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Food and Fertility: What Should Women Consume When Trying to Conceive?

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What Should I Eat to Enhance Fertility?

A young fertile couple’s chance of conceiving in the first month they try is 25%-30%.[1] By the end of the first year, about 85% of couples achieve a success; the remaining 15% are diagnosed with infertility.[2]

Infertility has many known causes (eg, ovulatory defect, tubal occlusion, low sperm counts), and many factors lower the chance of pregnancy (eg, older age, lower ovarian reserve, endometriosis). There are modifiable and nonmodifiable risk factors for infertility or reduced fertility. Although some factors can’t be altered (eg, age and ovarian reserve), others, such as body weight and lifestyle habits, are modifiable.

Patients frequently ask providers to offer them guidance on the ideal diet to improve their chances of conceiving and carrying a pregnancy to term. A recent review by Chiu and colleagues[3] summarizes the available epidemiologic literature on the reproductive benefits of diets and dietary supplements.

Nutrition and Fertility: Review Findings

This article reviews the potential benefits of consumption of certain micronutrients, macronutrients, and dietary patterns. The following conclusions are drawn from this review:

Folic acid. Folic acid is important for germ cell production and pregnancy. The recommended daily dose to prevent neural tube defects is 400-800 µg. Women who take folic acid-containing multivitamins are less likely to be anovulatory, and the time to achieve a pregnancy is reduced. Those who consume more than 800 µg of folic acid daily are more likely to conceive with assisted reproductive technology (ART) than those whose daily intake is less than 400 µg.

Vitamin D. Vitamin D may affect fertility through receptors found in the ovaries and endometrium. An extremely low vitamin D level (< 20 ng/mL) is associated with higher risk for spontaneous miscarriage risk. Some reports suggest that women with adequate vitamin D levels (> 30 ng/mL) are more likely to conceive after ART when compared with those whose vitamin D levels are insufficient (20-30 ng/mL), or deficient (< 20 ng/mL). These findings, however, are inconclusive.

Carbohydrates. Dietary carbohydrates affect glucose homeostasis and insulin sensitivity, and by these mechanisms can affect reproduction. The impact is most pronounced among women with polycystic ovary syndrome (PCOS). In women with PCOS, a reduction in glycemic load improves insulin sensitivity as well as ovulatory function. Whole grains have antioxidant effects and also improve insulin sensitivity, thereby positively influencing reproduction.

Omega-3 supplements. Omega-3 polyunsaturated fatty acids lower the risk for endometriosis. Increased levels of omega-3 polyunsaturated fatty acids are associated with higher clinical pregnancy and live birth rates.

Protein and dairy. Some reports suggest that dairy protein intake lowers ovarian reserve. Other reports suggest improved ART outcomes with increased dairy intake. Meat, fish, and dairy products, however, can also serve as vehicles for environmental contamination that may adversely affect the embryo. Fish, on the other hand, has been shown to exert positive effects on fertility.

Dietary approach. In general, a Mediterranean diet is favored (high intake of fruits, vegetables, fish, chicken, and olive oil) among women diagnosed with infertility.

Viewpoint

A well-balanced diet, rich in vegetables and fruits, is preferred for infertile women and should provide the required micro- and macronutrients. It remains common for patients consume a wide variety of vitamin, mineral, and micronutrient supplements daily.[4] Supplements should not replace food sources of vitamins and trace elements because of differences in bioavailability (natural versus synthetic), and inaccuracy of label declarations may result in suboptimal intake of important nutrients.[5,6] Furthermore, naturally occurring vitamins and micronutrients are more efficiently absorbed.

With respect to overall diet, women are advised to follow a caloric intake that won’t contribute to being overweight or obese. Obesity is on the rise among younger people, including children. Obese women have a lower chance of conceiving and are less likely to have an uncomplicated pregnancy.[7] Proper weight can be maintained with an appropriate diet and regular exercise.

Finally, women must abstain from substances that are potentially harmful to pregnancy (eg, smoking, alcohol, recreational drugs, high caffeine intake).

Unfortunately, very few large studies are available to guide us in our recommendations to patients. Most of the available literature is based on retrospective data. Therefore, prospective, randomized studies are urgently needed to study the association between nutrition and fertility, as well as dietary influences on pregnancy outcomes.

Dear women, pay attention to oral hygiene if you’re trying to conceive

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The finding is independent of other risk factors contributing to conception, such as age, current smoking, and socioeconomic status.

Health
Researchers advise fertile women to take care of their oral health.

If you’re trying to conceive, it might be a good idea to pay attention to your oral care routine. A common bacterium associated with gum disease may delay conception in young women, warns a new study. “Our results encourage young women of fertile age to take care of their oral health and attend periodontal evaluations regularly,” said one of the researchers Susanna Paju of the University of Helsinki in Finland.

Periodontal (gum) disease is an inflammatory reaction to a bacterial infection below the gum line. The study involved 256 healthy non-pregnant women (mean age 29.2 years, range 19 to 42) who had discontinued contraception in order to become pregnant. They were enrolled from the general community from Southern Finland.

Participants were followed-up to establish whether they did or did not become pregnant during the observation period of 12 months. Porphyromonas gingivalis, a bacterium associated with periodontal diseases, was significantly more frequently detected in the saliva among women who did not become pregnant during the one-year follow-up period than among those who did, according to the study published in the Journal of Oral Microbiology.

The levels of salivary and serum antibodies against this pathogen were also significantly higher in women who did not become pregnant. Statistical analysis showed that the finding was independent of other risk factors contributing to conception, such as age, current smoking, socioeconomic status, bacterial vaginosis, previous deliveries, or clinical periodontal disease.

Women who had P. gingivalis in the saliva and higher saliva or serum antibody concentrations against this bacterium had a three-fold hazard for not becoming pregnant compared to their counterparts. Increased hazard was nearly four-fold if more than one of these qualities and clinical signs of periodontitis were present.

“Our study does not answer the question on possible reasons for infertility but it shows that periodontal bacteria may have a systemic effect even in lower amounts, and even before clear clinical signs of gum disease can be seen,” Paju said, adding, “More studies are needed to explain the mechanisms behind this association. Young women are encouraged to take care of their oral health and maintain good oral hygiene when they are planning pregnancy.”