There's no evidence that putting your legs in the air for 20 minutes after sex does anything to help conception, Dr Hood warns
Every day I see couples struggling to conceive – exhausted, emotional and fearing the worst.
And I can understand why – after all, barely a week goes by without another headline warning about falling sperm counts or women 'leaving it too late'.
Just yesterday, scientists writing in the BMJ declared that 'urgent action is needed to investigate disturbing trends in men's reproductive health'.
Professor Niels Skakkebaek, at the University of Copenhagen, pointed to research showing significant declines in sperm counts among men in the Western world, adding we must act now to find out what could be causing such disturbing trends.
The research, published in July, reviewed thousands of studies and concluded that sperm concentration had fallen by 52 per cent among men in Western countries between 1973 and 2011.
Today, around 20 per cent of men have a low sperm count – and first time mothers are, on average, four years older than they were 40 years ago.
So what are anxious couples to do?
WORRYING REALLY DOES MAKE IT WORSE
As hard as it sounds, try to relax. Stress is a huge problem when it comes to fertility and really can create a vicious circle.
The more stressed couples become about the situation, the harder it can be to conceive. Stress doesn't just drive a wedge into your relationship – it damages the body, too. One theory is that stress raises cortisol levels and this affects many physiological functions in the body – including fertility.
Indeed, the link between stress and fertility is continually being cemented.
In 2014, scientists at Ohio State University discovered that women with the highest levels of stress hormones in their saliva were far more likely to fail to get pregnant within 12 months of trying.
Women with high levels of the biomarker were 29 per cent less likely to get pregnant each month than those with low levels, the researchers found.
TRY NOT TO FEAR FAILURE
Unlike Hollywood films, where one roll in the hay will often get you pregnant, this often isn't the case in real life. Yes, it can happen, but don't rely on it. It can take a normal, healthy couple one year of regular, unprotected sex to conceive.
Despite this, nearly half of couples (42 per cent) who are trying to become pregnant are worried they may fail altogether, according to new research for a conception device called The Stork.
Two-thirds (63 per cent) of the women surveyed were making pregnancy plans before they were 30, but almost a quarter (22 per cent) were aged between 31 and 35, when female fertility is already falling, and one in six (15 per cent) was over 36 — when their chances of conceiving were in rapid decline.
Among women who were struggling conceive, more than half (52 per cent) said they 'felt like a failure and less womanly'. And 48 per cent felt isolated around family and friends with babies, while 47 per cent and that the pressure to conceive was taking the pleasure from love-making.
Stress is a huge problem when it comes to fertility and really can create a vicious circle
DITCH THE DIARY…
Indeed, this pressure to have sex in order to conceive can wreak havoc with relationships, taking away the intimacy associated with sex.
For men, so-called 'timed' intercourse - the 'quick, I'm ovulating' order, can cause massive stress – and affect their ability to perform.
Men often feel their partner only wants them for their sperm, which to some extent is true, because as much as they love their partner, women are very aware of the finite window of fertility they have each month.
You need to try and keep the intimacy in your relationship while having enough sex to get pregnant.
…AND HAVE SEX EVERY TWO DAYS
NO NEED TO PUT YOUR LEGS IN THE AIR
There's also a long-held idea that women should stick their legs in the air for 20 minutes after sex to increase their chance of getting pregnant, as it helps direct the sperm to the egg.
But there's no evidence this has any effect. Nor is there any evidence that certain sexual positions boost your chance of conceiving.
Many couples who can't get pregnant simply aren't having enough sex (at the right time of the month) due to their stressful lifestyles.
There are around five days during a woman's cycle that she is likely to become pregnant.
Yes, you can use urine tests that tell you when you're ovulating – they can help some women who don't have a regular cycle – but some women become slaves to these kits and again, they can make everything very 'planned' and clinical.
Instead, try and have sex every two to three days throughout the month – as then you're bound to hit the jackpot at some point.
Sperm can live in the genital tract for three to seven days – this means there will be sperm around when an egg is released during ovulation.
People find this very difficult with the pressures of work, etc – as it means having sex during the week, not just on the weekend. But it'll be worth it!
THE HIS AND HERS GUIDE TO MAXIMISING CHANCES OF CONCEPTION
1) Lose those excess pounds (both of you!)
Being overweight (having a BMI of 25 to 29.9) or obese (a BMI of 30 or more) can double the time it takes to conceive. That's because excess fat causes hormonal imbalances (a surge in oestrogen) that affect ovulation in women. Therefore, it's important to get down to a healthy weight to maximise your chances of conceiving. Not only that, you may not be accepted for fertility treatment unless you have a BMI of 25 or under. Part of the reason is that being overweight also reduces the efficacy of fertility treatment as it makes it harder to collect eggs, etc.
Overweight men could be at risk of suffering from a lower sperm count, Indian researchers warned earlier this year in the journal Andrologia.
It's important to get down to a healthy weight to maximise your chances of conceiving
2) Try not to leave it too late
Yes, there are some ageing rockers who can still sire a child well into their 70s, such as Mick Jagger – but for most of us, age isn't on our side – so don't be lulled into a false sense of security that it's OK to wait. Women's egg also decline in quality as they age, so are more likely to be damaged, making conception harder.
3) Ditch coffee for tea
Tea contains half the caffeine of coffee and is rich in antioxidants to boot your health. A Dutch study of 9,000 women found drinking four or more cups of coffee a day slashes the chances of conceiving by a quarter. The researchers claimed that caffeine reduces muscle activity in the Fallopian tubes that carry eggs from a woman's ovaries to her womb.
Drinking too much coffee can radically reduce a man's ability to father children, another study has found.
Men who drank two or more cups of strong coffee a day had just a 20 per cent chance of becoming fathers through IVF.
However, for those who drank less than a cup, the chance of having a child rose to nearly 52 per cent.
The researchers at Massachusetts General Hospital, Boston, believe that caffeine may harm the DNA of sperm.
4) Don't smoke or vape nicotine products
Nicotine makes it harder for women to conceive and has been shown to reduce sperm quality and quantity. Researchers from the Buffalo School of Medicine found that that male smokers experience changes in their sperm that make fertilization more difficult.
WHAT MEN SHOULD DO
Heat is a big problem when it comes to damaging sperm. Therefore, it's very wise to avoid anything that heats the testicles – even something seemingly 'good' for your health such as cycling.
- Wear boxers instead of tight briefs. Sperm are sensitive to overheating and a rise of just 1°C in scrotal temperature will reduce fertility.
- Don't use a laptop computer on your lap, or carry a mobile phone in your trouser pocket.
- Avoid saunas and hot baths. One study found sperm counts rose by 491 per cent and sperm motility (movement) improved by up to 34 per cent when men with fertility problems skipped hot baths.
- Keep out of the kitchen — chef Gordon Ramsay blamed hours standing at hot ovens for his fertility issues.
- Skip soya milk and tofu. Soya products contain isoflavones which mimic the effect of the female hormone oestrogen, affecting fertility.
- Cut alcohol consumption. Regularly drinking as few as five units a week reduces sperm quality and counts.
- 30 minutes exercise, three times a week boosts sperm count, but training too hard can reduce it by lowering testosterone.
- Eat oily fish - it's rich in omega-3, which supports production of healthy sperm.
WHAT WOMEN SHOULD DO
• Keep active, but avoid overly strenuous work-outs — they can inhibit ovulation. In fact, exercising to exhaustion increases the risk of fertility problems by 230 per cent, according to a study published in the journal Human Reproduction.
• Avoid exposure to toxins. According to the Mayo Clinic: 'Agricultural workers, hair stylists and certain other groups might be at risk of menstrual disorders, while dental assistants exposed to high levels of nitrous oxide, anyone exposed to elevated levels of organic solvents — such as dry cleaning chemicals — and industrial workers exposed to drugs or chemicals during the manufacturing process also might be at risk of reduced fertility'.
THE GREAT PILL MYTH
Many women who have been on The Pill, especially those who've taken it for a long time, blame it on the fact they they're not getting pregnant – and fear the hormones are still inside their body, or 'working their way out'. This is not the case.
What's actually happening is that they aren't having enough sex – or at the right time of the month – and/or they have been on The Pill for so long that their eggs simply aren't as good quality as they used to be. Their fertility has changed because they have aged.
Studies have shown that many couples conceive within the first six months of coming off The Pill and often, in fact, in the first month.
The Pill basically tricks your body into thinking you're pregnant.
There is no evidence that it affects fertility or that the hormones 'accumulate' over a period of years.
Other methods of hormonal contraception might – such as the injection – as it takes time to work its way out of your body, so your fertility might take six months to return to normal.
• Go easy on the painkillers. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin, may make it difficult to conceive. Speak to your GP about other pain relief options if you take them regularly.
• If you can, say no to nightshifts as they may increase the risk of infertility. One theory is working nights disrupts hormone production.
• Become a dairy queen, but make sure it's full-fat. A Harvard study found women who ate at least one serving of high-fat dairy food a day reduced their risk of ovulation problems by 25 per cent, but those who regularly consumed low-fat dairy products were 85 per cent more likely to have issues.
• Minimise sugary foods and simple carbohydrates such as white bread, pasta and rice. They will cause spikes in insulin levels, and this appears to inhibit ovulation.
A DEVICE TO BOOST YOUR CHANCES
One thing that I recommend to some of my patients who are struggling is a device called The Stork.
It helps boost the potential to conceive by increasing the amount of sperm in the genital tract, helping women get sperm as near as possible their cervix after sex.
The device, available in the US, UK, Canada and Australia combines a condom-like sheath with a cervical cap which collects sperm during love-making. An applicator is then used to place the sperm-filled cap over the cervix, to optimise the chance of conceiving.
Compared with IVF, it's a much less invasive, less stressful, cheaper way to boost your chances.
The $79.99/£99.99 device works in the same way as a commonly-used IVF technique - intracervical insemination (ICI). The ICI technique has been used as an effective, clinically proven treatment option for decades with a pregnancy success rate of up to 20 per cent.
A peer-reviewed clinical trial, published in the journal Surgical Technology International, showed a higher average concentration of sperm at the cervix using The Stork when compared to natural intercourse sperm scores.
The quantity and quality of sperm was analysed using a post-coital sperm assessment which is a standard World Health Organisation protocol. Sperm scores were assessed after couples used The Stork and compared to the same couple's natural intercourse score.
Therefore, if couples are getting worried after a few months of trying then I might suggest it – the device is something practical they can use which might help take the stress out of the situation.
If time isn't on your side, and you don't feel you have a year to play with, it could be worth using from the start – or sooner rather than later - to increase the number of sperm heading towards the egg.