Have you ever been curious about your fertility health? Maybe you've wondered how your day-to-day choices affect your reproductive hormones? Or how your age truly affects your ability to conceive?

I have women asking me these questions (and many more!) on a daily basis. Through my clinical experience helping hundreds of women get pregnant and through my own hormonal imbalance journey, I've come up with 13 factors that can influence your fertility health—for those of you that I don't get to see face-to-face in my office:

1. Hormone health is everything.

Your hormones affect your fertility, mood, energy, weight, and even your happiness! Estrogen and progesterone are two of the most important hormones for optimal fertility, and they need to be happy and balanced to prepare your body for pregnancy. When your estrogen and progesterone are out of balance, you experience things like breast tenderness, irritability, low libido, mood swings, insomnia, irregular menstrual cycles, miscarriages, painful periods, and yes—infertility.

While progesterone and estrogen are two key hormones for your fertility health, there are several others that need be in sync as well. During the course of a menstrual cycle, various hormones are working together in a complex symphony to trigger the components of ovulation and menstruation.

To determine where your hormones are (and which ones might be out of balance), I always recommend doing a comprehensive hormone test so we can get a baseline read of your hormone levels. These results will help us understand the root cause of your hormonal issues and what areas are causing the most harm.

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2. It's good to know your risk factors.

Risk factors such as age, weight, reproductive history, and length of time trying to conceive can have a significant impact on your odds of getting pregnant and having a healthy, full-term pregnancy without any complications. Unfortunately your age really does matter when it comes to fertility. At age 30, the average woman's chance of conceiving during any one cycle is 20 percent. By age 40, that chance drops to a low 5 percent.

Weight can also be a major fertility factor, and being excessively thin or overweight can lead to infertility problems. Estrogen is partially produced in our fat cells—so too much or too little fat on the body can wreak havoc on estrogen levels.

Being diagnosed with certain reproductive conditions such as endometriosis, low ovarian reserve, fibroids, or a thyroid disorder most definitely affects your fertility health. It's super important to talk with your doctor and make sure you're getting the proper treatment necessary BEFORE trying to conceive.

3. Thyroid problems can affect fertility.

Did you know that one in eight women will develop a thyroid disorder during her lifetime? Thyroid disorders are very common in women with unexplained infertility, premature ovarian failure (a condition in which the number and quality of eggs severely limits fertility), ovulation disorders, and recurrent miscarriage.

There have been plenty of recent studies confirming that having an autoimmune thyroid disorder (such as Hashimoto's or Graves disease) significantly increases the risk of miscarriage—36 percent in women who tested positive to thyroid antibodies, compared to just 1.8 percent for those without thyroid antibodies.

So what do symptoms of a thyroid disorder look like? You should be on the lookout for things like rising cholesterol, hair loss, weight gain, fatigue, low sex drive, and depression or moodiness.

4. Understand the relationship between your adrenal glands and your fertility.

The adrenal glands support a proper stress response and play a key role in hormonal balance. One of the main jobs of the adrenal glands is to release hormones in response to stressors like intense emotion, physical injury, overexertion, or environmental factors such as eating unhealthy foods and chemical exposure.

Chronic stress affects fertility by signaling to your body that conditions are not ideal for conception. Your brain doesn't differentiate modern-day "stress" from "primal" stress. In other words, if you're constantly stressed out, your body perceives that stress the same as if you were running from a bear, deciding that your environment is not safe to bring forth new life and diverting all your energy away from the reproductive system and to the organs necessary for survival.

Unfortunately, we live in a time when stress levels are out of control, so it's important to do something every day to support your adrenal glands.

5. Know the importance of high-quality food.

We've all heard the saying "you are what you eat," but I would argue that what you DON'T eat is equally important. What you choose to avoid plays a huge role in your fertility health, and consuming toxin-free food is essential.

Eating toxin-free foods means that the foods you choose to eat are grown and raised without chemicals (pesticides, herbicides, insecticides), hormones, antibiotics or steroids and are not genetically modified. Many of the pesticides, chemicals, and hormones used in conventional farming contain synthetic estrogen-like substances. All of this excess estrogen exposure wreaks havoc on your body's delicate hormonal system.

In men, pesticides have been shown to negatively affect sperm health, sperm motility, sperm count, overall male fertility, and hormonal balance. In women, pesticides negatively affect fertility by disrupting hormone production, hormone release and storage, thyroid function, and the central nervous system. This is totally avoidable! We may not have control over the air we breathe or the environment we live in, but we have absolute control over what we choose to put in our mouths every day. Choosing organic, pasture-raised meats, organic fruits and veggies, and clean fats and oils is important to providing your reproductive system what it needs!

6. Think about your blood sugar.

One of the key goals of an optimal fertility diet is to keep your blood sugar levels nice and steady. This ensures that you're not creating extra stress for your body, and you do this by choosing the right kinds of carbohydrates. To get off the blood sugar roller coaster that keeps you spiking and crashing all day, it's important to limit your consumption of refined, processed carbohydrates like pasta, bread, cookies, dessert, pretzels, etc.

When we eat processed carbohydrates and sugar, we get a rapid rise in glucose levels, which causes the body to overcompensate by sending out a huge release of insulin. We've all experienced this before—the high you feel from the sugar rush followed by the sugar crash—headache, exhaustion, irritability, anxiety, and more.

The best way to balance blood sugar levels is to choose high-quality fats, clean protein, and lots of veggies at every meal and snack! This guarantees nice and steady blood sugar levels throughout the day and will keep your hormones happy.

7. Fats and cholesterol are important for your hormone production.

Eating plenty of healthy fats is essential for getting your hormone system in shape and preparing for pregnancy. Once you're pregnant, fats are critical for the development and growth of your baby's brain and central nervous system, as well as your emotional health during and after pregnancy! Healthy fats keep you satiated and feeling full longer so you're not hungry all the time, eliminating the need to snack all day.

Another very important thing to note about fats is that all of our major reproductive hormones—specifically estrogen, progesterone, testosterone, and cortisol are made from cholesterol. Cholesterol is literally the mother hormone that turns into each of the necessary hormones to make a baby. Without enough fats and cholesterol in the diet, it's like trying to build a house without bricks. It just doesn't work! We need enough cholesterol coming in on a consistent basis to build reproductive hormones. Examples of super good-for-you fats include: eggs and egg yolks, coconut oil, wild-caught fish and seafood, avocados, grass-fed butter and ghee, and raw nuts and seeds.

8. Caffeine and alcohol are associated with low fertility.

Heavy caffeine and alcohol use should be avoided while trying to get pregnant. There's no evidence that a few drinks a week will affect your fertility, but a 2004 Swedish study that tracked more than 7,000 women found that the heaviest drinkers were more likely to have sought out fertility treatments. Studies have also shown that regular caffeine consumption increases the length of time it takes to become pregnant.

Remember that it takes upward of 90 days for the changes you make today to affect your future egg health. So if you are actively trying to get pregnant, or hope to be pregnant in the near future, I suggest making changes sooner rather than later. Finding an alternative to caffeine to get some pep in your morning step could benefit your fertility health long-term. My favorites are cold showers and fresh air first thing in the morning! And while you're changing up your morning routine, it may be helpful to look at how you wind down in the evenings. Consider choosing a hot bath and a book instead of that glass of wine.

9. Nutrients and supplements are key to a healthy egg and sperm.

Nutritional deficiencies have been linked to ovulation issues, hormonal imbalance, poor egg quality, low sperm count, and so much more. Certain nutrients such as vitamin D, folate, fish oil, CoQ10, and prenatal vitamins specifically promote fertility health and prepare your body for a healthy pregnancy.

Vitamin D is all the rage these days, especially when it comes to fertility health. Studies show a significant correlation between vitamin D levels. Research also show that omega-3 fatty acids (found in fish oil) not only support healthy egg and sperm health, but proper formation of your baby's nervous system, brain, eyes, and heart. Folate is another nutrient that is needed by the young fetus before you can even detect pregnancy, and a deficiency in this nutrient can cause serious birth defects.

CoQ10 has been shown in studies to improve both egg and sperm health while playing a key role in protecting DNA at a cellular level. CoQ10 is especially important if you've been diagnosed with poor egg health or are over the age of 40.

Here's the main take-away when it comes to nutrients and supplements: supplementing with specific, high-quality, fertility-boosting nutrients is mega important to your fertility!

10. Stress and cortisol can sabotage your efforts.

When we're under stress, our bodies respond by producing the hormone cortisol. Cortisol is often referred to as the main stress hormone, and with good reason! Cortisol is made in the adrenal glands and is produced and secreted in response to stress. This can be any kind of stress—physical, mental, or emotional.

The thing is, our sex steroid hormones are made from the same raw materials as cortisol, so when the body has to make extra cortisol, you run the risk of decreasing your other steroid hormones (like progesterone and estrogen) on behalf of cortisol production. This wreaks havoc on your reproductive hormones, leading to missed periods and ovulation, weight gain, and altered sleep patterns, which can all affect your fertility.

And while you can't just eliminate stress from your life completely, you can be proactive in managing daily stressors. Start small by taking 10 deep belly breaths every time you start to feel stressed, anxious, or tense and get a good night's sleep so that your body is able to restore and heal. Taking steps to decrease stress in your life will help support a healthy balance of hormones, which in turn supports your fertility health!

11. Remember to exercise...but not too much.

Consistent exercise should be one of the first steps in optimizing fertility and improving uterine health. Walking and yoga are two of the best ways to promote circulation and improve strength and flexibility of the muscles surrounding the uterus.

Leading an inactive lifestyle limits blood flow to the uterus and other reproductive organs. The main artery that supplies blood to our legs is also responsible for supplying blood to our uterus, ovaries, and vagina. If we sit around too much, the blood flow to our uterus may be compromised, so get moving!

On the flip side, exercising too much can have a negative impact on ovulation, and it's not just an issue that affects high-performance athletes. Remember that excess exercise creates stress on the body, which takes vital energy away from the reproductive system.

12. Don't compromise on your sleep (ever).

Various dietary and lifestyle factors have the ability to affect your fertility and hormones, but sleep—quality and quantity—is at the very top of the list. Unfortunately for us, studies have shown that upward of 35 percent of Americans don't get enough quality sleep. That's HUGE! Interrupted sleep patterns can suppress ovulation, negatively affect your thyroid and adrenal glands, and consequently create hormonal chaos and decreased fertility.

Sleep affects the production of our key fertility hormones including estrogen, progesterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH). Proper sleep is critical to keep these hormones in balance and in check. But there is another hormone that is a vital link between fertility and sleep: leptin.

Regular sleep is required to produce proper amounts of leptin, which regulates your menstrual cycle and intimately affects ovulation. Research shows that getting less than seven to eight hours of sleep has been associated with reduced leptin levels the following day, and leptin disturbances have been linked to poor egg quality.

13. Toxins are definitely something to think about.

This is a topic that definitely doesn't get enough attention. In our modern world, we are exposed to more chemicals than ever before, and unfortunately, many of these chemicals are estrogen-based, meaning your hormone and fertility health are the first to suffer.

Research shows that exposure to pollutants, pesticides, and industrial chemicals can decrease a couple's ability to conceive by up to 29 percent. Yes, that is FOR REAL!

These chemicals include PCBs (which have been banned since 1979 but still exist in older products), pesticides, plastics, phthalates (often found in personal care items and beauty products like shampoo, deodorant, perfumes, and nail polishes), sulfates (found in most of the lotions and potions we put on our skin), and BPAs (found in canned goods and plastics). It's super important to clean up your environment when preparing your body for conception.

So how do you rid your environment of toxins? There are a few easy steps to get you started: Always filter your water, don't drink out of plastic water bottles or use plastics for storing food, avoid aluminum and canned goods, and always purchase organic meats, fruits, and vegetables. This will keep your exposure to chemicals to a minimum, which will positively affect your fertility health.

Remember that lifestyle change is your most powerful tool.

So there you have it, 13 easy-to-digest factors that can influence your fertility health. These are all areas that CAN be changed through diet and lifestyle modifications, and as with any big changes, I recommend baby steps. Making huge changes all at once can be overwhelming and hard to stick with. So take a deep breath and remember that even small adjustments will benefit your fertility health greatly, increasing your chances of conception and having a healthy pregnancy!



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