woman holding pregnancy test

Most of us don’t start thinking about factors affecting our fertility until we’re ready to have a baby. While this approach might be harmless for some folks planning to start a family, it can leave others dealing with unforeseen issues regarding their ability to have a baby. In other words, it might happen quickly and easily for one couple and might be incredibly difficult and time-consuming for the next.

“Fertility involves a complex interplay of intricate physiology, anatomy and genetics,” explains Anate Brauer, M.D., a reproductive endocrinologist at the Greenwich Fertility and IVF Centers and assistant professor of OB/GYN at NYU School of Medicine. “There are so many factors that affect a couple’s ability to achieve pregnancy, and even after years of research there are still many questions left unanswered.”

One thing experts know for certain is that most people don’t know enough about the factors that lead to infertility. “There is a false narrative that fertility is a problem for a select few, but one in eight couples suffer from infertility, making it a fairly common disease,” says Jennifer Hirshfeld-Cytron, M.D., director of fertility preservation at Fertility Centers of Illinois.

Here are some factors affecting fertility that you might not know.

Sexually transmitted infections

If you’ve been diagnosed with STIs in the past that went untreated for months at a time, you may be at an increased risk for infertility. “Pelvic infections, such as gonorrhea and chlamydia, can cause inflammation which can eventually lead to scarring,” says Dr. Brauer. “This scarring can damage the fallopian tubes, leading to blockages, which would prevent egg and sperm from meeting.” The key to avoiding these scenarios is to get check out immediately if you think something’s going on down there.

Poor diet

To properly prepare your body to carry a healthy baby to term, it’s vital that you fuel it with nutrient-dense food that allows it to be as healthy and strong as possible. “Junk food, processed foods, sweets, refined carbohydrates and saturated fats don’t do your body any favors,” says Dr. Hirshfeld-Cytron. “Make meals that include fruits, vegetables, lean proteins and whole grain and try not to overdo carbohydrates—too many can lead to the production of ovarian hormones, which can interfere with ovulation and cause harm to women with PCOS.”

Weight fluctuations

While obesity can certainly be a factor affecting fertility, so can minor weight gain or weight loss. “Extra weight causes hormonal shifts in women and men that can affect ovulation and semen production and can also make conception a challenge,” explains Dr. Hirshfeld-Cytron. “On the other hand, too little body weight can result in irregular or absent periods.” The best way to tell if you’re on track is to see where you fall on the Body Mass Index (BMI)—you should be in the 20 to 25 range.

Irregular periods

You might dread Aunt Flo’s arrival every month, but she’s one hard-to-miss sign that everything’s working well down there. If you’re not getting your period, that means that you’re not ovulating, or releasing a mature egg that’s viable for fertilization by a male’s sperm. “Polycystic ovaries (PCOS), thyroid disease and other endocrine disorders can interfere with ovulation,” explains Gloria Richard-Davis, M.D., OB/GYN, with the University of Arkansas Medical Sciences (UAMS) and author of Planning Parenthood. “If your cycles are less than 25 days or longer than 35 days between bleeds, it is likely you did not ovulate and you should seek the help of a fertility specialist.”

Stress

On top of everything you have going on in your work and personal life, adding the act of “trying to conceive” to your list can be far more stressful than most couples realize. “The emotional and psychological burden of trying to 'time" sexual intercourse is fraught with problems that cause unnecessary stress for the couple and ultimately can lead to marital strife when the lovemaking process becomes a chore instead of being pleasurable,” explains David Diaz, M.D., reproductive endocrinologist at MemorialCare Orange Coast Medical Center in Fountain Valley, California. “Natural fertility seems to work best by keeping it simple—making it intimate and tossing away the gadgets.”

Smoking

Puffing on anything, be it tobacco or marijuana, can significantly be a major factor affecting fertility—and there’s plenty of research to support this. “In men, smoking can affect sperm motility and morphology and may play a role in DNA damage and, in women, smoking can have an effect on egg quantity and quality and has been linked to infertility and may lead to earlier menopause,” says Dr. Brauer. “Smoking can also paralyze cilia in the fallopian tubes, tiny feet that are responsible to moving egg and sperm along.”

Certain medications

Before you and your partner begin trying to conceive, it’s best to run any medications you might be taking—be it prescription or over-the-counter—by your doctor, as many can affect fertility. “Conception requires a complex communication between the brain, ovaries and uterus,” explains Dr. Brauer. “This communication requires release of various hormones that can often be affected by several classes of medications including anti-depressants, anti-psychotics, anti-epileptics, steroids and thyroid medications among others.”

Lube

It might make sex a bit more comfortable, but most lubricants are not conducive to healthy sperm. In fact, Dr. Brauer points out that many can affect sperm motility and integrity. When trying to conceive, she recommends using a water-based lubricant that doesn’t affect sperm quality, such as Pre-Seed™. If you’re not sure which brand is safe for you, ask your OB/GYN for some recommendations.

Caffeine

You might love your morning cup of joe, but research has found that ingesting caffeine can be one of the factors affecting fertility. “One study showed that women who consumed more than the equivalent of one cup of coffee per day were half as likely to become pregnant, per cycle, as women who drank less,” says Dr. Hirshfeld-Cytron. “It’s easy to overdo it—caffeine is in coffee, tea, soda, energy drinks, and chocolate—but try not to have more than two servings a day.”

Too little sleep

“Research shows that the hormone leptin, which has a critical role in female fertility, is reduced when the body is deprived of sleep,” says Dr. Hirshfeld-Cytron. “If you don’t give your body the sleep it needs, it will compensate in other ways.” Aim to get an average of seven hours per night and listen to your body’s cues to ensure you’re getting the rest you need.

Chemical exposure

Believe it or not, but many of the products you’ve been exposed to throughout your life contain chemicals such as BPA, parabens, and phthalates. They’re found in common household items like cosmetics and skincare products, water bottles, the inside coating of food cans and plastic food packaging, air fresheners, bug sprays, heavily perfumed products and the shiny surface covering many sales receipt, explains Dr. Hirshfeld-Cytron. “Over time, these endocrine disrupting chemicals (EDC), as we call them, can build up in our bodies and impact personal fertility potential.” To avoid exposure, she recommends paying close attention to labels on food and household products, microwaving  with glass or china rather than plastic and tossing old receipts.