When you are trying to conceive, it is important to take the right steps to prepare your body for pregnancy. As part of an ongoing blog series about fertility nutrition, we recently interviewed Dr. Melissa Esposito of SGF’s Harrisburg, PA and Frederick, MD offices to discuss diet and lifestyle strategies to help improve fertility and prepare your body for pregnancy.
1) Eat a fertility-focused diet
According to Dr. Esposito, “There is no one food that women trying to conceive should avoid.” She advises her patients to, “Eat as many fruits and vegetables as you can. Shop the periphery of the store, and limit processed foods, which have a lot of salt and sugar.”
A large study conducted by Harvard researchers showed that women who adhered to five or more of the following diet and lifestyle factors were at a 69% lower risk of ovulatory disorder infertility.1
- Increase the amount of “good” fats in your diet. Eat more avocados, nuts and seeds, and use olive oil and canola oil for cooking and salad dressings.
- Limit foods with trans fats, such as vegetable shortenings, margarines, baked goods, pie crusts, frostings, and fried foods. Check the Nutrition Facts Panel for trans fats, and avoid packaged foods with “hydrogenated” oils.
- Eat more plant protein. Replace a serving of meat each day with vegetarian sources of protein (beans, lentils, legumes, quinoa, nuts, seeds, or nut butter).
- Choose low glycemic carbohydrates (dried beans, legumes, fresh fruits, non-starchy vegetables, 100% whole-grain breads, oatmeal, quinoa) for a slower rise in blood sugar levels.
A good rule of thumb is to limit processed carbohydrates such as white rice, bread, and pasta, and most crackers, chips, cookies, and other packaged foods. This is beneficial for any woman trying to conceive, and especially important if you have PCOS (polycystic ovary syndrome).
Watch: SGF’s New On-Demand Webinar, PCOS
- Eat more vegetarian sources of iron, such as spinach, beans, legumes, prunes, and cashews.
- Choose full-fat dairy, such as whole milk, full-fat yogurt, or cheese. Women who ate full-fat dairy at least once a day had better fertility compared with those who rarely ate full-fat dairy.
According to Dr. Esposito, cooking with healthy ingredients can help you adhere to a fertility-focused diet. “When you eat out, you really don’t know what is in the meal. A lot of things we think are healthy are not. We are all busy, but taking the time to cook will be better for you and will save money in the long run.”
2) Aim for a healthy body weight
Being overweight or underweight can disturb hormone production, interrupt normal menstrual cycles, and impair ovulation and fertility.
Research indicates that obesity has a negative impact on fertility.2 A recent Fertility and Sterility study found that miscarriage rates increased, and pregnancy and live birth rates decreased with increasing body mass index (BMI).3 According to Dr. Esposito, “Being successful will be a lot easier if you attain a normal BMI. Studies have shown clearly that even a 5 to 10 percent reduction in body weight can change hormonal and metabolic parameters enough to make a significant impact on your fertility.”
“Women who are obese need higher doses of medications during treatment, which puts them at a higher risk of side effects and multiple births,” says Dr. Esposito. She advises her patients to “try to clean up your diet, do some exercise each day, drink lots of water, and aim to lose 5 to 10 percent of your body weight.”
Losing weight has been shown to improve fertility4 and may reduce the risk of pregnancy complications such as preterm birth, gestational diabetes, preeclampsia, and certain birth defects.
3) Get active
Moderate physical activity is best while trying to conceive. If you are obese, studies show that regular physical activity improves your chances of conceiving.5 “I recommend getting back into exercise slowly. Starting a strenuous exercise routine as you are embarking on fertility treatment is not a good idea,” says Dr. Esposito.
If you are underweight or normal weight, too much vigorous activity can actually increase the time it takes you to conceive.6 Dr. Esposito adds, “If a patient is running enough to result in irregular menstrual cycles, I advise her to decrease the amount of time she is exercising, or switch to a lower impact activity.”
According to Dr. Esposito, “Moderate, low-impact exercise, especially during stimulation, is okay. You should be able to talk through your work out, so that too much blood and oxygen is not being diverted away from the uterus.”
“Since exercise is a stress reliever for many women, telling them to stop is counterproductive. My philosophy is to allow patients to continue their normal activity, but nothing to the extreme,” continues Dr. Esposito.
The goal is to find the right balance to optimize your reproductive function. In general, 30 to 60 minutes of moderate exercise is recommended on most days of the week.
To watch our On-Demand Webinar on Weight and Fertility, click here. During this free, on-demand event, viewers will learn about the impact weight, either over or under, has on the ability to conceive and tips for maintaining and achieving a healthy body mass index (BMI).
4) Take a high-quality preconception prenatal vitamin
Start taking a good preconception prenatal vitamin as soon as you start trying to conceive. A preconception vitamin should provide a complete range of nutrients including folate, choline, iodine, iron, and vitamin D.
“I used to tell my patients to take any prenatal, but now I recommend TheraNatal Core because it has methylated (activated) folate, and the higher dose of vitamin D3 that we recommend. I also like that it is NSF certified to assure quality and purity, and reasonably priced,” says Dr. Esposito.
5) Consider other preconception supplements
Depending on your age and health history, adding certain nutrients may improve egg quality and help you conceive.
Coenzyme Q10 (CoQ10)
CoQ10 plays a crucial role in energy production in the body’s cells, including egg cells.
As you age, your cells make less CoQ10 and are less efficient at producing energy. This can lead to poorer fertilization and early miscarriage.
A decrease in egg quality is the most important factor affecting fertility with increasing age. Research indicates that CoQ10 improves egg quality and potentially increases fertility in women of advanced maternal age.7
“For all my patients 35 and over, or for younger patients with signs of decreased ovarian reserve, I recommend TheraNatal OvaVite because it has coenzyme Q10 along with the preconception vitamin,” says Dr. Esposito.
Vitamin D3
Vitamin D is made in our skin in response to sun exposure. However, most of us are not in the sun enough to maintain an adequate vitamin D level. Our diets generally don’t provide enough vitamin D either.
Getting enough vitamin D is important before and during pregnancy. Several studies have linked “normal” vitamin D levels (30 ng/mL or higher) with higher pregnancy rates.8
It is important to have your vitamin D level checked when you start trying to conceive. Low vitamin D levels have also been linked to preterm birth9 and other pregnancy complications.
Inositol
Inositol is a B-vitamin-like nutrient that seems to have two functions for fertility. It is particularly important for women with PCOS (polycystic ovary syndrome). Studies show that inositol decreases insulin levels and insulin resistance, decreases androgen levels, and promotes regular menstrual cycles, ovulation, and fertility.10 “I like to recommend inositol to all my patients with PCOS,” says Dr. Esposito.
For women going through IVF, studies indicate that inositol may improve egg quality and the response to ovarian-stimulating drugs.11
The two forms of inositol that have shown benefit are myo-inositol and D-chiro-inositol. Recent studies have shown that taking a combination of these forms, in the body’s naturally occurring ratio of 40 to 1, is more helpful than taking either form alone.12
In summary, eat a fertility-focused diet, exercise moderately, take the right supplements, and make other lifestyle changes to prepare your body for pregnancy. Try to incorporate these diet and lifestyle habits into your daily routine.
Remember, diet and lifestyle strategies can be an important complement to your fertility treatment but they do not replace fertility evaluation and care. At Shady Grove Fertility’s Wellness Center, we provide individual nutritional consultations with a licensed nutritionist. The nutritional program at Shady Grove Fertility is focused solely on enhancing your fertility by making changes to your diet to maximize nutrient intake, improve mood and energy levels, and keep you feeling healthy.
You should have your fertility evaluated if you are under 35 years old and have been having unprotected intercourse for 1year without conception, or between 35 and 39 years old and have been having unprotected intercourse without conception for 6 months. If you are 40 years old or older, your male partner has a known fertility issue, or you have PCOS or other known fertility issue, you should have your fertility evaluated as soon as you start trying to conceive.
References:
- Chavarro et al. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol. 2007; 110(5):1050-8.
- Broughton and Moley. Obesity and female infertility: potential mediators of obesity’s impact. Fertil Steril. 2017; 107(4):840-7.
- Provost et al. Pregnancy outcomes decline with increasing body mass index: analysis of 239,127 fresh autologous in vitro fertilization cycles from the 2008-2010 Society for Assisted Reproductive Technology registry. Fertil Steril. 2016; 105(3):663-9.
- Sim et al. Weight loss improves reproductive outcomes in obese women undergoing fertility treatment: a randomized controlled trial. Clin Obes. 4(2):61-8.
- Palomba et al. Physical activity before IVF and ICSI cycles in infertile obese women: an observational cohort study. Reprod Biomed Online. 2014; 29(1):72-9.
- Wise et al. A prospective cohort study of physical activity and time-to-pregnancy. Fertil Steril. 2012; 97(5): 1136–1142.e4.
- Ben-Meir et al. Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging. Aging Cell. 2015; 14(5):887–95.
- Paffoni et al. Vitamin D deficiency and infertility: insights from in vitro fertilization cycles. J Clin Endocrinol Metab. 2014; 99(11):E2372-6.
- Zhou et al. Vitamin D and risk of preterm birth: Up-to-date meta-analysis of randomized controlled trials and observational studies. J Obstet Gynaecol Res. 2017; 43(2):247-256.
- Unfer et al. Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials. Int J Endocrinol. 2016; 1849162.
- Caprio et al. Myo-inositol therapy for poor-responders during IVF: a prospective controlled observational trial. J Ovarian Res. 2015; 8(37).
- Dinicola et al. The rationale of the myo-inositol and D-chiro-inositol combined treatment for polycystic ovary syndrome. J Clin Pharmacol. 2014; 54(10):1079-92.
Medical contribution by: Melissa Esposito, M.D., of Shady Grove Fertility’s Harrisburg, PA and Frederick, MD offices
To learn more about preparing your body for pregnancy or to schedule an appointment, please call our New Patient Center at 1-877-971-7755 or click here to complete this brief online form.
At Shady Grove Fertility, we’re here to give you the caring support you deserve as you start or grow your family. As a leading fertility and IVF center of excellence, we offer patients individualized care, innovative financial options, over 30 accepted insurance plans, and pregnancy rates among the highest of all national centers. We offer patients the convenience of 19 full-service and 6 satellite locations across Maryland, Pennsylvania, Virginia, and Washington, D.C. More than 1,700 physicians choose Shady Grove Fertility to refer their patients, and more than 96 percent of our patients say they would recommend Shady Grove Fertility’s 35+ physicians to a friend. With 10 Shady Grove Fertility babies born each day, your dream of starting or growing your family are within reach.
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