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Wednesday 23 March 2022

can ginger induce ovulation?

 Ovulation Induction



Trying to get pregnant? You have landed at the right place. Some recent studies have found that certain herbs can have a positive effect on fertility. Here is a list of five such herbs that can be helpful.

Shatavari (Asparagus)

Asparagus is considered a female reproductive tonic and as the name implies, the tonic has the ability to increase fertility and vitality.

It's rich in phytoestrogens, a group of naturally occurring compounds that has a similar chemical structure to oestrogen, which plays a major role in the reproductive cycle.

It also helps by reducing stress, which can cause fertility issues. It's also used for menopausal symptoms and to increase lactation.

Withania somnifera (Ashwagandha)

Ashwagandha has been used traditionally to treat fertility issues in men. It is believed to improve semen quality, erection and sperm count.

It helps in improving male sexual health in disorders such as psychogenic impotence and unexplained infertility.

Agnus castus (chasteberry)

Some small studies have suggested that agnus castus balances reproductive hormones and helps regulate the menstrual cycle.

The irregular menstrual cycle also makes it difficult for many women to get pregnant.

Black cohosh

The herb is said to improve female fertility. It's believed to stimulate the ovaries and give ovulation a boost.

Chinese herbs

There is not much evidence, but Chinese herbs are said to improve fertility when taken along with other fertility drugs. However, the effect of Chinese herbs on fertility when taken alone has not been tested and proven yet.

Knowing how to increase fertility can really make a difference if you’ve been trying to get pregnant for a while.


Around 84% of couples having regular sex will get pregnant within a year and 98% after two years (though this figure drops to 90% if you’re between the ages of 35-39). However, when you’re trying to get pregnant it can feel like forever. So, to maximise your chances of getting pregnant sooner rather than later, read about how to increase fertility by making simple changes.


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From diet to exercise, to understanding your ovulation cycle, our guide on how to increase fertility provides useful information from fertility experts and nutritionists to help you get your mind and body in the best possible shape to conceive.


Don’t forget that it takes two to make a baby, which is why we’ve also got advice on boosting male fertility. We’ve also got tips on the best sex positions for conception to add a little fun to what can become a stressful time.


Fertility is affected by many factors. These include age, lifestyle and biology. If, after making these positive changes, you’re still having problems conceiving, a health professional will be able to offer reassurance and talk you through your options, including medication and IVF.


How to increase fertility: 42 ways to boost your chances of conceiving

1. Come off the Pill

The general consensus is to come off the Pill at least one month – but preferably four months – before you attempt to conceive.


‘Come off the Pill once you’re ready to start a family,’ says Dr Irfana Koita, a fertility consultant and director of IVF Matters. ‘You should ovulate spontaneously and have regular cycles right away. If not, make sure you see a fertility specialist and get assessed,’ she advises.


2. Know when you ovulate

Many women have no idea what their normal menstrual cycle is, especially after years of regulated periods on the Pill. Contrary to popular belief that women have a 28 day cycle,  some have a short one (25 days) and others a longer one (35 days). The fertility cycle starts on the first day of your period but ovulation doesn’t necessarily start mid-cycle.


If you do have a regular 28 day cycle then ovulation occurs around day 14, but if you have a 25 day cycle ovulation occurs around day 11 and if you have a 35 day cycle then ovulation occurs around day 21. For women whose cycles aren’t regular an ovulation date calculator can come in very handy.


Do women need to keep a menstrual diary? ‘If you’re seeing a period every month (between 25 and 35 days) you don’t need to maintain a menstrual diary,’ says Dr Koita. ‘If your cycles are regular it’s an indication that you’re ovulating every month.’ To keep an eye on your periods try using an app such as the Hormone Horoscope app (available at Apple and Google Play).


3. Book a reflexology session

Stress can affect fertility so if you’re looking at how to increase fertility consider relaxation techniques, such as reflexology.


Reflexology is based on the idea that specific areas on your hands and feet link to different organs in your body. Putting pressure on those points may stimulate the energy flow to those organs.


‘One way to relax is to book a regular slot for a massage or a reflexology session,’ says women’s health expert Natasha Richardson (foragebotanicals.co.uk). ‘Relaxation helps us balance our hormones and ovulate regularly; it’s a major factor in fertility for both men and women.’


4. Use a basal thermometer

A basal thermometer is one way to track your most fertile days. Your basal body temperature is a measure of your regular temperature upon waking, which rises as a result of the hormonal changes during ovulation.


With a basal thermometer such as the Beurer Ovulation Thermometer (£14.99, Holland & Barrett) you can track the smallest basal temperature changes in your body, allowing you to know when you’re ovulating and are therefore most fertile. While these sensitive thermometers are inexpensive, easy to use, and a form of natural family planning, they’re not always the best ovulation predictor if you have irregular periods. Many women now find ovulation tests easier and more precise.


5. Use ovulation tests

Ovulation tests record surges in your hormone levels which indicate that you’re ovulating. You can opt for a well-know brand such as Clearblue (£14.99, Amazon), or buy an own-brand version from pharmacies such as Boots.

Ovulation Induction - Shawn E. Gurtcheff, MD, MS



‘These are a good screening tool to reassure you that you’re ovulating every month,’ says Dr Koita. ‘Use these for a couple of months. Once they confirm ovulation stop using them as they can make the process of trying to conceive very stressful,’ she advises.


A test may also highlight potential problems with ovulation. Fertility expert Dr Arpita Ray from assisted conception clinic Bourn Hall estimates that about a third of women struggling with infertility have a hormone imbalance. This can impact ovaries and prevent the release of one mature egg each month, reducing the chances of becoming pregnant.


Stressed woman lllustration now to increase fertility

Stress can have an adverse effect on getting pregnant (Credit: Getty)


6. Deal with stress

Stress affects everyone differently so it’s good to know the signs and symptoms of stress. Stress can put you off having sex, which makes it difficult for you to conceive, as well as ’cause unexplained infertility,’ says Natasha.


Chronic stress can cause long-term exposure to flight-or-fight hormones, such as adrenaline and cortisol, which are bad for general health. ‘When stressed, we produce a hormone called prolactin – the same hormone produced by breastfeeding women to inhibit ovulation, so it will make conception more difficult,’ explains Dr Gillian Lockwood, medical director at fertility clinic CARE Fertility Tamworth.


Take some time for yourself and focus on winding down at the end of every day. Give yourself half an hour each evening to relax your body and mind – have a warm bath, read a book, try breathing exercises to calm your mind. Gentle exercise such as yoga may help you conceive.


‘It’s important to try to de-stress when trying to conceive,’ says Professor Geeta Nargund, medical director of CREATE Fertility  ‘Although easier said than done, a healthy mind promotes a healthy body, so try to reduce your stress wherever possible,’ she advises.


7. Keep your vagina chemical-free

Avoid scented tampons and vaginal sprays as they can cause a pH imbalance in your vagina. Artificial lubricants, arousal oils and douches should also be avoided as these alter the normal acidity of the vagina, can cause pelvic inflammatory disease, and can affect the cervical mucus that transports the sperm.


‘The pH of the vagina changes naturally during each cycle from inhospitable to hospitable for sperm, so it’s important to just leave it be. Vaginal douching and washes can disturb this unnecessarily,’ explains Natasha.


8. Lie down after sex

Rather than heading to the bathroom after you’ve had sex, take time to relax your body for a minute whilst the sperm is still inside you.


While some regard it as folk legend, others think that lying down for a few minutes, or putting your legs up, will help the sperm on their journey towards the egg.


The FERTI·LILY Conception Cup (Boots, £32.99) works on this principle and has had rave reviews from customers who believe it’s worked. Insert this reusable soft silicone cup into your vagina after sex to push the semen towards your cervix (the opening to your uterus) and “increase the amount of sperm that enters the cervical mucus”.


9. Give up booze

It may be your go-to to help you unwind, but if you’re serious about trying for a baby you should consider how much alcohol you drink.


‘A study co-authored by the Boston University School of Public Health found that moderate alcohol consumption does not affect a woman’s ability to get pregnant. Women who drank fewer than 14 servings of a 4 ounce glass of wine were no less likely to conceive than those who abstained completely,’ explains nutrition expert Hayley Pedrick, founder of Habitude.


‘However, heavier drinking – the equivalent of two bottles of wine or more a week – was associated with an 18% decrease in fertility,’ she says. ‘Researchers still recommend that women abstain from alcohol during their “fertile window” until a pregnancy is ruled out, because the foetus may be particularly vulnerable to alcohol during the first few weeks of conception.’


Alcohol intake may also affect fertility in men. In the NHS article ‘How can I improve my chances of becoming a dad‘ it states, “Drinking alcohol excessively can affect the quality of sperm. The UK Chief Medical Officers’ recommendation is to drink no more than 14 units of alcohol a week, which should be spread evenly over 3 days or more.” So ask your partner to cut back or go teetotal.


Track your drinking with charity Drinkaware’s alcohol calculator and find out more about alcohol’s impact on fertility.


10. Get a medical check-up

It’s sensible to book an appointment with your doctor to have a check-up before you decide to try for a baby. ‘General health can be linked to fertility health so do speak to your doctor if you have any general health conditions,’ says Professor Nargund. This will be able to rule out any major factors affecting fertility. For example, according to the charity Verity, 1 in 10 women in the UK have Polycystic Ovary Syndrome (PCOS), which is one of the leasing causes of infertility. Left undiagnosed and unmanaged it can impact fertility.


Likewise, you should be screened for sexually transmitted diseases, which often show no symptoms, and also be checked for other potential problems.


‘In the preconception period I also recommend all women have their Rubella immunity checked,’ adds Dr Koita. Catching Rubella during pregnancy can harm the foetus.


Woman's-hand-with-supplements-how-to-increase-fertility

Supplements can help prime your body for pregnancy. (Credit: Getty)


11. Start a supplement programme

Although a healthy diet is the best way to gain nutrients, a basic vitamin supplement programme – particularly one that contains folic acid (B9) and vitamin D – can help ensure you get what you need.


‘Supplements should be a vital component of a woman’s conception plan; they complement a healthy, balanced diet,’ says Kate Davies, an independent fertility nurse consultant and director of Your Fertility Journey. ‘I recommend the BetterYou Conception Oral Spray (£14.95, Boots) to all my patients as it includes essential folic acid, vitamin D and other important vitamins and minerals for optimising good fertility.’


NHS advice is to take folic acid if you’re trying for a baby or are pregnant, up until your 12th week of pregnancy. Folic acid is the man-made version of folate, which is essential for healthy red blood cells and to help your baby grow normally, but it’s not suitable for everyone so check with your GP first.


See No. 26 for what you need to know about Vitamin D.


12. Weigh yourself

Check you’re the right weight for your height before trying to conceive. ‘It’s important to make sure you are at a healthy weight,’ says Professor Nargund. ‘Being over or underweight can affect your fertility.’ For example, underweight women sometimes find their periods stop so they may have difficulty conceiving.


‘A healthy Body Mass Index (BMI) of between 18.5 and 24.9 increases the chances of pregnancy,’ says fertility expert Dr Ray.


Dr Kotrotsou, chief medical officer for Apricity, agrees, ‘Doctors often struggle to have frank discussions with patients about the impact of weight on the chances of pregnancy. In reality, being outside of a healthy BMI can cause hormonal imbalances that interfere with female cycles, normal development of eggs and implantation of embryos,’ she says.


‘Our fertility predictor has found that losing just 6 or 7 kilos to reach a BMI that’s in the healthy range can increase the chance of pregnancy by more than half, which is very significant.’


13. Stock up on Vitamin E

‘Vitamin E is a powerful antioxidant. Research shows it can be used to reduce age-related ovarian decline. And in men it plays a role in combating free radicals which may otherwise reduce sperm count,’ says Hayley.


‘It’s believed to be important to supplement with 160mg daily, using a natural rather than synthetic vitamin E. The reason for this is that a study, published in the American Journal of Clinical Nutrition, found that the absorption rate of the natural version is more efficient than the synthetic. Almonds, hazelnuts, sunflower seeds, beef, corn and eggs (yolk) are all good food sources of this nutrient,’ she adds.

What fertility drugs help induce ovulation in PCOS patients?



14. Eat healthy food

Diet plays a major part in helping you conceive. Healthy eating throughout pregnancy will help you give birth to a healthy baby, too.


‘The Murdoch Children’s Research Institute identified the first 1,000 days of life as a critical period of developmental plasticity,’ says Hayley. ‘During this time the child is most influenced by nutritional choices, environmental exposures and stress. The microbiome is also a key influencer of health and disease outcomes,’ she explains.


‘However, we never know at the start of a fertility journey how long it is going to take to fall pregnant and keeping to a very strict healthy eating regime can be very difficult,’ continues Hayley. ‘We therefore aim for balance and work towards eating healthy 80% of the time and allowing space for enjoyment and a bit of what you fancy 20% of the time. This keeps up morale and doesn’t detract from enjoyment of food, eating out and celebratory occasions while trying to conceive,’ she explains.


‘Diet absolutely has an impact on fertility,’ adds Dr Kotrotsou. ‘It’s important to maintain a healthy diet that includes all food groups (carbohydrates, protein, fats), and contains the right amount of nutrients. Your diet should also include more low GI (glycemic index) carbs such as porridge, lentils and beans, rather than high GI carbs, such as sugary and processed foods, because low GI carbs are digested more slowly. And you should choose unsaturated fats over saturated fats, and have plenty of sources of omega-3 fatty acids (found in fish and flaxseed).’


Our guide to fertility boosting foods offers plenty of information about eating for pregnancy.


15. Reduce your toxin intake

One of the biggest impacts on fertility – in both men and women – comes from smoking. Toxins in tobacco smoke can harm both eggs and sperm, including damaging DNA and reducing your chance of pregnancy. And it actively affects the success rate of fertility treatments such as IVF.


‘If you’re a smoker, it’s advised to give up smoking as soon as possible if you are looking to conceive. Research has shown that smoking can be linked to early menopause in women and damaged sperm in men, so it’s paramount to try and stop to help protect your fertility,’ says Professor Nargund.


Quitting smoking can multiply your chances of pregnancy by almost half, according to research by Apricity. For help quitting find your nearest NHS Stop Smoking Service, or call the Smokefree National Helpline on 0300 123 1044.


‘Smoking and alcohol are both outright poisons to the body and should be avoided altogether whilst trying to conceive,’ says Natasha. ‘And plastics in our food packaging, cosmetics and cleaning products can disturb hormone balance, especially in women, due to exogenous oestrogens which we absorb in small quantities throughout the day. ‘


Try to eat organic if possible, avoid processed and packaged food, use glass containers to store leftovers and opt for paraben-free cosmetics, skincare and cleaning products.


Woman's-legs-as-she-runs-how-to-increase-fertility

Exercise offers a host of benefits, including aiding your chance of conceiving. (Credit: Getty)


16. Exercise more

‘Regular exercise and maintaining a healthy lifestyle and diet are not only important for your overall health, but have also been found to help increase your chances of conception,’ says Professor Nargund.


Exercise helps boost ‘happy hormone’ endorphins, reduces stress, helps us lose excess weight, increases heart function and lowers cholesterol. Try to get the recommended minimum of 30 minutes exercise a day which leaves you slightly breathless, five days a week.


One study found that four hours of vigorous exercise a week could boost your chances of getting pregnant. Postnatal exercise is also important to your wellbeing and to help you get back in shape after you’ve had a baby.


17. Boost your B12 intake

Almost 50% of us have unhealthy levels of vitamin B12 according to research by health tracking service Thriva, even though we need it for cellular reproduction and men need it for a healthy sperm count. ‘Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy and makes DNA, the genetic material in all cells,’ says Rob Hobson, head of nutrition at Healthspan.


‘Studies have linked vitamin B12 deficiency to suboptimal fertility by causing changes in ovulation, development of the egg or changes leading to defective implantation which heightens the risk of miscarriage,’ says Hayley. ‘Chances of successful conception significantly increase once the deficiency has been corrected,’ she adds.


The best sources of B12 include beef liver and clams, but it’s also found in fish, meat, poultry, eggs, milk and dairy products. Consider a supplement if you’re vegan or vegetarian because vitamin B12 is only found naturally in animal foods. ‘Plant foods have no vitamin B12,’ says Rob. ‘Although some breakfast cereals, nutritional yeasts and other food products are fortified with vitamin B12.’


18. Don’t forget zinc

Zinc is an essential nutrient. It ensures the production of good quality sperm and can reduce the chance of miscarriage, so it’s integral to both male and female fertility.


‘Zinc is required for every enzymatic process that occurs in the body,’ says Hayley. ‘This makes it a high-demand nutrient and one that is quite easy to become deficient in if you’re not conscious about including foods that contain it in your diet on a regular basis. Numerous studies have shown zinc to be vital to male fertility, as it influences the sperm motility, improving its ability to reach and fertilise the egg. It also supports healthy testosterone levels in men,’ she explains.


Video of the Week

‘A new study shows that a zinc deficiency can also negatively affect the early stages of development, reducing the ability of the egg cells to divide and be fertilised,’ continues Hayley.


The daily requirement for zinc is 30mg and it can be sourced through food. ‘Most people think of oysters as good sources of zinc. Love them or loathe them they’re hardly a staple on anyone’s meal plan!’ says Hayley. ‘More accessible sources for day-to-day zinc support include beef, lamb, peppers, sunflower and pumpkin seeds, wholegrains and seafood.


Don’t forget legumes, such as beans, peas and lentils.’ They’re high in mineral levels, especially zinc,’ says nutritionist Elizabeth Stewart from vitamin supplement subscription service Vitl. ‘Legumes such as chickpeas and lentils are easy additions to warming soups and stews, increasing the nutrient value of any dish.’


19. Go organic

It’s definitely worth spending a little extra to give your body the best food possible. Aim for eight portions of organic fruit and veg daily, which contains low levels of pesticides and have a higher nutritional content than non-organic.


‘It’s possible that organic food has a higher nutritional density,’ says Hayley. ‘A 2015 study by Newcastle University analysed 343 studies into the compositional differences between organic and conventional crops. Their findings showed that the additional antioxidants provided if one ate organic fruits, vegetables and cereals was equivalent to eating between 1-2 extra portions of fruit and vegetables per day. ‘Antioxidants such as polyphenolics were between 18-69% higher. These are important to egg quality, guarding against free radical damage,’ she reports.


‘However, the real benefit of choosing organic may be what you avoid,’ adds Hayley. ‘The same study found 48% lower concentrations of the toxic heavy metal cadmium. Cadmium has been linked to male infertility. It also found pesticide residues were likely to be four times lower in organic crops. Pesticides have been found to interfere with the health of our mitochondria, the energy powerhouses of our cells. It takes a lot of energy to produce a healthy baby, so you want to protect your mitochondrial function,’ she advises.

Fertility 101 - Q&A with fertility experts from Michigan Medicine



20. Hydrate!

The benefits of drinking water are useful for everyone, but especially for those who are trying to conceive.


Aim for eight glasses of filtered water or herbal or fruit tea per day – more if it’s a hot day – to keep you well hydrated and your body in good physical condition. Water helps to flush out your system and wakes you up, which means you’re less likely to crave a caffeine fix.


‘Keep yourself well-hydrated,’ advises Dr Kotrotsou. ‘Water is best, but whole milk is also good.’


Brown-sourdough-bread-Getty

Brown bread has more fertility-boosting zinc. (Credit: Getty)


21. Switch from white to brown

Switch white refined foods to brown wholefoods if possible. That means swapping all white options for brown rice, wholemeal bread and wholewheat pasta.


‘Our blood sugar balance has a regulatory effect on our sex hormone balance. Choosing brown, wholemeal versions which slowly and steady release glucose into the blood stream, will be more beneficial to supporting hormone balance than white refined foods,’ says Hayley.


‘Wholemeal grains also have a higher nutrient density than refined grains but we need to prepare them properly in order to access the benefits,’ says Hayley. ‘Rolled oats, for example, should be soaked overnight to draw out the phytates which otherwise keep important minerals “locked away.” The water containing the phytates should be drained away the following morning before consuming them.’


22. Spoon on the honey

Honey has been regarded as a natural fertility booster for generations, so much so that the word “honeymoon” is thought to have come from the age-old tradition of newlyweds eating a spoonful of honey each night in order to speed up the baby-making process.


‘Honey is a highly nutrient-dense food with promising antioxidant, anti-inflammatory and antibacterial properties. It has a long traditional history of use as a fertility enhancer. It’s thought to improve egg quality and general fertility because of its rich B vitamin, iron, calcium, and amino acid content,’ explains Hayley. ‘


‘And 100g of honey has also been shown to increase nitric oxide levels in the blood by up to 50%,’ she adds. ‘This chemical substance improves vasodilation and can therefore improve erection in men suffering with erectile dysfunction. Locally sourced, high quality honey is recommended to access the full immune and fortifying benefits. However, it’s best to avoid this remedy if you’re struggling with a metabolic disorder, such as type 2 diabetes.’


23. Enjoy good fats

Fat is fine if it’s good fat. Fat is an essential part of a healthy, balanced diet. It helps the body absorb certain fat-soluable vitamins, such as A, D and E, which are important for boosting fertility.


‘There’s a strong focus on including healthy fats to support fertility,’ says Hayley. ‘Omega-3 fatty acids play an important role in regulating hormone balance, modulating inflammation and improving the conditioning of the uterine lining to support implantation and a healthy pregnancy. Oily fish are considered to be the most bioavailable source of omega-3. These include sardines, mackerel, anchovies, trout, salmon and herring. Good plant sources include avocados flaxseeds, walnuts and chia seeds,’ she says. See our selection of easy salmon recipes for inspiration.


Cut down on bad fats, which are found in red meat, dairy foods, biscuits and pastries. Eating too much of these can raise cholesterol levels in your blood, increasing your risk of heart disease and stroke.


24. Get some sun

Experts say that getting vitamin D from the sun can boost your female sex hormone levels and help regulate your menstrual cycle, making conception more likely. In men, it can improve his sperm count since vitamin D helps with nucleus development, plus sunshine can raise a man’s libido and testosterone levels.


‘Sunshine boosts vitamin D3 as well as our endorphins and serotonin, so it’s good all round (in safe quantities of course),’ says Natasha. ‘It only takes a small amount of exposure to sun each day to get what you need, plus studies have shown that women with higher levels of vitamin D in their follicular fluid are more likely to have successful IVF treatment,’ she adds.


GP Dr Gill Jenkins says, ‘Between March to October, half an hour a day with direct midday sunlight, no sunscreen, on your face and arms or legs, should be enough to convert vitamin D3 to active vitamin D, which is absorbed into the bloodstream. In the winter none of us get enough direct sunlight and it’s advisable to take a supplement.’


25. Consume B6-rich foods

‘Research has found that eating foods rich in vitamin B6 (also known as pyridoxine) can double your chances of becoming pregnant,’ says Hayley. ‘It’s important for regulating sex hormones, particularly progesterone. Progesterone is known as the pregnancy hormone because it helps the fertilised egg implant, establish and maintain itself in the uterine lining for a healthy pregnancy,’ she explains.


‘Good dietary of sources B6 include avocados, bananas, carrots, eggs (yolks), lentils, mackerel, peanuts, salmon, tuna, sunflower seeds and walnuts,’ she says.


Open-can-of-sardines-how-to-increase-fertility

Oily fish, such as sardines, are a great source of dietary vitamin D. (Credit: Getty)


26. Get enough Vitamin D

‘Studies show that vitamin D deficiency is a risk factor for reduced fertility,’ says Hayley. ‘But due to our northern latitude in the UK, vitamin D deficiency is very common. I like to include this marker in our preconception work-ups at Habitude so that we can supplement at a level appropriate to the individual. Supplementation (10mcg for pregnant women) is usually the best course of action to improve vitamin D levels since our sun exposure is limited to just a few short months. Plus most people spend at lot of the summer indoors, and habitually cover-up with sunscreen when they go out, which reduces their ability to produce adequate levels of vitamin D naturally,’ she explains.


‘There are certain foods which can support vitamin D production,’ adds Hayley. ‘These include eggs (yolks) milk, butter and sprouted seeds.’ Although fish liver oils (e.g. cod liver oil) are a good source of vitamin D they are not recommended during pregnancy.


27. Take selenium (men and women)

Having enough selenium is very important. ‘Selenium deficiency in women has been linked to an increased risk of miscarriage,’ says Hayley.


Selenium is also good for males as it’s an antioxidant that has been shown to increase male fertility. ‘Good levels are also essential to maintain healthy testosterone levels and for the production of sperm in men,’ adds Hayley. ‘It is particularly important in the creation of strong whiplash tails in the sperm. One study found selenium supplementation to increase fertility from 17.5 to 35.1% in sub-fertile men,’ she says.


‘It’s recommended that both men and women supplement with 100ug selenium a day,’ she advises. ‘Further dietary support can be obtained through herring, tuna, garlic, eggs, carrots, mushrooms and broccoli.’ You can also find selenium in Brazil nuts and lobster.


28. Reach your RDA of fibre

It’s essential for keeping your bowels regular, so make sure you eat plenty of wholegrains, fruit and vegetables to keep your digestive system functioning properly. The NHS recommends 30g of fibre a day, but 90% of Brits fall short of this figure, according to studies.


However, don’t eat fibre excess, warns Hayley. ‘Fibre has many health promoting benefits in the body. However, when it comes to fertility, don’t consume too much fibre. This is because one of the effects fibre has is to reduce oestrogen levels in the body. It does so by reducing β-glucuronidase activity, restricting oestrogen reabsorption in the colon. The result may be a lowering of reproductive hormones, which increases chances of anovulatory cycles occurring (cycles when there’s an absence of ovulation),’  she says.

Top 8 foods to boost your fertility



The solution? ‘Swap very high fibre foods such as bran flakes, wholemeal breads and pastas for more gentle fibre foods such as oats, sweet potato, nuts and seeds and green beans, which contain moderate amounts of fibre and are packed with fertility enhancing nutrients,’ advises Hayley.


29. Cut back on caffeine

It was initially believed that caffeine affects fertility, but recent studies have shown that this may not be true, says fertility doctor Dr Kotrotsou. ‘However, the data on this isn’t particularly robust yet, so the general advice would still be to limit caffeine to less than 200mg per day.’


‘Some studies show links between miscarriage and those who have five or more caffeinated drinks a day, but nobody knows exactly why!’ adds Natasha. To be on the safe side limit your intake and remember thar caffeine isn’t just in coffee – it’s also in caffeinated tea, certain fizzy drinks, energy drinks, chocolate and some over-the-counter medicines.’


30. Plan ahead

‘There is so much that women can do to optimise their fertility. It’s all about feeling empowered to take back control. I recommend getting to know when you’re fertile, as research shows us that fertility awareness knowledge can significantly reduce your time to pregnancy. In some cases, as much as up to six months!’ says Kate.


In order to boost your fertility, you should start to make positive lifestyle changes at least four months before you start trying to conceive. This is how long it takes the body to register change. If you already have a child, 18 months between birth and conception allows your nutrient stores to replenish. Our guide to the best time of year to have a baby is also helpful.


Pencils-in-bed 

Sex is a pleasure, not a chore. (Credit: Getty)


31. Keep things interesting in bed

There’s no evidence that some sex positions are better than others for conceiving, but if you’re trying for a baby don’t let sex become a chore. Bring back the fun by trying one of our sex positions for conception which encourage deep penetration so your man’s sperm is better able to reach your egg.


To keep you both excited and engaged try new positions and even places, and have regular sex (more of that, below).


32. Have regular sex

‘You should have sex 3-4 times a week irrespective of your cycle day,’ advises Dr Koita. ‘The egg lives for only 24 hours after ovulation and sperm live for 48-72 hours. By having intercourse regularly you will ensure that the egg and sperm have the opportunity to meet every month. Importantly, the sperm quality drops when men abstain for more than three days.’


Research suggests that even if you have sex six days prior to ovulation you stand a good chance of conceiving. If you want to have sex only on the day you ovulate, you may miss your chance of pregnancy. Our ovulation guide will tell you what you need to know.


33. Embrace yoga

‘Yoga is a fantastic way to prepare your body for pregnancy as it focuses on relaxation techniques and breathing,’ says Cheryl MacDonald, founder of YogaBellies.


‘In fact, there have been studies in America (Dr Alice Domar, 2002), which revealed that women who practice mind and body techniques achieved pregnancies at a rate almost three times higher than those who didn’t,’ says Cheryl. ‘This is because yoga benefits the reproductive functions – both in men and women – by improving the overall integration of physiological systems, reducing stress and balancing the neurohormonal profile,’ she explains.


‘Yoga also lets mothers prepare for the actual birth, by using physical yoga postures, meditation and also yogic breathing techniques,’ she adds. ‘So, not only is it fantastic when you’re trying to get pregnant but it gets you into the correct mindset for giving birth.’


Try a YogaBellies for Fertility class (there are classes around the country). ‘It’s perfect for women who are trying to conceive, or those who want to get their body in the best possible condition for conception,’ says Cheryl.


34. Treat yourself to a break

Lots of women get pregnant during a getaway so pack your bags, grab your partner and head off somewhere away from daily stresses such as work and commuting. If we rest and relax we are also more likely to want sex.


‘It can become quite overwhelming when you’re trying to conceive so it’s important to reset the balance,’ says Kate. ‘Taking the opportunity to care for your emotional health as well as your physical health is vital.’


‘Holidays also help us easily dissociate from our workload and practice the relaxation we so desperately need more of in our weekly schedule,’ says Natasha.


35. Book a thyroid check

If you’ve been trying to get pregnant with no positive results it’s worth checking to see if you have a thyroid problem. A dysfunctional thyroid can wreak havoc on fertility. Yet it can be hard to diagnose as there aren’t always symptoms.


‘Checking your TSH levels (thyroid hormone) and vitamin D levels are important as they play an important role in one’s ability to get pregnant and maintain a pregnancy,’ says Dr Koita. Ask your doctor for a thyroid profile.


Woman-sleeping-peacefully-how-to-increase-fertility

Sleep is essential to your mental and physical wellbeing. (Credit: Getty)


36. Get a good night’s sleep

To improve your chances of getting pregnant you need to keep yourself as healthy and happy as possible and that includes getting enough sleep.


‘Sleep is the time our bodies recover and heal,’ says Natasha. ‘And having a good routine around your bedtime is crucial to a good night’s sleep. I recommend closing the curtains and making the space dark for two hours before sleep. Please, no screens in the last hour. I particularly like a cup of chamomile to seal the deal,’ she says.


If you become severely fatigued, a lack of sleep can disrupt your periods, so if you are suffering from any sleep problems look at ways to fix them.


37. Use lubricant

Even if you haven’t needed it before, you may now. Having lots of sex can make your vagina dry, so invest in lubricant. It’s not advisable to use chemical-based lubricants as they can hurt sperm. Instead, use a lubricant such as Pre-Seed Fertility Lubricant (£18.49, Boots).


38. Reconsider your medication

If you’re taking any medication (prescription or not), have a chat with your doctor about how these could affect your fertility, or a foetus if you fall pregnant.


‘Speak to your GP if you are on any medication – e.g. antiepileptic, antidepressants or antihypertensives. You should be aware of the effects of these drugs on pregnancy and if there are alternatives available,’ advises Dr Koita. Steroids, hormone-based hair and skin treatments and cancer treatment, amongst others, can also have an impact. But don’t come off medication without profession advice. It could make you ill.


39. Take a fertility MOT

‘Taking a fertility MOT is a great way of understanding your own unique fertility potential,’ says Professor Nargund. ‘For women, the fertility MOT can provide an assessment of your egg reserve, providing an indication on your biological clock and your ovulation status. A 3D internal ultrasound examines the uterus and gives you information on your womb, helping to spot any fibroids or polyps, which can potentially affect implantation,’ she says.


‘Additionally, advanced Doppler technology can assess the blood flow to your uterus, giving you further information about the quality of eggs and if there are any factors that can affect implantation or potentially cause miscarriage,’ she adds.


‘For men, a fertility test gives a detailed analysis of semen. It examines the count, morphology and motility of sperm,’ continues Professor Nargund. ‘Results are instant, and you can then talk to your doctor about the results to decide on the best next steps to take.’ Visit CREATE Fertility for more info.


Flamingoes kissing

Love conquers all… (Credit: Getty)


40. Be kind to each other

It’s easy to forget each other during the process of getting pregnant. Making a family takes time, energy, a sense of humour and love. If you find yourself just going through the motions and forcing yourselves to schedule sex you may start to miss out on what should be an intimate time. Ironically, this can result in you wanting to less sex.

How to Boost Your Fertility in Your 30s | Natural Ways to Improve Your Fertility in Your 30s



Every now and again take a break and inject some joy and romance into your relationship. Go on a country walk, treat yourselves to a dinner date, or give each other a seductive massage. Make sure you keep it fun and flirty with lots of talking. Focus on reliving your honeymoon period – not making a baby.


41. Educate yourself

‘Fertility and general health are closely intertwined, so alongside educating young people about the importance of maintaining a healthy lifestyle, we also need to empower them with an understanding of how to best look after their fertility,’ says Professor Nargund.


‘I have long campaigned for fertility education to be provided in schools – by educating young women and men about their fertility from a younger age, we can enable them to be in control and proactive about protecting their natural fertility by making the necessary positive changes to their lifestyle,’ she says.


Forewarned is forearmed, so read up on how to increase fertility or reach out for advice.


42. Don’t give up

If you’ve been trying for a baby for a while with no success don’t worry. You’re not alone.


‘Around 1 in 6 couples in the UK have trouble getting pregnant,’ says Dr Koita. ‘But with the right help and support you can fast-track your journey to parenthood,’ she says. ‘Female age is the most significant factor that determines the chances of a successful outcome, so a timely intervention is important. ‘


Remember, the more stress and pressure you put on yourself, the longer it will take. Stay well, keep positive and good luck!

Fertility is fast becoming one of those difficult issues in life, with studies showing that up to a third of couples face difficulties when trying for a baby. However, there a few simple steps you can take to get your body in optimum condition to conceive – these include eating the the right foods, eradicating toxins from your life, banishing stress and using complementary therapies. Here, the top lecturers from the College of Naturopathic Medicine share their advice on how to help boost your fertility.


1. Nutrient boost

Giving your body a nutrient boost can increase your chance of conceiving. Eat a rainbow assortment of five to seven portions iof vegetables and fruit daily to get a good intake of health protecting compounds. Vitamin E should be especially plentiful in your diet and can be found in cold pressed vegetable oils, wheat germ, sunflower and sesame seeds, and sardines. Fresh ginger root and some seeds are good sources of zinc, which is also required. You should also include protein and complex carbohydrates at each meal and eat a variety of whole grains; brown rice, quinoa, whole wheat, rye, and spelt. Try taking a good quality pregnancy multivitamin and mineral supplement too.


2. Exercise

Exercise helps to keep the body in balance. Yoga and walking for example, are great for metabolism and stress reduction, while tai chi and qi gong helps to regulate and strengthen the reproductive system.


3. Boost your reproductive energy

In traditional Chinese medicine, conception relies on sufficient reproductive energy or ‘jing’. Certain foods and supplements can help increase jing – for instance bone marrow, nettle, pollen and royal jelly. Some of the tonifying Chinese herbs such as cordyceps (a kind of mushroom) and Dang Gui (sometimes called ‘womens ginseng’) also help.


4. Avoid the culprits

Make dietary and lifestyle choices to support the body rather than fill it with artificial hormones, toxins and heavy metals:

Eat organic food to reduce your exposure to hormones and pesticides.

To reduce exposure to xenoestrogens (manmade compounds that mimic oestrogen), avoid foods wrapped in plastic clingfilm, and drink water out of glass bottles rather than plastic.

Don’t buy bagged salad due to possible toxins/bacteria.

Opt for a probiotic supplement, which includes at least 8 billion probiotic cultures, to help the body dispose of unwanted excess hormones.

Avoid caffeine – try instead fresh ginger and/or lemon with hot water to help the liver eliminate toxins.

Cut out smoking as it lowers fertility levels by directly affecting the ovaries and decreasing oestrogen levels.

5. Optimum absorption

Infertility can be linked to malabsorption in the digestive tract. If you suffer from conditions such as IBS, bloating, wind or nausea alongside problems conceiving, you may need to look at these issues first. Sprouted barley and mixed fermented grains have been shown to help improve absorption.


6. Essential fatty acids

EFAs are vital to regulate hormones so make sure you’re getting a sufficient helping in your diet


Eat oily fish three times a week, including wild salmon, mackerel, and herrings but not tuna due to its potential mercury content.

Incorporate seeds such as flax, pumpkin, sunflower and sesame into your diet. Use them in salads or salad dressings, or grind and add to porridge or soup.

Take an omega 3 (EPA and DHA) supplement at a level of 1000mg/day.

7. Herbal Helpers

Herbs are often used on the basis of their pharmacological actions.


Herbs such as epimedii and cuscutae can raise the basal body temperature to promote ovulation.

Chinese Angelica can help normalise of oestrogen and progesterone, helping to regulate menstruation.

Chinese turmeric – taken orally or as a pessary – can help dissolve endometrial or cyst tissue.

Some herbs – such as goji berries -– are known to contain high levels of key nutrients, which help to promote fertility.

A three herb combination including astragalus which prevents the rejection of the foetus by the body’s immune system (but this must be administered by a registered herbalist).

REMEMBER: Chinese herbs must only be taken under the guidance of a fully qualified herbalist, and member of appropriate professional body, such as the Register of Chinese Herbal Medicine (RCHM). Inappropriate use of herbs can worsen medical conditions.


8. Reflexology

A traditional healing art dating from the ancient Egyptians, reflexology involves manipulation of pressure points in the feet, which can help treat problems relating to fertility. Like a mini map of the inside of the body and relating to the organs and body systems, the massage of different points can unblock energy pathways in the body, to regain a natural balance. More specifically, it can affect the action of the fallopian tubes and the ovaries, and thus help boost fertility.


9. Acupuncture

Acupuncture has been shown to help reduce stress, increase blood flow to the reproductive organs and normalise ovulation and the menstrual cycle. It can also help increase sperm counts and mobility. Similarly, ear acupuncture can be effective in reducing stress and promoting conception.

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women which affect fertility. Clomiphene citrate is used as first-line treatment for this disorder, which is associated with some complications and therapeutic resistance.


Objective:

In this research, we compare the effectiveness of ginger with clomiphene on sexual hormones such as Luteinizing hormone (LH), Follicle-stimulating hormone (FSH), estrogen and progesterone in order to treat PCOS effectively with fewer side effects.


Materials and Methods:

In this experimental study, 63 adult female rats (170-200 gr) were studied and divided randomly into 9 groups as control (not received any interventional substance for 60 and 89 days), sham (were given distilled water and ethyl alcohol intraperitoneally daily for 60 and 89 days), and 7 experimental groups receiving estradiol valerate (PCOS inducing agent, intramuscular) alone and with 100 mg/kg clomiphene or different doses of ginger extract (175 and 350 mg/kg) orally daily for 60 and 89 days. Sexual hormones were analyzed and compared in different groups.


Results:

Our results showed that in the PCOS-induced group, LH and estrogen concentration increased while progesterone and FSH concentration decreased remarkably (p<0.05) as compared to control group. Furthermore, in groups receiving clomiphene and ginger extract, we demonstrated significant (p<0.05) improvement in hormonal secretion as compared to the PCOS-induced group. Clomiphene, compared with the lower dose of ginger extract, had a better improving effect on balancing sexual hormones in PCOS. Moreover, ginger extract at higher doses has better effects in improving PCOS.


Conclusion:

As the long-term administration of clomiphene citrate has some side effects, the use of ginger as a herbal medicine without any side effects at high doses can be an effective and good alternative in improving PCOS.


Key Words: Ginger, Clomiphene citrate, Polycystic ovarian syndrome

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Introduction

Female reproductive system disorders such as hormonal and ovarian tissue disorders and how to prevent and treat them are one of the most important issues that researchers have now focused on (1, 2). One of the major causes of ovulation disorders is polycystic ovarian syndrome (PCOS) which is the most common endocrine disorder in women. Ovulation disorders account for about 30-40% of all infertility cases in women (3). Metabolic disorders including increased serum levels of Luteinizing hormone (LH), testosterone and prolactin is very common in women with PCOS and could influence women health in long-term (4-6).

Pregnancy in your 30s: Why talking about fertility shouldn’t be taboo



One of the most common therapies is the administration of clomiphene citrate with an injection of human chorionic gonadotropin (7). Clomiphene can be used to improve ovarian function, menstrual pattern, and glucose metabolism in women with PCOS (2, 8). As clomiphene has structural similarity to estrogen compounds it could have negative effects on endometrial thickness (1, 8). On the other hand, long-term administration of chemical drugs could cause various side effects on human body and today experts believe that we should direct the patient to use herbal medications with lower side effects (1, 2).


Zingiber officinale Roscoe (family, Zingiberaceae), known as ginger, is consumed worldwide as a flavoring agent and medicine for thousands of years (9). In Ayurveda, ginger has been used as a carminative, sweat-inducing, anti-seizure, and blood circulation stimulator for the treatment of inflammation and rheumatoid arthritis (10). The main medicinal value of ginger is due to gingerol and shogaol which have potent antioxidant activity. In addition, it contains zingerone and some oily resin called gingerin (11-13). It has been shown that ginger could have a good effect in menstrual irregularities treatment and can inhibit ovarian cancer cells (14-16). Furthermore, some studies showed that ginger could enhance fertility index, serum testosterone level, testis and seminal vesicle weight, sperm motility, count, and quality and enhance male fertility in rats (17, 18).


So in this study, we decided to compare the effects of different doses of clomiphene citrate and ginger extract in the treatment of PCOS in female rats.


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Materials and methods

Chemicals


Clomiphene was purchased from Sigma Company (Germany). LH, FSH, estrogen and progesterone measurement kits were purchased from Diameter Company (Italy).


Collection and extraction of ginger


Ginger rhizome was washed and dried in the laboratory and mixed with ethanol 70 (ethanol 70 and distilled water in 50:50 proportion), mixed for 24 hr at room temperature and a homogeneous mixture (Eidolph UNImax, 2010, Germany) was obtained. Then, the uniform solution was filtered and dried for 48 hr to obtain solid extract without ethanol. For drying and preparation of pure extract powder, the extract was placed in water bath and desiccator for 24 hr each in order to evaporate alcohol and water. The final dried extract was dissolved with distilled water. To prevent contamination, the extract stored in the refrigerator. Ginger doses were selected based on previous studies done on this herbal treatment. In this study, a minimum (175 mg) and maximum dose of ginger extract (350 mg) were selected which were extractedfrom previous study (19).


Experimental animals


63 adult female Wistar rats (weight: 170-200 gr, Age: 7-8 wk) were obtained from the Jahrom University of Medical Science’s animal house. The animal house temperature was maintained at 22±2oC with a 12 hr light/dark cycle. All animals were kept for 2 weeks prior to the experiment and had free access to food and water.


Experimental design


This is an experimental and randomized study. This study was performed in 2016 at Jahrom University of Medical Sciences. The rats were divided randomly into 9 groups (n=7/each) as followed:


Two control groups: rats did not receive any interventional substance during the study for 60 and 89 days, respectively.


Two sham groups: rats were given distilled water and ethyl alcohol (0.2 ml/ the ratio of 50: 50) intraperitoneally daily for 60 and 89 days, respectively.


Experimental group 1: rats were given estradiol valerate (used for induction of PCOS in female rats) once at the dose of 4 mg/kg intramuscularly and after 60 days the blood sample was collected.


Experimental group 2: rats were given estradiol valerate (single dose, 4 mg/kg) intramuscularly and after 89 days the blood sample was collected.


Experimental group 3: rats were given estradiol valerate (single dose, 4 mg/kg) intramuscularly and then clomiphene (100 mg/kg/day) orally daily for 88 days.


Experimental group 4: rats were given estradiol valerate (single dose, 4 mg/kg) intramuscularly and then ginger extract (175 mg/kg/day) orally daily for 88 days.


Experimental group 5: rats were given estradiol valerate (single dose, 4 mg/kg) intramuscularly and then ginger extract (350 mg/kg/day) orally daily for 88 days.


Blood sampling


The day after the end of the study (day 60 and 88) blood samples were collected from rats’ hearts directly using 5 cc syringes (rats were anesthetized by barbiturate), blood serum was collected after centrifugation (15 min, 3000 rpm) and stored at -20oC until they were tested. Biochemical measurement kits (Diametra, Italy) using the colorimetric method and an autoanalyzer machine (Selectera XL model made in Holland) were used for analyzing of sexual hormones including LH, FSH, estrogen and progesterone.


Ethical consideration


All procedures involving animals were reviewed and approved by the Institutional Animal Care and Use Committee (IACUC) of Jahrom University of Medical Sciences (IR.JUMS IR.JUMS.REC.1394.145).


Statistical analysis


All values were given as mean±SEM. Statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS), version 21.0, SPSS Inc, Chicago, Illinois, USA, One-way analysis of variance (ANOVA) followed by Duncan post hoc test. Statistical p<0.05 was considered significant.


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Results

Effect of different treatments on LH serum concentration


The results of this study showed that LH serum level was significantly increased in the sham group (89 days) compared to control groups and sham group (60 days) (p<0.001). Also in experimental groups 1 and 2 (60 and 80 days) a significant increase in LH serum level was observed compared to control and sham groups (p<0.001). On the other hand, experimental groups 3, 4, and 5 showed a significant decrease in the level of LH compared to experimental group 1 and 2 (p<0.001) (Figure 1).


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Figure 1

Effect of estradiol valerate, clomiphene and ginger extract on serum levels of LH. All data represent Mean±SEM. a: Significant difference (p<0.001) between PCO groups and sham/control groups, b: Significant difference (p<0.001) between treatment groups and sham/control groups, c: Significant difference (p<0.001) between PCO groups and treatment groups


Effect of different treatments on FSH serum concentration


The results of serum concentration measurement of FSH showed that in experimental groups 1 and 2, FSH significantly reduced compared to control and sham groups (p<0.001). Furthermore, in experimental groups 3,4 and 5 showed a significant increase in FSH serum concentrations compared to experimental groups 1 and 2 (p<0.001).


Moreover, in experimental group 5, FSH serum level significantly increased compared to experimental group 1 (p<0.001). These results showed that clomiphene and ginger extract could have positive and dose-dependent effect in PCOS treatment. In addition, the experimental group 5 showed a higher increase in FSH serum level compare to the experimental groups 4.


Effect of different treatments on estrogen serum concentration


The results of our study showed that estrogen serum level increased significantly in all 5 experimental groups compared to control and sham groups (p<0.001). This showed that in PCOS, estrogen level will increase. On the other hand, in the experimental groups 3, 4 and 5 significant decrease in levels of estrogen were seen compared to Experimental groups 1 and 2 (p<0.001) (Figure 3).


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Figure 3

Effect of estradiol valerate, clomiphene and ginger extract on serum levels of estrogen. All data represent Mean±SEM. a: Significant difference (p<0.001) between PCO groups and sham/control groups, b: Significant difference (p<0.001) between treatment groups and sham/control groups, c: Significant difference (p<0.001) between PCO groups and treatment groups


Effect of different treatments on progesterone serum concentration


The results of our study showed that progesterone serum level decreased significantly in all 5 experimental groups compared to control and sham groups (p<0.001) which showed that PCOS can cause a reduction in progesterone serum level.


On the other hand, in experimental groups 3, 4 and 5, significant augmentation in serum levels of progesterone was seen compared to experimental groups 1 and 2 (p<0.001) (Figure 4). Moreover, in experimental group 5 significantly higher increasing effect on progesterone serum level was seen compared to experimental group 4 (Figure 4).


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Figure 4

Effect of estradiol valerate, clomiphene and ginger extract on serum levels of progesterone. All data represent Mean±SEM. a: Significant difference (p<0.001) between PCO groups and sham/control groups, b: Significant difference (p<0.001) between treatment groups and sham/control groups, c: Significant difference (p<0.001) between PCO groups and treatment groups

What is fertility diet? - Dr. Manjunath C S



Table I

Serum LH, FSH, estrogen, progesterone levels in the studied rats


Groups Hormones

LH (IU/L) FSH (IU/L) Estrogen (pg/ml) Progesterone (ng/ml)

Control (60 day) 8.22 ± 0.42 11.94 ± 0.41 264.04 ± 5.59 372.16 ± 4.47

Control (89 day) 8.28 ± 0.24 12.66 ± 0.39 259.88 ± 5.43 369.3 ± 7.91

Sham (60 day) 8.14 ± 0.34 11.38 ± 0.56 250.54 ± 5.82 366.76 ± 5.62

Sham (89 day) 8.36 ± 0.32 11.6 ± 0.51 262.64 ± 5.69 365.8 ± 5.56

Experimental group 1 12 ± 0.46 a 6.34 ± 1.15 a 372.64 ± 5.12 a 251.54 ± 6.77 a

Experimental group 2 11.94 ± 0.53 a 4.78 ± 0.23 a 375.34 ± 5.33 a 249.94 ± 2.99 a

Experimental group 3 9.06 ± 0.36 b, c 9.96 ± 0.28 b, c 281.58 ± 5.11 b, c 320.3 ± 4.16 b, c

Experimental group 4 9.8 ± 0.28 b, c 6.7 ± 0.43 b, c 322.48 ± 3.43 b, c 291.94 ± 7.94 b, c

Experimental group 5 9.22 ± 0.33 b, c 9.08 ± 0.66 b, c 299.58 ± 8.65 b, c 323.08 ± 3.79 b, c

P-value <0.001 <0.001 <0.001 <0.001

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All data are presented as the Mean ± SEM.


Statistical analysis was carried out using One-way analysis of variance (ANOVA) followed by Duncan post hoc test.


Statistical p<0.05 was considered significant


LH= Luteinizing hormone


FSH= Follicle stimulating hormone


a: Significant difference (p<0.001) between PCO groups and sham/control groups,

b: Significant difference (p<0.001) between treatment groups and sham/control groups,

c: Significant difference (p<0.001) between PCO groups and treatment groups.

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Figure 2

Effect of estradiol valerate, clomiphene and ginger extract on serum levels of FSH. All data represent Mean±SEM. a: Significant difference (p<0.001) between PCO groups and sham/control groups, b: Significant difference (p<0.001) between treatment groups and sham/control groups, c: Significant difference (p<0.001) between PCO groups and treatment groups


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Discussion

The researchers found that one of the most important diagnostic criteria for the polycystic ovarian syndrome is changes in the level of sex hormones. In women with this syndrome, the serum level of testosterone, estradiol, and LH will increase and level of progesterone and FSH will decrease. In some cases, the serum level of FSH will not change in PCO disorder (20). Previous researches stated that hyperandrogenism and increased serum levels of LH are very common in PCOS (21). Some other reviews demonstrated that PCOS could increase secretion of testosterone and LH and reduce FSH hormones secretion (22). One possible mechanism for an explanation of sex hormones changes in PCOS is relative lack of aromatase enzyme in the ovary which could increase androgen concentration (23).


Furthermore, androgens could enhance the level of FSH receptors in women with PCOS and thereby cause a reduction in the concentration of this hormone and augmentation of LH serum level (23). The present study demonstrated a significant increase in LH and estrogen serum level and remarkable reduction in FSH and progesterone serum level in PCO-induced groups compared to control group which indicates the negative effect of this disorder on estrogen, progesterone and gonadotropin hormones. These changes were in accordance with those previous studies and probably these changes in hormonal level in PCOS are due to a mutation in aromatase enzyme (23).


Previous studies on LH and FSH serum level changes in PCOS illustrated that there is a connection between the increased level of LH/ reduced level of FSH in PCOS and insulin resistance. Enhanced level of LH hormone stimulates ovarian theca cells, which in return stimulates androgen production (24, 25). In the present study, we also reported enhancement in serum level of LH and estrogen hormone and reduction in the level of FSH and progesterone which were in concurrence with previous studies. On the other hand, any agent that could reduce estrogen and LH and increase FSH and progesterone level can be used to treat this disorder.


The results of this study showed that clomiphene citrate could significantly decrease estrogen and LH serum level and remarkably increase progesterone and FSH serum level compared to PCO-induced groups (with no treatment) which indicate the useful effect of clomiphene citrate in improving hormonal changes in rats with PCOS. These results were supported by previous studies (26, 27).


Clomiphene citrate has some structural similarity to estrogen compounds and by occupying estrogen receptors could decrease the function of estrogen and increase progesterone performance (27). Furthermore, clomiphene by having an anti-estrogenic effect could stimulate the pituitary Gonadotropin-releasing hormone secretion, regulate gonadotropin secretion and ultimately stimulate ovulation (1). Therefore, it is likely that clomiphene could improve the sex hormone changes in women with PCOS due to having anti-estrogenic properties, which is consistent with our results. Other studies had suggested that clomiphene citrate will improve ovulation and fertility in women with PCOS (28, 29).


Also, previous studies suggested that clomiphene citrate is more effective than similar drugs in the treatment of PCOS (30). In the current study, improvement in sex hormone serum level was higher in rats receiving clomiphene citrate than the ginger-exposed group, which indicates that clomiphene is more effective in improving sex hormone changes in patients with PCOS. Moreover, our study showed that ginger extract could improve sex hormone changes compared to the PCO-induced group with no treatment. We observed that ginger extract could have positive and dose-dependent effect in improving serum level changes of LH, FSH, estrogen and progesterone in PCOS. Although ginger extract is more effective in improving hormonal changes at higher doses, even at the highest dose, it has less improving effect compared to clomiphene.


In addition, results of the current study showed that serum concentration of LH and estrogen hormone significantly decrease in the group receiving ginger extract compared to non-treated PCO group while ginger could remarkably increase serum level of FSH and Progesterone. These results confirm the positive effect of ginger extract in the treatment of PCOS. Previous studies suggested that ginger extract contains active ingredients such as gingerols and sesquiterpenes which inhibit arachidonic acid production by interfering with lipoxygenase and cyclooxygenase pathways and thereby inhibit prostaglandin production (12, 31).


In turn, this effect regulates gonadotropin production (12). So it is likely that changes in gonadotropin level in this study be due to possible effects of ginger extract active ingredient on prostaglandins, which is consistent with results of previous research. So we can suggest ginger extract as adjunctive therapy for improvement of gonadotropin hormones level in patients with PCOS. On the other hand, it has been stated that in patients with PCOS, the levels of progesterone decreased while estrogen levels increased (32).


Thus, any agent that could regulate the secretion of these hormones can be effective in the treatment of PCOS. Studies had shown that ginger extract also contains many flavonoids and polyphenolic compounds which previously mentioned (31). Researches had suggested that polyphenols have anti-androgenic effects. Evaluation of other plants with similar compositions to ginger extract demonstrated that these herbal extracts could reduce estrogen level compared to PCOS group and this effect is mostly due to flavonoids and phytoestrogens component of the extract which reduces aromatase enzyme activity and thus reduce estradiol concentration. On the other hand, it has been expressed that plants with similar compositions with ginger extract will reduce cholesterol level and as steroid hormones such as estradiol are derived from cholesterol, this reduction in cholesterol concentration could decrease synthesis of steroid hormones such as estradiol which was in accordance with estrogen serum level changes by ginger extract in the current study (33).


It is also indicated that in PCOS rats some changes in estrogen and progesterone level will occur as progesterone to estrogen ratio will reduce and balance of these hormones can be one way of treating this disorder (33). Results of the current study showed that serum level of progesterone significantly increased in ginger-treated group compared to PCOS group which indicates the useful effect of ginger in PCOS treatment.


Studies on plants with similar compositions to ginger extract exerted that plants with flavonoids and phenolic compounds could establish a natural balance between estrogen and progesterone and with their specific pharmacological-physiological effects could rebalance increase or decrease of sex hormone (34, 35). So it is possible that ginger extract could make a balance between estrogen and progesterone hormones in PCO-induced rats via having flavonoid content and antioxidant activity which is inconsistent with the results of previous studies. So dose-dependent increase in progesterone and decline in estrogen level seen in the group receiving ginger extract in comparison to PCOS groups can represent balancing properties of ginger extract in this disorder.


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Conclusion

The results of the current study showed that clomiphene citrate, compared with ginger extract, has more improving and effective properties in balancing LH, FSH, estrogen and progesterone hormones in rats with polycystic ovarian syndrome. ginger extract at higher doses also has a better effect in improving this disorder so that ginger extract in high doses has an almost similar function with clomiphene citrate. As the long-term administration of clomiphene citrate has some side effects, the use of ginger as a herbal medicine without any side effects at high doses can be an effective and good alternative in improving PCOS.

Age and Fertility: What Happens to Your Eggs as You Get Older?



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Acknowledgments

This article was financially supported by Jahrom University of Medical Sciences, Jahrom, Iran.

Background: Due to renowned medicinal properties, Ginger rhizomes (Zingiber officinale Roscoe) used traditionally in the treatment of arthritis, rheumatism, muscular aches, constipation, indigestion, hypertension, dementia, fever, and infectious diseases. As an antiemetic, Ginger is consumed by approximately 80% of pregnant women to treat nausea and vomiting of early pregnancy.


Purpose: The aim of this study is to evaluate the impact of ginger extract on the oestrous cycle and implantation in female mice.


Study design and methods: Four experimental episodes were identified. One considered the main study of outcomes and lasted 90 days; one lasted 35 days and considered the oestrous cycle; while the third and fourth intended antifertility and abortifacient and continued 20 days for each. Mice dosed Ginger orally at 0, 250, 500, 1000 or 2000 mg/kgbw/day (GNC, GN1, GN2, GN3, GN4, respectively).


Results: GN3 and GN4 dams showed maternal toxicity. High dose significantly reduced the number of live fetuses and increased fetal death and resorption. Mice treated with 2000 mg/kgbw/day displayed significant decreases in implantation sites. At a dose of 2000 mg/kgbw/day, Ginger prolonged the length of oestrous cycle with a significant decrease in the duration of diestrous-metestrus (luteal) phase, prolonged proestrus-estrus (ovulatory) phase and reduced the number of cycles as well. Therefore, Ginger impairs the normal growth of corpus luteum because of progesterone insufficiency during early pregnancy. The observed-adverse-effect dose set at 2000 mg/kgbw, but no-observed-adverse-effect dose set at 250 and 500 mg/kgbw.


Conclusion: These findings suggest that Ginger can disrupt the oestrous cycle and blastocyst implantation without teratogenesis.


Keywords: Estrous cycle; Fertility; Fetus; Ginger; Implantation; Resorption.

Is ginger tea good for ovulation?

When it comes to boosting fertility, unfortunately there is no one magic bullet that works for everyone. Instead, we have to tackle fertility with an integrative approach. In my professional opinion as a registered dietitian, a nutrient-rich healthy fertility diet that nourishes our reproductive organs and our hormones is the foundation food that increases fertility. I always get questions about what to eat when trying to conceive and nutrition advice for pregnancy. Researchers have estimated we make roughly 227 decisions about food every single day. That gives us 227 opportunities to make the best decisions when it comes to our reproductive health and to choose foods that will enhance our fertility, nourish our bodies, and promote healthy pregnancies.


10 Best Foods to Eat When Trying to Conceive


Below are the 10 best foods I suggest to eat when you are ttc:


Beets



Beets contain nitrate, a compound that improves blood flow to the uterus. One of the main causes of infertility and poor IVF outcome is weak uterine artery pulsatility index. This is also know as inadequate blood flow to the uterus, which in turn decreases our endometrial-lining thickness. Healthy blood flow also helps stimulate ovulation, assisting in our chances of successful conception.


Chef Tip: Dice a few raw beets and freeze them to toss into your smoothies for a pop of vibrancy and nutrients.


Oysters


You either love ‘em or hate ‘em. But after reading why they’re incredible for a healthy fertility diet, I hope you jump on the oyster train. Oysters are one of the best dietary sources of zinc, a powerful anti-inflammatory and hormone regulator. Zinc helps stimulate ovulation by nourishing our ovarian follicles aka good egg quality.


Chef Tip: Not into the raw bar? Bake oysters with a little ghee, coarse salt, and spinach at 400 degrees F for 20 minutes.


Kombucha



Probiotics, we all know they’re great for our gut...but what about fertility? The answer is YES! Dysbiosis (when our gut bacteria are out of whack) can contribute to hormone imbalances. Hormone imbalances like estrogen dominance can shorten our luteal phase. Food and beverages that contain high levels of probiotics, like kombucha, can help balance our gut bugs and improve luteal phase length.




Chef Tip: To get used to the tart and tangy flavor of kombucha, mix a drink up with ½ kombucha and ½ your favorite flavored sparkling water.




Ginger



Gingerol, the main bioactive compound in ginger, has powerful anti-inflammatory effects. Conditions like PCOS and endometriosis, that greatly affect fertility, are heavily tied to inflammation in the body. Getting more ginger into our diet can help mitigate inflammation and facilitate conception.


Chef Tip: Peel and puree a hunk of ginger root and add it to your next batch of brown rice. Add in a generous splash of full-fat coconut milk, a little lime juice, and a pinch of salt and you won’t be able to stay away from it’s sweet, peppery taste.




Sweet Potatoes



Vitamin B6 plays an essential role in the multiplication of cells, making it important for the development of a healthy embryo. The ability of our body to successfully create these cells again and again is what makes a pregnancy possible. Sweet potatoes are a great source of this B vitamin.




Chef Tip: Eat the skin for extra fiber (just make sure to give it a scrub, first)!




Persimmons



Persimmons are packed with ascorbic acid a.k.a. vitamin C. Vitamin C is integral to healthy ovulation and the prevention of luteal phase defect. In other words, ascorbic acid helps trigger the release of the mature egg and sustain progesterone levels during our luteal phase.




Chef Tip: There are two common types of persimmon: Fuyu are the smaller, shorter variety and best eaten raw. The Hachiya are acorn-shaped and great for cooking.




Cod liver oil



Hear me out on this one: cod liver oil is a super concentrated source of vitamin D. Research shows that vitamin D may influence steroidogenesis (the process that turns cholesterol into valuable sex hormones like estrogen and progesterone). It may also improve menstrual cycle regularity. A regular cycle means a better shot at calculating our fertile window correctly.




Chef Tip: Purchase a high-quality brand and knock back a few teaspoons per day. Cheers!




Almonds



They’re a healthy fat packed with vitamin E, which fertility studies show improves our egg quality health. High-quality eggs are essential to achieving a viable healthy pregnancy. Not only that, low levels of vitamin E intake may be associated with an increase in miscarriage rates.

Fertility Supplements: What Supplements Should You Take if You Are Trying To Get Pregnant?



Chef Tip: Not a fan of raw almonds? Spread raw almond butter on celery sticks, smear on sweet potato or whole grain toast, or swirl into your low-fat dairy yogurt.




Mushrooms



Mushrooms contain hefty doses of an essential mineral called selenium. Selenium helps promote the development of mature follicles, nurturing them for a strong, healthy ovulation. Selenium also protects our thyroid, aiding in the conversion of T4 to T3.




Chef Tip: Salt mushrooms at the end of cooking. Salt draws out moisture (which can prevent browning) so we want to save it for the last step so they brown properly.




Ghee



Don’t skimp on your healthy fats...just the trans fats when it comes to your fertility diet. Dietary fats like ghee are essential for manufacturing our reproductive hormones. Plus, adding fats to our veggie and fruit-heavy meals actually enhances the nutrients we absorb from these foods which better optimizes our fertility.




Chef Tip: Ghee has an even higher smoke point than butter, making it friendly for cooking high-heat items like sauteed leafy greens and veggies and lean proteins. 




Fertility Diet Recap



This is not an exhaustive list, so don’t feel like you have to binge on cod liver oil at every meal and snack. Instead, be flexible in your approach to eating for conception and try to integrate these fertility-friendly ideas, along with plenty of other fresh whole foods, into your nutrition routine. A few more healthy foods we recommend if you aren't a fan of some recommended above: avocado, pumpkin seeds, blueberries, kale, lentils, pomegranates, omega-3 fatty acid filled foods, folic acid and healthy carbs such as brown rice and quinoa. Your baby (and body) will thank you.

What foods help ovulation?

Can eating certain foods really boost your fertility? The answer is yes. It’s important to remember that there is no magic diet that will result in pregnancy, but food and lifestyle choices do have a significant impact on the reproductive health of both women and men. The foods you eat, along with other factors like lifestyle and stress levels, can boost fertility through their impact on your gut, blood flow, hormone levels and overall health.


Laurel Fertility Care offers a holistic approach that includes many natural adjustments like diet and lifestyle changes before moving on to advanced treatment. Here are 10 foods to incorporate into your diet to boost your fertility.


1. Beans and Lentils

Beans and lentils are high in fiber and protein, which can help improve ovulation. Studies have shown that replacing animal protein with vegetable sources of protein can reduce the risk of ovulatory infertility. Both of these legumes are also an excellent source of folic acid, a vital component that aids with conception and helps in healthy embryo development.


2. Sunflower Seeds

Eating sunflower seeds is an easy way to help maintain proper sperm levels without making any huge dietary changes. Roasted, unsalted sunflower seed kernels are rich in Vitamin E, an essential nutrient that increases sperm count and motility. Sunflower seeds also offer substantial amounts zinc, folic acid, and selenium— all of which are potent fertility nutrients with stellar benefits.


3. Fruit

Antioxidant-rich foods like fruit and berries are high in vitamin C and folic acid, which provides healthy fetal growth after conception. Raspberries, blueberries, and strawberries all contain natural antioxidants and anti-inflammatory phytonutrients, two components that greatly improve fertility for both men and women. This study showed that women with high fruit intakes had a significantly reduced chance of infertility. 


4. Avocados

Avocados are full of Vitamin K, potassium and folate that assists your body with so many things— vitamin absorption, blood pressure regulation and more! They are also comprised of monounsaturated fats (healthy fats) that offer tons of dietary fiber and folic acid, which we know are crucial during the early stages of pregnancy.


5. Quinoa

Quinoa is an amazing whole grain because it’s not only carb-free, but it’s also a perfect source for protein, zinc, and folic acid. Altogether, these components offer a robust prenatal protection plan, while maintaining healthy fetal growth once pregnancy takes place. Not to mention, quinoa gives you all of the essential amino acids that meat products offer without any potentially harmful additives.


6. Greek Yogurt and Cheeses

Fatty foods are great for boosting fertility. Greek yogurt and cheese contain calcium, probiotics, and vitamin D, all of which help improve ovulation. Also, you’ll receive an ample amount of protein from each food, reinforcing your odds of a successful pregnancy through more precise ovulation cycles.


7. Salmon

To pile on more of those healthy fats, salmon offers loads of protein and valuable omega-3s that improve fetal development throughout pregnancy. Men can also benefit from eating salmon for its high levels vitamin D and selenium, two components that raise semen levels and enhance its overall health. Keep in mind, it’s best to purchase wild-caught salmon to decrease the presence of mercury, which can be harmful to a pregnancy if too much is consumed. To be safe, limit your salmon intake to once or twice a week.


8. Asparagus

Asparagus is a powerhouse food with incredible benefits for those trying to get pregnant. Studies show that eating one cup of boiled asparagus will provide you with over 60% of your daily recommended value of folic acid, fulfill your daily vitamin K value, and strengthen your reproductive health with more than 20% of vitamins A, C, and B. It also contains substantial amounts of zinc and selenium, so men should also incorporate asparagus into their diet!


9. Walnuts

Walnuts are packed with omega-3s and omega-6s that help your body maintain healthy brain functions and regulate hormones. Research also shows that men who eat walnuts on a regular basis will experience improved semen health, resulting in a better motility, quantity and morphology.


10. Egg Yolks

Most people ditch the yolk of the egg to cut back on calories, but yolks contain vitamin B and essential omega-3s. Yolks also contain folic acid which helps the body create red blood cells and help to maintain embryo development after conception.


Takeaway

Making healthy choices and changes while on your fertility journey can help your stress levels and provide some control during a time when circumstances can often feel overwhelming.


While these 10 foods are recommended as a natural way to boost your fertility, we encourage each patient to practice balance in their diets! Extreme restrictions or punishing yourself for the the occasional indulgence in a bowl of ice cream or a slice of pizza is not beneficial to your mind or body while on this journey!

Is ginger and garlic good for a woman trying to conceive?

When a couple decides to have a baby, there are certain things that need to be considered. Apart from being mentally and financially ready, a couple also needs to be healthy and fertile to start trying to conceive. For some fortunate couples, getting pregnant is not hard; but for others, it may seem like an unachievable goal! They might think they are doing something wrong, but what they may not consider is their fertility levels (or the lack of fertility). Fertility plays an important role in conception. If you and your spouse are facing fertility issues, simple home remedies like eating garlic can work. Garlic is known to be fertility-boosting food. Let’s discuss this fertility-enhancing herb in detail.


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Is Garlic Good for Fertility?

The medicinal properties of garlic not only improve the quality of sex but also act as a remedy for impotence. Garlic is a fertility enhancer for men and women. Let’s understand how it can help in conception.

Fertility 101: How to increase your chances of pregnancy



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Daily consumption of garlic keeps the body healthy. Just 2-4 cloves of raw garlic daily can ensure a healthy reproductive system.

Garlic acts as a blood cleanser; it aids in blood circulation, thus, giving a couple the stamina required when trying to conceive.

Selenium and Vitamins C and B6 found in garlic eliminate chromosomal defects.

Garlic has allicin that increases blood flow to the sex organs.

Garlic keeps the sperm and eggs healthy. It is rich in nutrients that boost fertility in men and women. But can this herb cure infertility? Let’s find out!


In many men, increased production of reactive oxygen species (ROS) is the main reason for infertility. This, in turn, creates oxidative stress at such a high rate that the body’s natural antioxidants cannot keep up. Garlic is a natural antioxidant that treats impotence in men by reducing the cellular damage that is caused by this oxidative stress.


How Does Garlic Help Improve Male Fertility?

Garlic is known to enhance potency in men. It contains vitamins and other nutrients in large amounts that are vital for a healthy cardiovascular system. Garlic has:


Allicin- It helps in improving blood flow to sex organs and also protects the sperms.

Selenium- It is a natural antioxidant that improves sperm motility.

Vitamins C and B6 – These vitamins keep the sperm healthy.

Garlic and male fertility are closely linked as regular consumption of garlic purify the bloodstream. This blood, devoid of any harmful substances, flows to the penis on erection. Garlic helps the blood flow better and in the faster advancement of erection, thereby, ensuring longer durability.


This purified blood also helps in the production of healthy sperms and, thus, in the birth of a healthy baby.


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How Does Garlic Help Improve Female Fertility?

The connection between garlic and female fertility is strong as garlic is known to stimulate ovulation and prevent chromosomal defects. Women who regularly include garlic in their diet are known to have painless periods and healthy pregnancies. Thus, women are recommended garlic for conception.


Garlic is rich in Vitamin B6 which aids in ovulation.

Garlic improves blood quality and ensures a healthy baby and a healthy pregnancy.

Nutrients found in garlic keep the egg healthy and prevent from any chromosomal damages.

The pungent smell of garlic may be repulsive, but there are enough and more reasons to include it in your diet, especially for you ladies. Garlic prevents breast cancer and other diseases and helps control weight and yeast problems. It also keeps the skin, hair and nails healthy. Eating garlic also helps build immune system and keep cardiovascular health in check.


Healthy Garlic Recipes to Boost Fertility

Garlic can give a boost to your fertility and thus make the baby-making process quite easier. Ideally, 1-2 cloves of raw garlic are recommended to be consumed on a daily basis for improving fertility. Many people consider drinking garlic milk for infertility issues, but its overpowering odour may not agree with everyone. Let’s look at some other garlic recipes that you can try to boost your fertility levels.


1. Garlic and Honey Tea

Garlic and honey tea makes for a wonderful morning beverage. Here’s how you can make garlic and honey tea.


Ingredients


Garlic (minced) – 2 cloves

Honey – 1 tbsp

Water – 3 cups

How to Make


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Clear garlic pods. Steep it in boiling water to bring out the essence. Add a dash of honey. Serve it as a tea.


Garlic and Honey Tea


2. Garlic Infusion

This medicinal infusion may not taste great but has all the benefits you need.


Ingredients


Garlic – 1/2 kg

Water

A jar 3-litre capacity

How to Make


Chop the garlic cloves and put it in a jar. Boil water and pour it into the jar. Close it with a lid and cover the jar with foil. Keep the jar in a dark place for a month. Shake the jar every day.


Use one teaspoon of this infusion daily on its own or with a glass of milk.


Garlic Infusion


3. Garlic With Nuts

Another medicinal mix that can help you increase your chance of conceiving.


Ingredients


Cooked garlic – 100 gm

Ground walnuts – 300 gm

Hazelnuts – 100 gm

Rhodiola Rosea roots – 50 gm

Honey – 1 kg

How to Make


Mix all the ingredients thoroughly. Consume one tablespoon of this mixture once a day after meals.


Garlic with Nuts


Besides these recipes, you can simply include garlic in your daily meals. Just blend in a few cloves with smoothies or fresh juice.


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A Word of Caution

Remember, garlic mustn’t be consumed in cases of epilepsy and also during acute inflammatory processes in the kidney when pregnant. It should not be consumed on an empty stomach. You can take garlic supplements if you don’t like eating raw garlic. But you must consult a doctor before trying out garlic to improve your fertility levels.


Garlic can be the answer to your fertility issues. Garlic is known to improve fertility and can help you conceive but we will say it again that you speak to your doctor before considering this remedy for fertility enhancement.

What herbs increase ovulation?

Trying to get pregnant? You have landed at the right place. Some recent studies have found that certain herbs can have a positive effect on fertility. Here is a list of five such herbs that can be helpful.

Shatavari (Asparagus)

Asparagus is considered a female reproductive tonic and as the name implies, the tonic has the ability to increase fertility and vitality.

It's rich in phytoestrogens, a group of naturally occurring compounds that has a similar chemical structure to oestrogen, which plays a major role in the reproductive cycle.

It also helps by reducing stress, which can cause fertility issues. It's also used for menopausal symptoms and to increase lactation.

Withania somnifera (Ashwagandha)

Ashwagandha has been used traditionally to treat fertility issues in men. It is believed to improve semen quality, erection and sperm count.

It helps in improving male sexual health in disorders such as psychogenic impotence and unexplained infertility.

Agnus castus (chasteberry)

Some small studies have suggested that agnus castus balances reproductive hormones and helps regulate the menstrual cycle.

The irregular menstrual cycle also makes it difficult for many women to get pregnant.

Black cohosh

The herb is said to improve female fertility. It's believed to stimulate the ovaries and give ovulation a boost.

Chinese herbs

There is not much evidence, but Chinese herbs are said to improve fertility when taken along with other fertility drugs. However, the effect of Chinese herbs on fertility when taken alone has not been tested and proven yet.

What does ginger do to the Virginia?

Caution: The foods recommended in this article will not make your vagina smell like Chanel No. 5. Because you know what? You vagina is supposed to smell like, well—a vagina. What else, d-uh?

Natural ways to boost fertility



That said, what you eat affects each and every part of your body—including your vagina. In fact, according to an article published in the journal Scientific Reports, your vaginal and gut health are linked to each other. 


Basically, if you keep your gut healthy, your vagina will be healthy too. Needless to say, a healthy vagina will be devoid of infections, have the correct pH, and won’t smell pungent.


So, here’s a list of foods that can help your vajayjay stay that way:


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1. Yogurt


Many gynaecologists recommend concentrated cranberry juice or whole cranberries to women suffering from urinary tract infections (UTI). In fact, several studies like the one published in the American Journal of Clinical Nutrition backs this claim.


The reason is fairly simple: cranberries are packed with antioxidants and powerful infection fighters. Plus, they are acidic in nature and help maintain the pH of your vagina. Now, obviously, a healthy and infection-free vagina has no reason to smell bad.


3. Pineapple


Pineapple is a rich source of vitamin C, vitamin B, and fibre. Not only do these nutrients improve gut health, but they also help maintain your vagina’s natural smell by keeping it healthy and preventing any infections.


4. Apple


The phytoestrogen phloridzin and antioxidants in apples stimulate the blood flow in your vagina, keeping it healthy and fresh. In fact, a 2014 study published on PubMed Central shows that these compounds also prevent the development of uterine fibroids and help with sexual arousal.



Plus, eating apples can also increase the probability of climaxing during sex. What more do you want?


5. Ginger Tea


The antimicrobial properties of ginger are just what you need to promote a healthy gut, a healthy vagina, and ward off any vaginal infections, keeping Miss Vayjayjay smelling au-naturel!


6. Lemon


This citrusy wonder is rich in vitamin C and acidic in nature. This is exactly why it can help maintain the vaginal pH and keep matters in control.



7. Celery


Celery is bursting with vitamin C and hence can help restore the ecology of vaginal bacteria. Moreover, the presence of chlorophyll in the salad essential helps maintain the smell of your lady bits.



8. Cinnamon


While all things citrusy and acidic help maintain the pH of your vagina, cinnamon happens to be an alkaline spice which can help neutralise any excess acidity down there. A healthy balance means a healthy smelling vagina!


  

Feminine Hygiene

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Home Intimate Health Feminine Hygiene That pair of seamless synthetic undies could be harming your vagina. Here’s how

FEMININE HYGIENEThat pair of seamless synthetic undies could be harming your vagina. Here’s how

Updated on:17 November 2019, 21:29pm IST

Sure, a no VPL pair of underwear comes with a plethora of benefits. But thanks to its synthetic fabric, it can also wreak havoc on your vagina.

Sonakshi Kohli 66 Likes 

vaginal yeast infectionThink twice before wearing synthetic underwear, girls. Image courtesy: Shutterstock

Life without synthetic underwear can be really difficult, don’t you think? After all, how else do you hit the gym without getting conscious about your panty line showing through those skinny yoga pants? How do you pull off those bodycon dresses without a tummy-tucking underwear? How do you possibly enjoy a beach vacay without sporting a fancy bikini? And what’s a fun night without a set of lacey thongs? 



Unfortunately, though, life is difficult even with the presence of this saving grace. I say this because synthetic underwear might make you look fab, but they can wreak havoc on your vagina.


So, what’s so bad about synthetic underwear? 


“Wearing synthetic underwear for long periods of time can lead to yeast infections, urinary tract infection (UTI), and vaginal infections,” says Dr Nupur Gupta, director, obstetrics & gynaecology at Fortis Memorial Research Institute.


The reason is pretty obvious, folks: most synthetic fabrics are sweat absorbers and aren’t breathable. And by now you know what all that trapped sweat and moisture down there is capable of doing. 


“Vaginal moisture, which tends to accumulate around the vulva region, can cause skin irritation and infections in and around the vagina,” explains Dr S.N. Basu, senior director & head of department, Obstetrics & Gynaecology at Max Super-Speciality Hospital.


“The warm and moist environment is quite ambient for the bacteria and yeast to grow, and the probability of facing an intimate health problem becomes high even in the case of minute incontinence,” she adds.


Relax! You don’t have to give it up completely


In this time and age of fashion ruling the world, giving up fancy underwear might not be possible. So, we asked experts about how you can take care of your intimate hygiene while sporting them and here’s what Dr Nisha Jain, gynaecologist at Saroj Super-Speciality Hospital in Delhi suggests:


1. For working out, wear shorts or pants that have a built-in moisture-wicking underwear.


2. Make sure that the underwear fits you properly so as to avoid friction and irritation that can worsen your case.


3. Get out of the synthetic underwear as soon as you can and slip into a comfy and breathable cotton one.


4. Take a shower after your workout and change your underwear. Heavy exercise can also cause vaginal discharge, which along with sweat can make your private parts itch like crazy and can even give you a terrible infection.


5. If you can’t shower, clean your vulva with a dry, clean towel and make sure that there is no wetness down there.


6. You can even count on anti-rash vaginal powders and intimate hygiene washes to keep your private parts clean and sweat-free.

The top foods to eat if you're trying to get pregnant



So ladies, now that you’re in the know–whip out the cotton undies. It’s what your vagina wants!

What does ginger do to the uterus?

Ginger root is being commonly used to treat various ailments. Ginger gives our food a unique flavour, aroma and has various health benefits. From relieving the symptoms of cold to reducing acidity, the list of health benefits of ginger is a long one.

Here we tell you five most important health benefits of ginger and an easy way to inculcate it in your daily diet.


02/7​Ginger prevents cell damage


Ginger is densely rich in antioxidants than many other foods. Only pomegranate and berries surpass it in terms of its antioxidant content.

Antioxidants help prevent oxidative stress, a process that is linked with diseases like diabetes, stroke and cancer. Oxidative stress happens when too many free radical molecules are produced by metabolic processes. Antioxidants help by stabilizing free radicals and preventing oxidative stress and thereby preventing us from diseases.


A study conducted in 2017 tested the antioxidant effects of ginger on cancer patients receiving chemotherapy. Patients who received the daily ginger extract had higher levels of antioxidants and lower levels of oxidative stress than the placebo group.


READMORE

03/7​Ginger is anti-inflammatory


Excess of free radicals can cause inflammation, which is the body's natural response to harmful foreign objects.

Inflammation goes away as your body heals. But if someone has oxidative stress, it can cause chronic inflammation. Chronic inflammation can lead to diseases like heart attacks and chronic pain like arthritis.


A study conducted in 2001 found that patients with osteoarthritis who took ginger extract twice a day for six weeks had reduced knee pain caused by inflammation.


READMORE



04/7​Ginger can help treat nausea


It is a well-established fact that ginger can help ease the symptoms of nausea and vomiting.

It is a safe and effective remedy for pregnant women who get morning sickness. In a small study conducted in 2019, it was found that pregnant women who took 250 mg of ginger capsules for four days experienced less nausea and vomiting than other women who did not take the capsule.


05/7​Ginger eases menstrual pain


Ginger works wonders as a remedy for menstrual cramps. It suppresses the chemicals that make your uterus contract and cause pain.

In a study, it was found that 750-2000 mg of ginger powder can help relieve the pain during the first three-four days of the menstrual cycle.



06/7​Ginger helps regulate blood sugar levels


There are evidences that show that ginger can help control blood sugar levels in people with type 2 diabetes. People who took 2 grams of ginger powder per day have improved blood sugar, found a study.

Another study found that taking ginger capsules reduced blood sugar level in women suffering from gestational diabetes.


07/7​5 ways to add ginger to your daily diet


- Add ginger to your herbal tea/masala chai/

- Add freshly chopped ginger to curries and stir-fries


- Add ginger powder to your smoothies


- Add ginger while baking cookies, cakes and pastries.


- Have ginger with warm water to soothe a sore throat.

Is ginger good for egg quality?

Need a recipe for love and baby-making? Look no further than your kitchen pantry if protecting your fertility health is on your mind.


BY: KENDRA TOLBERT, MS, RDN, CDN, CLC

We tend to think of medicinal herbs as being a completely different than culinary herbs, but that’s not always the case. The foods you eat can double as wellness tonics that support your body’s innate ability to stay healthy and get pregnant. Hippocrates said it best when he said, “Let thy food be thy medicine and medicine be thy food.”


And who are we to argue with Hippocrates?

The great thing about kitchen herbs is you don’t need to study clinical herbalism to take full advantage of their health and fertility benefits. Just open your pantry and fridge, add some flavor to your food, sip some delicious teas, and savor every bite & drop.


Here are a few kitchen herbs to consider if fertility health is on your mind.


1. Garlic

Garlic is the ubiquitous herb used by nearly every culture. All over the world, folks turn to it to add some serious flavor to food. Plus it’s one of the most widely used medicinal herbs.


It relaxes your blood vessels and promotes circulation, and good blood flow is vital to keeping your organs in tip top shape, including your ovaries and uterus. For the fellas, adequate blood flow is necessary for erections.




How to use:

Add chopped cloves to stir-fries, soups, and pesto.

Rub a cut clove over bread or even in a bowl just before adding soup or salad to it.

Infuse olive oil with a few cloves to use anytime a recipe or meal calls for a drizzle of EVOO.

2. Ginger

Ginger is without question a delicious herb that can be easily added to a number of meals and drinks, and helps mitigate period cramps and nausea during pregnancy. It’s high in antioxidants, which plays a protective role for your ovaries and eggs from oxidative damage and stress. Many herbalists also say it increases blood flow to your lady parts, delivering important nutrients and clearing away toxins.


How to use:

Shred about a thumb size amount and add it to hot cereals.

Add a 1/2 inch peeled piece to a smoothie.

Make into a tasty tea. Add lemon and honey or just enjoy as is.

3. Turmeric

Turmeric, the golden child of Ayurveda, protects your DNA from damage, acts as an anti-inflammatory, and protects your liver. With your liver playing a very important role in detoxification and hormonal health, keeping it healthy and happy is crucial to both fertility and your overall wellness.


How to use:

Add 1/8 -1/4 tsp to smoothies.

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Combine with your favorite aromatic spices, especially pepper, and add to sauteed vegetables.

Stir a bit into rice or quinoa for flavor and color that just won’t quit.

4. Cayenne

Cayenne has a reputation among herbalist as adding just as much heat to your libido as it does to your food. It’s regarded as an aphrodisiac, capable of increasing sexual desire and spicing up your sex life.


Whether or not any of that is true, is debatable, but what we do know is that cayenne has been shown to positively impact energy metabolism. The strong association between energy metabolism, hormonal regulation, and female reproduction makes cayenne a helpful kitchen spice for fertility.


How to use:

Sprinkle (and I do mean sprinkle, this stuff is potent) on avocado toast.

Add a dash to hot chocolate.

Stir a bit into peanut butter with a little cinnamon for a new spin on an old favorite- apple and peanut butter. Or try this spiced peanut butter mix on a baked sweet potato. Delectable!

5. Cinnamon

Who doesn’t love the aromatic smell of cinnamon? Despite lending a subtle sweetness to foods and drinks, cinnamon can actually help normalize blood sugar. Balanced blood sugar can help improve overall hormonal balance, especially for those with fertility issues due to PCOS.




How to use:

Sprinkle on hot cereals.

Add to apple (or pear) and peanut butter.

Use it to season lentils and bean dishes.

6. Nettles

Nettles really don’t get enough attention. They’re versatile, easy to use, and chock full of health benefits. It’s full of plant-based, non-heme iron, one of the micronutrients that have been linked to decrease the chance of ovulatory infertility.  


How to use:

Make a simple tea or infusion to sip throughout the day.

Add to smoothies, soups, and stews.

Steam and eat as a delicious side dish.

Have fun exploring your pantry and fridge. Just a sprinkle and a pinch will do to add fun and variety to your meals,

How can I boost my ovulation naturally?

Fertility issues affect up to 15 percentTrusted Source of couples. The road to parenthood can sometimes be a huge challenge, but know you’re not alone in those challenges.


Luckily, there are a few natural ways to increase your fertility. In fact, food choices and lifestyle changes can help boost fertility.


Here are 16 natural ways to boost fertility and get pregnant faster.


1. Eat foods rich in antioxidants

Antioxidants like folate and zinc may improve fertility for both men and women. They deactivate the free radicals in your body, which can damage both sperm and egg cells.


One 2012 study of young, adult men found that eating 75 grams of antioxidant-rich walnuts per day improved sperm quality.


A studyTrusted Source of 232 women showed that higher folate intake was associated with higher rates of implantation, clinical pregnancy, and live birth.


The jury is still out on how much antioxidants will or won’t affect fertility, but there’s evidence pointing to the potential.


Foods such as fruits, vegetables, nuts, and grains are packed full of beneficial antioxidants like vitamins C and E, folate, beta carotene, and lutein. Eating more of these healthy foods shouldn’t hurt in the effort.



2. Eat a bigger breakfast

Eating a substantial breakfast may help women with fertility problems.


One study found that eating a larger breakfast may improve the hormonal effects of polycystic ovary syndrome (PCOS), a major cause of infertility.


For moderate weight women with PCOS, eating most of their calories at breakfast reduced insulin levels by 8 percent and testosterone levels by 50 percent. High levels of either can contribute to infertility.


In addition, by the end of the 12-week study, these women had ovulated more than women who ate a smaller breakfast and larger dinner, suggesting improved fertility.


However, it’s important to note that increasing the size of your breakfast without reducing the size of your evening meal is likely to lead to weight gain.


Check out these ideas for healthy, delish breakfast options if you need some inspiration.


3. Avoid trans fats

Eating healthy fats every day is important for boosting fertility and overall health.


However, trans fats are associated with an increased risk of ovulatory infertility, due to their negative effects on insulin sensitivity.


Trans fats are commonly found in hydrogenated vegetable oils and are usually present in some margarine, fried foods, processed products, and baked goods. Some of the faves, we know.


Studies have found that a diet higher in trans fats and lower in unsaturated fats was linked to infertility for both men and womenTrusted Source.


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4. Cut down on carbs if you have PCOS

Following a lower carb eating plan (where less than 45 percent of calories come from carbs) is generally recommended for women with PCOS.


Several studies have indicated that managing carb intake provides beneficial effects on some aspects of PCOS.


Lower carb diets may help you maintain a healthy weight, reduce insulin levels, and encourage fat loss, all while helping menstrual regularity.


Here’s a primer on how to eat fewer carbs in a healthy way.


5. Eat fewer refined carbs

Speaking of carbs: It’s not just the amount of carbs that’s important, but also the type.


Refined carbs may be especially problematic. Refined carbs include sugary foods and drinks and processed grains, including white pasta, bread, and rice.


These carbs are absorbed very quickly, causing spikes in blood sugar and insulin levels. Refined carbs also have a high glycemic index (GI). The GI tells you if a carbohydrate-dense food will raise your blood sugar significantly.


Insulin is chemically similar to ovarian hormones. These hormones help our eggs mature. Consistent elevated insulin can cause the body to produce fewer reproductive hormones because it thinks it doesn’t need it. This can contribute to a lack of egg maturation and ovulation.


Given that PCOS is associated with high insulin levels, refined carbs can make it even worse.



6. Eat more fiber

Fiber helps your body get rid of excess hormones and keeps blood sugar balanced. Certain types of fiber can help remove excess estrogen by binding to it in the intestines. The excess estrogen is then removed from the body as a waste product.


One older 2009 studyTrusted Source associated soluble fiber, such as from avocados, sweet potatoes, oats, and fruits, with lower levels of estrogen and progesterone. Soluble fiber from fruit especially had the strongest association with lower concentrations of estrogen.


Some examples of high fiber foods are whole grains, fruits, vegetables, and beans. The daily recommended intake of fiber for women is 25 grams per day and 31 grams for menTrusted Source.


One 2009 study found that eating 10 grams more cereal fiber per day was associated with a 44 percent lower riskTrusted Source of ovulatory infertility among women older than 32 years.


However, the evidence on fiber is still mixed. Another study of 250 women aged 18 to 44 showed that increasing fiber by 5 g per day decreased hormone concentrationsTrusted Source with a higher probability of anovulation (when ovulation doesn’t take place).


Check with your doctor on your current fiber intake to see if you should be eating more.


7. Swap protein sources

Replacing some animal proteins (such as meat, fish, and eggs) with vegetable protein sources (such as beans, nuts, and seeds) is linked to a reduced risk of infertility.


A study showed that when 5 percent of total calories came from vegetable protein instead of animal protein, the risk of ovulatory infertility decreased by more than 50 percentTrusted Source.


A 2018 study concluded that eating more fishTrusted Source correlates to a higher probability of live birth following infertility treatment.


Consider replacing some of the proteins in your diet with protein from vegetables, beans, lentils, nuts, and low mercury fish. Try this coconut chickpea curry for a protein-filled dinner.


8. Choose high fat dairy

High intakes of low fat dairy foods may increase the risk of infertility, whereas high fat dairy foods may decrease it.


One large study from 2007 looked at the effects of eating high fat dairy more than once a day or less than once a week.


It found that women who consumed one or more servings of high fat dairy per day were 27 percent less likely to be infertile.

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To reap these potential benefits, try replacing one low fat dairy serving per day with one high fat dairy serving, such as a glass of whole milk or full fat yogurt.


This buffalo chicken dip made with full-fat Greek yogurt is divine.


9. Add in a multivitamin

If you take multivitamins, you may be less likely to experience ovulatory infertility.


In fact, an estimated 20 percentTrusted Source of ovulatory infertility may be avoided if women consume 3 or more multivitamins per week. Micronutrients found in vitamins have essential rolesTrusted Source in fertility.


For women trying to get pregnant, a multivitamin containing folate may be especially beneficial.


Have a chat with your doctor about supplements including any multivitamins that could help get you closer to pregnancy.


10. Get active

Exercise has many benefits for your health, including increased fertility. Increasing moderate physical activity has positive effectsTrusted Source on fertility for women and men, especially those with obesity.


The trick is that moderation is key. Excessive high intensity exercise has actually been associatedTrusted Source with decreased fertility in certain women.


Excessive exercise may change the energy balance in the body, and negatively affect your reproductive system. If you plan to increase your activity, add it gradually and make sure your healthcare team is aware.


See if your doctor is in favor of you adding these yoga poses to your routine.


11. Take time to relax

If you’re trying to conceive, stress is probably on the menu, too. As your stress levels increase, your chances of getting pregnant decrease. This is likely due to the hormonal changes that occur when you feel stressed.


Research on the links between stress and fertility are mixedTrusted Source, but there’s evidence that stress can suppress fertility.


Receiving support and counseling may reduce anxiety and depression levels, and increase your chances of becoming pregnant. And don’t forget to take time for you.


12. Cut the caffeine

The association between caffeine and fertility isn’t very conclusive.


One older 1997 study suggests that women who consume more than 500 milligrams of caffeine daily take up to 9 1/2 months longerTrusted Source to get pregnant.


However, other studiesTrusted Source did not find a strong link between caffeine intake and an increased risk of infertility.


Consider limiting your caffeine intake to one or two cups of coffee per day to be on the safe side. Give these non-coffee options a try.


13. Aim for a healthy weight

Weight is one of the most influential factors when it comes to fertility for men and women. In fact, being either underweight or overweight is associated with increased infertility.


This is because the amount of fat stored in your body influences menstrual function. Having obesity especially is associated with lack of ovulation and menstrual irregularity but also with impaired egg development.


To improve your chances of getting pregnant, work with your healthcare provider to try to lose weight if you’re overweight and gain weight if you’re underweight. They can help you do it in a healthy and sustainable way.


14. Check those iron levels

It’s time to start pumping iron. The supplement kind, that is. Consuming iron supplements and non-heme iron, which comes from plant-based foods, may decrease the risk of ovulatory infertility.


A recent 2019 study concluded that heme iron (from animal sources) had no effect on fertility and non-heme only had some benefit for women who already had iron deficiency.


More evidence is needed to confirm whether iron supplements should be recommended to all women, especially if iron levels are already healthy. But making sure your iron levels are solid with your doctor is a good step.


Non-heme iron sources are more difficult for your body to absorb, so try taking them with foods or drinks high in vitamin C to increase absorption.


15. Avoid excess alcohol

Alcohol consumption can negatively affect fertility. However, it’s unclear how much alcohol is needed to cause this effect.


One 2016 study found that having more than 14 alcoholic drinks per weekTrusted Source was associated with a longer time to get pregnant.


An older 2004 studyTrusted Source involving 7,393 women found that a high alcohol intake was associated with more infertility examinations.


However, the evidence on moderate alcohol consumption is mixed. One older studyTrusted Source found no link between moderate consumption and infertility, while other studies report that moderate intake can affect fertility.


Ultimately, avoiding excessive consumption of alcohol is recommended. Talk to you doctor about your own intake to ensure the best outcome for you.


16. Natural supplements

Certain natural supplements have been linked to increased fertility, especially in animal studies. Always check with your doctor before taking of natural supplements as efficacy in humans has not been well studied.


Examples include:


Maca: Maca comes from a plant grown in central Peru. Some animal studies found it improved fertility, but results from human studies are mixed. Some report improvements to sperm qualityTrusted Source, while others find no effectTrusted Source.

Bee pollen: Bee pollen has been linked to improved immunity, fertility, and overall nutrition. One animal studyTrusted Source found that consuming bee pollen was linked to improved sperm quality and male fertility. However, human studies are still needed.

Bee propolis: A study of women with endometriosis found that taking bee propolis twice a day resulted in a 40 percent greater chance of becoming pregnant after 9 months. More studies are needed.

Royal jelly: Royal jelly, which is also made by bees, is packed with amino acids, lipids, sugars, vitamins, fatty acids, iron, and calcium. Animal studiesTrusted Source found it may improve reproductive health in rats.

Takeaway

Good nutrition is vital for a healthy body and reproductive system and to help you become pregnant.


Eating a nutritious diet and making positive lifestyle changes can help boost fertility and prepare your body for pregnancy. Plus, it’s just helpful to you all around.


If you’re trying to get pregnant, it’s important that you begin making healthy nutrition and lifestyle choices today. But don’t let stress and worry get you down. Talk to your healthcare team to find the best choices for you.


Quick tips for increasing fertility naturally

Taking an antioxidant supplement or eating antioxidant-rich foods can improve fertility rates, especially among men with infertility.

Some studies suggest that eating more calories at breakfast and fewer at your evening meal can improve fertility.

To boost fertility levels, avoid foods high in trans fats. Eat foods rich in healthy fats instead, such as extra virgin olive oil.

Eating a diet high in refined carbs may raise insulin levels, which may increase the risk of infertility and make it harder to get pregnant.

Eating more protein from vegetable sources, instead of animal sources, may improve fertility levels in women.

Replacing low fat dairy products with high fat versions may help improve fertility and increase your chances of getting pregnant.

Taking a multivitamin may help boost fertility if you’re not getting all the nutrients you need from your diet.

A sedentary lifestyle is linked to infertility, and exercise can improve fertility. However, exercising too much can have the opposite effect.

High stress and anxiety levels can reduce your chances of conception. Managing your stress level can increase your chances of becoming pregnant.

Being either underweight or overweight can reduce your chances of becoming pregnant.

Background

Ginger (Zingiber officinale) is a well known and extensively used antioxidant in traditional remedies. In this study, we aimed to investigate the effects of ginger powder on ovarian folliculogenesis and implantation in rats.

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Methods

There were two study groups. In the 5-day treatment group (one estrous cycle), 100 mg ginger powder, 200 mg ginger powder or distilled water was given for 5 days to the three subgroups each containing seven rats. In the 10-day treatment group, same doses were given for 10 days (two estrous cycle) to the three subgroups each containing seven rats. At the end of the 5th and 10th days, ovarian volumes, ovarian weights, primordial follicles, antral follicles, atretic follicles, and corpus luteum counts were assessed. To evaluate the angiogenic effects of ginger, vascular endothelial growth factor (VEGF) and for the antioxidant effects of ginger endothelial nitric oxide synthase (eNOS) were examined in the ovaries and in the endometrium immunohistochemically.


Results

In the 5-day treatment group, antral follicle count and ovarian stromal VEGF were significantly high in the 100 mg ginger subgroup in comparison to the control group (p < 0.05). In the 10-day treatment group, endometrial VEGF and ovarian stromal eNOS were significantly high in the 100 mg ginger subgroup in comparison to the control group (p < 0.05). There was no statistically significant difference at 200 mg ginger dose both in 5-day and 10-day treatment groups.


Conclusion

The increases in the antral follicle count and ovarian stromal VEGF in the 100 mg/5-day treatment subgroup indicate that ginger have positive effects on folliculogenesis in short term with low dose. Additionally, ginger may enhance implantation in rats in long term with low dose.


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Keywords

eNOSFolliculogenesisGingerImplantationOxidative stressVEGF

1. Introduction

Herbal medicine is very popular and gains much attention nowadays. It has been believed that it is much more safer than synthetic drugs. Ginger (Zingiber officinale) has a long historical medicine use dating back 2500 years in China and India.1 Its pharmacological properties are varied including antioxidant, anti-inflammatory, anticancer and antimicrobial activities.2, 3, 4, 5


More than 60 active constituents are known to be present in ginger, which have been broadly divided into volatile and nonvolatile compounds. Hydrocarbons mostly monoterpenoid hydrocarbons and sesquiterpene include the volatile component of ginger and impart distinct aroma and taste to ginger. On the other hand, nonvolatile compounds include gingerols, shogaols, paradols, and also zingerone. The active ingredients like gingerols, shogaols, zingerone, and so forth present in ginger exhibit antioxidant activity. It inhibits an enzyme xanthine oxidase, which is mainly involved in the generation of reactive oxygen species.6


Antioxidant applications are important for protecting the human body from various sources of oxidative damage and are used extensively for prevention of a variety of diseases. In order to protect the human body from various forms of oxidative damage, recently there has been a noticeable increase in the search and identification of natural and safe antioxidants.


Oxidative stress can significantly negatively impact cellular survival and longevity and lead to programmed cell death.7 The generations of reactive oxygen species (ROS) that result in oxidative stress include nitrogen based free radical species such as nitric oxide and peroxynitrite as well as superoxide free radicals, hydrogen peroxide, and singlet oxygen.8 Physiological levels of ROS are required for proper functioning of different biological pathways and in maintaining homeostasis within the human body. Low levels of free radicals act as modulators in female reproductive pathways such as oocyte maturation, physiological follicular atresia, ovulation, fertilization, luteal regression, and corpus luteum formation during pregnancy.9 ROS is also believed to play a role in the different phases of the endometrial cycle. Disruption in physiological levels of ROS leads to female reproductive dysfunction.10


Nitric oxide (NO) is known to mediate physiological functions, such as vasodilation, regulation of angiogenesis, and blood flow in many tissues, including the ovary.11 Endothelial NO synthase (eNOS) was detected in ovarian follicles and in the corpus luteum during the estrous cycle in several species. It has been demonstrated that NO plays a role in the regulation of angiogenesis, steroidogenesis, apoptosis, and luteolysis.12


Defects in ovarian angiogenesis may contribute to a variety of disorders including anovulation and infertility, pregnancy loss, ovarian hyperstimulation syndrome, and ovarian neoplasms.13 Vascular endothelial growth factor (VEGF), during gonadotropin surge, controls the crucial follicles transition from preovulatory to periovulatory stage that precedes ovulation.13 Besides, VEGF is known to play an essential role in the regulation of angiogenesis in the endometrium. Its expression increases during the proliferative phase and has a second expression peak later during the mid-secretory phase, being responsible for maturation of spiral arteries during the “implantation window”.14


The effects of ginger on male infertility and sperm parameters were investigated in a few studies.15, 16, 17, 18, 19 The results showed favorable outcomes on sperm indices.15, 16, 17, 18 However, the effects of ginger on ovarian functions have not been studied so far. In this study, we aimed to investigate the effects of ginger powder on ovarian folliculogenesis and implantation in rats. We evaluate the effects of ginger in the ovaries and in the endometrium by VEGF and eNOS levels. This is the first study in the literature that investigates this topic.


2. Methods

The experiments were approved by the Experimental Animal Ethics Committee of Ankara Training and Research Hospital (protocol no: 0019/23.10.2014). There were 42 female albino rats in estrous cycle, each weighing approximately 200 gr (28 in the study groups and 14 in the control groups). The animals were housed in standard propylene cages in the same animal facility under conventional conditions (12:12-h light:dark; room temperature: 22 ± 2 °C). Specific pelleted food and filtered bottled tap water were supplied ad libitum. The animals were allowed to acclimatize for 2 weeks. Three days before the beginning of the experiments, the female rats were exposed to soiled bedding of a mature male rat to synchronize their estrous cycles.20 Estrous phase was confirmed by vaginal smear examinations. Organic ginger roots were rinsed with distilled water. After drying, the roots were grated into small pieces and dried again using a dehydrator. Then, a mixer was used to grind the small ginger pieces until a powder was obtained. There were two study groups, each with a different length of treatment.


Group 1 (5-day treatment group): 100 mg ginger powder, 200 mg ginger powder or 2 cc distilled water (control group) was given to three subgroups, each containing seven rats, daily for 5 days (one estrous cycle). Ginger powder was mixed with 2 cc distilled water and administered by gavage. The control group also received 2 cc distilled water by gavage.


Group 2 (10-day treatment group): 100 mg ginger powder, 200 mg ginger powder or 2 cc distilled water (control group) were given to three subgroups, each containing seven rats, daily for 10 days (two estrous cycle). Like the 5-day treatment group, the ginger powder was mixed with 2 cc distilled water and administered by gavage. The control group also received 2 cc distilled water by gavage.


At the end of the 5th and 10th days, the rats were sacrificed and the inner genital organs were removed. All surgeries were performed under sodium pentobarbital anesthesia and all efforts were made to minimize suffering. The ovarian volumes and ovarian weights were measured. The primordial, antral, and atretic follicles and the corpus luteums were counted using histopathological examination stained with hematoxylin eosin in the entire cross-sectional area of both ovaries for each rat. To evaluate the angiogenic effects of ginger, immunohistochemical assessment of ovarian cortical, ovarian stromal, and endometrial VEGF were done by anti-VEGF receptor 2-antibody kit (catalog number ab15292, Abcam, Cambridge, UK). For both groups, eNOS was immunohistochemically examined in the ovaries (cortical and stromal) and in the endometrium by eNOS antibody kit (catalog number ab66127, Abcam, Cambridge, UK). For each rat, the entire cross-sectional area of the ovaries and endometrium were scanned consecutively and the stained cells were counted at ×200 magnification. All pathological and immunohistochemical examinations were done by the same pathologist who was blinded to the codes given to the rats.


Statistical analyses were performed using the Statistical Package for the Social Sciences version 15.0 (SPSS, Chicago, IL, USA). The variables are expressed as mean ± standard deviation (SD). Shapiro–Wilk tests were used to determine the normality of the distributions of the continuous variables. The normally distributed variables were examined using one-way analyses of variance, followed by Tukey's post-hoc tests. The non-normally distributed variables were analyzed with Kruskal–Wallis tests and Mann–Whitney U tests, with post hoc Bonferroni corrections. p values < 0.05 were considered to be statistically significant.


3. Results

First, we analyzed Group 1 (5-day treatment group), which was divided into three subgroups and given 100 mg ginger, 200 mg ginger, or 2 cc distilled water for 5 days (Table 1). In the 100 mg subgroup, the ovarian volume, ovarian weight, primordial follicle count, atretic follicle count, corpus luteum count, ovarian cortical VEGF, endometrial VEGF, ovarian cortical eNOS, ovarian stromal eNOS, and endometrial eNOS were not statistically different in comparison to the control group (p > 0.05). The antral follicle count and ovarian stromal VEGF were significantly high in the 100 mg group (p < 0.05) (Fig. 1-A, B). The comparison of the 200 mg subgroup and the control group revealed no statistically significant differences between the variables.


Table 1. Comparison of the variables between the Group 1 subgroups with ± standard deviations.


Group 1 (5-day treatment) Control 100 mg ginger 200 mg ginger p

Ovarian volume (mm3) 4.35 ± 1.02 5.14 ± 0.55 5.07 ± 1.09 0.241

Ovarian weight (mg) 45 ± 8.1 53.5 ± 6.2 54.2 ± 16.1 0.245

Primordial follicle count 11.14 ± 8.33 6.86 ± 3.53 8.86 ± 4.05 0.695

Antral follicle count 18.57 ± 5.47 28.29 ± 7.91 18.71 ± 6.34 0.020a

Atretic follicle count 5.00 ± 1.91 5.29 ± 2.98 4.14 ± 1.34 0.605

Corpus luteum count 13.43 ± 4.99 11.00 ± 3.74 11.43 ± 3.20 0.502

Ovarian cortical VEGF 116.71 ± 45.24 163.86 ± 58.80 96.00 ± 45.72 0.058

Ovarian stromal VEGF 47.14 ± 23.21 105.71 ± 61.37 50.43 ± 15.64 0.019a

Endometrial VEGF 79.86 ± 51.91 80.86 ± 40.34 44.86 ± 22.07 0.188

Ovarian cortical eNOS 70.14 ± 22.01 75.17 ± 56.09 66.14 ± 21.13 0.896

Ovarian stromal eNOS 14.71 ± 9.53 12.67 ± 11.29 19.57 ± 10.37 0.226

Endometrial eNOS 45.71 ± 18.08 51.00 ± 21.61 40.43 ± 19.33 0.709

VEGF = vascular endothelial growth factor; eNOS = endothelial nitric oxide synthase.

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a

The difference between the control and the 100 mg ginger subgroup is statistically significant.


Fig. 1

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Fig. 1. AHistopathological image of the increased antral follicle count in the 100 mg/5-day treatment subgroup; B Immunohistochemical staining of the ovarian stromal VEGF in the 100 mg/5-day treatment subgroup; C Immunohistochemical staining of the endometrial VEGF in 100 mg/10-day treatment subgroup; D Immunohistochemical staining of the ovarian stromal eNOS in 100 mg/10-day treatment subgroup.


We then analyzed Group 2 (10-day treatment group), which was divided into three subgroups and given 100 mg ginger, 200 mg ginger or 2 cc distilled water for ten days (Table 2). Ovarian volume, ovarian weight, primordial follicle count, antral follicle count, atretic follicle count, corpus luteum count, ovarian cortical and stromal VEGF, ovarian cortical eNOS, and endometrial eNOS were not statistically different between the three subgroups (p > 0.05). Endometrial VEGF and ovarian stromal eNOS were significantly high in the 100 mg ginger subgroup in comparison to the control group (p < 0.05) (Fig. 1C and D). No statistically significant differences in the variables were found between the 200 mg subgroup and the control group.


Table 2. Comparison of the variables between the Group 2 subgroups with ± standard deviations.


Group 2 (10-day treatment) Control 100 mg ginger 200 mg ginger p

Ovarian volume (mm3) 4.71 ± 0.85 5.75 ± 2.11 5.00 ± 0.50 0.570

Ovarian weight (mg) 67.1 ± 20.7 62.5 ± 20.6 59.2 ± 8.8 0.705

Primordial follicle count 4.71 ± 4.68 8.33 ± 3.93 6.86 ± 4.84 0.214

Antral follicle count 8.86 ± 3.62 11.67 ± 7.73 7.14 ± 4.33 0.338

Atretic follicle count 39.43 ± 6.13 40.17 ± 14.55 52.29 ± 20.15 0.225

Corpus luteum count 11.29 ± 3.98 11.83 ± 4.35 8.00 ± 2.38 0.142

Ovarian cortical VEGF 98.43 ± 21.90 103.33 ± 30.57 76.43 ± 22.50 0.140

Ovarian stromal VEGF 27.00 ± 10.56 35.83 ± 10.88 24.00 ± 6.53 0.073

Endometrial VEGF 29.71 ± 8.51 52.00 ± 13.94 39.29 ± 11.28 0.009a

Ovarian cortical eNOS 157.71 ± 59.36 138.71 ± 50.96 117.86 ± 52.48 0.409

Ovarian stromal eNOS 39.29 ± 20.04 76.14 ± 19.57 53.29 ± 9.75 0.003a

Endometrial eNOS 85.43 ± 29.43 99.29 ± 48.07 79.29 ± 23.40 0.564

VEGF = vascular endothelial growth factor; eNOS = endothelial nitric oxide synthase.



a

The difference between the control and the 100 mg ginger group is statistically significant.


Fig. 2, Fig. 3 show the immunohistochemical staining images of two proteins in the three subgroups for the 5-day and 10-day treatment groups, respectively.


Fig. 2

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Fig. 2. a Immunohistochemical staining of the endometrial stromal VEGFx400 in the 5-day control group; b Immunohistochemical staining of the endometrial stromal VEGFx400 in the 100 mg/5-day treatment subgroup; c Immunohistochemical staining of the ovarian antral follicle wall VEGF ×400 in the 200 mg/5-day treatment subgroup; d Immunohistochemical staining of the endometrial stromal eNOS ×200 in 5-day control group; e Immunohistochemical staining of the endometrial stromal eNOS ×400 in the 100 mg/5-day treatment subgroup; f Immunohistochemical staining of the ovarian antral follicle wall eNOS ×400 in the 200 mg/5-day treatment subgroup.


Fig. 3

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Fig. 3. a Immunohistochemical staining of the endometrial stromal VEGF ×400 in the 10-day control group; b Immunohistochemical staining of the endometrial stromal VEGF ×400 in the 100 mg/10-day treatment subgroup; c Immunohistochemical staining of the ovarian antral follicle wall VEGF ×400 in the 200 mg/10-day treatment subgroup; d Immunohistochemical staining of the endometrial stromal eNOS ×200 in the 10-day control group; e Immunohistochemical staining of the endometrial stromal eNOS ×400 in the 100 mg/10-day treatment subgroup; f Immunohistochemical staining of the ovarian antral follicle wall eNOS ×400 in 200 mg/5-day treatment subgroup.


4. Discussion

The present study aimed to investigate the effects of ginger powder on ovarian folliculogenesis and implantation in rats. Many studies have described the antioxidant, anti-inflammatory, anticancer, and antimicrobial activities of ginger. But, this is the first study in the literature, which investigates the optimal dose and duration of the ginger powder on the female reproductive system. In our study, we found statistically high antral follicle count and ovarian stromal VEGF in the 100 mg/5-day treatment subgroup. Antral follicle count is one of the most reliable tools that show ovarian reserve. These two findings indicate the favorable effects of ginger in ovarian folliculogenesis.

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The control of ovarian stromal cells and germ cell function is a diverse paradigm and oxidative stress may be one of the modulators of ovarian germ cell and stromal cell physiology. A number of autocrine and paracrine factors affect the modulation of various ovarian functions and steroidogenesis.21 Mammalian ovulation or follicular rupture was proposed to result from the vascular changes and the proteolytic cascade.22 The cross talk between these two cascades is mediated by cytokines, VEGF and reactive nitrogen and oxygen radicals.21 Oxidative stress and cytokines are proposed to be interlinked and act as intercellular and intracellular messengers in the ovary.


The importance of the follicular vasculature for maintaining follicular health has been emphasized in several studies.23 VEGF is expressed and secreted in the human ovary in a manner that suggests a role for this growth factor in both cyclic angiogenesis and regulation of vascular permeability, both of which are critical for ovarian folliculogenesis and normal reproductive function.13 Follicle selection success is strictly related to the development of a widespread blood vessel network required to sustain the enhanced proliferative and endocrine function of follicles. Blood vessels allow growing follicles to acquire an increasing amount of nutrients, precursors and hormones, as to release steroids and other regulating ovarian hormonal molecules to the systemic circulation. In addition, reduced follicular vascularity is one of the earliest signs of atresia marked by a smaller vascular network and increased apoptosis in thecal capillaries.24


Angiogenesis is important for cyclical regeneration of endometrium in the menstrual cycle. Any imbalance between the cytokines and angiogenic factors could result in implantation failure and pregnancy loss.25 Estrogens promote angiogenesis in the endometrium by controlling the expression of factors such as VEGF.26 Reactive oxygen species generated from NADP (H) oxidase is critical for VEGF signaling in vitro and angiogenesis in vivo.27 Recent studies suggest that early pregnancy loss and implantation failure may be caused by an impaired VEGF expression, although the data are controversial.28 Luteal phase defect was found to be accompanied by an increased impedance of blood flow in the corpus luteum and spiral arteries in infertile patients.29 It was recently shown that recurrent miscarriage and failed IVF attempts may be associated with an impaired expression of VEGF, the main angiogenic factor in the endometrium.30


Another our finding was significantly high endometrial VEGF in the subgroup, which was given 100 mg ginger for 10 days. This finding may indicate the positive effects of ginger in implantation. Though we did not observe any changes in endometrial eNOS levels, both iNOS and eNOS proteins are shown to be up-regulated in the implantation sites.31 NOS inhibitors block decidualization and establishment of pregnancy and additionally NOS inhibitors act synergistically with antiprogestins. However, besides progesterone, additional embryonic signals are shown to be involved in NOS regulation.31 As we did not mate the rats and look for pregnancy outcome, perhaps lack of embryonic signals may the reason for unchanged levels of endometrial eNOS.


Ovarian folliculogenesis not only involves gonadotropins and the steroids, but it also involves local autocrine and paracrine factors. Nitric oxide radical is one of the local factors involved in ovarian folliculogenesis and steroidogenesis.21 The major regulator of NO production is the enzyme, NO synthase (NOS), which appears in three isoforms: neuronal NOS (nNOS), inducible NOS (iNOS), and endothelial NOS (eNOS). Both eNOS and iNOS have been detected in ovarian tissues of several species.32 A regulatory role for NO in ovulation is supported in most species, with sources thought to be both iNOS and eNOS, with iNOS activity increasing with the LH surge.33 eNOS was detected in ovarian follicles and corpus luteum during the estrous cycle in several species. It has been demonstrated that NO plays a role in the regulation of angiogenesis, steroidogenesis, apoptosis, and luteolysis.12


NO is one of several intraovarian mediators that have been shown to influence ovarian functions, including follicular development and atresia, ovulation, steroidogenesis, oocyte quality, apoptosis, and luteal function.34 In addition, NO may positively regulate the expression of angiogenic factors, including VEGF and the angiogenesis in the ovaries and other tissues.35


Folliculogenesis involves the participation of both growth and programmed cell death and NO regulates both. We found statistically high ovarian stromal eNOS in the 100mg/10-day subgroup. The interpretation of our result is somewhat difficult but a negative relationship between VEGF and NO levels were observed in porcine granulosa cells.36 Although low concentrations of NO may prevent apoptosis, pathologically high concentrations of NO may promote cell death.37 On the other hand, in the 100 mg/5-day subgroup, we found high levels of antral follicle count and high levels of ovarian stromal VEGF with normal levels of ovarian stromal eNOS. Under these findings, we can only speculate that the optimal duration of ginger powder on folliculogenesis may be for short term. We postulate that with the increase of ovarian stromal eNOS in the long protocol, the positive effects of ginger displayed in the short protocol are lost. Very recently, a study showing similar detrimental effects of increased levels of eNOS and iNOS in rat spermatogenesis has been published.38 In this study, impaired spermatogenesis could not been improved by long usage of antioxidants (12 weeks) and especially overexpression of iNOS was shown to be responsible for destructive effects. In fact, the studies indicating beneficial effects on sperm indices have used ginger for 4–8 weeks, which is the average duration of spermatogenesis in rats.39

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Physiological levels of ROS are required for proper functioning of different biological pathways and in maintaining homeostasis within the human body. Any disruption in the antioxidant/ROS balance leads to a state of oxidative stress in the cell with damaging consequences In our study, positive findings were only observed in 100 mg ginger powder given group, instead of 200 mg ginger powder given group. This shows that high dose antioxidant disturbs physiologic balance in folliculogenesis and implantation. This is in close correlation with the statement that follicle maturation is a classic example of the delicate balance that exists between ROS and antioxidants in the maintenance of the regulated sequence of events that culminate in ovulation as mentioned by Gupta et al.10


In conclusion, our results showed that ginger powder increases antral follicle count and ovarian stromal VEGF at low dose with short duration and endometrial VEGF at low dose with long duration. Our results suggest positive effects of ginger in folliculogenesis and implantation. Essentially, the results of this study stress the importance of ginger as an antioxidant to suppress ROS buildup and maintain physiological levels of free radicals for proper cell functioning and homeostasis. Newer studies should be designed with different doses, intervals and parameters to show the exact effects of ginger in female reproductive system before routine recommendation for infertile women to achieve pregnancy.

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