Expert's Perspective

A Healthy Fertility Diet

“Let food be thy medicine and medicine be thy food.” - Hippocrates 431 B.C.

One of the main questions my patients have when they come to my office is: what is the best diet to optimize my chances of conception? I find that diet is one of the easiest ways you can actively participate in impacting your fertility outcome.

In this article, I want to help clear up some of the confusion regarding the ideal diet for fertility, highlight the value of the Mediterranean diet, address the issues with eating inflammatory foods, and provide a list of foods that will likely improve your reproductive health. At the same time, it’s important to remember that many different factors can affect one’s fertility and addressing one’s diet should not be considered a panacea.

NUTRITION


It’s natural to feel overwhelmed with conflicting advice when trying to figure out how to eat to increase your chances of conception. Fertility doctors don’t always underscore the importance of a proper diet, let alone touch on what foods to avoid or eat more of. This leaves a lot of room for questions on what is nutritionally essential or if changing one's diet is even necessary to aid fertility in the first place.

Let’s state right off the bat that one’s diet matters and there is a lot of data to prove it. When a major Dutch hospital ran a 1,200-patient study looking specifically at the issue they concluded, “the quality of the preconception diet of patient-couples undergoing a first IVF/ICSI treatment associates with the chance of ongoing pregnancy after IVF/ICSI treatment.”

So what is a quality “preconception diet”? My own approach with patients is to recommend an anti-inflammatory, nutrient-rich diet that consists of whole foods, such as a Mediterranean diet. The Mediterranean diet consists of a high intake of vegetable oils (olive, coconut), vegetables, fish, and legumes, with a low intake of snacks (sugar, salt). In 2010, Fertility and Sterility published a study on the benefits of the Mediterranean diet for pregnancy, which concluded that consuming a Mediterranean diet was associated with higher rates of clinical pregnancy, despite the fact those eating a Mediterranean diet were older (and thus were a more challenging population) than other patients in the study.

Conversely, the same study found that “a nutritionally unbalanced diet characterized by low intakes of minerals and vitamins has been associated with adverse fertility outcomes.” Specifically, low intakes of B-vitamins, folate, vitamin B6 and vitamin B12 can negatively affect one’s fertility. When you eat a whole-foods diet, you consume the vitamins essential pregnancy.

While our focus for the moment may be getting (and staying) pregnant I try to instill in my patients the importance of eating a whole-foods diet for the rest of their lives. Having a child is most enriching when you have balance, strength and vitality for many decades to come. That starts with what we choose to eat. The agonizingly long period of time it can take to conceive gives us a window to reexamine our dietary choices and make the type of healthy changes that are likely to endure.

FOODS TO AVOID


As a first step, I suggest removing inflammatory foods from a patient’s diet. One of the factors that can contribute to infertility is inflammation, abetted by poor food choices. Inflammation is also believed to be a contributing factor in several infertility causing issues, including PCOS and endometriosis. It's widely agreed that women who suffer from fertility conditions, particularly PCOS, would benefit from a diet that is low in sugar and refined carbohydrates. Refined carbohydrates include white rice, white bread, and added sugar.

Other inflammatory items we commonly consume are caffeine and alcohol. Studies have shown “high caffeine consumption is associated with disorders such as increased anxiety, sleep disorder, hypertension, cardiovascular disease, stroke, fibrocystic breast changes and infertility or pregnancy loss.” In addition, another study cited that even while trying to get pregnant, alcohol consumption by “couples who share a bottle of wine a week reduce their chances of having a baby through IVF by more than a quarter.”

Once my patients eliminate inflammatory foods from their diet, they are able to see where their bodily deficiencies lie, whether it be fatigue from the lack of caffeine, or headaches from reducing their intake of processed foods.

What To Avoid

  • Sugar
  • Gluten
  • Dairy
  • Soy
  • Caffeine
  • Alcohol

Foods To Include


According to the Harvard Fertility Diet, eating more complex carbohydrates can help improve your fertility. The authors determined that the type of carbohydrates one ate had more of an impact on ovulatory function than the quantities consumed. What helped? Fresh fruit, vegetables, whole grains and legumes. What hurt? Juice, sweetened yogurts, and cookies. According to the Harvard professors, women who took steps to cut out “bad fats” (e.g. red meat) and refined carbohydrates reduced their risk of ovulatory infertility by upwards of 80%.

Consumption of folate is another important element to be aware of. A 2013 study on Spanish women and their intake of folic acid noted, “adequate folic acid intake has been related to female fertility.” The study found that these women’s “[f]olate intake was higher with greater adherence to the Mediterranean Diet.” Eating a complete whole-foods diet ensures you are getting the appropriate amounts of vitamins and minerals to support reproduction. I recommend the following foods to my patients, as they bolster the Mediterranean diet and have sufficient levels of folic acid (and other essential nutrients) to plausibly “move the needle” in one’s pursuit of conception. After three weeks of changing their diet, many of my patients see and feel an extraordinary difference in their physical and mental health.

What To Include

  • Organic proteins, vegetables, and fruit
  • Dark leafy greens: kale, collard greens, broccoli
  • Whole grains: brown rice, quinoa, barley, buckwheat, millet, organic steel-cut oatmeal
  • In terms of cooking oils: extra virgin olive oil and coconut oil
  • Healthy fats: nuts, avocados, legumes
  • Superfoods: wheatgrass, chia seeds, maca, acai, goji berries, spirulina

A nutrient rich, whole-foods diet can change your life. I have seen it happen many times. However, it’s important to make changes at your own pace. Observe how you feel when you eat certain things for a few weeks, and how you feel when you take certain items out of your diet (allow for about three weeks to see an impact). You are what you eat, so by fueling your body with the best food possible, you’re not only improving your health, but creating the best possible conditions for conception.