The Truth About Fertility (Spoiler Alert: It's Complicated)

by Deena Kara Shaffer

The Truth About Fertility (Spoiler Alert: It\'s Complicated)

The raw ingredients of conception may seem simple, but the truth is that our body is a complex system—and the machinery of conception requires
an intricate fusion of factors to succeed.
Menstrual cycle health, sperm viability, environmental factors, what we eat, our age—so much goes into trying to conceive.
To learn about fertility’s fine details, I turned to naturopathic doctor Caroline Meyer and osteopathic manual practitioner Jill Bodak. I also interviewed Andrea about her personal journey to conceive.

A complex dance

Meyer calls the science of conception a “complex dance of many factors.” A mid-cycle surge in hormones, specifically LH (luteinizing hormone), signals to one of the ovaries to release an egg.

Travelling through the fallopian tube until it enters the uterus, nearby sperm fertilize the egg (zygote), which then nestles into the wall of the uterus, where other hormones such as progesterone and hCG (human chorionic gonadotropin) facilitate growth.

“It is literally,” says Bodak, “the least likely series of events to occur successfully when you consider the odds: millions of sperm, one egg, on a particular day, fusing and finding a safe space to attach and multiply.”

Back to basics

To help align the factors in your complex dance and increase your odds of conceiving, start with some basics.

Maintain a healthy weight

A body mass index (BMI) of 20 to 24 appears to be the best range for fertility. Weighing too much or too little can change menstrual cycles and disturb—or even stop—ovulation.

Eat a healthy diet

Include whole grains, healthy fats, plenty of fruits and vegetables, more plant protein, and less red meat, and avoid unhealthy processed foods, including deli meats, pastries, sweets, and sweetened beverages. Be sure to include plenty of seafood in your diet, including salmon, scallops, and shrimp.

Drink water

Staying hydrated is always important, but drinking water is by far the best way to do this while trying to conceive. Sugary drinks, including fruit juices, may have a negative effect on fertility.

Supplement, just in case

Supplementing with vitamins, minerals, and botanicals can help, especially if you’re having difficulty getting enough of the important nutrients in your diet.

  • multivitamin
  • folic acid (if not taking a multivitamin with folic acid)
  • vitamin B12
  • omega-3 fatty acids
  • soy supplements

And, according to Meyer, acupuncture has been used for many years to increase the likelihood of successful conception.

Harder said than done

“Nobody knows if conceiving will be easy or hard for their body to do,” says Bodak, “until they try. In our current culture and understanding of how not to have a baby, it’s often scary and disorienting to struggle with conception when we actually want to be pregnant.”

Fertility roadblocks

According to Meyer and Bodak, some of the other potential challenges to conception include

  • lifelong menstrual irregularity
  • long-term oral contraceptive use
  • cysts, polyps, fibroids
  • endometriosis
  • fallopian tube malfunction
  • older age
  • environmental pollutants driving down sperm counts and quality
  • low thyroid function
  • eating habits that don’t feed ova and sperm well

The stress spiral

Trying to conceive can itself be stressful. As Bodak puts it, “Trying to ‘not stress’ about having a baby is stressful. People can feel caught in a vicious cycle of sensing that time is running out, all the while wanting to stay relaxed about the fact that the process is taking time.”

Attempts and age

“Although many women and men are quite healthy as they age,” says Meyer, “women are born with a limited store of eggs, and this supply diminishes every period. Egg and sperm quality also tend to decrease with age, which can lead to conception challenges and miscarriages.”

Chemicals and conception

“Recent research indicates that the health of the environment has direct and indirect impacts on human fertility,” notes Meyer. “Chronic exposures to plastics and chemicals, increased toxic loads, and food quality can also contribute to difficulties with fertility.”

Andrea’s family story 
Andrea and her partner were married at age 35, after many years of enjoying travel, food, music, and life together. They tried to conceive naturally for a few months, then focused on cycles and timing. After a year of trying, they sought support at a fertility clinic.

Andrea was diagnosed with premature ovarian aging, and in vitro fertilization (IVF) was recommended. Andrea felt strongly that she wanted to acclimate her body and mind to the fertility drugs and process, advocating for first undergoing intrauterine insemination (IUI)—where sperm is placed into the vagina to improve likelihood of pregnancy.

For months, Andrea attended daily clinic visits for monitoring, experiencing multiple cycles of “not great eggs,” which prevented intervention.

After four months, Andrea describes feeling “tired with the emotional roller coaster, clinic visits, and injections. I was ready to take a break. With my partner, we decided to persist, and the next month’s monitoring showed the first viable opportunity for an IUI.”

After her 18-month journey, Andrea and her partner became pregnant with twins. Their little girl and boy are now three years old.


Andrea shares her suggestions for those struggling to conceive.

Be kind and sensitive. You never know what another is going through. Well-intended questions can be agonizing.

 Self-compassion is crucial. Sometimes, I declined baby showers when they felt too hard emotionally.

 Find support. The fertility clinic managed the physical aspects well, but for the emotional support I turned to my amazing partner, family, and trusted friends.

Consider a mindfulness course for fertility. Mine offered meditation techniques I still use today.

 Advocate for your own health. I became more in tune with my body and mind throughout my fertility journey, and I trusted my gut.

You’re not alone. So many are going through this, yet it’s still not a commonplace discussion.

Trying and timing

When does trying to conceive become trying itself? Both Bodak and Meyer suggest six to 12 months of unsuccessful trying as a reasonable gauge, after which to seek medical clarification.

Family making

Making a family is much more than fertility. “Literally everyone,” emphasizes Meyer, “has many options to create a family of their own.” The possibilities for what constitutes a family, as Meyer puts it, “are vast indeed.”

Deena Kara Shaffer, PhD, is a learning specialist and co-creator of the Thriving in Action initiative at Ryerson University, an educational consultant, and a published poet. @deenakshaffer


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