Does what you eat impact fertility? Up until 10 years ago, we didn’t have many answers. Since then, research has revealed that there could be a significant link.
Fertility rates are at an all-time low in the US. While delayed pregnancy partially explains these figures, our lifestyle coupled with a poor diet can also contribute. It is estimated that 20-30% of infertility cases could benefit from better dietary choices. Conditions that could stand to benefit include; Polycystic Ovary Syndrome (PCOS), Prediabetes and Type 2 Diabetes, Celiac Disease, Hypothalamic Amenorrhea and low sperm quality, among others. For patients requiring assisted reproductive technology (ART), an improved diet may result in fewer complications, better outcomes, and an easier pregnancy.
So what should we eat to improve our fertility? The fertility and nutrition field is still relatively new, however, a few foods have stood out in clinical trials.
Green Leafy Vegetables
One of the most well-researched nutrients in the reproductive world is folic acid, or Vitamin B9. Folic acid has been proven to help reduce the risk of neural tube defects (NTD) in fetuses, and there is evidence it may boost fertility too.
Research shows that women undergoing ART can also benefit by taking folic acid at doses higher than for the prevention of NTD, around 800 μg/day. Similarly, another study showed lower risk of ovulatory infertility when consuming folic acid.
Aside from taking a prenatal supplement, eating more leafy green veggies can boost your intake. Aim for 2-3 servings per day, such as spinach, kale, romaine lettuce, asparagus, broccoli, or collard greens. Increasing your intake with real food has added benefits including better absorption and fiber. Try to eat your greens raw or steamed and wash thoroughly to remove pesticides.
Eating more fish, especially fatty fish, may help support fertility in men and women. The anti-inflammatory action of omega 3 fatty acids is linked to improved egg quality, maturation and embryo implantation.
Results from the Environment and Reproductive Health (EARTH) Study also found that men who consistently ate foods containing omega 3 fatty acids had a higher number of healthy sperm. Rich sources include salmon, sardines, herring, and freshwater trout. As with pregnancy, high mercury fish should be avoided such as, swordfish, tilefish, king mackerel, and shark. Not a fan of fish? You can also get a good serving of omega 3's from a daily sprinkling of walnuts and chia seeds. In contrast, trans fats (those found mostly in highly processed, sugar laden foods) are associated with impaired fertility.
Eating a diet rich in whole grains provides a range of health benefits, including supporting improved fertility. Aside from vitamin and minerals, wholegrains contain lignin. This plant-based compound has a similar structure to the hormones involved in reproduction. One study found that women that consumed a diet high in lignin containing foods had a shorter time to pregnancy. Another study showed that women undergoing ART who consumed high quantities of whole grains had a higher number of live births, compared to women who consumed smaller amounts. Other lignan-rich foods include flaxseeds, sesame seeds, beans, berries, and nuts.
Choose unrefined, fibrous whole grains such as brown rice, buckwheat, oatmeal and farro. The fiber helps to slow down breakdown and digestion, releasing glucose into the bloodstream slowly. This action is particularly helpful for women with PCOS and diabetes who can struggle to maintain healthy blood glucose control.
Full Fat Dairy
One prominent fertility study found that consuming high-fat dairy foods, such as whole milk, decreased the risk of infertility linked to a lack of ovulation. In contrast, consuming low-fat dairy products, such as yogurt and sherbet/frozen yogurt, around 2 servings per day, increased the risk of infertility.
A dairy component which could explain the fertility boosting property is Vitamin D. Maintaining adequate levels has been shown to be supportive of fertilization. In one study, women undergoing IVF who had normal Vitamin D levels had pregnancy rates 4-fold higher than those who were deficient in the nutrient.
With that said, I recommend 1-2 servings of full-fat, low added sugar dairy per day. Good choices include plain whole fat milk, full fat greek yogurt, kefir and cheese.
The connection between body fat and fertility has been a focus of much fertility research.
Some studies have shown that obese women (that is those with a BMI >30), are more likely to have ovulatory dysfunction and poorer outcomes with IVF. While the biological mechanisms underlying this remain unclear, higher levels of inflammation and altered hormone levels could play a role.
The good news is there is research to indicate that weight loss of as a little as 5-10% can dramatically improve ovulation and pregnancy rates. Having too little body fat can also be detrimental to fertility and maintaining a healthy pregnancy. Patients with very low BMIs (<20) are also at an increased risk for reduced fertility. Maintaining a BMI of 20-24 has consistently been shown to promote increased pregnancy rates and healthy pregnancy outcomes.
Infertility is a complex condition with a variety of known and unknown causes. While changing your diet will not make a difference for every couple, research does indicate that for some, simple diet and lifestyle changes can have significant impact. Nourishing our body with adequate nutrients strengthens our immune system, allows the normal production of hormones and supports healthy blood sugar control – all factors that are supportive of conception and healthy pregnancy outcomes.
Want to include some ‘fertility’ foods in your diet? Give this sample menu a try!
The Fertility Diet - Sample Menu
3/4 cup plain greek yogurt, ½ cup unsweetened granola, ½ cup mixed red berries
1 cup decaf tea with whole milk
Small handful of almonds + a piece of fruit or hard boiled egg + 1 slice wholegrain toast
Mediterranean Salad: 1 head of shredded romaine lettuce, 3oz organic chicken breast, ½ cup chopped cherry tomatoes, cucumber, olives, crumbled feta, ½ can of no-salt-added chickpeas, 2 tbsp extra virgin olive oil
1 slice of wholegrain baguette with butter or toasted wholegrain pita bread
Celery, cucumber, zucchini + ½ cup hummus OR
Protein smoothie ( 1/4 c berries, 1/2 cup plain greek yogurt, 1 cup unsweetened almond/ soy/ skim milk, 1 scoop protein powder, 1 tbsp chia seeds)
3 oz cooked wild salmon, ½ cup seasoned brown rice, 1 cup steamed broccoli and asparagus, 1 tbsp melted butter and tartar sauce
1 oz dark chocolate (75% cocoa or more) or homemade berry sorbet
Tamsin Jordan is a Registered Dietitian, wellness expert and mom living in NYC.
She provides one to one nutritional counseling to people of all ages, with a specialty in women’s health, bariatrics, diabetes and digestive health. She writes about nutrition and wellness topics on her blog you can also find her on Instagram: @nutritionbytamsin
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