, and exercising regularly 4
• Dietary patterns, including a Mediterranean or balanced diet with an adequate intake of monounsaturated fatty acids, fruit, and vegetable products 5
• Supplementing the diet with multivitamin products containing folic acid and iron 5
• Medical treatments, such as combined clomiphene and letrozole therapy for the treatment of Polycystic Ovarian Syndrome (PCOS) subfertility 6

Dietary Recommendations

Dietary recommendations to enhance fertility include:

• Eating a diet rich in dietary fiber, omega-3 fatty acids, plant-based protein, and vitamins and minerals 7
• Avoiding a diet high in trans fats, refined carbohydrates, and added sugars 7
• Maintaining a healthy weight, as obesity and being underweight can both affect fertility 3, 4
• Considering supplementation with folic acid, vitamin D, and iodine if necessary 7

Lifestyle Factors

Lifestyle factors that can affect fertility include:

• Smoking and alcohol consumption, which can negatively impact fertility 4
• Exercise, which can improve fertility when done regularly and in moderation 4
• Stress, which can be managed through methods such as yoga and cognitive behavioral therapy 4