When my husband and I made the decision that we wanted a family, the following are things we adjusted to our lifestyle with the goal of improving our health in order to increase chances of conception, improve the health of the pregnancy, and the long term health of our future child.

47% of pregnant or breastfeeding women in the US are deficient in at least 1 micronutrient.

We first started thinking about the timeline. I wanted us to have a 3 month timeframe to really focus on these changes because that’s the amount of time it takes to have a significant impact on the health of the egg and sperm.

Just because I wanted that specific 3 month timeframe, doesn’t mean we waited until then to start making changes. Obviously given what I do, I am well aware of the lifestyle factors that will improve fertility and have been very health conscious for 12+ years. Slowly, over those years, we have made changes to improve our health so the additional things we wanted to implement closer to conception weren’t overwhelming or a major change. It was simply easier to have a 3 month window where we knew we should try to be a little more strict although within reason as to not increase stress or negatively impact our enjoyment of life. 

Around that 3 month mark or maybe slightly before, we started doing some testing. We both did a DUTCH hormone test and that gave us some specific direction on where our focus should be to make those levels as optimal as we could. For example, my progesterone was good but not optimal so I knew that would be an area I wanted to focus on and improve. That wasn’t a surprise given previous test results. Progesterone is important for conception itself; if you’re not producing enough progesterone after ovulation, fertilization and implantation are less likely to occur. It is also important in the first couple of weeks and months of pregnancy. Low progesterone is associated with increased risk of miscarriage. Additionally, I found out my methylation was low so I knew I needed to focus on nutrients which supported that process. 

Lab Testing for Fertility

Next, we both did blood work.

The major changes that come from the blood work was an increased dose of vitamin D supplementation for my husband as well as a continued focus on thyroid health for myself. My thyroid levels were okay but again, not optimal so I knew that was something I’d have to keep an eye on because low thyroid hormone is associated with both infertility and miscarriage. Once I got pregnant, I had a plan to retest thyroid every 4 weeks in early pregnancy to determine if any additional action would need to be taken. The thyroid gland changes a lot during pregnancy and is under increased stress during the first trimester.

Lastly, for testing, my husband did a semen analysis and we were able to determine a couple of changes that could be made to optimize levels given the results.

I’m a proponent of doing testing proactively because we knew we were going to take that time period to prepare anyway so why wait until there’s an issue? It would just push our end goal of a child further down the timeline. Especially if we can reduce chances of miscarriage before that happens and positively impact the health of our future child, why wait?

Nutrition Changes Preconception

Among the changes we implemented given our test results, we both started taking a specific multivitamin. My husband started taking a men’s fertility multivitamin daily and I started taking a prenatal

Other nutritional changes we made were simply an increased focus on cutting out low nutrient foods like chips and poor quality sweets. We didn’t have many of those things to begin with but when we did want those things, we would opt for a simple organic tortilla chip, vegetable oil-free crackers, a simple organic chocolate bar, or a homemade treat. 

I personally was really focused on avoiding folic acid and that’s something my husband started looking out for as well. I don’t know if I have a MTHFR genetic snip which impacts my ability to convert folic acid, the synthetic version of folate, into the active version but I think it’s safe to assume that you are part of that 40-50% of the population. There is no downside to simply focusing on getting enough folate through real food instead of fortified grain products. Whereas there is enough data to indicate that folic acid can be detrimental to the health of a growing baby especially if you do have a genetic snip affecting the MTHFR gene. Plus, most food (refined grain products) that has folic acid in it isn’t nutrient dense anyways. In practice, this meant avoiding foods with fortified and enriched grains such as most store bought breads and products containing enriched flour. This wasn’t too challenging because I was already making all of our bread products from organic unrefined flour mostly using the sourdough long fermentation method. 

We were already eating mostly organic but started focusing on that even more to reduce pesticide exposure. We also made an effort to have most of our cheese organic or/or grass fed. Our milk and yogurt already was. I tried to include more probiotic foods. I had fermented foods usually at least once a week but tried to increase it to 3 or more times per week. My go-to options were yogurt, kombucha, and sauerkraut. 

I had the goal to eat 3 ounces of liver or oysters weekly but I was not very successful with that frequency. I just tried to get those things in as often as I could. I also tried to eat fish at least twice a week and was more successful with that. Previously, closer to once a week was my average. 

We tried our best to continue to focus on eating mostly at home. We rarely go out to eat but would occasionally pick up a pizza. That practice stopped but we still enjoyed a couple of meals out while on vacation. I did my best to eat well while going to our family’s houses for meals but didn’t stress about it because that was only a once-in-a-while kind of thing. 

My husband and I both focused on increasing our sodium intake. I know that seems backward from what you usually hear but because most of our meals are made at home from whole foods, our sodium intake is actually fairly low even though I season our food well. Only 3% of the average American’s sodium intake comes from the salt shaker- the rest comes from restaurants and processed, packaged food. When you have a mostly “real food” diet, then sodium intake tends to be lower. We also both workout very regularly which increases sodium requirements. It’s something we both struggle with and I tend to have low blood pressure so that combined with my lower-than-ideal progesterone told me I needed more salt. Sodium intake that’s too low can cause progesterone to be low! So we both started drinking an LMNT daily. I would often combine mine with 1 cup of coconut water and maybe some lemon juice then dilute it with water. This would often be my workout drink.

Physical Activity Preconception

Because we both have worked out consistently for a really long time, we didn’t have to adjust anything there. We both focused on a balance of strength training and cardiovascular exercise without stressing our bodies too much.

Alcohol & Caffeine Preconception

We tried to limit alcohol although we only had maybe 2 drinks a month prior and we didn’t cut it out entirely. We also limited caffeine. I only had tea and was almost always below 100 mg per day and because my husband tends to have an all-or-nothing personality, he ended up cutting it out almost entirely. 

Environmental Toxins Preconception

We dialed in the environmental toxins and endocrine disruptors as much as possible as well. Again, this is something we’ve been focused on for 12+ years but there were still a couple of loose ends. The biggest one was that my husband was still using plastic shaker bottles for protein shakes so we switched to glass. We also got an air filter for the bedroom and a water filter for the shower along with the filter we already had for our drinking water. We were using the ice made from the freezer that didn’t have a filter so we started making ice from the filtered water instead. 

My husband also took extra care to keep his testicles cool. He switched to some looser underwear and made an effort to keep his phone out of his pocket as much as possible. Sperm motility (how they swim) can be negatively affected by the electromagnetic radiation emitted by wifi enabled laptops and cell phones.

Stress Management Preconception

We both focused on stress management as well. That’s a huge part of progesterone production. We were preparing over the summer so it was a little easier to do but every morning that I didn’t have to work early, I would go out to the porch first thing and get some sunlight while I read. That practice really helped me have a relaxing, slow start to the day and get my cortisol pattern turned in for the rest of the day. I also just tried to get outside as much as I could because that’s always been an easy way to make me feel less stressed.

Your priority as a new mom? Replenish nutrient stores, bond with baby, and set yourself up for breastfeeding success.

Seemingly unrelated to stress, I also started making sure to eat breakfast earlier. I was always bad about waiting a few hours before I ate breakfast but for both progesterone production and thyroid health, the concept of “safety” is really important. One way we can signal to the hypothalamus, your brain’s hormone compound center, that the environment is safe is to eat breakfast (especially a protein rich breakfast) within the first hour of waking. The hypothalamus is constantly assessing the environment for safety. One of the things that is assesses is food intake. Eating breakfast tells your brain that you’ll be fed today and that you have the resources around to complete the taxing processes critical for fertility. Because fertility isn’t necessary for survival, if you under-eat or go too long between meals, then your body will smartly save resources for processes that are important for survival which means things like fertility can suffer. I have to say, I feel so much better eating breakfast earlier. My food cravings have decreased and my desire to snack has decreased. 

Sleep

Sleep was a big focus for my husband. Luckily, I have always been a pretty good sleeper and love my sleep so it’s never been a challenge for me to get to bed at a reasonable time. For my husband, it takes a little more work to get quality sleep throughout the night so he focused on increasing his sleep time and having a more consistent bedtime and wake up time. 

Fertility Awareness

Another aspect of the preconception prep for us was fertility awareness. At least a year before we started trying to conceive, I started keeping track of my cycles a bit more closely. Luckily I have always had fairly regular, non symptomatic cycles. However, in addition to the days of bleeding, I also started tracking cervical mucus and basal body temperature as a way to both predict and confirm ovulation. This information would give me an indication of my overall hormone health and give insight into any adjustments that may need to be made to my lifestyle. It would also help us understand how to time intercourse. There’s only about a 5-6 day window each cycle where a woman can get pregnant. Technically, that window is only about 24 hours but sperm can live inside of a woman that is producing adequate cervical mucus for 4-5 days leading to a total of a 5-6 day fertile window. 

Research

Lastly, I did a TON of reading. Now of course I’m in a different position than many because this is what I do for a living so I went into it with a deep level of understanding but I also am completely aware that I don’t know everything. And because it’s helpful for me professionally anyway, I started reading as many fertility and preconception books as I could. Once I got a little bored of those because I had read many of them already, I started reading more pregnancy books.

Our Preconception Journey

We were so lucky to get pregnant the first month we tried. I almost feel guilty for that because I work with some many women that are doing all the right things and still struggle but that’s our experience. We will never be able to know why we were that lucky or how much that preparation really helped but all we can do is thank God.

When it comes to preparing for conception, it’s really all about stacking the deck in your favor as much as possible but so much is still outside of our control. So focus on what you can control and don’t let the other things cause unnecessary stress. Don’t let others’ stories be a source of frustration either. Comparison never ends well. You either end up feeling worse about yourself because you’re comparing only one small part of someone else’s life to the entire picture of your own life or you feel better about yourself at someone else’s expense. Even if you do something the exact same as someone else, you will have a different outcome because we are individuals. 

Resources to help you on your own fertility journey