Fertility boils down to healthy eggs and sperm. Sure, the anatomy being sound matters, but if physically both you and your partner are fine, then all that matters is healthy eggs and sperm.

Until recently, it was thought that men’s sperm is not affected by age. There are some doctors who believe that is not true. Some doctors think it starts young, like age 25, while others say it’s not until around age 45 that age-related effects on sperm occur. Since men produce so many sperm, a few duds in there usually won’t matter too much. Even younger men can have problems with sperm motility, speed and quantity. Often, these problems can be overcome by resorting to techniques such as IUI (intrauterine insemination), or IVF (in vitro fertilization) with ICSI (intracytoplasmic sperm injection). Before these techniques improved, couples with male factor infertility often had to use a sperm donor. If sperm deficiencies are suspected, simple tests can evaluate the sperm.

Men make new sperm continually. Because there is a constant renewal in a man’s sperm, he has opportunities to improve his health to make improvements in his sperm—things like exercise regularly, stop smoking, limit alcohol, and improve nutrition. Acupuncture has also been discussed as a way to improve sperm quality. I think anything that helps reduce stress will probably help with fertility as stress raises cortisol levels in the body, and that is never conducive to reproduction. There is a lot of information about various herbs and vitamins that can help, but that is beyond the scope of our discussion here.

Evaluating a woman’s eggs is not so easy since obtaining them is invasive. Furthermore, once you have the eggs in a lab, just looking at them doesn’t tell anybody much. Once they’re fertilized for IVF, then the embryos can be visually evaluated for fragmentation and cell division, and there are processes to take a sample of the embryo and run genetic analysis. Generally, what people hear is that egg quality is almost entirely related to age.

Ouch.

It is true that it’s easier to get pregnant if you’re under 30, and the risks of certain genetic disorders, like Downs Syndrome, are lower. However, it’s not impossible to get pregnant even at age 42—before birth control was widely available, women got pregnant later in life all the time. Yet there is a natural end to our fertility, which is mostly genetically determined.

While women are born with all the eggs they’ll ever have, those eggs are dormant until they begin the process of maturing for release, which is about 3 months in advance. With that in mind, the same health advice given to men can help your egg quality, and just as importantly, the quality of your uterus to receive an embryo. The trend today to eat low fat or no fat everything may actually hamper your fertility. Fat is essential to make new cells, as is protein. Many people don’t realize that your hormones, estradiol and progesterone, are made from cholesterol. Cholesterol is manufactured in the liver from fats in your diet, so you need to eat some! However, avoid trans fats as these are detrimental to your reproductive cells.

Moderate exercise is important for stress relief and for improving blood flow throughout the body. As we age, blood flow to our reproductive organs decreases, and exercise can help maintain good blood flow. However, over-exercising does the opposite! A daily 30 minute walk is plenty of exercise when you’re trying to conceive. And being either too thin or too heavy can impact your odds of conceiving, too, by affecting regular ovulation and your nutritional balance. Your weight doesn’t make conception impossible, but it can make it harder, and it can make pregnancy more difficult also.

I have a doctor friend who advocates to his patients to eat low to the ground and exercise moderately daily. By that he means eat unprocessed, fresh foods as much as possible. That’s good advice for your fertility, too. Then as a man’s testes are making sperm, and the woman’s eggs are getting recruited for release, all the essential nutritional and lifestyle components will be there.