Foundations of Fertility

Written By Sumner Amin

Trying to conceive can be a very exciting endeavor, but for some, it can also be a very challenging and stressful time. What makes it harder is that most people don't have anywhere to turn for guidance early on. And the reality is, there's a lot you can do through daily practices and lifestyle changes that genuinely support fertility.

This article covers the basics: five foundational areas that support fertility and that you have real influence over, starting during or even well before you ever start trying.

Nutrition

Our diet has a huge effect on our health and the health of our ovaries and sperm. A lot of the recent data is looking at inflammation, and how even low, chronic levels can affect the quality of egg and sperm, ovulation and implantation. This is why we want to focus on an anti-inflammatory or Mediterranean diet. We want to prioritize whole foods, fresh fruits and vegetables, legumes, healthy fats and protein. It's important to limit or eliminate the more inflammatory foods, including red and processed meat, added sugar and refined grains. This type of diet also supports healthy metabolic function, which is crucial for optimal fertility.

The data backs this up. A 2025 meta-analysis pooling 17,711 people across nine studies found that those eating the most pro-inflammatory diets had 61% higher odds of infertility than those eating the least inflammatory diets, and the effect held for both men and women.

Sleep

Sleep is another crucial factor that we have influence over to change our fertility, and it's also linked to fertility through inflammation. With sleep, the inflammatory pathway starts with melatonin, which is a potent antioxidant found in high concentrations in the follicular fluid in the ovary, protecting the ovary from oxidation damage. Sleep deprivation suppresses melatonin production, leading to increased oxidative stress exposure in the ovaries and impaired hormonal signaling that governs ovulation.

A 2025 study using NHANES data found infertile women with sleep disorders had measurably higher inflammatory markers, and separate research has linked poor sleep to reduced egg quality, lower fertilization rates, and lower clinical pregnancy rates.

Stress

Stress is a tricky topic when it comes to fertility, mostly because the relationship runs in both directions — stress can affect your ability to conceive, and trying to conceive can itself be incredibly stressful. So how does stress actually affect fertility? It comes down to the HPO axis (hypothalamic-pituitary-ovarian), the hormonal chain of command that governs your cycle. The hypothalamus releases GnRH, which signals the pituitary gland to release FSH and LH, which are the two hormones that drive follicle development and ovulation. Stress, through the action of cortisol and glucocorticoids, interferes with the release of GnRH, ultimately affecting follicle development and ovulation.

A prospective cohort of 401 couples trying to conceive — the LIFE study — measured salivary alpha-amylase, a biomarker of sympathetic nervous system stress activation, before conception occurred. Women in the highest third of alpha-amylase levels had a 29% lower chance of conceiving in any given cycle and more than double the risk of infertility after 12 months of trying, compared to women in the lowest third. This study was impactful in that it was using salivary biomarkers, rather than self-reported stress, and was measured before couples started TTC and not after, ruling out that infertility itself was causing the stress.

Exercise

Recommended for many health conditions, exercise is an important factor in fertility as well. Beyond the general health benefits, exercise appears to reduce chronic, low-grade inflammation, which likely benefits fertility through the same pathway we talked about under nutrition. It's a little more nuanced though, as some exercise is helpful, but over-exercising can actually disrupt the hormonal cascade that leads to healthy menstrual cycles and ovulation. If you're doing a lot of vigorous exercise, make sure you're eating enough to match it, since an energy deficit is often what tips exercise from helpful into harmful for ovulation.

I also want to highlight weight lifting and muscle building specifically, especially for women. Muscle is the largest site of glucose disposal in the body, and the ovaries are very sensitive to insulin. When insulin resistance is present, the ovaries can overproduce androgens, which disrupts ovulation. This is a well-documented pathway, particularly in PCOS. Building muscle mass improves insulin sensitivity, so it's a reasonable, low-risk way to support ovulation, even though direct research on weight lifting specifically (versus exercise in general) is still limited.

Toxins

This category deserves its own article that I'll write one day, but for now I'll summarize what we know. There are thousands of chemicals out there that act as "endocrine-disrupting chemicals" (EDCs) and interfere with normal hormone signaling. The mechanisms include acting as "xenoestrogens" (weakly binding and activating estrogen receptors), disrupting the enzymes that convert cholesterol into reproductive hormones, and inducing oxidative stress in eggs, sperm, and ovarian tissue. Here are where people encounter these chemicals:

  • Plastics and food packaging (phthalates, BPA)

  • Non-stick/stain-resistant/water-resistant products (PFAS)

  • Agricultural chemicals (pesticides and herbicides)

  • Personal care and cosmetic products (parabens, triclosan)

  • Industrial and legacy pollutants (PCBs, PBDEs)

Plastic and PFAS exposure has some of the best data on their negative effects on fertility. Agricultural chemicals are mostly found to affect fertility if you're working with them in an occupational manner. 

It can feel overwhelming to know what to do about this. My recommendation is to start in the kitchen and remove any sources of plastic and non-stick products — plastic food containers, plastic utensils, plastic cutting boards, non-stick pans, etc. Takeout food often comes in plastic or plastic-lined containers, so I'd limit that as well. That is a great place to start, and I'll write another article detailing more changes you can make.

Conclusion

These five areas — nutrition, sleep, stress, exercise, and toxin exposure — are all things you have real influence over, and small, consistent changes add up. If you're looking for personalized support putting any of this into practice, I'd love to work with you — preconception and fertility care is what I do, and I'm here to help.

Sources

  • Govarts, E., et al. "Endocrine disrupting chemicals: Impacts on human fertility and fecundity during the peri-conception period." Environment International, 2020.

  • Lynch, C.D., Sundaram, R., Maisog, J.M., Sweeney, A.M., Buck Louis, G.M. "Preconception stress increases the risk of infertility: results from a couple-based prospective cohort study — the LIFE study." Human Reproduction, 2014.

  • Xin X, Li J, Zhang J, Wu H. "Association of Sleep, Inflammation and Female Infertility: A Cross-Sectional Survey and Genetic Approach." Brain and Behavior, 2025 Jun;15(6):e70627. doi: 10.1002/brb3.70627. PMID: 40525280; PMCID: PMC12171637.

  • Zahedi, Y., Bonyanpour, S., Alizadeh, S.D., et al. "Association between the dietary inflammatory index and infertility: a systematic review and meta-analysis." Frontiers in Nutrition, August 26, 2025. DOI: 10.3389/fnut.2025.1599782

Sumner Amin