First, let me say, you CAN improve your fertility naturally through nutrition and other lifestyle choices. Even if you’re not having fertility troubles and simply want to prepare your body for pregnancy, this is a great place to start.
It’s ideal to start preparing at least 3-4 months before trying to conceive (TTC) because that’s how long it takes an egg to mature before it is ovulated. Many get confused because you may have heard that females are born with all of the eggs they will ever have. While that is true, it doesn’t mean that you can’t make an impact on the health of that egg and thus the chances of a healthy pregnancy. Eggs still have to go through a maturity process before being ovulated.
You have the ability to intervene in that time period to improve egg quality which increases your chances of a successful, healthy pregnancy. Interestingly, a similar time frame is important for males to improve sperm quality. The process of sperm formation (spermatogenesis) takes about 3 months. All of these lifestyle factors will help both egg and sperm quality so it’s important to focus on both.
The Menstrual Cycle
Make sure you understand your menstrual cycle and don’t rely on ovulating on day 14. On average women ovulate on day 14 but that means many women ovulate on other days! Start by tracking your cycles using pen and paper or something like the free app, Kindara. Don’t simply track the days you bleed, track everything you can about your entire monthly cycle. Consider taking your basal body temperatures each morning as a way to confirm ovulation. You can learn more about this by searching “fertility awareness method” or reading the book The Fifth Vital Sign.
You are fertile about 5 days of the month; the day you ovulate and about 4 days leading up to ovulation when you have prime cervical mucus. If you’re not having sex during those fertile days, no diet or lifestyle change is going to help you get pregnant!
The Fertility Diet
These are things that both partners should consider. Start with the following high impact changes.
- Reduce sugar and refined carbohydrate intake and replace it with protein sources, vegetables, and whole grains. Higher blood sugar and insulin reduces egg quality. To balance blood sugar and help insulin maintain a healthy level, include a protein source at each meal. Good protein sources include meat (ideally from pasture raised animals) such as beef, fish and shellfish, pork, poultry, lamb, or game. In addition to eggs (ideally from pasture raised chickens), greek yogurt, and cottage cheese.
- High fiber carbohydrates include whole grains (barley, buckwheat, couscous, kasha, millet, oats, quinoa, wheat germ, and wild rice), beans and lentils, winter squash, and root vegetables (potatoes, rutabagas, turnips, carrots, parsnips, and sweet potatoes). Eat a variety of vegetables including fresh or frozen, raw, steamed, or roasted. Try to get at least 1 cup of leafy greens per day as part of your 2 cup daily minimum of vegetables.
- Don’t skip meals or allow yourself to get too hungry as a drop in blood sugar can lead to excessive hunger and an appetite that is hard to satisfy. Rather than having 1-2 big meals a day, having 3-4 moderate sized meals spread throughout the day can help keep your blood sugar balanced.
- Balance snacks with protein and fat to help reduce blood sugar highs and lows. Reach for things like string cheese, nuts and seeds, apple and peanut butter, beef jerky, or yogurt for snacks. Minimize low nutrient snack food like chips and crackers.
- Increase antioxidant intake to help protect the maturing egg and sperm from oxidative damage. Eat lots of colorful fruits and vegetables. Some sources that give you the most bang for your buck include berries, leafy greens, and cruciferous vegetables like broccoli, kale, cauliflower, and cabbage.
- Eat fish at least twice per week to ensure adequate omega 3 intake. The most important omega 3 fatty acids that many people aren’t getting enough of are DHA and EPA which are found in animal products like fish as well as eggs from chickens raised on pasture. You cannot rely on the plant omega 3 sources such as flax seed for DHA and EPA because of poor conversion rates from the plant omega 3, ALA. Focus on fish that is high in omega 3 fatty acids but low in mercury. Some of the best sources are wild caught salmon, anchovies, sardines, and fish roe. Use a high quality fish oil supplement like Nordic Naturals containing about 1,000 mg/day if you do not eat fish regularly. Keep your fish oil in the fridge to reduce the likelihood of oxidation.
- Switch your focus to cooking meals at home using mostly whole ingredients. Think about having a protein source, a high fiber carbohydrate, and a vegetable at each meal. Minimize restaurant meals.
- Especially for women, make sure you’re eating enough! A low nutrient and/or energy (calorie) intake can lead to a reduction in thyroid function which greatly impacts fertility. While I’m not a proponent of tracking calories or macronutrients long term, this can be a time where short term tracking may be helpful. Track current intake for 1 week to ensure adequate calories. Generally, I wouldn’t recommend women eating below 2,000 calories per day but needs are widely variable from person to person. Reach out if you’d like more individualized recommendations.
- Minimize intake of alcohol and recreational drugs. Eliminating these entirely is ideal.
- Start taking a prenatal supplement. Ideal timing is 3-6 months prior to TTC but any period of time before conceiving will be helpful. Prenatals are not something you should rely on because they cannot meet all of your nutrient needs but it can be a good insurance policy. I suggest FullWell Prenatal. Most prenatal supplements are poorly designed and do not contain proper amounts and/or inadequate forms of many nutrients. Male partners a male specific fertilityproduct such as Fullwell Men’s Multivitamin. Because men’s health matters just as much to female health for fertility, learn more in my Male Fertility Nutrition and Lifestyle Guide.
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Additional Lifestyle Considerations for Fertility
Exercise
Improve blood flow to the ovaries by exercising, acupuncture, and/or abdominal massage. As a personal trainer and dietitian, I’m a huge advocate for the exercise piece. Doing a mix of cardiovascular exercise and strength training several times a week can greatly improve blood flow and help improve your insulin sensitivity and blood sugar control. You shouldn’t be killing yourself in the gym because this can actually make your fertility worse as it can raise your cortisol and negatively impact thyroid hormones if the exercise is too intense, for too long of duration.
This is also important for the male partner because exercise (specifically strength training) can increase testosterone along with improving blood sugar response. Click here if you’d like to learn more about virtual personal training.
Sleep
Sleep 7-9 hours per night. Focus on quality sleep and sleep timing. If you think you’re someone who doesn’t need that much sleep, you’re wrong. You’re simply used to operating on less sleep than you actually need for optimal health.
Make an effort to go to bed and wake up within a certain window each day to normalize your sleep patterns. Keep your room extremely dark and slightly chilly. Avoid electronic use in the bedroom and maintain a consistent pre-bedtime calming routine.
Reduce Stress
Especially if you’ve been TTC for a while, it can get stressful. Heck, life in general is stressful enough! However, stress does impact egg and sperm quality so trying to manage stress is important. Consider what you enjoy that reduces stress. Some ideas might be getting outside in nature, meditation (there are many different forms), gentle movement like walks or easy yoga, reading, sitting quietly with soft music, dancing it out with louder music, or talking with a loved one. It can look like a lot of different things but make sure you’re doing something to relieve your stress daily.
Toxin Exposure
Toxins such as endocrine disruptors can impact your reproductive hormones. To optimize your fertility, those hormones have a balance to maintain and anything that comes in and disrupts that can hurt your fertility. Some examples of endocrine disruptors include BPA, triclosan, parabens, and phthalates. These substances mimic estrogen and can disrupt your hormone metabolism.
Do not fall for the newest sexy advertising of a detox supplement, detox diet, or quick fix to eliminate toxins. These products are simply laxatives and can do more harm than good.
How to reduce exposure to endocrine disruptors
- Store food (especially hot food and liquids) in stainless steel or glass instead of plastic. Even BPA free plastics likely use BPA alternatives such as BPS and BPF which may be just as (if not more) harmful. If you need to use plastic, wait until the food is cooled to store and do not reheat the food in the plastic container. Use wax paper, parchment paper, or beeswax dish covers instead of plastic wrap.
- Reduce canned food. You certainly don’t have to eliminate all canned foods but cans do contain BPA so we want to mitigate exposure as much as possible. The biggest offender is acidic foods because the acid will leach the BPA from the can liners quicker. Tomato products are acidic so avoid these from cans as much as possible and opt for tomato products packaged in glass instead.
- Don’t use hand sanitizer then handle paper receipts. Paper receipts contain BPA and hand sanitizers increase dermal penetration, meaning that it increases skin permeability and lets more BPA get absorbed through the skin.
- Avoid scented products like air fresheners and dryer sheets. Fragrance and perfumes contain phthalates. Avoid products with “fragrance” or “parfum” in the ingredients.
- Avoid skin care products that contain parabens.
- Avoid nonstick pans. Non-stick cookware contains PFAS chemicals that act as endocrine disruptors and are notorious for staying in your system for a very long time because they don’t readily break down. Use stainless steel or cast iron cookware instead.
- Avoid antibacterial soaps containing triclosan.
I know this list can get overwhelming if you haven’t considered these things before so I do NOT want you to go out and try to implement every single one of these things tomorrow. Look through this list and consider which ONE or TWO is the easiest for you to implement this week. Focus on that. After you’ve implemented that first change, move on to the next one that seems most do-able.
Reminder: sometimes fertility problems cannot be resolved via lifestyle so make sure you are working with a knowledgeable health care provider.
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