Fertility

After studying medicine, I trained to become an embryology. So naturally I was quite immersed in the field of infertility.
In fact, it was during my studies of epigenetics, that I became aware of nutrigenomics and how food and nutrition can affect foetal development and even affect generations to come.
So, it comes as no surprise that with a consistent proper nutritional regiment, some obstacles of infertility can be alleviated with proper nutrition.

How can Nutrition help?

Following a good fertility diet is beneficial for everyone trying to conceive. A study conducted by the University of Surrey concluded that couples with a history of infertility who made changes in their;
Lifestyle
Diet
Too Nutritional Supplements
Had an 80% success rate.
Even if you are going for an IVF or ICSI cycle, positive diet and lifestyle changes will improve your chances of success. A good fertility diet will provide the raw materials to support healthy egg and sperm quality.
It can also help alleviate hormonal imbalances and reduce inflammation. It usually takes around three months for eggs and sperm to mature.
So, it makes sense to start a three-month pre-conceptual plan before trying to conceive.
However, healthy changes to your diet and lifestyle will positively affect your fertility/pregnancy outcome no matter what stage in your journey you are on.
Based on numerous studies we know that a fertility friendly diet is high in fruits, vegetable, nuts and seeds. Fish intake is also important especially those high in Omega 3 like salmon, mackerel, sardines and anchovies.
Including more pulses and plant-based foods is helpful. Reducing red meats, especially processed meats can be extremely beneficial.
An overall reduction in high fats and high sugar and overly processed foods is recommended.

Folic Acid

It is well known that folic acid can prevent spina bfida and other neural tube defects in your baby.
It is essential you get plenty before and during pregnancy. Taking a supplement of 400ug of folic acid fourteen weeks before pregnancy and twelve weeks into pregnancy is essential.
Folic Acid is part of the very important B complex family of vitamins. These are necessary to produce genetic materials DNA and RNA in growing embryo. Together with Vitamin B12 they help ensure baby’s genetic codes are intact. It is recommended to take a vitamin B supplement (especially vitamin B12 if you are vegan) with folic acid.

Zinc and Selenium

These minerals are usually associated with male fertility, but as they are important anti-oxidants, they are essential in protecting egg quality and egg DNA. These minerals are primarily found in nuts and seeds, and it is recommended that you include a mix of these in your daily diet.
Zinc plays a huge part in balancing hormones. It is essential for how reproductive hormones oestrogen and progesterone are used. It is also involved in thyroid hormone production. Thyroid hormone is a master regulator of hormones hence it is very important especially in fertility.
Zinc deficiencies are very common. Great sources of zinc can be found in meat, chickpeas, nuts and seeds. One thing to note is Zinc cannot be properly digested if you are on Proton Pump Inhibitors (PPI) to help with gastric reflux or ulcers.
If you are vegan extra effort has to be exerted to get a proper intake. This can be overcome by soaking, sprouting or fermenting pulses and beans.
The best source of selenium is Brazil nuts. Just one Brazil nut has the daily recommended allowance. Selenium is also found in eggs, shellfish, fish, chicken and meat.

Vitamin C and E

These are crucial antioxidants, especially in women of advanced age. They work together as vitamin C is water soluble and Vitamin E is fat soluble. Egg quality is a major concern as one starts to age. Egg quality is a crucial factor in the success of both natural and assisted conception.
Vitamin E supports a healthy womb lining to develop.
Vitamin C is found in fresh fruits, especially citrus fruit. We recommend aiming for two portions of fruit and five portions of vegetables daily.
It is recommended to ‘eat the rainbow’ or eat varying colours of fruit and vegetables to include a wide array of nutrients.
Vitamin E is found in almonds, avocados, sunflower seeds, salmon, sweet potatoes, olives and olive oil.

Omega 3

These essential fats have an effect on every system in the body, including the reproductive system as they are crucial for healthy hormone functioning.
They also control inflammation which may affect obtaining and maintaining a pregnancy. Eating two portions of oily fish a week are recommended, if you do not consume fish a supplement containing over 500mg of each EPS and DHA is beneficial.

Amino Acids

These are the building blocks of protein and are found in al foods containing protein. Some amino acids like l-arginine can support blood flow to endometrium.

Vitamin D

Conception rates increase during the summer which may show a role for vitamin D in fertility. There are vitamin D receptors in ovaries and uterus. However, be careful with Vitamin D supplementation as they are fat soluble and can accumulate in fat and become toxic.
Even though in Egypt we have a lot of sunshine, most people tend to stay indoors during the sunny hours and opt to go out after sunset.

Coenzyme Q10

Coenzyme Q10 is an important antioxidant in preserving egg quality, especially as women get older.
Taking CoQ10 for three months prior to fertility treatment has shown to improve outcome.

Reducing Caffeine

There has been some evidence showing that caffeine especially in the form of coffee reduces fertility. According to one study, drinking as little as one cup pf coffee a day can halve your chances of conceiving. Drinking two or more cups of coffee increases risk of miscarriage. Limiting and reducing caffeine intake during prenatal period is strongly recommended.

Alcohol

Alcohol consumption cuts down fertility by half. Reducing or cutting alcohol in prenatal care period is highly recommended. Once pregnancy is achieved stopping alcohol completely is a must. If you are undergoing assisted conception and taking medications it is also recommended to avoid it completely.

Smoking

Smoking has been linked to infertility in both men and women. It can also bring on early menopause. You will need to completely stop during pregnancy so it will be good practice to start quitting during pre-conceptual care period.

Exercise

Moderate exercise is excellent for weight management, stress reduction and maintaining hormonal balance. It is very important in the pre-conceptual care period. While pregnant it is recommended to keep up a similar moderate exercise regimen. To reduce stress, try less vigorous forms of exercise such as Pilates and yoga. Walking and swimming are also great form of exercise. If you cannot go out because of weather or limited time, there are lots of amazing videos on YouTube.

Stress

Stress is the number one enemy when it comes to fertility. Mediation and mindfulness can help reduce stress. Stress can wreak havoc with your cortisone levels, which negatively affects fertility and increases the chance of a miscarriage. Vitamin B and magnesium can help with this.
Try not to go too long between meals to keep blood sugar and cortisol levels stable. Snack on nuts and seeds and switch from refined carbs to wholegrain. Try to get plenty of sleep and you might find guided meditation audiobooks useful. For more tips on how to tackle anxiety and depression click here.
References

i Carta G et al, 2005, Clin Exp Obstet Gynecol, 32(1):49 – 51 ii Rafraf M et al, 2012, J Am Coll Nutr, Oct;31(5):361 – 8 iii Aksoy,Y. et al, 2006, Prostaglandins Leukotrienes and Essential Fatty Acids, Aug, 75(2), 75 – 79. iv Safarinejad MR, 2011, Andrologia, 43, 1, 38 – 47 v Blomberg Jensen M et al, 2011, Hum Reprod, 26, 6, 1307 – 17 vi Hayes, C. E. et al, 2003, Cell Mol Biol. 49(2):277 – 300 vii Showell MG et al, 2011, Cochrane Database Syst Rev, CD007411 viii Safarinajad et al, Int Urol Nephrol. 2012 Jun;44(3):689 – 700 ix Wong WY, 2002, Fertility and Sterility, 77, 3, 491 – 8, Omu AE et al, 2008, Med Princ Pract, 17, 2, 108 – 16 x Scott R et al, 1998, British Journal of Urology, 82, 1, 76 – 80 xi Hovdenak N., Haram K., 2012: 127 – 32, Eur J Obstet Reprod Biol, Oct;164(2)) xii Greco E et al, 2005, H um Reprod, 20(9):2590 – 4

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