Everything You Can Do In Your 20s To Maximize Fertility In Your 30s & Beyond
Maybe you want nothing to do with kids at the moment. After all, things look a lot different today than they did 50 years ago when having your first child in your early 20s was the norm. More women are going to grad school, paying off student debt, launching their badass careers, and taking time to explore the world, holding off on babies until life is a bit more predictable and financially stable.
Today, the average age of women at first birth is 26.8 years, but many are waiting until their mid to late 30s or even early 40s. And that's great for a lot of reasons. But it doesn't change the simple biological fact that fertility declines with age.
We're born with a finite number of eggs, and as we age, there are fewer and fewer eggs, and they're not as readily fertilized, says Victoria Maizes, M.D., executive director of the Arizona Center for Integrative Medicine and author of Be Fruitful: The Essential Guide to Maximizing Fertility and Giving Birth to a Healthy Child. By age 30, healthy women have about a 20 percent chance of getting pregnant each month they try, but by age 40, that drops to 5 percent—and even with IVF, conceiving is not a sure thing. "The focus for young women is almost exclusively on not getting pregnant. And women see celebrities in their 40s having kids galore, so they are often unaware that fertility wanes as you get older," says Maizes.
We're not trying to freak you out. And no, we are absolutely not telling you to start having babies now either! That's such a personal decision. But we are here to tell you that all this fertility stuff isn't completely out of your hands. If you are thinking about having a baby down the road, the good news is that there are plenty of simple steps you can take now, in your 20s (or even early 30s), that will set you up to be maximally fertile down the road.
Here, Maizes recommends six things you can do now to up your chances of conceiving later:
1. Load up on plants and ditch the refined carbs.
As you likely know, what you eat affects basically every aspect of your health, from your hormones to your inflammation levels to your mood. And cleaning up your diet as early as possible can go a long way toward preventing a variety of health issues that may negatively affect your fertility such as obesity, diabetes, and polycystic ovarian syndrome (PCOS)—one of the most common hormonal conditions among women, which affects 5 to 10 percent of women of childbearing age and is considered the No. 1 cause of infertility in the U.S.
Your best bet, according to Maizes, is really a Mediterranean-style diet featuring antioxidant-rich fruits, vegetables, whole grains, beans, legumes, nuts, seeds, olive oil, fish, and some lean meats, as several large studies have shown that it's associated with enhanced fertility. "Even among women undergoing IVF, when you're essentially overriding their normal hormones, there was an increased rate of conception among women who were eating a Mediterranean diet," she says.
Why so beneficial? The focus on minimally processed, anti-inflammatory, blood-sugar-balancing whole foods likely has something to do with it. In fact, another large study found that high glycemic carbohydrates (think: white bread, crackers, doughnuts, pretzels, pasta) were associated with infertility. "These foods are rapidly broken down and cause a bump in blood sugar. This increases insulin, which reduces sex-hormone-binding globulin, which increases testosterone and can contribute to PCOS—one of the most common reasons women have ovulatory trouble."
Taking a multivitamin containing folate in your 20s is also a great idea, says Maizes, since 52 percent of pregnancies in the U.S. are actually unplanned.
2. Reduce your exposure to common toxins.
We're exposed to a lot of toxins in our society, and your overall "body burden" of these toxins is something that the fetus you eventually carry will be exposed to—so the younger you are when you start paying attention to and limiting your toxin exposure, the better, and the less assault there will be on your baby's developing system, says Maizes.
Additionally, Maizes believes that one of the reasons so many women are being diagnosed with PCOS, which is known to cause fertility problems, is because we're exposed to so many endocrine-disrupting chemicals. These are chemicals in the environment that alter the normal functioning of our own hormones, and they include things like BPA in plastic bottles and food packaging, phthalates in personal care products, and certain pesticides.
To reduce your toxin exposure, avoid plastics marked PC and recycling #7 (which contain BPA), seek out phthalate-free personal care products (EWG's SkinDeep Database is a great resource), and go organic when possible—or at least when buying the fruits and veggies that have been shown to have the highest pesticide contamination.
3. Work toward a healthy weight.
Getting into a healthy weight range can benefit your future fertility for a variety of reasons. For one, women who are overweight tend to have estrogen dominance, as fat tissue generates estrogen in the body, which can lead to irregular menstruation and ovulation. Women who are overweight are also more likely to have PCOS. Your fat tissue also tends to store some of the nasty toxins we mentioned above—but losing weight and burning body fat mobilizes these toxins and gives your body a chance to eliminate them, says Maizes.
The key: If you have a significant amount of weight to lose, you want to do it in your 20s (or well before you're actually trying to conceive) "because you don't want to mobilize these toxins right as you're having a baby develop inside you," says Maizes. "That's because they're more active and potentially damaging when they're in your blood than when they're sitting in your liver or kidneys."
4. Develop strategies to cope with anxiety and depression.
While mental health disorders such as depression and anxiety are not definitively linked to infertility, some of the medications used to manage them, including selective serotonin reuptake inhibitors (SSRIs) like Zoloft and Prozac, have been associated with an increased risk of birth defects and autism, says Maizes.
So why does this concern you since you're not actually pregnant yet? If you're currently on one of these medications and want to have a baby in the future, now might be a great time to have a conversation with your doctor about whether you may be able to manage your condition with nonpharmacological strategies. Medication is often used as a first-line strategy for depression, says Maizes, even for mild to moderate depression when lifestyle changes may actually be enough. These lifestyle changes include things like exercise, getting more exposure to sunlight (or taking vitamin D), ensuring you have the social support system you need, and eating a balanced Mediterranean diet—which has been associated with a lower risk of depression.
To be clear, we are not telling you to ditch your antidepressants or anti-anxiety meds, but it's worth having a conversation with your doctor, or seeking out a holistic psychiatrist to see if a natural treatment approach might work for you.
5. Address hormonal imbalances now.
While there are no studies showing that hormonal birth control directly causes infertility, taking the pill can mask symptoms of hormonal disorders like PCOS. So, you may not even know you have a hormonal imbalance until you go off the pill in your 30s and try to get pregnant but can't, says Maizes. If you were put on the pill to help regulate infrequent or irregular periods, severe PMS, or acne, chances are you have something funky going in with your hormones—and possibly PCOS.
If you want to maximize fertility in the near future, you're going to want to address these imbalances as early as possible, says Maizes, so talk to your doctor about the best ways to address the root cause of your condition. The good news: Making the dietary and lifestyle recommendations above will help in a big way.
6. Get yourself tested for STDs.
While some sexually transmitted diseases are obvious (think: gonorrhea, which often causes increased discharge and abdominal pain), others can fly under the radar with nearly no symptoms at all. Case in point: chlamydia. "Chlamydia is very subtle, but it can cause pelvic inflammatory disease—when you have enough inflammation that you get scarring in your fallopian tubes, which can lead to a physical blockage that makes you infertile," says Maizes.
The good news: If you get diagnosed and treated (which consists of oral antibiotics) early, you can prevent this. The CDC recommends getting tested for chlamydia and gonorrhea every year if you're under 25 or if you have new or multiple sex partners.