How fertility and nutrition go hand in hand
The importance of optimum nutrition for fertility and pregnancy is too often overlooked. Just as you would not enter a marathon without training, it is important to prepare both body and mind for pregnancy and birth, which puts the female body under similar pressure to an endurance event.
It takes 12 months to make a baby; 3 months to mature a batch of eggs and sperm, and 9 months of pregnancy. Therefore, preconception preparation should start at least 3 months before trying for a baby, whether this is via Assisted Reproductive Treatment (ART) or natural conception. Women are often told that they are born with all the eggs that they will ever have, but each month a number of those eggs mature and develop and the quality of those eggs is dependent on our diet and lifestyle.
What you eat directly impacts all of the cells in your body, including the egg, sperm and the environment of the womb. The building blocks for hormones are found in the foods we eat, and to build another human being you need the right set of nutrients. Regardless of whether you have been trying unsuccessfully to have a baby or if you are about to try for the first time, it’s important to focus on this preconception period and consider it just as essential as the pregnancy itself.
What you eat before you get pregnant has a lasting effect on your baby’s health for their entire life. Especially during the first trimester, the growth and development, nutrition is of the utmost importance. If there are not enough nutrients to go round, some areas of baby’s development are prioritised over others, with the brain getting ‘first dibs’. It can also affect mum’s health negatively, as in some circumstances baby’s development will be prioritised at the expense of the mother’s nutritional status. Unfortunately, studies consistently show that women of childbearing age in the UK are not getting adequate amounts of vitamins and minerals from their diet.
We now have a lot of evidence that preconception nutrition impacts both maternal health and that of the child right through their childhood and into adulthood – studies show that our preconception nutrition can even impact the health of our grandchildren through the epigenetic impact of our diet! A study in the Lancet from 2018 stated:
‘Health and nutrition of both men and women before conception is important not only for pregnancy outcomes but also for the lifelong health of their children and even the next generation.’
It’s clear that nutrition plays an important role in the health of the eggs and sperm, as well as the health of mum-to-be. But it is not just important for women to focus on this, since that is only half the story with 50% of the DNA coming from the male partner.
WHAT SHOULD I EAT TO SUPPORT MY FERTILITY?
Whilst we are all biochemically individual and we all have slightly different needs, when it comes to studies looking at diets in relation to pregnancy success, the Mediterranean diet consistently comes out on top. It involves reducing red meat and processed foods, and instead eating a variety of differently coloured vegetables, fruit, fish, whole grains, nuts, seeds, lentils, herbs and spices – and of course olive oil. This makes the diet packed full of protein, good fats, slow release carbohydrates, and antioxidants to protect our cells from damage and deliver a wide range of fertility-friendly nutrients.
IS ORGANIC FOOD WORTH THE PRICE TAG?
Yes, studies show that eating organic food increases the chances of IVF success, and it is likely that this is also true for those who are trying naturally. Organic food tends to be higher in phytonutrients and we know that organic apples contain much more of the types of healthy bacteria that helps keep our gut bugs happy. Non-organic food also comes with pesticides that may be toxic to our bodies as well as that of the developing foetus. There have been no studies into the cocktail effect of pesticide residue from the food that we eat and the impact on our fertility or the developing foetus, however it is better to err on the side of caution and avoid pesticides as much as possible. The Environmental Working Group publishes a list of ‘dirty dozen’ and ‘clean fifteen’ every year, so if cost is an issue it’s worth sticking to these lists to at least minimise the worst exposure. Peaches, apples, pears, strawberries and spinach consistently come out as covered in the most toxic residue and it is worth avoiding these if organic isn’t available.
WHAT YOU DRINK MATTERS, TOO.
It is commonly known that excessive caffeine and alcohol intake can have a negative effect on fertility for both men and women. What is less well known is that consuming sugar-sweetened drinks, in particular sodas or energy drinks, is also linked to lower fertility in men and women. Also be careful with herbal teas, as they can be quite powerful, and may be detrimental to fertility or pregnancy. The ideal drink is plain water, but don’t buy it in plastic bottles, as the plastic leaches chemicals into the water. These chemicals can mimic oestrogen and disrupt both male and female hormones. Aim for 2 litres a day, and more if you have an active lifestyle or during hot days since dehydration can dry out your mucus membranes and secretions.
WEIGHT AND NUTRITION
A high BMI does impact on pregnancy rates and increases the risk of miscarriage, however being underweight can have a negative impact on ovulation. If you do have some weight to lose, doing so gradually is safest. We store toxins in our adipose tissue, and those toxins may overwhelm our detox pathways if they are released too quickly into the body. If you need to gain weight, don’t go for sugary baked goods but instead add more nutrient-dense foods and snacks to your diet such as avocados, nuts and seeds.
The vegan diet has become increasingly popular over the last 5 or so years, and influencers such as Ella Mills are making this a popular choice for those who are planning a family, too. There is no doubt that plants should absolutely focus heavily in a fertility diet, however it isn’t necessarily a good idea to exclude all animal products. It’s quite tricky getting enough of all of the nutrients we need for healthy fertility and pregnancy when eating a vegan diet. Do ensure that you are getting enough protein, iron, calcium, vitamin D, B12, omega 3 fatty acids, zinc, selenium and iodine which are all likely to be deficient in a plant-based diet but are essential for healthy hormones and pregnancy. A deficiency of these nutrients is likely to have a negative impact on both mother and baby’s health. It’s a good idea to work with a specialist fertility nutritionist who can analyse your diet and run some blood tests to check for any deficiencies if you have been vegan for a long time or are planning to have a vegan pregnancy.
SHOULD I TAKE SUPPLEMENTS OR IS DIET ENOUGH?
My philosophy is that a healthy diet and lifestyle should always come first and supplements are just that – supplementary to what you are already eating. You can’t out-supplement a bad diet so there is absolutely no point in popping a pill, without also ensuring that you have a nutritious diet alongside. However, researchers at Warwick University found that women who took preconception multivitamins were twice as likely to get pregnant, quicker to get pregnant and less likely to miscarry than women who took just folic acid so it is a good insurance policy.
Do make sure your supplements are good quality, since you do get what you pay for. Generally the independent local health food shops stock a better range than the supermarket or pharmacy. One of my favourite online stores that stock a good range is www.naturaldispensary.co.uk. A word of caution; be careful not to overdose on any vitamins or minerals, as this can also have a toxic effect. Supplements can also interact with prescribed medication and have negative side effects. A specialist fertility nutritionist can test your levels and tailor a supplement plan to you.
WHAT ABOUT THE MALE PARTNER?
Good nutrition, a healthy weight and lifestyle factors are key to managing issues for both partners, and good nutrition can influence sperm quality and motility. Good quality protein, healthy fats, complex carbohydrates with plenty of vegetables and fibre should form the basis of a male fertility diet.
Studies have shown that eating nuts can be very beneficial for all aspects of male fertility. A mix of almond, walnut, Brazil nuts, hazelnuts and pistachios makes a great snack option. This provides both healthy fats, vitamins and several minerals such as Zinc and Selenium that are known to improve male fertility.
The dark green vegetables such as broccoli, kale and spinach are good sources of folate, which is needed for healthy cell division. Lycopene from tomatoes, especially cooked, and watermelon, are also known to be very beneficial to male fertility specifically.
Changing their diet is something that couples can do together, to empower themselves in a situation where they may feel powerless and they are having a lot of procedures ‘done to’ them. Especially the male partner often feels completely ignored and removed from the situation, but that should not be the case. When both partners make what seems like small changes to their diet and nutrition, and support each other in doing so, it really does add up to making a huge impact on their combined fertility but also sense of control.
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Sandra Greenbank is a BANT registered nutritionist, functional medicine practitioner and coach. She has been specialising in helping couples optimise their nutrition and lifestyle for optimal fertility and pregnancy since 2009. Sandra also runs a 12-month fertility mentoring program, to support other practitioners to become safe and effective practitioners in this growing field. She has a busy online clinic as well as an online course (£100 discount with code LOCKDOWN) and podcast, focussing on helping couples create healthy, happy families. Follow Sandra on Instagram @sandragreenbank_fertility