Few experiences are more heartbreaking than infertility, which sadly is becoming a more widespread problem. Infertility is defined as the inability to become pregnant for one year or more, or if a woman experiences multiple miscarriages. Around one in six Australian couples experiences a delay of greater than 12 months to achieve a planned pregnancy (1).
Stress, hormonal and gut dysfunction, age, and improper diet and exercise are factors implicated in the growing rate of infertility. But whether you’re about to start trying for a baby naturally or you’re undergoing IVF, taking specific steps to boost your health can significantly improve your chances of carrying a healthy baby to full term.
Starting with strategic food and supplementation is key. A balanced fertility diet and healthy lifestyle can do wonders not only for your body, but also for your emotional and mental well-being going into pregnancy. Here are seven simple but crucial ways to boost your fertility naturally with food.
1. Lay the foundations
But laying the foundations with good preconception care is crucial. Taking time to ensure your nutritional stores are plentiful, and to clear your body of chemical residues and environmental toxins, is likely to result in a better pregnancy, birth and postpartum period for mother and baby.
Preconception care involves making sure there is an adequate supply of nutrients essential to your sperm and ova and to the development of a baby, and an absence of those things which are harmful. Sperm take up to 116 days to form, and ova are susceptible to damage during their period of maturation, which is around 100 days before ovulation (2).
Therefore, both you and your partner need to enjoy a period of optimal health for at least four months immediately preceding any attempt to conceive.
Sort out your bad habits
One of the most impactful health behaviours you can implement is quitting drinking or smoking, which deplete nutritional stores. Excessive caffeine is also suspected to cause problems with fertility, so cutting it out completely, or limiting yourself to one or two cups a day is recommended.
It is also ideal to stop using recreational and pharmaceutical drugs in the lead-up to conception. Since it can take several weeks for chemical residues to leave your body, avoiding all drugs for least four months before trying to conceive will improve your odds of conceiving a healthy baby. Please check with your doctor prior to coming off any medication.
If your doctor is willing to work alongside one, a naturopath or Chinese medicine practitioner can be a powerful ally in finding options that allow you switch to a natural alternative to a medication, or to best support your system should you need to stay on medication. If you haven’t already, now is the time to replace chemical-laden cleaning and body care products with safe, eco-friendly, fertility-friendly equivalents.
The fertility diet
Four months of good preconception care gives you time to load your body up with nutrients as part of a solid fertility diet.
When I say fertility diet, I don’t mean juice fasting and raw food diets. While these may be seen as the basis of a ‘healthy’ diet these days, this is not a diet that supports fertility. Traditional systems such as Chinese medicine and Ayurveda stress that, for optimal fertility, a woman needs a robust diet teeming with nutrients, not to deplete her body with fasting and excess raw and cold foods.
There are three parts to the fertility diet: eating the right balance of macronutrients, getting adequate micronutrients, and eating enough.
2. Eat enough
In our fat phobic culture women are often scared to eat more food than they are currently, especially if they have been labelled ‘overweight’ according to the BMI scale. But you can be underfed and malnourished regardless of your weight. For this reason I encourage women to work on boosting their overall health rather than focusing on weight loss.
Some women under eat because they’re busy, others because they’re actively dieting and/or over exercising. Many more women under eat due to the nature of any number of innately restrictive ‘lifestyle’ diets they may be on. Most of these diets don’t provide enough overall energy or nutrients for healthy reproductive function. Irregular, scanty or absent menstrual periods could be a sign of this.
Some women under eat because they are experiencing more severe forms of disordered eating, or even a clinical eating disorder. I strongly recommend that you seek additional support from an eating disorder dietitian (like me!) if you have an eating disorder history.
If your body thinks there isn’t enough food to keep you healthy and fed, then it’s probably not going to put precious resources into building and birthing a baby! So it’s important to eat regular, well-balanced, adequate and satisfying meals and snacks to keep your blood sugar levels in check and your hormones balanced.
3. Eat all three macros
Every woman needs three essential macronutrients: carbohydrate, fat and protein. They’ve all fallen victim to fad diets. But all are critical for optimal fertility. Diets that restrict or eliminate any one of these will not best support your fertility goals.
Nowadays we’re subject to an overt societal ‘carbophobia’. It is common for women trying to lose weight – or even just to look good – to eat very few carbohydrates, fast, restrict overall food intake, and exercise frequently. The more of these restrictions a woman undertakes at the same time, the more her body interprets this as living in a stressed, starved state.
In this state fertility and libido decrease. Additionally, thyroid function can suffer, leading to reproductive irregularities and weight gain. The liver is taxed from performing so much gluconeogenesis, insulin sensitivity drops, body fat levels fluctuate, sleep quality decreases and moods can swing wildly (3).
Of course every woman is unique – some women feel they do well on a lower carb diet – but for those who struggle with menstruation, fertility, stress, fatigue, or exercise performance, carbohydrates reassure her body that she is fed. This is crucial for healthy fertility.
While excessive amounts of highly refined carbohydrates can disrupt blood sugar and insulin levels, a balanced intake of nutrient-dense complex carbohydrates has the opposite effect. Please don’t eschew perfectly nutritious foods out of some fear that they contain excess sugar, and deplete yourself in the process.
I recommend you eat adequate amounts of nutrient-dense complex carbohydrates. You need not eat a high carbohydrate diet (unless you want to), but for optimal fertility I recommend avoiding very low carb diets. Include starchy tubers (e.g., sweet potatoes, potatoes, cassava), ancient and whole grains (e.g., quinoa, buckwheat, brown rice) and fruit.
Fat is critical for reproductive health. We need fat to make hormones, build our tissues, enhance metabolism, direct nutrients into the nervous system and keep ourselves warm.
All natural fats have a role to play in our health, and what matters most is proper balance. A ratio of 2:1 omega-6 to omega-3 fats is a great goal. We can get closer to this by increasing our intake of dark green leafy veggies, walnuts, flaxseed, sustainably caught oily fish and whole eggs. A high quality fish oil supplement (or algal DHA supplement if you’re vegan) can make it easier for you to reach this target.
Hundreds of studies have shown the health benefits of increasing your intake of omega-3 fats while also minimising trans-fats and highly refined carbohydrates. When sugar and insulin levels are normalised by eating regular balanced meals, and your diet has the right balance of omega-3 and omega-6 fats and micronutrients from whole foods, then there’s no need to worry about the impact of dietary fat intake on overall health.
Interestingly, studies have shown that full-fat dairy is very supportive for fertility as opposed to low-fat dairy foods. In fact, low-fat dairy foods may increase the risk of anovulatory infertility (4). While not everyone can tolerate dairy, if you can do so, then swap your low fat dairy foods for full fat. The great thing about yoghurt, labneh, kefir and other cultured dairy foods is that you also get probiotic gut health benefits!
Good quality protein is crucial in the lead-up to conception. Research shows a strong link between low birth weight, infant mortality and congenital defects, and low protein intake2. It’s too late to increase your protein intake during pregnancy; you need it before conception, since adequate protein is vital for egg and sperm quality, fertilisation, and the early development of the embryo (2).
You need an average-sized serving of protein-providing foods at least twice a day. Both excessively high protein diets and protein deficient diets will create problems – so you need to get enough without going overboard on daily bacon and egg breakfasts, or highly protein-deficient diets such as extreme raw veganism or fasting. Meat, fish, seafood, eggs, full fat dairy, nuts, and legumes are all good sources of protein. Go for the best quality you can afford.
4. Address micronutrient deficiencies
In the few months you put aside for preconception care it pays to be a little more mindful about what you eat, as long as it doesn’t put significant additional stress on you. Instead of placing certain foods completely ‘off limits’ – which usually backfires – focus on eating more nutrient-dense foods, and a wider variety of foods. Aspiring to increase food quality and variety tends to crowd out less nutritious foods without making you feel deprived and frustrated.
A naturopath or holistic nutritionist can order a specific blood test for you that will give you insight into a wider variety of micronutrients than the average run of the mill blood test ordered by your GP. This makes it easier to detect certain nutrient deficiencies or imbalances should you have them.
Below I’ll cover just a few of the important micronutrients to consider. This is by no means exhaustive, but it might guide you towards eating a more nutrient-dense diet.
Vitamin A deficiency is a common factor in infertility. Some people have problems converting beta-carotene (found in orange vegetables like carrots) to vitamin A, which has a crucial role in reproductive hormone production. Vitamin A is vital for progesterone synthesis, and is also an antioxidant; so it is crucial for detoxification. It keeps the cilia of the fallopian tubes healthy, and is essential for testicular health and sperm production.
Possibly the best natural source of vitamin A is liver, which doesn’t present the same risks for overdose that supplemental vitamin A can pose. When buying liver always go for organic. If the idea of eating liver makes your stomach turn, desiccated liver capsules are a great alternative.
The status of your vitamin D intake is also important. Calcitriol (the active form of vitamin D) has many different roles in female reproduction, both for conception and during pregnancy.
Vitamin D deficiency in pregnant women ranges between 20-85%5,6. Since deficiency during pregnancy puts you at higher risk for pre-eclampsia, low birth weight babies, and gestational diabetes (7,8), it’s crucial that you get ample sunlight exposure so you can make enough vitamin D. People living in extreme latitudes or those with darker skin have a greater risk of vitamin D deficiency. In these cases it’s a good idea to ensure there’s adequate vitamin D in your prenatal multivitamin. Most prenatals only contain 400 to 600 IU of vitamin D, which isn’t enough to keep your levels normal without regular midday sun exposure. Get your GP to check if your levels are adequate.
Other important micronutrients are the B vitamins, vitamin C, vitamin E, and coenzyme Q10, which are all cofactors in many underlying metabolic pathways. Magnesium, iron, zinc, selenium, manganese, calcium, chromium, and iodine should all be considered important minerals when gearing up for a healthy conception and pregnancy.
5. Take a good quality prenatal supplement
Always question your prenatal supplement. There are some really good ones on the market, and some really poor quality ones. In many of the supermarket prenatal supplements the form, ratio and amounts of certain nutrients are just not sufficient or even pro-inflammatory and can cause more issues if they’re not suited to you.
A good prenatal supplement contains the right form of folate. Folate is important for preventing neural tube defects. Folic acid, a synthetic form of folate, has been aggressively added to many processed foods such as breads and cereals. You’ll see folic acid in many over-the-counter prenatal supplements.
Due to genetic reasons, some people have trouble converting synthetic folic acid to usable folate. This can lead to accumulation of non-converted folic acid, which can turn down natural killer cell activity, promote inflammation and more. Research has shown that approximately 45% of the population have some compromised ability to convert folic acid (9).
As an alternative, methyltetrahydrofolate (or 5-MTHF) is well tolerated by most people. For this reason I recommend a high quality prenatal supplement containing 5-MTHF for all women planning a pregnancy.
It’s a good idea to work with a practitioner to find a suitable prenatal supplement for you because other nutrients may need special attention too. For example, for vitamin B12 you need to choose the most suitable form from three different available forms. Finding the right one for you is important because you may experience adverse effects from having the wrong one. If a prenatal supplement says cobalamin on it, consider seeing a practitioner to get something better.
6. Take care of your gut
Gut health is inextricably linked to the immune system, which is involved with fertility, pregnancy, and childbirth (9,10). A healthy gut equals a healthy immune system and therefore optimal fertility.
Strong healthy gut bacteria is our first line of immune defence and the starting point for gut healing. These critters help us digest and utilise nutrients from food, maintain the gut lining integrity, and create B vitamins. All of this is crucial for fertility.
We cannot begin to heal fertility issues if gut flora is out of balance, since this can contribute to poor nutrient absorption. We are not what we eat, but what we absorb. So if your diet is not optimal, or you have food sensitivities, IBS, or other digestive issues, then you may not be getting enough raw materials to make healthy eggs.
Eating fermented foods daily provides probiotics or good bacteria. These support healthy bacterial growth in the gut, as well as the vagina. A good vaginal pH encourages optimal cervical mucus for conception. Sauerkraut, kimchi and kombucha are options, as is taking a good probiotic.
Bone broth is another fantastic fertility food that supports gut healing and hormone balance. The collagen (which becomes gelatin when cooked) in bone broth helps to heal gut permeability issues. This leads to better nutrient absorption from the food and supplements you eat.
The amino acids proline and glycine in bone broth support hormone production and detoxification. This allows your body to correct imbalances such as oestrogen dominance, which causes all sorts of infertility issues.
Reducing stress and getting good quality sleep pay dividends when it comes to gut health. Stress and sleep deprivation create inflammation both at the gut and systemic level. High levels of cortisol (long-term stress hormone) can wipe out good bacteria and profoundly impact all hormones. You may know women who struggled to get pregnant, but when they left their highly stressful jobs they conceived naturally. Or women who are desperate to have a baby who stop trying and are surprised when they become pregnant.
7. Get your man to read this!
The primary micronutrient deficiency that shows up in men is antioxidants. You typically see a lot of oxidative stress in men who are struggling with infertility. This is because sperm are very sensitive to oxidative damage. Increasing antioxidant-rich food intake; herbs such as rosemary and turmeric, and antioxidant supplements will reduce inflammation and work nicely for men. Nutrition for male fertility is a huge topic all of its own. Regardless, increasing antioxidants is a crucial first step most men can take to improve chances of their partner conceiving.
If you’re struggling with infertility it is vital that you speak with a specialist to figure out why. Polycystic ovary syndrome (PCOS) and hypothalamic amenorrhea (HA) are two female hormonal conditions that can complicate your fertility journey. However, that doesn’t mean you can’t work with these conditions and conceive.
If you’re ever unsure about your nutritional requirements and how to reach them, see a dietitian, nutritionist or naturopath. Setting yourself up for a healthy conception and pregnancy is possibly one of the best reasons to see a health professional who specialises in fertility - that's me! That being said, eating nutritious food, supporting your gut, reducing stress and getting good sleep will boost your fertility.
If you would like to enquire about a private nutrition consultation, please contact me here
1. McChesney P (2010). Demographics of Infertility – citing a 2006 study
2. Naish F & Roberts J (2000). The natural way to better babies, Milsons Point, Random House Australia.
3. De Castro, JM (1987). Macronutrient relationships with meal patterns and mood in the spontaneous feeding behavior of humans. J Physiology & Behavior 39(5); 561-569.
4. Chavarro JE, Rich-Edwards JW, Rosner B & Willett WC (2007). A prospective study of dairy foods intake and anovulatory infertility, Hum Reprod, 22(5): 1340-7.
5. Bodnar LM et al. (2007). High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. Journal of Nutrition 137(2): 447-452.
6. Dawodu, Adekunle, & Tsang RC (2012). Maternal vitamin D status: effect on milk vitamin D content and vitamin D status of breastfeeding infants. Advances in Nutrition: An International Review Journal 3(3): 353-361.
7. Wei, Shu-Qin et al (2013). Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine 26(9): 889- 899.
8. Aghajafari F, et al (2013). Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes. Systematic review and meta-analysis of observational studies. British Medical Journal 34(6).
9. Linus Pauling Institute Micronutrient Information Center. Folic Acid. http://lpi.oregonstate.edu/infocenter/vitamins/fa/. Updated May 9, 2011. Accessed June 21, 2018.
10. Jabbour N, Catalano D, et al (2009). Inflammatory pathways in female reproductive health and disease. Reproduction 138: 903-19.
11. Wu HJ & Wu E (2012). The role of gut microbiota in immune homeostasis and autoimmunity. Gut Microbes, 3(1): 4–14.