Fertility Health: Is your fertility health as good as it could be?

For Women                 

The menstrual cycle is another "vital sign". Age when menstrual periods start and menstrual cycle characteristics are indicators of endocrine function and overall health. Length and regularity of the cycles may be tell us when a young woman is developing normally and/or who is at risk for cardiovascular disease, polycystic ovarian syndrome (PCOS), and reproductive cancers. 

Menstrual Variability: Cycle length is defined as the beginning of menses (period) to the last day before the start of the next menses. Many women have variation in the length of a cycle and that is entirely normal! What that means is that a range is what is usual...such as 25 days, then 30 days, then 27 days, then 32 days and so on. Women with truly irregular cycles have less than 9 cycles per year. Only about 13-15% of women actually have 28 day cycles!

Post-hormonal contraceptive cycles:

Oral Contraceptives: Research shows that immediately after discontinuing birth control pill use, almost 60% of the first cycle after stopping is ovulatory. The cycle length was prolonged until the ninth cycle. Cycle disturbance and insufficient post-ovulatory phases are more frequent (30% of women) until the seventh cycle. So waiting for 3 cycles to try to get pregnant is usually advisable.

Cycles after Depo-Provera: the average time for clearance of the drug from the body is about 6 months. The average time for the return of fertility is 9 months.

Stress: Acute or chronic stress is associated with variation in the menstrual cycle either shortening or lengthening the cycles. High levels of perceived stress significantly increased the probability of long cycles i.e. over 43 days. The type of stress may vary depending on the woman's life situation. Stressful jobs doubled risk for short cycle length. It is possible that stress would lead to poor quality of ovulation and thus inadequacy of the post-ovulation phase.

BMI -- Body Mass Index: Body mass index influences menstrual function in healthy women. There is evidence that fertility is decreased by having a BMI of 25 kg/m2 (too heavy); both have longer than average cycle lengths. This may indicate disturbances in ovulation. Post-ovulation (Luteal) phase defects may occur (this means that there is inadequate progesterone levels) which can lead to miscarriage or pre-menstrual symptoms (PMS).

Exercise: Exercise is recommended in moderation. The health benefits of exercising are well-known including improving insulin levels. Only excessive exercise resulting in a low BMI (unhealthy levels) would have a negative effect on the cycle.

Smoking: Smoking is associated with short cycle length. The greater the amount of smoking, there was a possible increased risk of not ovulating and short post-ovulation phase. The effect can last a long time. Cycle lengths of ex-smokers with ten or more pack-years of exposure were also more likely to be short and have shorter luteal phases than those of never smokers.

Marijuana & Alcohol: Marijuana is disruptive to ovulation and to the menstrual cycle. The substance in marijuana (THC) is found in vaginal secretions and interferes with the sperm's ability to fertilize the egg. There are few studies that include the effect of alcohol consumption on menstrual cycle characteristics. The evidence is unclear as to exactly what level of alcohol consumption has an effect upon fertility. High consumption (> 8 drinks/week) was associated with decreased fertility.

Sleep Habits:

Light exposure at night may have pronounced effects on the menstrual cycle and symptoms through the influence of melatonin (sleep inducing hormone). For example, female shift workers report more menstrual irregularity and longer cycle lengths. Women with 20+ months of rotating shift work were more likely to have irregular cycles or short cycles. However, there are women who are more sensitive to light at night. It is a good practice to keep your bedroom as dark as possible--not only will you sleep better but it is good for your fertility as all menstrual cycles characteristics were improved but such practices in research studies.

Keep the electronics out of your bedroom. Turning off your router at night is also advisable. More information is emerging that demonstrates the disruptive effects of the EMFs emitted from these devices.

For Men

Fertility reflects a man’s “overall” health! Men who live a healthy lifestyle are more likely to produce healthy sperm and better semen quality. Those habits that promote healthy fertility also reduce your risk of disease later in life.

BMI -- Body Mass Index:

Obesity is directly associated with increasing male infertility. Obese males have lower testosterone, higher estrogen levels, higher risk of heart disease, higher risk of erectile dysfunction, poorer sperm quality and reduced fertility. High BMI is also associated with poorer semen quality.

Exercise: Exercise is recommended in moderation. However the man should be selective regarding the type. For example, regular bike riding poses a risk because of pressure and friction against the seat restricting blood flow to the testicles. Use of steroids to build muscles suppresses testosterone, decreases sperm count and motility and leads to erectile dysfunction.

Scrotal temperature: Increased scrotal temperature can depress semen quality: fever, hot tubs, tight underwear, exposure to high-temperature working conditions, and occupations that require long periods of sitting have been shown to affect sperm quality. Using a laptop on the knees for extended time (heat produced by battery) may increase scrotal temperature.

Stress: Being stressed has been linked to poorer semen quality in men. Stress may lead to reduced testosterone levels and sperm production because of the influence on carbohydrate, protein, and fat metabolism.


Smoking affects semen volume, sperm density, total sperm count, motility, and shape of the sperm. In addition, nicotine can cause sperm DNA damage.

Marijuana & Alcohol:

Marijuana reduces testosterone production, sperm count, and semen quality and inhibits the ability of the sperm to fertilize the egg. Excessive alcohol causes fertility abnormalities: lowering testosterone levels, lowering sperm counts and impairing sperm motility. It can also reduce libido and cause impotence. Heavy drinking can reduce a couple's chances of conceiving but the effects can be quickly reversed.


Caffeine intake can be difficult to study since intake is often associated with alcohol and smoking. But, researchers examined the association between semen quality and caffeine intake. High cola (> 3 sodas (12 oz) per day) and/or caffeine (>800 mg/day) intake was associated with reduced sperm concentration and total sperm count.. Therefore, there is a possibility of an amount of cola, and probably caffeine, which lowers semen quality. 

Sleep Habits

Although there are no sleep studies examining the effect on male fertility, emerging information on sleep generally leads to the conclusion that sleeping in cool dark rooms is optimal for all.

Keep the electronics out of your bedroom. Turning off your router at night is also advisable. More information is emerging that demonstrates the disruptive effects of the EMFs emitted from these devices.

For Both Men and Women

Similar dietary recommendations can be made for both men and women—see Table. A healthy diet is key to overall health and has been studied for its effects on fertility. 

It is important to remember that the right kind of fat in our diets is important for making adequate hormones, essential to the fertility process. Chavarro and colleagues (2007-2010) published a number of articles regarding diet and fertility as well as a book “The Fertility Diet”. One serving of a full-fat food per day (like full fat cheese) is recommended because skim milk or fat free products lead to increased insulin resistance which is tied to the cause of polycystic ovarian syndrome. 

Moyad (2012) reviewed current issues and published recommendations for the Optimal Male Health Diet and Dietary Supplement program geared to preventing heart disease. The same habits that promote healthy male fertility also lessen the risk of heart disease. 

Chavarro (2011) reported that trans-fats were present in human sperm and and may affect formation of healthy sperm profoundly.