After the necessary tests, treatment is tailored to the cause and to the couple. The first-line measures can be summarized as follows.
Lifestyle and work habits
- Stop smoking. It harms both sperm and eggs, and in pregnancy it can impair the placenta and reduce the baby’s growth.
- Avoid alcohol. In men it reduces sperm production and can cause erectile problems; in women it can disturb ovulation.
- Limit caffeine to about 200 mg a day (roughly two cups of coffee). Higher intakes are linked with a longer time to pregnancy and a higher miscarriage risk.
- For men: avoid heat to the testes, such as saunas, hot baths, laptops on the lap and very tight underwear.
- Take care with workplace hazards such as radiation, high heat, harmful chemicals and genital injury.
- Treat general health problems such as anaemia and diabetes, and review any medications that may reduce fertility, including testosterone and anabolic steroids in men.
Diet, weight and exercise
Women trying to conceive should aim for a healthy weight, balanced eating and regular moderate exercise, and avoid extreme exercise, crash diets and disordered eating, which disturb the hormones that control ovulation. A balanced diet with plenty of vegetables, fruit, whole grains and fish, good hydration, and limited processed food is recommended. Food safety matters too: wash fruit and vegetables well, cook meat thoroughly, avoid raw eggs and drink only pasteurized or boiled milk.
Women should take folic acid 400 micrograms daily, starting at least one month before conception, to protect the baby against neural tube defects (a higher dose is advised in some cases, such as diabetes, obesity or a previous affected pregnancy). For men, antioxidants such as zinc, vitamin E and coenzyme Q10 are widely used, but the evidence that they increase live births is limited.
Preventing avoidable causes of infertility
- Keep vaccinations up to date. Tuberculosis can cause adhesions in the uterus, tubes and pelvis, and can damage the male ducts and testes. Mumps vaccination protects boys from mumps orchitis, which can cause testicular atrophy. Women should check rubella immunity before pregnancy.
- Do not undergo tubal ligation or vasectomy for contraception without careful counselling and only once the family is complete.
- Avoid, and promptly treat, genital infections and sexually transmitted infections such as chlamydia, gonorrhoea and syphilis.
- Avoid unnecessary surgery, such as cervical cautery, removal of fibroids that do not affect fertility, or removal of simple ovarian cysts that would resolve on their own, which can damage the ovarian reserve. Accurate diagnosis of appendicitis also avoids unnecessary operations.
- Do not insert an IUD or perform a tubal X-ray (HSG) while a genital infection is present.
- Treat undescended testes in early childhood (ideally by 12–18 months). Leaving a testis in the abdomen raises the risk of cancer and damages its ability to produce sperm.
Treating unexplained infertility
Infertility is considered unexplained when a couple has not conceived despite regular intercourse and no cause is found on standard tests. Treatment is planned mainly around the woman’s age. For women under 35, a period of trying naturally may be followed by ovarian stimulation with intrauterine insemination (IUI), then IVF. For women over 35, going directly to IVF is usually advised, because there is less time for repeated trials.
International Guidelines
In line with global standards, Dr. Sabry follows the latest recommendations from the American Society for Reproductive Medicine (ASRM), European Society of Human Reproduction and Embryology (ESHRE), and Royal College of Obstetricians and Gynaecologists (RCOG). Thus, patients receive care that is safe, ethical, and evidence-based.
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Why Choose Dr. Ashraf Sabry?
Dr. Ashraf Sabry, consultant in obstetrics, gynecology, fertility, and aesthetic gynecology, is recognized among the best OBGYN and fertility specialists in Cairo. With over 20 years of experience, he combines science and compassion to provide world-class care. Book your appointment through the contact page, WhatsApp, or call +201022224442.