“How can I improve my fertility?” This is one of the most common questions I get asked as a Fertility Doctor. Women are actually born with all the eggs they will ever have. Both the quantity and quality of our eggs decline with age. Fertility can start to decrease in our late 20s and early 30s and relative fertility drops by about half among women in their late 30s compared to women in their early 20s.

You can’t stop or reverse ovarian aging. So what CAN you do to improve your natural fertility and increase your chances of getting pregnant? Read ahead!

1. Aim for a Normal BMI to Improve Fertility

Obesity negatively impacts human reproduction and can significantly hurt your ability to get pregnant. Body mass index (BMI) is a tool used to determine if you are at a healthy weight for your height. A normal BMI is 18.5-25 kg/m2. A BMI of 25-30 kg/m2 is considered overweight and a BMI greater than 30 kg/m2 is classified as obese. A BMI greater than 40 kg/m2 is considered morbidly obese, which means that you are at high risk of experiencing obesity-related health problems like diabetes or high blood pressure.

Obesity can wreak havoc on your hormones, which can lead to menstrual cycle abnormalities, ovulatory dysfunction, decreased egg quality, and altered endometrial receptivity, which can affect implantation.

Obesity is also linked with increased pregnancy loss and a higher risk of pregnancy and perinatal complications including gestational diabetes, preelampsia, preterm delivery, stillbirth, C-section delivery, shoulder dystocia, and both small- and large-for-gestational age infants.

A BMI that is too low (less than 18.5 kg/m2) can also be harmful to fertility. Maintaining a healthy BMI greatly increases your chances of getting pregnant and reduces the risk of developing complications once you are pregnant. The best way to achieve a normal BMI is through regular exercise and a healthy well-balanced diet.

2. The Harmful Effects of Smoking on Fertility

Smoking is incredibly harmful to fertility and reproduction. Women who smoke are significantly more likely to be infertile. They also reach menopause 1 to 4 years earlier on average. Smoking has been shown to delay conception, accelerate the loss of eggs, increase the risk of birth defects and it has been associated with an increased risk of miscarriage and ectopic pregnancy.

Secondhand or passive smoke is also harmful to fertility, not to mention all the harmful effects during pregnancy. Smoking cessation for women trying to conceive and/or their partners is one of the best things you can do to optimize fertility and have a healthy pregnancy.

3. Reduce or Eliminate Alcohol When Trying to Conceive

Several studies have suggested that higher levels of alcohol consumption (more than 2 drinks per day) lower rates of conception. Alcohol should be limited to 3-4 drinks per week and no more than 1 drink per day, but it’s best to avoid alcohol altogether when trying to conceive.

Alcohol consumption should stop completely during pregnancy because alcohol has well-documented harmful effects on the baby. There is no “safe amount” of alcohol in pregnancy.

4. Limit Caffeine to Decrease Miscarriage Risk

Consuming large amounts of caffeine (500 mg or greater than 5 cups of coffee per day or its equivalent) has been associated with decreased fertility. During pregnancy, more than 200-300 mg per day (2-3 cups per day) of caffeine may increase the risk for miscarriage.

Limited caffeine intake (1 to 2 cups of coffee per day or less than 200 mg of caffeine) before or during pregnancy does not appear to have adverse effects on fertility or pregnancy outcomes.

Be aware of how much caffeine is in your beverage because not all cups of coffee are created equal. And don’t forget to factor in other sources of caffeine such as sodas, teas, and energy drinks.

5. Take Prenatal Vitamins to Prepare For Pregnancy

For women trying to conceive we recommend taking a prenatal vitamin, which can help prepare your body for pregnancy, prevent birth defects, and increase your chance of a healthy pregnancy. Women trying to conceive and women who are pregnant need additional nutrients such as calcium, iron, and folate.

Folic acid (at least 400-800 mcg daily) can help reduce the risk for neural tube defects. Docosahexaenoic acid (DHA) is an omega-3 fatty acid found in fish oil that is important for pregnant women. DHA has been shown to improve the baby’s brain, nervous system, and eye development. Many prenatal vitamins on the market now contain DHA, but if yours doesn’t take a supplement that provides a minimum of 200 mg of DHA.

Vitamin D has a number of important roles in our bodies including bone structure, immune function, and reproductive health. Vitamin D deficiency is very common and easy to treat. Patients should take 800-1,000 IU daily to maintain levels. If you are deficient, your doctor may prescribe a larger dose to bring your levels up to the normal range.

You should start taking a prenatal vitamin at least 3 months prior to conception.

6. Eliminate Environmental Toxins that Affect Fertility

Exposure to environmental toxins and pollutants can hurt fertility. Women trying to conceive should avoid consuming some large fish, such as shark and swordfish, because they contain high levels of methylmercury, which is a known teratogen.

Eating organic foods will help decrease pesticide ingestion and avoiding canned foods will reduce levels of bisphenol A (BPA) and phthalates. Drinking out of BPA-free water bottles and avoiding plastics made with BPA is also recommended.

Certain chemicals and solvents such as those used in the dry cleaning and printing industries may decrease fertility in women. If you are worried about toxic exposures in the workplace, talk to your doctor about it.

7. The Relationship Between Stress and Fertility

The relationship between stress and fertility is real and it can affect both women and men. Not only can infertility increase stress, but studies also suggest that stress may affect fertility.

Effective coping strategies are key to combating the potentially negative impact of stress. Some strategies worth considering include individual or couples counseling, joining a support group, acupuncture, and mind/body approaches such as meditation or yoga. Even simple things like going for a walk outside, spending time with friends, or taking time for self-care can make a big difference. Every patient and couple manages stress differently so it is important to find a technique that works for you.


Even though women can’t increase the number of eggs, there are several things that you can do to improve your natural fertility.

  • Maintain a normal weight and BMI through a healthy diet and exercise.
  • Quit smoking.
  • Reduce or eliminate alcohol.
  • Limit caffeine consumption.
  • Watch out for environmental toxins.
  • Make sure you are taking a prenatal vitamin and getting enough folic acid, DHA, and vitamin D to support a healthy pregnancy.
  • Find ways to minimize stress while trying to conceive. It’s good for your fertility, mental health, relationships, and general well being.

And remember, if you are under the age of 35 and have been trying to conceive naturally without success, consider making an appointment to see a Fertility Doctor. If you are over the age of 35, we recommend trying for only 6 months before seeing a Specialist. We can help you understand your fertility with some simple tests and give you some guidance and recommendations to help you achieve your goals.

Wishing everyone trying to conceive lots of luck and baby dust!