How to Optimize Your Fertility Health - by Registered Dietician Naomi O'Connor
Have you ever stopped to think about your fertility health? While many couples have no problems falling pregnant and having a healthy baby, for others, medical assistance is needed to help them conceive. Even if you are not thinking or planning to have a baby any time soon, or you may be actively trying or going through assisted reproductive therapy (IVF), you and your partner can make improvements to your nutrition and lifestyle to optimise your fertility now.
Recent research has shown that the health and lifestyle of both parents in the six months before conception can affect the quality of the egg and the sperm. Together with ‘The first 1,000 days’ (pregnancy and first two years of a baby’s life), early life nutrition has been seen to affect babies' development and future health. So, it's advised that you and your partner consider your preconception health to give your baby the best start in life.
Infertility affects between 8 to 12 % of couples worldwide. It is often thought that infertility (which is defined as the inability to get pregnant for 12 months of trying with unprotected sex) is a woman's problem. However, 30% is attributed to men, 30% to women, 30% to the couple and 10% to the unknown. While men's fertility health is as important as females, this blog's focus will be on optimising women's health for fertility.
Factors Affecting Women's Fertility
Many factors can affect a woman's fertility: the biggest one being her age, existing medical conditions, genetics, and body weight. Women are born with all the eggs they will ever have. As a woman ages, the quality and quantity of her eggs naturally decline. A marked decline in fertility starts at around 30 years of age, with a steeper decline from 35.
Having a health condition like coeliac disease, diabetes, overactive or underactive Thyroid, PCOS (polycystic ovary syndrome), and endometriosis can affect a woman's ability to conceive, and the time taken to conceive., So, it's advised to seek the help of your gynaecologist or doctor to ensure you receive the best treatment for your condition and ensure that you aren't deficient in any vitamins or minerals.
Our genetics can affect our ability to conceive. If you have a family history of genetic disorders or chromosomal abnormalities and are concerned, please speak to your doctor.
Being overweight or underweight can affect fertility. While BMI, in my opinion, isn't a great indicator of health, studies have shown that an optimal BMI for fertility is between 20 and 25Kg/m2. In addition, a healthy weight helps with having regular periods (approximately 28 days), giving regular ovulation, which is needed to conceive.
Optimising Nutrition for Fertility
One of the most important things when trying to conceive is not restricting your intake or going on a diet. To optimise your fertility, you need to make sure you are eating a well-balanced diet and, more importantly, that you are eating enough. Research has shown that following the Mediterranean dietary pattern can be beneficial for fertility health. It consists of minimally processed foods, plenty of fruit and vegetables, whole grains, legumes, nuts, seeds, fish, small amounts of red meat and chicken, and good fat sources.
Contrary to popular belief, carbohydrates are not evil. Carbohydrates are one of our main energy sources and are extremely important for fertility nutrition. When it comes to carbohydrates, they should form the basis of all your meals. But there are some key things to consider, try and have low glycemic carbohydrates (slow-releasing carbohydrates). Instead of white refined carbohydrates, opt for wholegrain varieties, brown rice, oats, wholewheat pasta and wholegrain bread and become more aware of your portion sizes.
In general, people consume enough protein in their diets. However, research has shown opting for more plant-based sources of protein can be beneficial for fertility. Think legumes and lentils twice to three times a week as part of your main meal.
Good quality fat is beneficial to reproductive health. For example, recent research has shown that full-fat dairy can be beneficial to fertility health. While its well-known omega three fatty acids have many benefits try and have one to two servings of oily fish per week, such as salmon, trout, sardines, and mackerel. Other good sources of dietary fat include avocados, nuts, and seeds. It's best to avoid trans-fatty acids found in bakery goods, cakes, biscuits, microwave popcorn, and fried foods, as high intakes have been linked to endometriosis and infertility.
When it comes to alcohol, the advice given is that it is best to avoid alcohol if you are planning or trying to conceive, as you would in pregnancy.
Research has shown that having no more than 200mg of caffeine a day won't affect fertility. Caffeine is present in coffee, tea, green tea, carbonated drinks like 7up, Coca Cola, energy drinks, and chocolate. One shot of coffee is equivalent to 120mg of caffeine.
Supplement Recommendations in the Preconception Period
It’s recommended to start taking a combined prenatal supplement for at least 12 weeks prior to conception. It should contain at least 400ug of Folic acid, Vitamin D 10ug and Iodine 150ug. However, some women will require higher prescribed doses of folic acid, such as women with a pre-existing medical condition like coeliac disease, diabetes, anaemia and obesity or a previous pregnancy with a neural tube defect. Other nutrients that can help support fertility include Omega 3, Iron, Calcium, Choline, Vitamin B12 and the antioxidants of Vitamin C, Selenium and Zinc. However, it's worth noting that a well-balanced healthy diet can provide you with enough nutrients to meet your needs. If you're concerned that you may be deficient in any nutrients mentioned above, please speak to a fertility dietitian, a doctor, or a fertility specialist before starting nutritional supplements.
It's best to avoid Vitamin A in supplement form in preconception and pregnancy as excessive amounts can lead to birth defects and miscarriage. However, please be aware that Vitamin A can be in a standard multivitamin, so taking a prenatal or preconception supplement is always best.
Lifestyle & Exercise
Smoking has been found to reduce fertility by up to 40%. So, before you start trying to conceive, it's best to seek help to stop.
Exercise for women health; it's advised to get at least 30 minutes 5 days a week with a minimum of 150 minutes over the week with a mixture of cardiovascular exercise and weights. However, too much exercise can have a negative effect on your fertility, affecting ovulation. On the other hand, exercise will give you energy, manage stress, help achieve better sleep, and help you to optimise your health for your fertility.
In summary, if you are thinking of starting or trying for a baby you should, at the minimum, start to:
1) Take a prenatal supplement which must include Folic Acid and Vitamin D
2) Eat a well-balanced diet based on the principles of the Mediterranean diet
3) Reduce your caffeine intake to less than 200mg per day
4) Cut out alcohol or at least reduce your intake
5) Start exercising for at least 30 minutes, 5 days a week
6) Stop smoking
7) Speak to your doctor or gynaecologist if you have any concerns with your health that you think may be impacting your fertility.
This blog was written By Naomi O'Connor, Asesoramiento Nutricional Madrid. UK Registered Dietitian. Naomi is starting shortly her online practice specialising in Women's Fertility & Pregnancy Nutrition. In the meantime, you can find her on Instagram @fertility.dietitian.pcos and at www.eggtobabynutrition.com
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