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Women in their late 30s can do much to improve their chances of getting pregnant. The fertility odds are workable: About two-thirds of women ages 35 to 39 can become pregnant within a year. Given these odds, women can take a number of steps to improve their fertility. Some are simple common sense: Stop smoking; reduce or eliminate use of alcohol and caffeine; maintain an appropriate weight; reduce stress. Even moderate alcohol use—as few as five drinks a week—can impair fertility. Likewise, consuming more than two cups of caffeinated coffee a day has been associated with lowered conception and increased miscarriage.

Naturopath Bonnie Nedrow, ND, LM, who teaches at Bastyr University near Seattle, encourages her midlife patients to focus on what they can control. "We are looking for optimal health, which is more than functional health," she says. "A woman's body will wait to make a baby until things are optimal." Nedrow gives each patient a hormone work-up, checking levels of progesterone, estrogen, thyroid hormones, and others. Then she advises them about cleansing the liver, which processes the majority of the body's hormones; balancing the diet; stabilizing menstrual cycles; and reducing both the woman's and her partner's stress levels.

A stable, predictable menstrual cycle is an important indicator of good reproductive health. "Many women have a long history of taking birth control pills," says Jana Nalbandian, ND, a Bastyr University colleague of Nedrow's. "When a woman decides she wants to get pregnant, her system is used to being regulated by hormones introduced into, rather than released by, the body. For certain women, it can take six months to a year for the body to regulate on its own."

A woman's weight also affects the regularity and effectiveness of her cycles. According to the Mayo Clinic, body fat levels that are 10 percent to 15 percent above or below normal can throw off a woman's reproductive cycles. Being overweight can mean estrogen overload. "We live in an estrogen-dominant world," says Nalbandian, pointing to the hormones used in meat- and dairy-products production, as well as the "estrogenic effect" of some pesticides. Because of these excess hormones, even women who aren't overweight may be at risk for estrogen overload and resulting fertility problems, Nedrow says.

Both doctors encourage their patients to avoid processed and sugar-rich foods and to replace them with organic, hormone-free, and pesticide-free foods. Nalbandian recommends eating beets, leafy greens, artichokes, and carrots to cleanse the liver and remove excess estrogen from the system. Nedrow suggests a daily serving of four ounces of fish, which is rich in essential fatty acids, to aid the digestive system. "Our grandmothers were right about cod liver oil," she says.

Women who are underweight also are at risk for menstrual irregularity and infertility. Women who adhere to intense exercise regimes share some of these risks. Strict vegetarians may experience fertility problems if they don't get enough vitamin B12, zinc, iron, and folic acid in their diets.

Luckily, most of these problems can be resolved through changes in nutrition. "If you are a fairly healthy 35-year-old woman with a healthy reproductive system," says Nalbandian, "you should be able to improve your chances of becoming pregnant simply through diet and lifestyle choices."

Additionally, Nalbandian advises using herbs to support the natural reproductive process, such as chaste tree berry (Vitex agnus castus) for regulating cycles, and herbal teas, such as raspberry leaf (Rubus idaeus), to tone the uterus. To move bile through the liver, she recommends dandelion root (Taraxacum officinale), a gentle, nontoxic cleanser. But because many herbs can contribute to miscarriage, once a woman becomes pregnant, Nalbandian warns, she must stop taking all herbal preparations until she consults her doctor.

Acupuncture may also be effective. Earlier this year, German researchers at the Christian Lauritzen Institute announced that acupuncture-treated subjects increased their success rate for in vitro fertilization by nearly 50 percent (Fertility and Sterility, 2002, vol. 77, no. 4). By relaxing the uterus, they theorized, acupuncture helps the uterine lining become more receptive to an embryo.

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Labels: exercise, fertility, healthy diet, leafy greens, liver, pregnancy