What Can I Do to Improve My Fertility? An Evidence-Based Guide for Women and Men

The most useful steps for improving fertility are to have intercourse regularly during the fertile window, stop smoking, review medicines and health conditions before pregnancy, begin appropriate folic-acid supplementation, maintain a balanced lifestyle and seek fertility assessment at the right time. Men and women should both be included because fertility difficulties may involve either partner, both partners or no immediately identifiable cause.

However, no food, exercise, supplement or home remedy can guarantee pregnancy. Lifestyle changes cannot reopen blocked fallopian tubes, reverse every age-related change, correct severe sperm-production problems or treat conditions such as endometriosis without medical care.

This guide answers “What can I do to improve my fertility?” by separating practical evidence-based actions from common myths and explaining when professional evaluation is more useful than trying additional home remedies.

Medical information notice: This article provides general education. It cannot diagnose infertility or recommend an individual treatment plan. Fertility advice should be adapted to age, medical history, medicines, menstrual patterns, semen findings and the length of time pregnancy has been attempted.

What does “improving fertility” actually mean?

Improving fertility means supporting the conditions needed for conception while identifying problems that lifestyle changes cannot solve. For natural pregnancy, ovulation must occur, viable sperm must reach the egg, at least one fallopian tube must allow fertilization, and the uterus must be capable of supporting implantation and pregnancy.

A person can influence some factors, including smoking, pregnancy timing, medicine review and general health. Other factors require testing or treatment. These include blocked fallopian tubes, significant sperm abnormalities, endometriosis, certain uterine conditions, ovarian disorders and some hormonal or genetic problems. WHO describes female infertility causes involving the ovaries, uterus, fallopian tubes and endocrine system. Male causes may involve sperm production, sperm movement, obstruction, ejaculation or hormonal disorders.

Age is particularly important because female fertility generally declines over time, with a more pronounced decline after the mid-30s. Lifestyle changes may support health, but they cannot stop reproductive ageing or restore the number of eggs present earlier in life. ASRM advises evaluation after six months of unsuccessful attempts for women aged 35 or older and potentially more immediate evaluation after age 40.

A realistic fertility plan therefore has two parts:

1. Take sensible actions that may support conception and pregnancy health.
2. Avoid delaying assessment when age, symptoms or medical history suggest that testing is needed.

How should intercourse be timed to improve the chance of pregnancy?

Intercourse every one to two days during the fertile window provides the highest reproductive efficiency, although intercourse two to three times per week is often nearly as effective and may feel less stressful.

ASRM defines the fertile window as the six-day period ending on the day of ovulation. The highest probability generally occurs during the two days before ovulation because sperm can already be present when the egg is released.

A practical timing approach

For people with relatively regular cycles:

• Have intercourse every two to three days throughout the cycle; or
• Have intercourse every one to two days during the estimated fertile window.

The second approach may be useful when work schedules, travel, sexual difficulties or other circumstances make frequent intercourse difficult.

Can an ovulation app identify the exact day?

An app can help identify cycle patterns, but it should not be treated as a precise measurement of ovulation. Menstrual cycles vary, including among people who describe their cycles as regular.

ASRM notes that calendar-based apps have important limitations because they estimate ovulation from previous cycle length. Urinary luteinizing-hormone tests and cervical-mucus observation may provide more direct information about the approaching fertile period. An LH surge usually indicates that ovulation may occur soon, but it does not guarantee that an egg has been released.

Should intercourse happen every day?

Daily intercourse during the fertile period is acceptable and does not generally reduce fertility. Every-other-day intercourse is also reasonable and may be easier to maintain.

Long periods of abstinence are not required to “save sperm.” ASRM reports that reproductive efficiency is highest with intercourse every one to two days in the fertile window and that couples should not be advised to restrict frequency when trying to conceive.

Timing should guide intercourse not turn it into a rigid obligation. If tracking creates distress, regular intercourse two to three times a week may be a more sustainable approach.

What should women do before trying to become pregnant?

Preconception care supports pregnancy health and can identify medical issues that may affect fertility, pregnancy or medication safety.

Begin folic acid before pregnancy

For most people capable of becoming pregnant, public-health guidance recommends 400 micrograms of folic acid daily, beginning at least one month before conception and continuing during early pregnancy. Folic acid helps prevent neural-tube defects; it is not a treatment for infertility and should not be marketed as a way to improve egg quality.

Some people require a different dose because of their medical or pregnancy history. Higher doses should be taken only after professional advice rather than by combining multiple prenatal vitamins.

Review medicines and supplements

Before pregnancy, discuss all prescription medicines, non-prescription medicines, vitamins, herbal products and supplements with a qualified clinician. Do not stop an important medicine suddenly unless the prescribing clinician advises it.

Some medicines may need to be changed, but untreated health conditions can also create risks. The correct decision depends on the medicine, dose, condition being treated and available alternatives. CDC pre-pregnancy guidance recommends reviewing health conditions, medicines, supplements and vaccinations before conception.

Address chronic health conditions

Conditions such as diabetes, thyroid disorders, hypertension, epilepsy and autoimmune disease may require preconception planning. The goal is not merely to achieve a positive pregnancy test; it is to support a safer pregnancy for the pregnant person and developing baby.

A preconception consultation may include:

• Current health conditions
• Previous pregnancies or losses
• Menstrual regularity
• Medicines and supplements
• Vaccination status
• Family and genetic history
• Previous pelvic surgery or infection
• Lifestyle and occupational exposure
• Mental and emotional wellbeing

Can food improve fertility?

A balanced eating pattern supports general and preconception health, but there is insufficient evidence that one specific diet or macronutrient pattern reliably improves natural fertility in everyone.

ASRM concludes that evidence is insufficient to recommend a particular fertility diet for people without a diagnosed nutritional or ovulatory problem. Healthy eating remains valuable because it supports overall health and helps address deficiencies, but readers should not be told that a certain fruit, seed, tea or meal plan will make pregnancy occur.

What does a reasonable fertility-supportive diet look like?

A practical pattern can include:

• Vegetables and fruits
• Lentils, beans and other pulses
• Whole grains
• Eggs, dairy, fish, poultry or other suitable protein sources
• Nuts and seeds
• Adequate fluids
• Foods that provide iron, folate, protein and other essential nutrients

For people in Nepal, this does not require imported “superfoods.” A balanced plate can be built from commonly available foods such as dal, beans, green vegetables, seasonal fruits, eggs, dairy, whole grains, nuts and suitable protein sources.

The purpose is nutritional adequacy and sustainable health—not a promise that individual foods will improve egg or sperm quality.

The website’s separate guide to fertility nutrition for prospective parents can provide supporting meal-planning context. Any strong claims on that page about supplements or specific nutrients should also undergo medical and evidence review.

Do fertility supplements improve fertility?

Most over-the-counter fertility supplements have less evidence than their marketing suggests. Antioxidants, herbal mixtures, CoQ10 and other products are often promoted for egg or sperm quality, but evidence varies by population, dose and outcome.

A supplement that changes a laboratory measurement does not necessarily improve natural pregnancy or live-birth rates. Some products can interact with medicines, duplicate vitamins already present in a prenatal supplement or provide doses that are unnecessary.

A sensible supplement framework

Supplement category	Evidence-based interpretation
Folic acid before pregnancy	Recommended for prevention of neural-tube defects; not an infertility treatment
Iron or vitamin B12	Useful when deficiency or increased need is identified
Vitamin D	May be recommended when deficiency is present; not a guaranteed fertility treatment
Antioxidant combinations	Evidence for improving meaningful fertility outcomes remains inconsistent
Herbal fertility products	Product quality, interactions and clinical evidence may be uncertain
High-dose multivitamins	More is not necessarily better and excessive intake may be harmful

For most readers, the safer question is not “Which fertility supplement should I buy?” but:

Do I have a documented deficiency or clinical reason to take this product?

Discuss supplements with a fertility specialist or another qualified clinician, especially during fertility treatment.

Does smoking affect fertility?

Stopping smoking is one of the clearest modifiable fertility and preconception-health actions. Smoking is associated with adverse reproductive and pregnancy outcomes, and exposure should be addressed in both partners.

ASRM describes smoking as having substantial adverse effects on female fertility and being associated with miscarriage. Smoking may also affect sperm concentration, movement and shape, although the degree of effect on an individual man’s fertility varies.

Electronic cigarettes and other nicotine products should not be treated as proven fertility-safe alternatives. People who need help stopping should ask a healthcare professional about appropriate cessation support.

What about alcohol, caffeine and recreational drugs?

Alcohol

People who may become pregnant should avoid alcohol during pregnancy, and avoiding it while trying removes uncertainty during the period before pregnancy is recognized.

Evidence about moderate alcohol consumption and natural fertility is mixed, but heavy alcohol intake is a concern. Chronic heavy alcohol use in men has been associated with hormonal, sexual and semen abnormalities.

Caffeine

Moderate caffeine consumption does not appear to have a major adverse effect on fertility. Very high intake should be avoided.

ASRM reports that one to two cups of coffee per day, or an equivalent moderate amount of caffeine, has no apparent adverse effect on fertility or pregnancy outcomes. Caffeine content varies substantially across coffee, tea and energy drinks, so “cups” are only an approximate measure.

Recreational drugs

Recreational drug use should be discussed openly with a clinician during pregnancy planning. Evidence concerning fertility varies by substance, but pregnancy, fetal and general-health risks make avoidance the safer approach.

Can body weight affect fertility?

Body composition and metabolic health can affect ovulation, menstrual regularity, fertility-treatment safety and pregnancy health, but the relationship is individual and should not be reduced to a single number.

At higher weights, some people experience irregular ovulation or metabolic conditions that influence reproductive function. Very low energy availability can also disrupt menstruation and ovulation. ASRM recognizes associations between obesity, menstrual and ovulatory function, natural fertility, fertility-treatment outcomes and pregnancy risk. It also notes that evidence about whether pre-treatment weight-loss interventions improve every fertility outcome is more complicated than commonly presented.

This means fertility care should avoid blame and crash dieting. The appropriate goal is to identify whether metabolic health, ovulation, nutrition or treatment safety requires individualized support.

A clinician may review:

• Menstrual regularity
• Blood pressure
• Glucose regulation
• Thyroid symptoms
• PCOS indicators
• Nutrition
• Movement and daily routine
• Treatment or pregnancy-related risk

Lifestyle changes should be sustainable and medically appropriate. Delaying fertility treatment solely to pursue an arbitrary target may not be appropriate when reproductive time is limited.

Do exercise, sleep and stress management improve fertility?

Regular movement, adequate sleep and psychological support benefit general health and may make the fertility journey easier to manage. However, they should not be presented as guaranteed treatments for infertility.

Moderate physical activity may support cardiovascular, metabolic and emotional health. Excessive training combined with inadequate energy intake may disturb menstrual cycles in some people.

Sleep problems, anxiety and distress can affect wellbeing, relationships and sexual frequency. Reducing stress may improve quality of life, but telling someone that they are infertile because they are “too stressed” is medically and emotionally inappropriate.

Helpful support may include:

• A sustainable movement routine
• Consistent sleep habits
• Time away from fertility tracking
• Counselling or psychological support
• Honest communication between partners
• Help for sexual pain, erectile difficulty or ejaculatory concerns

Mental-health support is a valid part of fertility care, not an admission that infertility is “only psychological.”

What can men do to support fertility?

Male fertility should be considered from the beginning rather than only after extensive testing of the female partner.

AUA and ASRM guidance recommends concurrent assessment of both partners. Initial male evaluation generally includes a reproductive and medical history plus one or more semen analyses. Semen values vary naturally, so one result does not always provide a complete answer.

Practical male-fertility actions

Men can:

• Stop smoking
• Avoid anabolic steroids
• Tell the clinician about testosterone use
• Review medicines and supplements
• Limit heavy alcohol intake
• Address erectile or ejaculatory difficulties
• Seek care for testicular pain, swelling or previous injury
• Follow a balanced eating and movement pattern
• Complete semen analysis when evaluation is indicated

Why testosterone deserves special attention

Testosterone used as an injection, gel or other external treatment can suppress the hormonal signals required for sperm production. Anabolic steroids can also interfere with sperm production.

Men who are using testosterone or performance-enhancing hormones and hope to conceive should discuss this with a male reproductive specialist. They should not stop prescribed treatment or begin an alternative hormone independently. AUA and ASRM specifically identify ongoing anabolic-steroid use as a cause of suppressed sperm production and impaired fertility.

What does semen analysis measure?

A semen analysis commonly examines:

• Semen volume
• Sperm concentration
• Total sperm number
• Movement or motility
• Shape or morphology
• Other laboratory features when relevant

No single mildly abnormal parameter automatically proves infertility. Results are interpreted together and in the context of both partners. The website’s guide to male fertility testing and semen analysis explains the clinic’s assessment pathway.

Readers seeking more detailed lifestyle information can also consult the clinic’s male sperm-health guidance, while recognizing that lifestyle measures cannot correct every male-fertility condition.

Which fertility methods do not have convincing evidence?

Several popular recommendations either lack convincing evidence or are commonly misunderstood.

Special sexual positions

There is no convincing evidence that a specific sexual position improves the likelihood of conception. Sperm can enter the cervical canal quickly regardless of position.

Lying down after intercourse

Remaining flat, raising the legs or placing a pillow under the hips is not necessary for natural conception. Leakage after intercourse does not mean all sperm have been lost.

“Saving” sperm for many days

Long abstinence is not routinely needed. Intercourse every one to two days during the fertile period is compatible with normal sperm availability for most couples.

Fertility detoxes

Detox drinks, cleansing plans and restrictive regimens have no established role in treating infertility. They may also distract from diagnosis or create nutritional problems.

One miracle food

Pineapple, pomegranate, dates, seeds, milk, ghee or any other individual food cannot guarantee implantation or pregnancy.

Buying multiple supplements without testing

More supplements do not necessarily mean better fertility. Unnecessary combinations can duplicate ingredients, create side effects and increase cost.

Depending only on an app

An app estimates fertility from calendar data. It cannot confirm ovulation, evaluate sperm, show whether tubes are open or diagnose endometriosis.

Waiting indefinitely while trying remedies

The greatest risk of unproven remedies is sometimes not the remedy itself—it is the time lost before an appropriate evaluation.

When are lifestyle changes not enough?

Lifestyle measures cannot replace fertility evaluation when pregnancy has not occurred within the recommended period or when known risk factors are present.

Evaluation is generally appropriate:

• After 12 months of regular unprotected intercourse when the female partner is under 35
• After six months when the female partner is 35 or older
• More promptly when the female partner is over 40
• Earlier when a known fertility-related condition exists

ASRM recommends starting evaluation without delay when medical history or clinical findings indicate a condition associated with infertility.

Reasons to seek earlier assessment

Consider earlier consultation for:

• Irregular or absent periods
• Very painful menstruation
• Known or suspected endometriosis
• Previous pelvic infection
• Previous pelvic or abdominal surgery
• Known fallopian-tube concerns
• Previous chemotherapy or radiation
• Recurrent pregnancy loss
• Erectile or ejaculatory difficulties
• Previous testicular injury or surgery
• Known low sperm count
• Use of testosterone or anabolic steroids
• A family or genetic condition relevant to reproduction

Do not wait for 12 months when a known issue is already present.

At Slavica IVF, a comprehensive fertility assessment in Nepal may include medical history, physical assessment, ovulation review, ovarian-reserve testing when useful, semen analysis, follicular monitoring, HSG and selected additional investigations. The exact tests should depend on the individual situation rather than a fixed package.

What happens during a fertility evaluation?

A fertility evaluation should assess both partners in parallel and begin with the least invasive tests likely to answer the most important questions.

Female fertility assessment may review

• Menstrual history and evidence of ovulation
• Age and reproductive history
• Ovarian-reserve information when clinically useful
• Uterine structure
• Fallopian-tube patency
• Symptoms of PCOS or endometriosis
• Previous infection, surgery or pregnancy
• Thyroid or other hormonal concerns

Male fertility assessment may review

• Reproductive and sexual history
• Medical conditions
• Medicines and hormone use
• Previous surgery, infection or injury
• Semen analysis
• Hormonal or genetic testing when indicated

Both partners should be assessed because infertility may involve male factors, female factors, a combination or unexplained factors. AUA and ASRM recommend concurrent evaluation rather than completing a long female-only work-up first.

Does evaluation automatically lead to IVF?

No. Fertility treatment does not always mean IVF.

Depending on the cause, age and prognosis, the plan may involve:

• Better fertile-window timing
• Treatment of a diagnosed health condition
• Ovulation induction
• Surgery for selected structural conditions
• Intrauterine insemination
• IVF
• ICSI
• Fertility preservation
• Donor treatment where appropriate

The correct pathway should provide a reasonable chance of pregnancy without unnecessary procedures or delay. Slavica IVF’s guide to fertility treatments available before IVF explains why structured assessment should come before treatment selection.

A practical fertility-improvement checklist

Start now

• Use regular intercourse rather than waiting for one “perfect” day.
• Consider every-one-to-two-day intercourse during the fertile window.
• Begin 400 micrograms of folic acid daily when pregnancy is possible, unless a clinician recommends another dose.
• Stop smoking and avoid recreational substances.
• Review medicines and supplements before pregnancy.
• Follow a balanced, sustainable eating pattern.
• Include the male partner in fertility planning.
• Record menstrual dates and major symptoms.

Avoid

• Miracle-food promises
• Unverified detoxes
• Random hormone use
• Testosterone or anabolic steroids when trying to conceive without specialist advice
• Taking several fertility supplements without clinical review
• Assuming that a normal-looking cycle proves that all fertility factors are normal
• Delaying assessment because of embarrassment or blame

Arrange evaluation when

• The recommended time threshold has been reached
• Periods are irregular or absent
• There is known endometriosis, tubal disease or reproductive surgery
• Semen or sexual-function concerns are present
• The female partner is over 40
• Either partner has had cancer treatment
• Pregnancy losses have occurred repeatedly
• You are uncertain whether continued trying, IUI or IVF is appropriate

Key takeaways

The strongest fertility plan is not a collection of hacks. It combines appropriate intercourse timing, preconception care, avoidance of harmful exposures, balanced health habits and timely medical evaluation.

Remember:

• Both partners matter.
• The fertile window is the six days ending on ovulation day.
• Intercourse every one to two days during that window is effective, but less rigid regular intercourse may be nearly as useful.
• Folic acid supports early fetal development; it does not cure infertility.
• No single diet or supplement guarantees pregnancy.
• Smoking and anabolic-steroid use are meaningful modifiable concerns.
• Lifestyle changes cannot treat every fertility problem.
• Age and known medical conditions affect how long you should wait before seeking help.
• Fertility treatment does not always mean IVF.

For delayed conception, irregular cycles, previous reproductive-health concerns or questions about male fertility, request an assessment at Slavica IVF and Research Center in Sinamangal, Kathmandu. A structured evaluation can clarify whether continued natural attempts, treatment of an identified condition, IUI, IVF or another pathway may be appropriate.