Optimising fertility
Patients often ask if there are ways of optimising their fertility with lifestyle changes and alternative therapies. This resource outlines evidence behind practices that may improve fertility related treatment outcomes, including assisted reproductive technology (ART).
Exercise
Evidence suggests that moderate, regular exercise positively influences fertility and ART outcomes in both men and women. Exercise not only helps with weight reduction, it reduces inflammation leading to improved egg and sperm quality as well as improving ovulatory function. On the other hand, excessive exercise may adversely affect fertility in women.
As well as improving physical health, exercise can also improve quality of life and emotional wellbeing. Studies have shown that exercise improves anxiety and depressive related symptoms for people undergoing fertility treatments.
Experts recommend being active every day. This could look like:
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2.5 to 5 hours of moderate intensity physical activity each week, such as a brisk walk or swimming.
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1.25 to 2.5 hours of vigorous intensity physical activity each week – such as jogging, aerobics, fast cycling, soccer or netball.
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an equivalent combination of moderate and vigorous activities each week.
Nutrition and supplements
Maintaining a healthy diet with a wide variety of food is the best way of achieving the optimal nutritional intake for fertility and pregnancy in women. As well as reducing the risk of birth defects, there is some evidence to suggest that some micronutrients may improve fertility outcomes for people with sub-fertility.
Folic acid - There is some evidence to suggest folic acid supplementation may improve fertility in some people, but it is not known if this applies to everyone. It is recommended that all women planning for pregnancy take folic acid (discuss dosing with your doctor), starting at least one month before conception to prevent neural tube defects in the developing baby.
Iodine - It is unknown if iodine directly improves fertility. Daily iodine (discuss dosing with your doctor) is recommended for people planning a pregnancy to support the development of the baby’s brain and nervous system.
Vitamin D – Vitamin D supplementation may improve fertility in women and men who are vitamin D deficient. Ask your doctor for advice about testing and whether you need Vitamin D supplementation.
Zinc and selenium – acts to reduce free radicals, a by-product of inflammation. There is some evidence to suggest that these nutrients may improve egg and sperm quality however it is unclear if this improves fertility more broadly.
Multivitamins - Preconception supplements for men and women and pregnancy supplements have not been proven to improve fertility or pregnancy outcomes. It is therefore recommended that people instead take micronutrients that are specific to their needs.
A nutritionist may be able to provide you with advice regarding optimising your fertility through adequate nutritional intake.
Weight
Research shows that being above or below the ‘healthy weight range’ increases the time to natural conception and can impact ART outcomes.
For women in the overweight and obese range, reducing weight by 5-10%, is shown to improve fertility. Similarly, women under the ‘healthy weight range’ also benefit from moving towards a healthy weight range.
BMI categories
<18.5 - Underweight
18.5 - 24.9 - Healthy weight
25 - 29.9 - Overweight
>30 - Obese
Click here to calculate your BMI
Studies have shown that obese men have lower fertility than those with weight within the healthy range – sperm counts are often lower and sperm less motile. This is likely to be due to the change in hormones and potentially due to heat around the scrotal area.
Combining exercise with a healthy diet is the best method for optimising weight in men and women. For some people, weight loss medication or surgery may be required to assist in achieving these goals.
Speaking with your GP about how to achieve weight loss is an important first step. A weight loss practitioner may also be a useful resource when working on weight optimisation.
Mental health
Subfertility can have a profound effect on mental health for individuals and couples seeking fertility treatment. There is some evidence to suggest that untreated mental health issues in men and women can lead to poorer fertility outcomes. It is therefore recommended that people with mental health concerns seek support. The best place to start is by speaking to a GP who can provide you with support and refer on to a counsellor of psychologist. Many psychological services offer Medicare rebates.
Complementary therapies - Acupuncture and Chinese medicine
While the scientific evidence for acupuncture and Chinese medicine in improving fertility outcomes is limited, some people find these therapies helpful in managing stress and improving overall wellbeing. The risks associated with acupuncture are relatively low (if it is administered by a certified acupuncturist) and therefore we support this as an option for our patients.
It is important to speak to a doctor before taking Chinese medicines including herbs, vitamins and minerals when undergoing fertility treatments, as they can interact with other medications and body processes.
Directory of local clinicians**
Acupuncture and Chinese Medicine
Bendigo Chinese Medicine
69 Mitchell Street
Bendigo VIC 3550
https://www.bendigochinesemedicine.com/
Nutrition
Modern Nutrition
Jessica Pease
103 Williamson St
Bendigo, VIC 3550
https://www.modernnutrition.com.au/
Melanie Hale – Dietician
Health Hub @ UFS Pharmacy
Hargraves Street
Bendigo VIC 3550
https://melaniehaledietitian.com/
Mental Health
St John of God Raphael Services
We provide free or no out-of-pocket confidential counselling and support for people who are experiencing fertility challenges and pregnancy loss.
15 MacKenzie Street
Bendigo VIC 3550
Tel: 1800 292 292
Email: raphael.bendigo@sjog.org.au
Happy Minds Psychology
Sarah-Jayne works with women who are trying to conceive, are pregnant, or are already parents.
Sarah-Jayne Dureya
Psychologist Level 1
87 The Parade Ocean Grove (Telehealth available)
Monash IVF Supportive Counselling (for Monash IVF patients only)
Counselling for individuals and couples can help you cope with medical treatments and uncertain outcomes, as well as helping you deal with family, friends, work and the fertile world. To make an appointment, contact your IVF clinic directly or speak with your IVF nurse.
Monash IVF Clayton Administration team:
Ph: 03 9590 8300
Monash IVF Nurse: Petra Clements
Ph: 03 9420 8218
Email: bendigonurse@monashivf.com
List of Australian and New Zealand Infertility Counsellors Association (ANZICA) counsellors, providing private practice (listed by state)
https://www.fertilitysociety.com.au/professional-groups-anzica-australia-new-zealand/#private
Weight optimisation
Weight Loss Clinician
Central Victoria Integrated Clinic
Rebecca East
Bendigo VIC & Echuca
Dr Kirby White
Bariatric General Practitioner
Bendigo Surgical Services
03 5444 0878
https://bendigosurgicalservices.com.au/
**This list is not intended to promote specific clinicians. Rather, it is a starting point for seeking out allied-health support in Bendigo and surrounding areas. There are many skilled clinicians working in these areas, and we encourage you to do your own research.
Support groups
ACCESS support groups - https://access.org.au/?p=206
Mens health support groups - https://www.healthymale.org.au/resources-tools/useful-websites-support-groups
Internet resources
ACCESS Fact sheets - https://access.org.au/?p=297
The Healthy Male - https://www.healthymale.org.au
Managing the stress of infertility –
31ff8d_50aca4928c3b49c39a04d4d355cd03a6.pdf (filesusr.com)
Your Fertility (Fertility Society of Australia) - https://www.yourfertility.org.au/
Your Fertility Fact Sheets - https://www.yourfertility.org.au/general-resources/fact-sheets