Nutrition and fertility

Pre- conception is a vital part of preparing for pregnancy. Diet, lifestyle and your health play an important role in conception. Eating a well-balanced diet which includes whole-grains, fruits, vegetables, dairy and meats or meat alternatives  along with regular physical activity can improve your chances of a successful pregnancy.[1,2] High calorie diets that can result in high cholesterol levels, diabetes, obesity and even poor food intake resulting in malnutrition are also suspected to affect fertility.[1] In addition, other non-modifiable lifestyle related factors such as smoking, increased consumption of caffeine, alcohol and stress can also affect fertility.[1]

Key nutrients important for women and fertility

• Folic acid

Folic acid is a B vitamin used to prevent major birth defects. Women should take 400mcg (micrograms) of folic acid daily even before the pregnancy as a prenatal supplement or shortly after finding out you’re pregnant to prevent any birth defects. [3] Apart from the supplement, it is also important to obtain folic acid from your diet through green leafy vegetables, nuts, beans and legumes as well as citrus fruits. [3]

Folic acid rich food: spinach, kale, thampala, curry leaves, ladies fingers, broccoli, oranges, grapefruit, lime, papaya, banana, ambarella, avocado, chickpeas, lentils, cowpea, mung beans, asparagus, eggs, beetroot, peanuts and other nuts and seeds.

• Zinc

Zinc has been shown to improve spermatogenesis and motility in men and improve hormone balance and ovulation in women. [1,4]

Zinc rich food: wholegrains, nuts, seeds, lean red meat, oysters etc.

• Iron

Increasing and building up iron stores may help prepare a mother’s body to support the needs of the foetus during pregnancy. [4,5]  Women of reproductive age are at increased risk of iron deficiency before conception due to menstrual losses, poor dietary intake or previous pregnancies. It is important to consider iron status prior to conception as it has been shown to impact fertility. [4]

Iron rich food: chicken, fish, beef, eggs, thampala, sarana, gotukola, mukunuwenna, kathurumurunga, beet leaves, spinach, green peas, broccoli, chickpeas, cowpea, lentils, soya beans.

• Calcium

It is important to build healthy bones while preparing for pregnancy.[5]

Calcium rich food: milk, yoghurt, cheese, curd

Avoid low fat or non-fat dairy sources when trying to conceive.

• Iodine

It is important to build iodine stores prior to conception to assist with egg maturation. The foetus also relies on maternal iodine stores until 18 weeks of pregnancy. Therefore it is important to obtain iodine from food or a supplement only if prescribed by your doctor.[5,6]

Iodine rich food: white fish, oily fish, dairy products, fortified plant milks for plant-based eaters.

• Protein and fats

Proteins have been shown to improve insulin sensitivity and are also important to improve fertility which is especially beneficial in women older than 32 years of age. [7] Fats especially monounsaturated fats such as olive oil, avocado, olives, oily fish etc. have been linked to higher fertility rates. [6]

Tips to help improve your fertility [4,6]

• Maintain a healthy weight within the healthy BMI range.
• Choose more monounsaturated fats or ‘good fats’ found in olive oil, avocados, nuts and seeds.
• Limit saturated fats and trans-fats which are found in fried food and junk food.
• Choose high fibre foods found in wholegrains, red rice, brown bread, atta flour, skins of fruits and vegetables.
• Limit the intake of high sugar foods and processed high salt or high sodium containing food items.
• Limit caffeine intake to only 2 cups per day.
• Do not cut out carbohydrates.
• Stop drinking alcohol and smoking.
• Add regular exercise to your daily life.

References

1. Silvestris E, Lovero D, Palmirotta R. Nutrition and Female Fertility: An Interdependent Correlation. Frontiers in Endocrinology. 2019;10.
2. Panth N, Gavarkovs A, Tamez M, Mattei J. The Influence of Diet on Fertility and the Implications for Public Health Nutrition in the United States. Frontiers in Public Health. 2018;6.
3.  Foods That Can Affect Fertility [Internet]. Eatright.org. 2020 [cited 17 November 2021]. Available from: https://www.eatright.org/health/pregnancy/fertility-and-reproduction/fertility-foods
4. A clinical update on diet and fertility [Internet]. Bda.uk.com. 2021 [cited 17 November 2021]. Available from: https://www.bda.uk.com/resource/a-clinical-update-on-diet-and-fertility.html
5. Barker M, Dombrowski SU, Colbourn T, Fall CH, Kriznik NM, Lawrence WT, Norris SA, Ngaiza G, Patel D, Skordis- Worrall J, Sniehotta FF. Intervention strategies to improve nutrition and health behaviours before conception. The Lancet. 2018. 5;391 (10132):1853-64
6. Chavarro JW, Rich-Edwards JW, Rosner BA, Willet WC. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstetrics & Gynecology. 2007 Nov 1;110(5):1050-8
7. Chavarro JW, Rich-Edwards JW, Rosner BA, Willet WC. Protein intake and ovulatory infertility. American journal of obstetrics and gynecology.2008 Feb 1;198(2):210-e1