Know your body. "Endometriosis is a condition in which cells that are normally found in the uterus grow outside the uterus instead," says Lynn Westphal, associate professor of obstetrics and gynecology at the Stanford School of Medicine. Pain is the most prevalent symptom, whether it's painful periods, pain during or after sexual intercourse, pelvic pain, or pain with a bowel movement. Some 8.5 million women in North America suffer from the disorder and typically experience symptoms for a full decade before diagnosis. It is also one of the top three causes of infertility, according to the Endometriosis Foundation of America. If you suffer from this condition, Chen advises seeing a reputable, board-certified reproductive endocrinologist for advice, "so that you can make an informed decision." A solution like surgery may contribute to infertility, as it can cause injury to the ovarian reserve.
Follow the sun. Then there are those factors you may have never imagined: In addition to your biological clock, think about the circadian one. Frequent long-distance fliers like female flight attendants and night-shift workers such as nurses have been shown to have fertility and menstrual issues, as they are often out of sync with the external light cycle. A lab study on female mice, published in the May issue of PLoS One, draws a direct correlation between a disruption in the circadian clock, the internal timekeeping mechanism that tracks the time of day, and pregnancy outcomes. In the control mice—those that experienced a normal setting of 12 hours of light followed by 12 hours of darkness—90 percent of the matings led to successful pregnancies. The mice in the most manipulated group had their 12 hours of light start six hours earlier every five days. Only 22 percent of those females went on to have full-term pregnancies. "The circadian disruption may have induced issues with fertilization, implantation, and/or early establishment of pregnancy," says Keith Summa, coauthor of the study and a graduate student in neuroscience at Northwestern University. "We did not anticipate such a dramatic impact."
When all is said and done, to ensure optimal fertility, people should adopt behaviors "that we should be doing anyway to keep ourselves healthy," says Chen. Stop smoking, manage your stress, eat a healthy diet, be a healthy weight, stay active, and get seven to eight hours of sleep. Women should take 400 micrograms of folic acid a day. And men, says Patel, "should abstain from saunas and hot baths, which increase testicular temperature and may lead to testicular dysfunction. Abuse of drugs like narcotics and marijuana can decrease sperm counts through hormonal pathways. And some sexually transmitted diseases can exacerbate or lead to infertility."
Says Chen: "We know that well over 90 percent of couples who seek treatment for infertility are eventually successful, yet 50 percent of people who suffer from infertility are afraid to seek help." Take charge and talk to your doctor.