Making the decision to have children is sometimes easier than
getting pregnant. According to research or other evidence, the following self-care steps may
improve your chances of conceiving:
- Stop smoking
- Kick the habit now to improve your chances of getting
pregnant
- Abstain from alcohol
- Avoid drinking alcoholic beverages to double your potential for
conception
- Cut the caffeine
- Stop drinking coffee and tea, and avoid other caffeinated
products
- Watch your weight
- Check with your doctor to see if weighing too much or too little
may be interfering with your fertility
- Get to know propolis
- This natural substance may improve the likelihood of pregnancy;
take 500 mg twice a day
- See a specialist
- Consult with a fertility expert to find out if there is a medical
reason for your infertility
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full female infertility article
for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About female infertility
Infertility is defined by doctors as the failure to become pregnant after a year of
unprotected intercourse.
It can be caused by sex-hormone abnormalities,
low thyroid function, endometriosis,
scarring of the tubes connecting the ovaries with the uterus, or a host of other factors. Some
of the causes of infertility readily respond to natural medicine, while others do not. The
specific cause of infertility should always be diagnosed by a physician before considering
possible solutions.
Product ratings for
infertility
What are the symptoms?
For most infertile women, no symptoms accompany the infertility. Some women with symptoms
of obesity, acne, and excessive facial hair;
heavy, irregular, or absent menstrual periods; or fluid leaking from the breasts could have
hormone imbalances that might interfere with fertility.
Medical options
Prescription fertility drugs such as clomiphene (Clomid®, Serophene®),
gonadorelin (Factrel®, Lutrepulse®), human chorionic gonadotropin or
“hCG” (A.P.L.®, Fullutein®, Humegon®, Pregnyl®,
Profasi®), and human menopausal gonadotropins or “hMG” (Metrodin®,
Pergonal®, Repronal®) are commonly prescribed.
Artificial insemination can be used to place sperm directly in the cervix or uterus.
Another more advanced procedure is called “in vitro fertilization,” wherein the
egg (collected from the ovary in a surgical procedure) and the sperm are combined under
controlled conditions in a laboratory. The fertilized embryo is then implanted into the
woman’s uterus.
Dietary changes that may be helpful
Consumption of one to one and a half cups of
coffee per day in one study1 and about three2 or four3
cups per day in other studies has been associated with delayed conception in women trying to
get pregnant. Caffeine consumption equivalent to more than two cups
of coffee per day has been associated with an increased incidence of infertility due to tubal
disease or endometriosis.4 In another study, women who consumed more than one cup
of coffee per day had a 50% reduction in fertility, compared with women who drank less
coffee.5
Caffeine is found in regular coffee, black
tea, green tea, some soft drinks, chocolate, cocoa, and many over-the-counter
pharmaceuticals. While not every study finds that caffeine reduces female
fertility,6 many doctors recommend that women trying to get pregnant avoid
caffeine.
In one study, consumption of three cups of decaffeinated coffee per day was associated with
an increased risk of spontaneous abortion.7 In another study, caffeine consumption
compounded the negative effects of alcohol consumption on female fertility.8 Some
researchers suspect that the tannic acid found in any kind of coffee and black tea may
contribute to infertility.9
Consumption of fish contaminated with
polychlorinated biphenyls (PCBs) may reduce the ability of women to conceive. In one study,
women who ate more than one fish meal per month of fish caught in Lake Ontario (known to be
contaminated with PCBs) had reduced fecundity (meaning that it took longer for them to become
pregnant) compared to women who ate less contaminated fish.10
Lifestyle changes that may be helpful
The more women smoke, the less likely they are to conceive.11 In fact, women
whose mothers smoked during their pregnancy are less likely to conceive compared with
those whose mothers were nonsmokers.12
Quitting smoking may enhance fertility.
Even moderate drinking of alcoholic beverages by women is linked to an increased risk of
infertility in some,13 although not all, research.14 In a preliminary
study, there was a greater than 50% reduction in the probability of conception in a menstrual
cycle during which participants consumed alcohol.
Caffeine appeared to enhance alcohol’s negative effect in this study. Women who
abstained from alcohol and consumed less than one cup of coffee per day were more than twice as likely to
conceive (26.9 pregnancies per 100 menstrual cycles) compared with those who consumed any
amount of alcohol and more than one cup of coffee per day (10.5 pregnancies per 100 menstrual
cycles).15 Based on this preliminary evidence, women who wish to improve their
chances of conception should avoid alcohol and caffeine.
Being excessively overweight or underweight
may also contribute to infertility in females.16 Infertile women who are overweight
or underweight should consult a physician.
Some conventional medications can interfere with fertility. When in doubt, women taking
prescription drugs should consult their physician or pharmacist.
Vitamins that may be helpful
In a preliminary study of women with infertility and mild endometriosis, supplementation
with propolis (500 mg twice a day for six
months) was associated with a pregnancy rate of 60%, compared with a rate of 20% in the
placebo group (a statistically significant difference).17 Whether propolis would be
beneficial for infertile women who do not have endometriosis is not known.
In some women, infertility is due to a hormonal abnormality known as luteal phase defect.
In this condition, the uterine lining does not develop and mature properly, presumably because
of a deficiency of the hormone progesterone. In a study of infertile women with luteal phase
defect, supplementation with 750 mg of vitamin
C per day for up to six months resulted in a pregnancy rate of 25%, compared with a rate
of 11% in an untreated control group, a statistically significant difference.18
A double-blind trial found that taking a
multivitamin-mineral supplement increased female fertility.19
Vitamin E deficiency in animals leads to
infertility.20 In a preliminary human trial, infertile couples given vitamin E (200
IU per day for the female and 100 IU per day for the male) showed a significant increase in
fertility.21
In preliminary research, even a subtle deficiency of iron has been tentatively linked to
infertility.22 Women who are infertile should consult a doctor to rule out the
possibility of iron deficiency.
Some previously infertile women have become pregnant after supplementing with PABA (para-aminobenzoic acid), 100 mg four times per
day.23 PABA is believed to increase the ability of estrogen to facilitate
fertility.
Supplementation with the amino acid, L-arginine (16 grams per day), has been shown to
improve fertilization rates in women with a previous history of failed attempts at in
vitro (test tube) fertilization.24
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Vitex is occasionally used as an herbal
treatment for infertility—particularly in cases with established luteal phase defect
(shortened second half of the menstrual cycle) and high levels of the hormone, prolactin. In
one trial, 48 women (ages 23 to 39) who were diagnosed with infertility took vitex once daily
for three months.25 Seven women became pregnant during the trial, and 25 women
experienced normalized progesterone
levels—which may increase the chances for pregnancy. In another double-blind trial,
significantly more infertile women became
pregnant after taking a product whose main ingredient is vitex (the other ingredients were
homeopathic preparations) than did those who took a placebo.26 The amount used in
this trial was 30 drops of fluid extract twice a day, for a total of 1.8 ml per day. This
specific preparation is not available in the United States. Some doctors recommend taking 40
drops of a liquid extract of vitex each morning with water. Approximately 35–40 mg of
encapsulated powdered vitex (one capsule taken in the morning) provides a similar amount.
Vitex should be discontinued once a woman becomes pregnant.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
Holistic approaches that may be helpful
Acupuncture may be helpful in the treatment
of some cases of female infertility due to problems with ovarian function. In a preliminary
trial, women who did not ovulate were treated with acupuncture 30 times over three months.
Effectiveness was determined by a combination of measures indicating ovulation was returning
to normal. Acupuncture treatment resulted in a marked improvement in 35% and slight
improvement in 48% of trial participants.27 The beneficial results achieved with
acupuncture may be due to alterations in the hormonal messages from the brain to the
ovary.28
Auricular (ear) acupuncture has been studied in a preliminary trial and compared with
standard hormone therapy for treatment of infertility. In both the acupuncture and hormone
therapy groups, 15 out of 45 patients became pregnant. Although the pregnancy rates were similar with either treatment,
side effects occurred only in women taking hormones.29 Still, double-blind trials
are needed to conclusively determine whether acupuncture is a useful treatment for female
infertility.
References:1. Hatch EE, Bracken MB. Association of delayed conception with caffeine
consumption. Am J Epidemiol 1993;138:1082–92.
2. Stanton CK, Gray RH. Effects of caffeine consumption on delayed
conception. Am J Epidemiol 1995;142:1322–9.
3. Williams MA, Monson RR, Goldman MG, et al. Coffee and delayed
conception. Lancet 1990;335:1603 [letter].
4. Grodstein F, Goldman MB, Ryan L, Cramer DW. Relation of female
infertility to consumption of caffeinated beverages. Am J Epidemiol
1993;137:1353–60.
5. Wilcox A, Weinberg C, Baird D. Caffeinated beverages and decreased
fertility. Lancet 1988;2:1453–6.
6. Joesoef MR, Beral V, Rolfs RT, et al. Are caffeinated beverages risk
factors for delayed conception? Lancet 1990;335:136–7.
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caffeine consumption and spontaneous abortion. Am J Epidemiol 1996;143(11 suppl);525
[abstract #99].
8. Hakim RB, Gray RH, Zacur H. Alcohol and caffeine consumption and
decreased fertility. Fertil Steril 1998;70:632–7.
9. Cramer DW. Letter. Lancet 1990;335:792.
10. Buck GM, Mendola P, Vena JE, et al. Paternal Lake Ontario fish
consumption and risk of conception delay, New York State Angler Cohort. Environ Res
1999;80(2 Pt 2):S13–S18.
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smoking, and other factors on fertility: findings in a large prospective study. BMJ
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prenatal exposure to cigarette smoking. Am J Epidemiol 1989;129:1072–8.
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alcohol use. Am J Public Health 1994;84:1429–32.
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infertility associated with minimal or mild endometriosis: a pilot randomized controlled
trial. A modern trend. Fertil Steril 2003;80(Suppl 3):S32 [abstract].
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supplementation on serum progesterone levels in patients with a luteal phase defect.
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20. Thiessen DD, Ondrusek G, Coleman RV. Vitamin E and sex behavior in
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21. Bayer R. Treatment of infertility with vitamin E. Int J
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22. Rushton DH, Ramsay ID, Gilkes JJH, Norris MJ. Ferritin and fertility.
Lancet 1991;337:1554 [letter].
23. Sieve BF. The clinical effects of a new B-complex factor,
para-aminobenzoic acid, on pigmentation and fertility. South Med Surg
1942;104:135–9.
24. Battaglia C, Salvatori M, Maxia N, et al. Adjuvant L-arginine
treatment for in-vitro fertilization in poor responder patients. Hum Reprod
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25. Propping D, Katzorke T. Treatment of corpus luteum insufficiency.
Zeitschr Allgemeinmedizin 1987;63:932–3.
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infertility. Randomized, placebo-controlled, clinical double-blind study. Forsch
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acupuncture stimulation of ovulation. J Tradit Chin Med 1993;13:115–9.
28. Chen BY. Acupuncture normalizes dysfunction of
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