Fertility problems have increased dramatically over the past 20 years, with a quarter of all couples planning a baby experiencing trouble conceiving (Glenville, 2010). Infertility can often be classified as ‘unexplained’; with no specific medical problem able to be identified. In these cases it may be as simple as poor diet and lifestyle choices that are impacting upon a couple’s chances of conceiving naturally. Establishing a healthy diet early on can improve chances of conception, set the stage for a healthy and successful pregnancy and give your baby the best possible start in life.
When to start
It takes a minimum of 3 months for eggs to mature sufficiently for release during ovulation and for sperm cells to develop fully (Marieb, 2004). This means that when trying to improve your fertility it is worth setting aside a 3 month period to make positive changes before aiming to conceive. It is as important to take care during this period as it is during the pregnancy itself.
The key to preconception nutrition is to eat a balanced and varied diet, rich in a vitamins, minerals, proteins and complex carbohydrates. This means eating the freshest, healthiest food you can afford with a focus on fresh fruits and vegetables, whole grains (including bread, cereals, pasta and rice), nuts and seeds, beans and lentils, lean meat, oily fish, dairy products and eggs.
It is important to avoid high sugar and high fat foods which can lead to weight gain. It is well documented that body fat content has an impact on fertility and women who are closer to their healthy body weight have less chance of suffering hormone imbalances and therefore better chances of conception (Glenville, 2010).
If using the contraceptive pill, you should also aim to stop taking it at least 3 months before conceiving. Contraceptive pills can deplete many vitamins and minerals (including vitamin B2, B6, C, A and zinc) (Pelton, 1999) and may therefore have a detrimental effect when trying to boost the nutrient-density of your diet.
Vitamins and minerals are generally best absorbed and utilised by your body when obtained from foods rather than in supplement form (with the exception of folic acid). It is also easy to inadvertently overdose on certain vitamins from supplements, which can cause more harm than good.
To help you make every mouthful count, I’ve outlined some of the most essential pre-conception nutrients and the best foods to find them in:
- Folic Acid
Folic acid is the most essential pregnancy nutrient. It works together with vitamin B12 to ensure that the baby’s genetic materials are fully developed. Low levels of folic acid increases the risk of brain and spinal cord defects, so it is essential that you have sufficient intake both before and during pregnancy (Scholl & Johnson, 2000).
Although folic acid can be found in many foods (such as beans, peanuts, avocado and green leafy vegetables), it is hard to get sufficient quantities from food alone. Folic acid is therefore the only supplement that all women must take before conception (Glenville, 2010). 400mcg per day is recommended from 3 months prior to conception until the end of the first trimester of pregnancy, plus a further 200mcg from food.
Zinc is the most widely studied nutrient in terms of fertility. It is an essential component of genetic material and deficiency can lead to chromosomal changes in both men and women, leading to difficulty conceiving (Carlson et al., 1992). It is also involved in the body’s use of reproductive hormones and in the development of the brain and immune system. Zinc is also found in high concentrations in sperm and reducing zinc in a man’s diet may therefore reduce his sperm count (Glenville, 2010).
Good sources of zinc include oysters, meat, beans, yogurt and brown rice.
- Vitamin A
Retinol (the animal form of vitamin A found in many supplements) should be avoided during pregnancy, as it can cause developmental and birth defects in excess (Azaïs-Braesco & Pascal, 2000). It is therefore important to be cautious when taking multi vitamin supplements or Cod Liver Oil which can contain high levels of Vitamin A in retinol form.
Healthy levels of vitamin A can be obtained from the diet in fortified foods, dairy products, eggs, chicken and fish and will help keep the fallopian tubes healthy. Beta-carotene, a precursor to vitamin A found in brightly coloured vegetables, may be supplemented as it does not carry the same risks as retinol.
When you fall pregnant, the volume of circulating blood in the body increases by a third. This leads to an increased demand for iron, which is essential for the formation of the baby’s blood, brain, eyes and bones (Glenville, 2010). Pregnant women can easily become deficient in iron and must ensure that they regularly consume plenty of iron rich foods before pregnancy in order to build up iron stores, along with Vitamin C to aid iron absorption.
Iron-rich foods include red meat, beans, nuts, dried fruit, whole grains (such as brown bread and rice), fortified breakfast cereals and dark green leafy vegetables.
Well known for strengthening bones and teeth, calcium is also needed to produce the fertile mucus that helps sperm to reach the waiting egg. Demand for calcium increases in pregnancy and breastfeeding (Glenville, 2010).
Dairy products such as yogurt, milk and cheese are good sources of calcium, along with canned salmon or sardines (with bones), nuts and tofu.
- Essential Fatty Acids (EFAs)
Essential fats are crucial for healthy hormone functioning and the ovulation process. Consumption is particularly crucial for men as the semen is rich in prostaglandins, produced from these fats. Men with poor sperm quality or low count tend to have inadequate levels of these beneficial prostaglandins (Carlson et al., 1992). The omega 3 fatty acids found in EFAs are also essential in foetal brain development.
Good sources of essential fatty acids are oily fish (such as sardines, mackerel, anchovies, salmon or herring), cold-pressed oils such as flaxseed and pumpkin-seed, eggs, soy products, nuts and seeds and green leafy vegetables.
NOTE: Elevated levels of mercury found in many deep-sea fish can be dangerous and may affect a baby’s developing nervous system. Avoid eating shark, swordfish or marlin before and during pregnancy and try to limit tuna consumption to a couple of times a week.
- Vitamin E
Vitamin E is a powerful antioxidant and has been found to increase fertility when given to both men and women during IVF treatment (Geva et al., 1996). It has been suggested that the antioxidant activity of vitamin E might regulate oestrogen levels and make the sperm more fertile (Glenville, 2010). Wheat germ oil is the best source, but other vegetable oils, nuts and whole grains are good sources too.
What to avoid
Certain foods and drinks can be detrimental when trying to conceive:
Research has indicated that drinking as little as one cup of coffee a day may reduce your chances of conceiving (Bolumer et al., 1996) and may also decrease sperm count in men. More research is required to substantiate these claims but in the meantime it is advisable to reduce consumption of caffeine-containing food and drinks. This includes cola drinks, chocolate, teas (including green tea, although to a lesser extent than black tea) and coffee. Tea and coffee also contain a substance that can bind with iron making it harder for the body to absorb it (Glenville, 2010). Cutting down on tea and coffee may therefore also help to improve iron levels.
NOTE: Caffeine is also found in some cold and flu remedies, so always check with your GP before taking any of these during pregnancy.
The Department of Health (DH) recommends that women should not drink alcohol while they are trying to conceive. Drinking alcohol causes a decrease in sperm count and an increase in abnormal sperm; it can also inhibit the body’s absorption of B vitamins and zinc. Birth defects associated with prenatal alcohol exposure can occur in the first 3-8 weeks of pregnancy, before you even know if you are pregnant (Maier et al., 2001). You should therefore eliminate alcohol from your diet for at least three months in order to give yourself the best possible chance of conceiving and having a healthy pregnancy. If you do drink during this time, try to limit yourself to 1-2 units per week.
Water should be your number one beverage before and during pregnancy. The human body is mostly composed of water, so consider it a vital nutrient.
Smoking has been linked with infertility in women (Hakim, 1997) and may bring on an early menopause, a particularly important consideration for older women hoping to fall pregnant. Nicotine ages the ovaries and can make the eggs resistant to fertilisation. It can also decrease sperm count and quality in men (Carlson et al., 1992).
- Aspirin and other NSAIDS
If at all possible, avoid unnecessary medications and drugs including over-the-counter preparations. Even non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen may inhibit ovulation.
Every mother wants her baby to be as healthy and strong as possible and the best way to do that is to start at the very beginning: before conception. Establishing a varied and healthy diet early on can help your chances of conceiving, set the stage for a healthy pregnancy and give your baby the best possible start in life.
It is possible to get all the nutrients you need naturally*, from the food you eat, in order to prepare your body for pregnancy and build the best possible environment for your baby to grow in. Making wise, informed decisions about your food and drink now will benefit both you and your baby for the long term.
* With the exception of folic acid.
© Sarah West Nutrition
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