Fertility – What You May Not Have Thought About
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When it comes to fertility prep, there are obvious things that most of us are aware of – taking folic acid of course (well, actually methyl-folate is better), understanding ovulation windows and quitting or reducing alcohol intake. However, there are lots of other nutrients and lifestyle factors involved in conception and here, Jen Walpole takes us through some of the lesser-known ones.
Nutritional Therapist Jen Walpole specialises in women’s health, specifically fertility and hormone balance. Jen often works with clients that are experiencing irregular menstrual cycles, have been diagnosed with PCOS, endometriosis or those that wish to support their fertility, pregnancy or require ante-natal support.
Optimising Fertility Through Diet
If you are planning on trying to conceive, consider preparing for at least 3 months prior to conception to allow for any nutritional deficiencies to be resolved. Nutritional deficiencies may be due to unexpected reasons including the fact that the oral contraceptive pill depletes many nutrients or perhaps there is gut dysbiosis which impacts digestion/absorption. Three months also accounts for the time it takes to mature an egg (oocyte) follicle and for the processes involved in semen production (known as spermatogenesis). So, remember that anything you start doing now will impact egg and sperm quality in 3 months’ time.
Specific nutrients play a crucial role in optimising fertility for both women and men. Firstly, vitamin B9, also known as folate, not only supports neural tube development (vital for a healthy pregnancy), but it’s also key for both female and male fertility. In women, folate supports the maturation of the ovum (egg), the quality of the embryo, and implantation processes (1). In men, folate supports the quality of sperm DNA (2). Whilst most of us are aware of the synthetic form of folate, known as folic acid, methyl-folate is a much more readily available form and can be found in better quality supplements such as Thorne’s Basic Prenatal and Pure Encapsulations Prenatal Nutrients . Whilst most supplements contain the recommended 400mcg, we actually need more than this so increasing dietary intake during the preconception period is key. Abundant in leafy greens, lentils, and liver, folate becomes even more bioavailable when paired with vitamins B12 and B6, found in whole grains, fish, and poultry.
Some minerals that are important to optimise preconceptionally include iron and zinc (3). Iron deficiency can contribute to ovulation issues and in pregnancy, low birth weight. Red meat and liver are the richest sources of iron, but this can be obtained from plant-based foods such as beans, and dark green leafy veg like spinach. Pairing them with vitamin C-rich foods like citrus fruits, tomatoes and peppers enhances absorption. Meanwhile, zinc regulates hormones, boosts sperm health, and aids egg quality. Oysters, pumpkin seeds, chickpeas, nuts, and seeds contain zinc. Most prenatal supplements will help to fill in any nutritional gaps here too.
Often overlooked, choline and iodine are important fertility nutrients also (4). Choline is often hard to obtain from diet alone although eggs are the richest source. Vegans may wish to supplement with this lesser-known nutrient. For example, BodyBio’s Phosphatidylcholine supports the egg and sperm cells. Meanwhile, iodine keeps your thyroid working optimally, which is crucial for hormone regulation and egg development. Consuming seaweed or dairy products, and supplementing will help keep thyroid functional optimal.
Finally, EPA and DHA, which are found in omega-3 fatty acids are the architects of healthy brain development in your future baby (5). They also help reduce inflammation, which is important when it comes to egg and sperm quality. Fatty fish like salmon and mackerel are their primary source, but plant-based alternatives like chia seeds and walnuts offer a vegetarian option, albeit in another form (ALA), which must be converted to EPA/DHA. I like to recommend clients take an omega 3 which contains both EPA and DHA.
However, it’s important to remember its ‘food first’ and beyond individual nutrients, a whole-food approach is key. The Mediterranean diet, with its emphasis on whole grains, legumes, fruits and vegetables, healthy fats, and moderate fish consumption, offers the best composition for pre-pregnancy health (6).
Nothing is off the menu with this ‘diet’. It’s about upping the colour, reducing processed foods, and probably increasing the amount of fish you consume. White and red meat, dairy and eggs are present in this diet, it’s about everything in moderation. For women with PCOS, balancing hormones through diet becomes even more important when trying to conceive. Reducing refined carbohydrates and sugars helps regulate insulin levels, while incorporating protein-rich foods like eggs, oily fish, legumes. Nuts and seeds promote satiety and manage weight. Anti-inflammatory foods including berries and turmeric can also be beneficial.
Remember, consult your healthcare professional or a nutritional therapist for personalised dietary guidance in managing PCOS.
‘Detoxing’ for a Healthy Pregnancy
While "detox" often conjures images of juice cleanses and restrictive diets, these can be counterproductive, depleting the body of essential nutrients needed for fertility. However, in the fertility context, environmental toxins that can disrupt our hormones should be considered carefully. Understanding their potential impact and taking steps towards gentle detoxification can empower you to create a safe environment for conception. From pollutants to plastics and pesticides in our food, we're constantly bathed in low-level exposure of environmental toxins. These can disrupt hormone balance, damage sperm and egg DNA, and hinder healthy embryo development. Heavy metals like lead and mercury can impair sperm motility and morphology, while pesticides and plasticisers have been linked to decreased sperm count and quality. Phthalates, found in many personal care products, can disrupt female hormones and egg maturation.
Gentle, sustainable practices that support your body's natural detoxification pathways. Nature's broom, fibre helps sweep toxins out of your digestive system. Load up on fruits, vegetables, whole grains, and legumes – their roughage content keeps things moving and prevents toxins from re-absorption. Whilst antioxidants neutralise free radicals – rogue molecules that damage cells, including sperm and egg DNA. Berries, leafy greens, colourful vegetables, and dark chocolate are your antioxidant heroes. Water flushes out toxins and keeps your system running smoothly. Aim for eight glasses a day and consider herbal teas and infused water for extra flavour and antioxidants.
Our world holds toxins that creep in beyond just our food. Here's how to minimise exposure:
Ditch the Chemicals
Swap conventional cleaning products for natural alternatives like vinegar, baking soda, and castile soap. Look for "fragrance-free" labels on personal care products, and opt for glass and stainless-steel water bottles over plastic.
Air It Out
Regularly ventilate your home to dispel indoor pollutants and consider investing in air purifiers for extra protection.
Embrace Organic
When possible, choose organic produce to minimise pesticide exposure. Each year, a list known as the ‘dirty dozen’ of the worst offending fruit and vegetables with the highest residues of pesticides is released. Last year, grapes, beans in pods, spinach, strawberries, and tomatoes.
Remember, the key is consistency. Small, sustainable changes are what truly move the needle. By incorporating these practices into your daily routine, you'll nurture a gentle yet effective cleanse, creating a safer environment for your precious seeds of conception.
Sleep: The Cornerstone of Fertility
Sleep is the cornerstone of hormonal health, meticulously balancing those essential for conception. In men, adequate sleep fuels testosterone production, crucial for healthy sperm count and motility. For women, sleep regulates ovarian hormones like oestrogen and progesterone, ensuring proper ovulation and a welcoming environment for the egg (7). Skimp on sleep, and this delicate dance gets out of sync, potentially impacting your chances of conceiving.
5 Tips for Fertile Sleep
Set a Sleep Schedule - Stick to a consistent bedtime and wake-up time, even on weekends. This helps regulate your body's natural sleep-wake cycle.
Create a Sleep Sanctuary
Make your bedroom a haven for slumber. Dim the lights, cool the temperature, and minimise noise distractions. Invest in blackout curtains if needed and an eye mask such as this blackout one.
Power Down Hour Before Bed
Ditch the screens at least one hour before bed! The blue light emitted by electronics disrupts melatonin production, the sleep hormone. Wind down with a relaxing activity like reading a book or taking a warm bath. Adding bath salts can be a lovely edition to aid relaxation.
Listen to Your Body
Avoid caffeine and alcohol in the evening, as they can interfere with sleep. Opt for a herbal tea instead. Exercise is great, but avoid strenuous workouts in the evening.
Mental and Emotional Wellbeing for Preconception Prep
Trying to conceive can feel like an emotional rollercoaster of hope, anticipation, disappointment, and frustration. But remember, you’re not alone in this, and there are ways to navigate your fertility journey feeling supported and confident in your next steps. However, stress, an often-unwelcome guest, can throw a wrench in the fertility works. Cortisol, the stress hormone, can disrupt ovulation and sperm production, making it less likely for conception to occur.
So, how do we tame this? Mindfulness can be incredibly powerful. Take mindful moments throughout your day, focusing on your breath and letting go of the mental chatter. Simple breathing exercises or guided meditations can do wonders for calming the mind and body. What’s more, meditation trains your attention and helps you cultivate inner peace. Dedicate even just 10 minutes a day to meditation, and you'll find yourself better equipped to handle the emotional ups and downs. Pouring your thoughts and feelings onto paper can be a powerful tool for self-reflection and stress release. Write about your hopes, fears, frustrations, and anything else that's swirling in your mind. Journaling can help you gain clarity and perspective amidst the emotional storm.
Sometimes, the emotional weight can feel overwhelming. Don't hesitate to reach out for support. Talk to your doctor, therapist, or a trusted friend or family member. Consider joining a support group for couples trying to conceive. Connecting with others who understand your struggles can be a source of immense comfort and strength.
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References
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Gaskins, A.J. et al (2012), The Impact of Dietary Folate Intake on Reproductive Function in Premenopausal Women: A Prospective Cohort Study, PLoS ONE, 7 (9), e46276.
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Boxmeer, J.C et al. (2008), Low Folate in Seminal Plasma is Associated with Increased Sperm DNA Damage, Fertility and Sterility.
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Skoracka, K. et al. (2021), Female Fertility and the Nutritional Approach: The Most Essential Aspects, Advances in Nutrition, 12 (6), pp. 2372-2386.
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Skoracka, K. et al. (2021), Female Fertility and the Nutritional Approach: The Most Essential Aspects, Advances in Nutrition, 12 (6), pp. 2372-2386.
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Stanhiser, J. et al. (2022), Omega-3 fatty acid supplementation and fecundability. Hum Reprod. 37(5), pp. 1037-1046.
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Simon, A. et al. (2022), Anti-Inflammatory Diets in Fertility: An Evidence Review, Nutrients 14 (19), p. 391.
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Caetano, G, et al. (2021. Impact of sleep on female and male reproductive functions: a systematic review, Fertility and Sterility, 115 (3), pp. 715-731.
This article is for informational purposes only, even if and regardless of whether it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of Healf.
