What are the Five Main Factors that Affect Fertility in Women?-image

What are the Five Main Factors that Affect Fertility in Women?

Embarking on your fertility journey can be both exciting and challenging. Understanding the various lifestyle factors that can affect fertility is crucial for individuals and couples. In this article, we’ll delve into the five main lifestyle factors that play a pivotal role in fertility, and how you can shape and optimise your lifestyle to support your reproductive health.

First, let’s explore what fertility is from a biological perspective. Ovulation plays a critical role, marking the release of an egg from the ovary. For a pregnancy to occur, a healthy egg must meet healthy sperm (usually in the fallopian tube) where the egg gets fertilised.

Plus, the uterus (womb) must be in optimal condition so the fertilised egg can implant and grow into a healthy baby.

To get pregnant and have a baby, many biological factors come into play. When one or more of these factors fall out of sync, that’s when you might face difficulties with fertility.


Lots of couples conceive without any issues, but it’s important to know the facts. 1 in 6 couples face fertility struggles, so if it’s taking longer than you’d hoped, know that you’re not alone. The earlier you know what’s going on inside, the earlier you can take action to support your future fertility goals.

Age and Fertility

Unfortunately, the ticking of the biological clock is a reality that every woman and those assigned female-at-birth (AFAB) face.

For a pregnancy to occur, you need healthy eggs. From a biological standpoint, the younger you are, the healthier your eggs will be. As you age, the quality and quantity of your eggs (known as your ovarian reserve) decline.

While an Anti-Müllerian Hormone (AMH) test can help you to understand how many eggs you have left, it can’t tell us the quality of the eggs we have.

Women and those AFAB are born with all the eggs they’ll ever have. Each menstrual cycle, you lose an egg, and once you hit your late thirties, that number has decreased dramatically, and it brings with it a host of hormonal changes. Collectively, it reduces your ability to become, and often stay, pregnant.

And it’s not just about your egg count either. After the age of 35, there’s a higher risk of pregnancy-related complications and negative health outcomes for the baby. There’s also a higher risk of miscarriage, high blood pressure, and gestational diabetes. Plus, chromosomal conditions like Down’s syndrome are more common.

It’s not just a woman’s problem either. Despite misconceptions, ageing affects male fertility too. From age 40 onwards, the sperm quality and sperm function decreases with significant implications to pregnancies and births including increased time to conception and increased risk of miscarriage.

Lifestyle Choices and Their Impact

Think your fertility is out of your control? Think again. While there are aspects of fertility that are beyond our control, there’s a lot we can do to support our reproductive health. Through lifestyle choices, we can impact the quality of our eggs and contribute to a healthier reproductive environment.

Eating a well-balanced, nutritionally rich diet, getting regular physical exercise, managing stress, getting enough sleep, limiting caffeine to less than 200mg a day (one small cup of coffee), and stopping or reducing smoking and excess alcohol can contribute to improving your fertility.

This is because your lifestyle choices directly impact your hormones, and hormonal balance (involved in regulating your menstrual cycle) is crucial to a successful conception, pregnancy and healthy baby.

Eat a Fertility-Friendly Diet

Being underweight or overweight can affect your ability to conceive because your hormones are often out of whack.

Eating a Mediterranean diet—one that’s based on plant foods like fruit, vegetables, nuts, beans and whole grains with a moderate amount of dairy, fish, meat and eggs—can support your fertility. Discover a fertility-friendly meal plan, and fertility nutrition shopping list to support your healthy diet.

Plus, when you’re trying for a baby and in the first 12 weeks of pregnancy, taking prenatal supplements like folic acid can help prevent major birth defects by supporting neural tube development. 

Get Regular Physical Exercise

Getting regular physical exercise is healthy no matter where you are in your fertility journey, but be wary of overexercise. Too much vigorous physical activity can stop ovulation, cause irregular periods or for them to stop altogether amenorrhea because of hormonal imbalances in important hormones that control your menstrual cycle.

An absent period is often a sign that something’s not quite right, so it’s worth speaking with a healthcare professional if you’re worried.

Limit Smoking and Alcohol

Smoking, alcohol and recreational drug use are associated with an increased risk of miscarriage and complications during conception and pregnancy.

Cigarette smoke contains chemicals that can disrupt your hormones and impact your fertility. It’s also been linked with early onset menopause.

There’s limited evidence to know how vaping affects fertility (although early studies suggest it could affect the ability to implant and result in lower birth weights) but if you’re trying to get pregnant, not vaping is safer than vaping. The lack of information doesn’t mean it’s safe, but by stopping, you’re being exposed to fewer chemicals. Get help to quit smoking in the UK with the NHS.

Excess alcohol consumption is not only associated with hormone imbalances, there is no safe level of alcohol that can be consumed during pregnancy as it can lead to adverse health effects for the baby. 

In women and those assigned-female-at-birth, disrupting your hormones can affect your menstrual cycle causing irregular periods which can affect ovulation, reducing your chances of conceiving.

As well as its impact on our hormones, alcohol negatively impacts our general health which can lead to knock-on impacts on our fertility making it harder to become and stay pregnant, as well as increasing the risk of foetal conditions and birth complications.

Protect Against STIs

Left untreated sexually transmitted infections can lead to fertility issues because they can lead to scarred or blocked Fallopian tubes, which can increase your risk of an ectopic pregnancy.

The only way to protect yourself from STIs is by using barrier protection such as a condom or dental dam as well as attending routine STI testing and your cervical screening appointments. Most STIs can be treated or managed with timely intervention.  

An egg takes 90 days (around 3-4 months) to mature, which means adopting healthy lifestyle choices at least three months before you try for a baby is crucial. It’s all about a healthy fertility-friendly preconception lifestyle (and this can start years before you’re ready to have a baby).

The earlier you start, the better. The idea is that you want your body to be in tip-top condition to support healthy egg quality and the best reproductive environment to get and stay pregnant.

Reproductive Health Conditions

Reproductive health conditions are common and can affect fertility. Unfortunately, some are difficult to detect. With our hormone and fertility test, you can get insights into your hormones, reproductive health and personalised advice within 10 days. The earlier you know, the earlier you can start steps towards your fertility goals.

How can you detect a reproductive health condition? Signs to look out for are irregular or absent periods, severe period pain, vaginal dryness and hot flushes, skin and hair conditions like acne, excess hair growth, fatigue and feeling cold, and deep pain during intercourse.

Ovulation disorders, which affect the release of eggs from the ovaries, can affect your fertility. Without an egg, pregnancy can’t occur. These include:

PCOS (Polycystic Ovary Syndrome)

Affecting 1 in 10 in the UK, PCOS is a common hormone and metabolic disorder that leads to a hormonal imbalance which can affect fertility and cause symptoms like acne, missed periods, and excessive hair growth.

Thyroid Problems (Hyperthyroidism or hypothyroidism)

The thyroid gland controls many of the mechanisms within your body including regulating the rate of metabolism, heart rate, temperature, muscle contraction, which is why hyperthyroidism may result in symptoms such as anxiety, heart palpitations and unintended weight loss and hypothyroidism may result in symptoms such as fatigue and weight gain.  If untreated, hyperthyroidism and hypothyroidism can affect your long term health and fertility.  

Hyperprolactinemia

Hyperprolactinemia is marked by abnormally high levels of the hormone prolactin (which stimulates breast milk production during and after pregnancy). 

In women, elevated prolactin levels can disrupt the normal menstrual cycle and ovulation, potentially leading to irregular periods and difficulties with conception.

Other reproductive health conditions include:

Endometriosis

Endometriosis occurs when tissue similar to the lining of the uterus (endometrium) grows outside the uterus. The exact prevalence is challenging to determine accurately because some individuals with endometriosis may not experience symptoms, and the condition can only be definitively diagnosed through surgery.

Estimates suggest that around 10% of women of reproductive age may have endometriosis. It is a leading cause of pelvic pain and can have a significant impact on fertility. Women with endometriosis are at an increased risk of miscarriage, ectopic pregnancy and other complications compared to those without.

Fibroids

Uterine fibroids (also known as polyps) are benign growths of fibrous and muscle tissue in or around the uterus (womb). Around 2 in 3 will develop one at some point in their life, and most often occurs when you’re aged 30 to 50.

Primary Ovarian Insufficiency (premature Menopause) 

Primary ovarian insufficiency (known as premature menopause and POI) is when the ovaries stop working before the age of 40, marking the end of your reproductive years.

Fallopian Tube Damage

Fallopian tube damage or blockage is often caused by pelvic inflammatory disease (PID) which can be caused due to untreated sexually transmitted infections. If PID affects the fallopian tubes, it can scar the lining making it more difficult for eggs to pass through to be fertilised.

Environmental and Occupational Factors

To support your fertility, you should avoid exposure to environmental pollutants, toxins and chemicals since these have been proven to negatively impact fertility. Pollutants can disrupt your hormones, affect your reproductive health and harm a baby’s chance for survival.

Surprisingly, they’re all around us. Chemicals exist in our air, food, water, cleaning products, and health and beauty products. Some practical steps to reduce your exposure to pollutants, chemicals and toxins include to:

  • Eat organic food to reduce exposure to pesticides and synthetic hormones.
  • Use natural cleaning products to avoid harsh substances at home.
  • Filter your water to reduce any contaminants in drinking water.
  • Choose health, beauty and personal care products free from harmful chemicals that could disrupt your hormones. 
  • Avoid using plastic containers and opt for stainless steel or glass instead. If you must use plastic, look for BPA-free.

Limit exposure to industrial chemicals in your workplace by wearing protective gear and taking precautions.

Stress and Emotional Wellbeing

While there aren’t many studies that suggest that stress itself affects fertility, reducing stress supports healthy hormones, and disruption to your hormonal balance might affect your reproductive health.

It’s likely down to the indirect effects. Chronic stress can cause a loss of sex drive or impact our menstrual cycle causing irregular periods and anovulation (when ovulation doesn’t occur). If you’re having sex less and you’re not ovulating, you’re much less likely to become pregnant.

It’s worth taking note of the choices you make when you’re stressed, anxious, or depressed too. Things like overeating, undereating, drinking alcohol, smoking, not exercising, overexercising, and trouble sleeping can negatively impact your health, well-being and fertility.

Manage your stress and emotional well-being with coping strategies to support your mental health. These could include boosting your relaxation with breathing techniques, yoga, massages, walks, exercise, cooking, reading, mindfulness, journalling, dancing, painting or meditation—anything that makes you feel calmer.

Sometimes distraction is a great way to destress too. Cleaning, decluttering or watching your favourite TV show can help to take your mind off things.

Talking with a friend, family or fertility counsellor about your worries could help too. A problem shared is often a problem halved. Even managing your boundaries can help you to feel less stressed—whether that’s taking more time for yourself or saying no more often.

Optimising Fertility 

When it comes to your lifestyle choices, they have a direct impact on your hormones and reproductive health.

Timing is everything and early planning is key. If you want to have a baby now or in the future, understanding your body is crucial.
Optimise your fertility by tracking your menstrual cycle so you understand what your menstrual cycle looks, so that you can track your fertile window (that typically lasts around 5-7 days), and so you can note down any symptoms that you experience.

This tracking offers insight into what’s going on inside. Only you know your body best, and coming armed with data will help to quicken the process if you ever want to speak to a healthcare professional about your fertility. Knowledge is power.

It’s not all about female reproductive health either. When it comes to infertility, one-third of cases come down to male causes, one-third to female causes and one-third come down to a mixture of both or the causes being unknown.

Understand more about what’s going on inside with a hormone and fertility test. In the world of fertility and female health, it’s often a waiting game. On average it takes between 2-8 years to be diagnosed with a reproductive health condition like PCOS, endometriosis, fibroids or thyroid issues.

Plus, you have to have been trying to get pregnant without success for a whole year before any fertility tests are carried out in standard healthcare settings. At Hertility, we believe you shouldn’t have to wait. Get a hormone and fertility test and get insights into your reproductive health within 10 days.

Speaking with a healthcare professional about wanting to become pregnant, and asking for guidance if you have concerns, is another effective way to support your reproductive health.

Our fertility advisors can offer personalised guidance from your unique health assessment, taking into consideration your medical history, family history, blood tests, menstrual cycle data and more.

Better reproductive health comes from knowing your body and making healthy lifestyle choices. Understanding the lifestyle factors that can affect your fertility, and taking action to manage them will ensure you’re taking control of your fertility health instead of leaving it to chance. Take your fertility into your own hands.

FAQs

How does age affect a woman’s fertility?

As we age, the quality and quantity of your eggs (your ovarian reserve) decline. To become pregnant and stay pregnant, you need healthy eggs and a reproductive environment that supports pregnancy. You can test your ovarian reserve with an Anti-Müllerian Hormone (AMH) test.

Age also increases the risk of pregnancy-related complications such as hypertension and gestational diabetes. The risk of chromosomal issues like Down’s syndrome increase with age, and the rate of miscarriage and stillbirths is higher.

What lifestyle choices can improve or impair fertility?

Eating a nutritionally rich, well-balanced diet, getting regular physical exercise, limiting caffeine to less than 200mg a day (one small cup of coffee), managing stress, and stopping or reducing smoking, alcohol and the use of recreational drugs can all positively impact fertility.

Being a healthy weight is important to support fertility, and a balanced diet with regular, but not vigorous exercise, is important to help maintain it.

What are common reproductive health issues that impact fertility?

Common reproductive health issues that impact fertility are PCOS (polycystic ovary syndrome), endometriosis, premature ovarian insufficiency (early menopause), fibroids and thyroid problems.

If you’re concerned that you have a reproductive health condition, track your symptoms, consider taking a hormone and fertility test, and speak with a fertility advisor.

Can environmental factors really affect fertility?

Unfortunately, research suggests that environmental factors like pollutants, chemicals and toxins in our air, food, water, cleaning products and health and beauty products can negatively impact fertility.

Studies suggest that they can reduce sperm count, cause anovulation (the loss of ovulation), impair implantation (where the fertilised egg attaches to the uterine wall to develop a foetus), and harm a baby’s chances for survival.

How does stress influence fertility?

While day-to-day stress is likely to have little impact on pregnancy, chronic stress can lead to a loss of sex drive and increase the chance of irregular periods and anovulation (the loss of ovulation). If you’re not having sex due to the loss of libido, and you’re not ovulating, you’re less likely to become pregnant.

Reference links

  1. https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887
  2. https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/causes/lifestyle
  3. https://crystaivf.com/blogs/link-between-environmental-factors-and-fertility/ 
  4. https://www.clearblue.com/how-to-get-pregnant/how-long-does-it-take/stress-affect-chances-getting-pregnant
  5. https://www.verywellhealth.com/lupus-and-infertility-5114589#:~:text=In%20lupus%2C%20the%20immune%20system,can%20develop%20into%20an%20egg
Zoya Ali BSc, MSc

Zoya Ali BSc, MSc

Zoya is a scientific researcher with a Bachelor's degree in Biotechnology and a Masters in Prenatal Genetics & Foetal Medicine from University College London. Her research interests are reproductive genetics, fertility preservation, gynaecological health conditions and sexual health.

  • facebook
  • instagram
  • twitter