Today's lifestyles seem to be fraught with fertility and pregnancy related issues.

If you are one of those couples who are having the "it's time to start our family" discussions, what should you be doing to enhance your chances of both falling pregnant and having a successful pregnancy?

Modern living, high stress and poor nutrition choices contribute to a "fertility toxic" environment that needs some serious attention.

The issues:
Weight
Attaining and maintaining a healthy body weight is important for fertility. Chronic dieting and low body weight are both associated with a condition called amenorrhea, or loss of menstrual cycles, and let's face it, if you are not menstruating the likelihood of ovulation is very low.

Without the key ingredient of a good quality egg to fertilise, our chances of falling pregnant are very slim, if not nil!

On the other hand, studies have shown that overeating combined with a lack of exercise leads to excessive fat deposition, and these higher levels of body fat are also associated with problems with ovulation, also resulting in infertility. Ideally, to fall pregnant you should not be under-weight or overweight.

Stress Management of stress is also something the modern woman needs to seriously consider when contemplating pregnancy. Cortisol is a hormone released during high stress episodes that can lead to the interference of serotonin production.

This neurotransmitter is highly important in the regulation of many biological rhythms in the body, including ovulation and menstruation. It is therefore possible that high stress levels maintained over time may interfere with ovulation and your body’s ability to conceive.

In a recent issue of the UK newspaper The Guardian, it was reported that Emory University in Atlanta, US, found that women who are struggling to get pregnant could improve their chances of conceiving by having stress-reducing therapy sessions.

The study found that rising levels of stress could lower a woman's fertility by disrupting her menstrual cycle, and in some cases prevent ovulation completely, and that women who had not had a period for at least six months found that psychotherapy had a dramatic effect, lowering stress levels and restoring fertility in 80% of cases.

In the study, the scientists monitored women with a condition called functional hypothalamic amenorrhea (FHA), which is caused by a drop in GnRH, a hormone that stimulates ovulation.

None of the women had had a period for more than six months. Tests on the women revealed that they had high levels of the stress hormone cortisol.

The women were split into two groups of nine, with half receiving 20 weeks of cognitive behaviour therapy (CBT), a form of psychotherapy that was designed to adjust their way of thinking and reduce their stress levels.

The other half did not receive any therapy. At least 80% of the women who received CBT started to ovulate again, as opposed to only 25% of those randomised to observation; and tests showed that those who had become fertile again had far lower levels of cortisol and higher levels of GnRH.

Smoking
If you smoke to manage your stress, beware! Smoking has been associated with a reduction in insulin sensitivity that may adversely affect your ability to fall pregnant.

In fact, research has revealed that smokers generally take longer to conceive than non-smoking women.

Too few nutrients
Some micronutrient deficiencies are also associated with infertility and miscarriage. Of particular concern are vitamin B12, A, E and betacarotene deficiencies.

Folic acid deficiency has been associated with the development of spina bifida in the foetus and thus is usually supplemented. It is currently recommended that all women of childbearing age should be supplementing folic acid daily. Your doctor will be able to advise you on the daily amount required.

Pots of coffee
High caffeine consumption has also been associated with infertility. It is however not certain whether this is solely to do with the caffeine, or if the individuals who consume large quantities of caffeine are highly stressed and the stress is more to blame than the caffeine itself.

Daily consumption of caffeine greater than one cup of coffee or three cans of cola has been associated with a 50% lower conception rate than the other women who consumed less caffeine.

Too much sugar
Diets that contain large quantities of sugar or sugary foods cause large quantities of glucose to enter the blood stream after eating.

The body has to release large amounts of the hormone insulin in order to clear glucose for the blood into muscle cells. Flooding your blood stream with sugar and insulin day in and day out can contribute to the development of a condition called insulin resistance.

This metabolic problem is in turn associated with infertility. Controlling sugar consumption has therefore some potential to improve your chances of being fertile.

The solutions:
Get moving
Research has shown that 60% of the world population does not exercise enough, leading to lifestyle-associated diseases. Inactivity can increase a person's risk for insulin resistance and in turn infertility.

It is advisable to exercise for 30 minutes a day on most days of the week or at least five times per week. Does that mean you should run The Two Oceans tomorrow? No, not if you haven't already been training for it.

A good exercise session requires that you are slightly short of breath and breaking into a light sweat. Being physically fit can help to manage stress and improve your chances of fertility, but remember there is no need to overdo it. It's good to glow ladies!

Improve your food:
Fruit and veg

Try to include a large variety of fresh fruit and vegetables in your daily diet to ensure you are getting all the micronutrients required for improved health. Five or more servings of fresh fruit or vegetables daily are considered to be optimal. One serving is equivalent to a piece of fruit or half a cup of vegetables or salad. It is a good idea to vary fruit and vegetable intake in order to ensure a variety of nutrients is included into your diet.

If you're not used to eating much fruit and veg, this might feel like a mission, but if you persist, the benefits will be enormous: a healthy body, healthy pregnancy, more energy, glowing skin and glossy hair, better moods, sweeter breath...

Calcium, etc
Including a variety of low-fat dairy products in your diet will not only help to ensure a good calcium intake but will also assist in achieving proper weight management.

Why low fat, you may be asking? Well, the calcium in milk is found predominantly in the protein fraction of the milk and the fat content of most dairy products is predominantly saturated fat, which is an unfavourable fat sub-type.

Other good dietary sources of calcium include soya products and fatty fish with bones, such as salmon and sardines. Yes that does mean you need to consume the bones too. These fatty fishes also contain essential omega-3 fatty acids, which are highly important for various functions in the body as well as being highly beneficial in brain and neurological development of the developing foetus. Good weight regulation and omega-3 fatty acids are associated with an improvement in insulin sensitivity, which is in turn associated with improved fertility.

Lovely fats
Monounsaturated fats are hugely beneficial in good biological functioning and utilisation of fuels in the body. They form part of the fatty acid bi-layer of cell membranes, making the permeability of cells better and allowing better uptake of nutrients into the cell. These fats are not only important in the membrane structure of our muscle and nerve cells, but in all cells, including an egg cell or sperm cell. Some fertility specialists suggest that if our diets have insufficient monounsaturated fats, the egg cell or sperm cell membrane structures will be too solid for fusion to take place. We all know that the two need to fuse in order for conception to take place. Hard membranes mean sperm are unable to penetrate the egg cell, resulting in lack of fusion. Good sources of monounsaturated fats include: avos, most nuts, olives and olive oil, canola oil and peanut butter. It’s okay to lick the peanut butter spoon after all!

Better carbs
Regulating blood sugar will result in better regulation of blood insulin levels. If you are insulin resistant, then lowering insulin levels may improve your chances of becoming fertile. To this end it is important to give preference to carbohydrate foods that convert into glucose slowly and that contain very little free sugars. Give preference to wholegrain and high fibre foods such as brown rice, barley, mealies, high fibre breakfast cereals, oats, sweet potatoes and seed and rye bread.

In a nut shell
Good fertility requires good stress management; regular exercise; controlled calorie intake in order to ensure you maintain a healthy body weight; a variety of fruit and vegetables for vitamins and minerals; a variety of fish, low fat dairy, soya and lean meats for quality protein and a little olive oil or avo in your salad for flavour. But remember portion control.

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