Preparing your bodies is a great place for you both to start when trying to conceive (TTC). To maximise your chances of conception and of a healthy pregnancy, ideally you want to start thinking about preparing your body three to six months before TTC.
Women are born with all the eggs that they will ever have and there is nothing you can do to change this, but by looking after your body you can affect the quality of your eggs.
For men, it’s important to understand that sperm production takes approximately three months. Therefore, positive lifestyle changes need to be made several months before TTC. Unfortunately, making changes to your lifestyle on Saturday will not ensure super sperm by the following Monday.
Diet and fitness
For her: Maintaining a healthy weight, especially when you are TTC and during pregnancy, is a good place to start when preparing your body. Being underweight or overweight can affect your chances of getting pregnant or mean it can take longer for you to get pregnant. Measuring your waist circumference is also a good way to check you are not carrying too much fat around your stomach, even if you have a healthy BMI. (See link below)
For him: Being overweight or having a poor diet can have an impact on male fertility too.
Action for you both: You don’t need to go on a special diet, but it is important to eat a balanced diet and increase your consumption of fruit and vegetables. Aim to eat at least 5 portions a day, which will increase the intake of the nutrients that your body needs. Cut down on sugar, refined carbohydrates and saturated fats too. Exercise can be a fun activity to do together and is a great way to reduce body fat and increase your sex drive!
Keeping fit also helps women to handle the strain that pregnancy puts on their body. If you are a vegan, we would recommend talking to your doctor when TTC to ensure you are getting enough nutrients.
You can calculate your BMI and waist circumference here.
Vitamins and food supplements
For her: All women are advised to take folic acid tablets when TTC to build up the level of folic acid in their body. This will give the baby protection against neural tube defects such as spina bifida, where parts of your baby’s brain or spinal cord do not form properly. Even if you have a healthy diet it is difficult to get the amount of folic acid you need from diet alone.
The UK Department of Health recommends that women TTC should take 400 micrograms of folic acid (vitamin B9) a day whilst TTC and for the first twelve weeks of pregnancy. It is a good idea to start taking your folic acid 2 to 3 months before TTC if possible. Having the right level of folic acid in your body when you conceive can reduce the risk of your baby developing a neural tube defect by 70%.
Some women have an increased risk of having a pregnancy affected by a neural tube defect which means you might need to take a larger dose of folic acid (5mg a day). You may have an increased risk if:
- you or your partner have a neural tube defect
- you have previously had a pregnancy with a neural tube defect
- there is a family history of neural tube defects
- you are overweight
- you are taking medication for epilepsy
- you have diabetes
If you think you need a higher dose of folic acid, talk to your doctor who can advise you and write you a prescription if necessary (5mg tablets of folic acid are only available on prescription).
Action: A folic acid supplement can be taken as either:
- a single 400 microgram folic acid supplement or;
- folic acid 400 microgram as part of a multivitamin
Warning: Pregnant women should avoid supplements, multivitamins and even cosmetics containing vitamin A (also known as retinol) because too much vitamin A can harm your baby’s development. Always check the label.
For him: The recommendation for the boys is not as clear cut as for the girls. There are a range of vitamins and supplements on the market designed for men who are TTC, many containing ingredients that act as antioxidants. Currently, there is no medical consensus regarding the optimal type, dose or duration you should take these antioxidants, or whether they are even effective.
Action: If you do decide to take a vitamin or supplement, look for products that are designed for men who are TTC. Ideally you should start taking these at least 3 months before TTC as sperm production takes approximately 3 months.
For her: Drinking a lot of caffeine when TTC and during pregnancy has been linked to fertility problems and miscarriage. (7) Caffeine can be found in lots of things such as tea, coffee, cola and chocolate.
Action: The NHS recommendation for pregnant women is a limit of 200 milligram a day of caffeine, which is the equivalent of two mugs of instant coffee. It is widely accepted that this is also good advice to follow when trying to conceive.
For her: We hate to be the bearer of bad news but, the Chief Medical Officers for the UK recommend that if you are planning to become pregnant or are pregnant, the safest approach is to not drink at all. This is because alcohol can harm developing babies and there is currently no proven safe amount of alcohol a woman can drink during pregnancy. If you do enjoy a drink, we fully understand that this can be difficult, especially if it is taking longer to get pregnant than you thought.
For him: Drinking alcohol within the recommended limit of 3 to 4 units per day is unlikely to affect your semen quality. However, drinking excessive amounts of alcohol can affect semen quality. Drinking alcohol can also affect your sex drive and even cause erectile problems. If you are going to have a drink, it is also important that you avoid saving up your daily units for a weekend binge. For more information check out our video with Professor Allan Pacey who offers some practical information for men regarding drinking when TTC.
Action for you both: We all know that reducing alcohol intake can only have a positive impact on your health, so why not take the opportunity to support each other and make a pledge to cut back. If either of you is struggling with the necessary changes to drinking, we would recommend that you have a chat with your Doctor. For more information, the Royal College of Obstetricians and Gynaecologists have developed a very helpful patient information leaflet.
For her: Direct or passive smoking is likely to reduce your fertility and can also mean it might take you longer to get pregnant than a non-smoker. Smoking can age your ovaries and have a negative impact on your fallopian tubes and the lining of your womb. To learn more about why smoking can affect your fertility watch our video with Kate Davies, Fertility Nurse Consultant.
For him: Apart from affecting erectile function, smoking can also reduce semen quality. The effects of smoking on sperm production are more complicated than you might think. To learn more about the impact of smoking on your swimmers, watch our video with Professor Allan Pacey.
Action for you both: It is important for both of you to stop smoking when TTC. Stopping will also improve your general health. You can talk to your pharmacist or doctor about smoking cessation programmes and the products available to help you quit. The NHS Smoking Helpline can also provide advice and support. The phone number is 0300 123 10 44 and the website is www.smokefree.nhs.uk.
Prescribed, over-the-counter and recreational drugs
Did you know that some medicines bought over the counter or prescribed by your doctor, as well as recreational drugs, can affect both female and male fertility?
Prescribed and over-the-counter medication:
Over-the-counter (OTC) medicines are drugs that you can buy without a prescription from your doctor. These are available from pharmacies and some are available from other places such as supermarkets and petrol stations. Many OTC medicines have not been well studied for safety in women trying for a baby or in pregnancy.
Cannabis: The sperm of cannabis users tend to have poorer size and shape, which means they’re less likely to navigate through the woman’s body to reach and fertilise the egg.
Anabolic steroids: Anabolic steroids are prescription only medicines that are sometimes misused to build body mass and improve physical performance. These steroids have been found to disrupt the hormones that control sperm production, so any man who is taking anabolic steroids runs the risk of infertility. It is reversible, but it can take up to a year to recover and sometimes even longer.
Action for you both: If you are taking any type of medicine, bought or prescribed, please seek advice from your Doctor or pharmacist before TTC and during pregnancy. Always avoid any recreational drugs such as cannabis and anabolic steroids that are known to affect fertility.
For him: This one might surprise you! Poor sperm quality has been associated with men who regularly consume protein shakes. The reason for this is currently unknown but it is thought that this could be because some protein shakes are contaminated with anabolic steroid type substances, which can disrupt the hormones that control sperm production.
Action: Go to the gym, sweat and work hard to build your muscle mass naturally and avoid taking protein shakes. Consider making natural protein shakes with milk, a banana and whatever else you enjoy when you get home.
Sexually transmitted infections (STIs)
For both: Are you secretly worried about STIs? We understand that this can be an embarrassing topic of conversation, even if you have been with your partner for a long time. These infections affect both men and women and some don’t necessarily cause you symptoms but can affect your fertility. Chlamydia, one of the most common STIs in the UK, can be a cause of fertility problems for both men and women. Sexually transmitted infections can also cause health problems for women during pregnancy and for the baby. They can even be passed on to the baby during labour.
Action for you both: Most STIs can easily be treated but some treatments are not suitable when you are pregnant. If you have any concerns that you might have an STI, it is very important for both you and your partner to get tested. You can find information on where your local genito-urinary medicine (GUM) clinic is by contacting the Sexual Health Line on 0300 123 7123 or the Family Planning Association’s website www.fpa.org.uk.
Your jobFor both: It is thought that some occupations are not as fertility friendly as others, especially if they involve you being exposed to chemicals, radiation or pesticides. It is also thought that occupations that can affect the temperature of the man’s scrotum, such as driving or working in a kitchen or a bakery, can affect sperm production.
Action for you both: If you are concerned that your occupation could affect your fertility, discuss this with your doctor and your manager at work to see if any adjustments to your role could be made while you're TTC.
CORI TANRIKUT, M.D. Life cycle of sperm: sperm developmet. [Online] 2019. [Cited: 18 July 2019.] https://www.shadygrovefertility.com/blog/fertility-health/fertility-facts-sperm-regeneration/.
NICE. Fertility problems: assessment and treatment. [Online] 2013. [Cited: 18 July 2019.] nice.org.uk/guidance/cg156.
guidance, NICE. Maternal and Child Nutition PH11. [Online] 2014. [Cited: 18 July 2019.] https://www.nice.org.uk/guidance/ph11/chapter/4-recommendations#folic-acid-2.
BMJ. BMJ Best Practice - Spina bifida and neural tube defects. [Online] 2018. [Cited: 18 July 2019.] https://bestpractice.bmj.com/topics/en-gb/1161.
NHS. Vitamin A - Vitamins and minerals. [Online] 2017. [Cited: 24 July 2019.] https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-a/.
Health, National Institute of. Couples’ pre-pregnancy caffeine consumption linked to miscarriage risk. [Online] 2016. [Cited: 18 July 2019.] https://www.nih.gov/news-events/news-releases/couples-pre-pregnancy-caffeine-consumption-linked-miscarriage-risk.
NHS. Should I limit caffeine during pregnancy. [Online] 2018. [Cited: 18 July 2019.] https://www.nhs.uk/common-health-questions/pregnancy/should-i-limit-caffeine-during-pregnancy/.
CMO. UK Chief Medical Officers’ alcohol guidelines review. [Online] 2016. [Cited: 18 July 2019.] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/489795/summary.pdf.
NHS. Moderate regular drinking may damage sperm. [Online] 2014. [Cited: 18 July 2019.] https://www.nhs.uk/news/food-and-diet/moderate-regular-drinking-may-damage-sperm/.
Drinkaware. Is alcohol affecting your sex life? [Online] [Cited: 18 July 2019.] https://www.drinkaware.co.uk/alcohol-facts/how-alcohol-affects-relationships/is-alcohol-affecting-your-sex-life/.
NHS. How can I increase my chances of getting pregnant. [Online] 2018. [Cited: 18 July 2019.] https://www.nhs.uk/common-health-questions/pregnancy/how-can-i-increase-my-chances-of-getting-pregnant/.
University, Sheffield. Sperm size and shape in young men affected by cannabis use. [Online] 2014. [Cited: 18 July 2019.] https://www.sheffield.ac.uk/news/nr/sperm-size-affected-by-cannabis-use-1.377749.
NHS. Anabolic steroids and their affect on male fertility. [Online] 2016. [Cited: 18 July 2019.] https://www.wwl.nhs.uk/News/2016/August/anabolic_steroids_effect_on_male_fertility.aspx.
Conservative management of azoospermia following steroid abuse. Gazvani MR, Buckett W, Luckas MJ, Aird IA, Hipkin LJ, Lewis-Jones DI. 1706-8, s.l. : Hum Reprod, 1997, Vol. 12.
NHS. Chlamydia complications. NHS Conditions. [Online] 2018. [Cited: 18 July 2019.] https://www.nhs.uk/conditions/chlamydia/complications/.
Occupational heat exposure and male fertility: a review. Patrick Thonneau, Louis Bujan, Luc Multigner. 8, 1998, Human Reproduction, Vol. 13, pp. 2122-2125.
Last updated 27/09/2019 Next review due 27/09/2022