Before the Baby: How Couples Can Optimize Their Health, Habits & Hormones to Boost Pregnancy Success

Introduction

The journey to parenthood is rarely straightforward. For many, it’s a path filled with hope, heartbreak, and hard-won resilience. In a special episode of the podcast Hormones & Hope, hosted by Dr. Chhaya Makhija, Dr. Erica Bove—double board-certified OBGYN and reproductive endocrinologist—joins as a guest to share her deeply compassionate and science-based perspective on optimizing fertility. This extensive conversation highlights Dr. Bove’s insights on the emotional landscape of infertility, the power of “authentic hope,” and practical steps couples can take to improve their chances of pregnancy.

The Emotional Landscape of Fertility

“The fertility journey is a very difficult journey for most people. I think it really threatens people's idea that they will become a parent.” — Dr. Erica Bove

The desire to become a parent is often central to a person’s identity. When faced with fertility challenges, individuals and couples can experience a cascade of emotions—hopelessness, despair, fear, anxiety, sadness, and grief. Dr. Bove emphasizes that these emotions are not just common but expected.

“When it works, it's wonderful, but usually there's a journey to get to that point and an acceptance that maybe it might not happen, which can not just affect the individual, but it can affect relationships too.”

She highlights the importance of acknowledging these feelings and seeking support, noting that the fertility journey can strain not only self-concept but also relationships.

Authentic Hope: Grounding Optimism in Science

“I'm a big fan of what I call authentic hope, which means hope grounded in science.”

Dr. Bove’s approach, as discussed with Dr. Makhija, is rooted in the concept of “authentic hope.” Unlike blind optimism, authentic hope is built on real, individualized factors—age, ovarian reserve, previous pregnancies, and embryo quality.

“Every single person's combination of factors for authentic hope is going to look a little bit different. There are no two identical fertility journeys. It just doesn't exist.”

She works with patients to identify their unique factors for hope, helping them see the scientific reasons to keep going, even when the process feels overwhelming.

The Role of Mindset and Emotional Regulation

A recurring theme in Dr. Bove’s philosophy is the power of mindset.

“People get so shut down by this process that they believe it's impossible. And then the actions and results tend to flow from that, because people miss their appointments. They miss their meds. Maybe they decide not to continue. And then that hopelessness becomes a self-fulfilling prophecy.”

She recounts the story of a patient who, after multiple losses and failed IVF (In Vitro Fertilization) cycles, struggled to believe in the possibility of success. Through coaching, they worked on shifting her mindset:

“You just have to crack that door open to possibility. Because otherwise, everything shuts down. And I truly believe our vibrational frequency is lower when we are shut down.”

This patient eventually conceived and delivered a healthy baby, illustrating the profound impact of believing in possibility, even when certainty is elusive.

Fertility Is More Than a Woman’s Issue

“A lot of male factor...just to back up, 40% of couples who see me who are heterosexual couples, 40% of those couples will have at least some element of male factor infertility.”

Dr. Bove, as Dr. Makhija’s guest, is passionate about dispelling the myth that infertility is solely a woman’s issue. She emphasizes the importance of evaluating both partners, noting that male health—testosterone, metabolic health, and lifestyle—plays a significant role.

She shares candidly about lifestyle factors:

“Many, many, many of my...male partners are chewing tobacco, which is even worse than cigarette smoking, right? Or they're smoking cigarettes and they're trying to quit but haven't been able to yet...I say your sperm are stoned, stoned, sir, your sperm are stoned like they swim in circles. We need to get your sperm where they are not stoned anymore, and they can actually move in the right direction.”

Lifestyle changes, she explains, can lead to measurable improvements in sperm health within about three months.

Stress, Cortisol, and the Biology of Fertility

“We know that when we're stressed out, what happens? The adrenals are on overdrive. We know that there's increased cortisol. We know that that affects insulin pathways and ovulation pathways. And when we're super stressed, I mean, sometimes our ovulation entirely shuts down.”

Dr. Bove discusses the biological mechanisms by which stress can disrupt fertility. Elevated cortisol can interfere with both ovulation and egg quality.

“At the end of the day, what we're trying to do is simulate a normal embryo, a normal menstrual cycle, which ultimately results in an embryo that will implant inside the uterus. And so if that's a stressed out environment with high cortisol...oftentimes the treatments don't work as well, and it really feels crummy to undergo that experience.”

She encourages patients to trust the process and not let stress take over:

“Your whole journey does not ride on the cycle. So let's trust the process, see what we can do in this cycle, see what we can learn and let me take the burden from you so that you don't have to be hypervigilant going down the Google rabbit hole.”

The Value of Community and Support

“There's tremendous power in that tremendous support. So even if you're like not a group person in air quotes, we don't know what we don't know. And there's so much healing and support that can happen. And just my suggestion is just to be open to it because it adds a whole other dimension to the experience that, you know, even in my one on ones, I can't create.”

Dr. Bove champions the healing power of community, whether through support groups or simply connecting with others on the same path. She notes that seeing your story reflected in another person can be profoundly normalizing and empowering.

Personalized Medicine: When to Seek Help

“If a couple has been trying to conceive for over 12 months and the woman is under the age of 35, that's an automatic referral to a fertility specialist. Or if somebody is, you know, the woman's 35 or over, that actually gets shortened to six months because we know that those women have, you know, egg quality issues sometimes.”

She urges couples not to wait if there are risk factors—irregular periods, history of pelvic infection, multiple surgeries, or prior chemotherapy. Early evaluation can make a significant difference, especially as age advances.

“If you're 40, say you meet the love of your life at 40 and you really want a baby, I would argue, don't even try six months, just go see somebody because, you know, by the time you get in and get established and you can try alongside. But so often I see people like, you know, in the 40s, every six months makes a difference.”

Lifestyle Interventions: What You Can Control

“Lifestyle is one of the most important things. And, you know, like I said before, there's some things we can control and some things we can't. We actually can control a lot of aspects of our lifestyle.”

Dr. Bove encourages a holistic look at health—diet, exercise, stress management, sleep, and substance use. She’s candid about the realities:

“If we have a toxic job that is causing a lot of stress, I think it's really important to evaluate, is this the environment in which I want to bring a child, right? Like we are starting the process now, right before we even have the child to say, you know, what kind of a space is this?”

She also addresses the role of supplements:

“I always recommend that people take folic acid just because that's been shown to reduce the risk of neural tube defects...And then the coenzyme Q10, you know, there's animal and human data that it can help with egg quality...It's specifically for people who are a little bit older trying to conceive and who have diminished ovarian reserve.”

Egg quality, she explains, is linked to mitochondrial energy:

“The eggs are the traffic controllers of the body of the chromosomes. And so they shut all the chromosomes in different ways as the cells are undergoing their divisions. And so you actually need a lot of energy to be able to do that process...You really want the mitochondria, which is the energy center in the egg cell, to be as robust as possible.”

Conclusion: Embracing the Full Journey

This special episode of Hormones & Hope with Dr. Chhaya Makhija and guest Dr. Erica Bove delivers a message of science-backed hope, resilience, and empowerment. Fertility is not a straight line, and every journey is unique. By combining medical expertise with emotional support and practical lifestyle changes, couples can maximize their chances for success—while also finding meaning and connection along the way.

“Fertility doesn't need to take everything, we can have a full life, while we're undergoing this process. It's still hard, but it's not the only thing driving the show.”

Whether you’re just starting to think about family building or are deep in the trenches of treatments, the wisdom shared in this episode offers a roadmap for navigating the complexities of fertility with courage, compassion, and authentic hope.

Ready to learn more?

Watch “Hormones & Hope” with Dr. Chhaya Makhija on YouTube, Spotify, and Apple Podcasts for more expert conversations and empowering health insights.