Doctor, what should we eat to boost our fertility? 

This is probably one of the questions that I get asked most often by my patients. The impact of diet, dietary supplements, and lifestyle on fertility is a subject of tremendous interest, and often concern, among those who are planning conception or experiencing difficulty in becoming pregnant. 

Taking in consideration the economic, psychological and emotional distress that infertility involves, identifying modifiable lifestyle factors, such as diet, that influence human fertility is of major clinical and public health significance. 

The literature regarding the relationship between diet and human fertility has greatly expanded over the last decade, resulting in the identification of a few clear patterns.

A recent study published by researchers from the Harvard T.H. Chan School of Public Health and Harvard Medical School reviewed studies which have evaluated the impact of diet on fertility to date and have identified a number of consistent conclusions.  

For women trying to become pregnant naturally (without “assisted reproductive technologies” such as in vitro fertilization), folic acid, vitamin B12, omega-3 fatty acids were linked to positive effects on fertility. 

The adherence to healthy diets such as the “Mediterranean diet” (characterized by high consumption of fruits and vegetables, fish and poultry, low fat products and olive oil) and the “fertility diet” (consisting of high consumption of monounsaturated fat, vegetable protein, high fat dairy, low glycaemic carbohydrates, multivitamins, and iron from plants and supplements) were linked to lower risk of difficulties getting pregnant.

On the other hand, antioxidants, vitamin D, dairy products, soy, caffeine, and alcohol appeared to have less effect on fertility than expected in this review. Trans fat and “unhealthy diets” (those “rich in red and processed meats, potatoes, sweets, and sweetened beverages”) were found to have negative effects.

The study also reported that consuming high levels of fast food and low levels of fruits and vegetables contributed to delays in the journey to pregnancy. 

Studies of men have found that semen quality improves with healthy diets while the opposite has been linked with diets high in saturated or trans fat. Alcohol and caffeine appeared to have little effect, good or bad, in male fertility. It is important to highlight that semen quality is not a perfect predictor of fertility, and most studies do not actually evaluate the impact of paternal diet on the rate of successful pregnancies.

For couples receiving assisted reproductive technologies, women may be more likely to conceive with folic acid supplements, while male fertility may be aided by antioxidants.

Although much work remains, current evidence has accrued to support that diet could be a modifiable factor for female fecundity. 

So what does this mean if you are trying to get pregnant?

For the average couple trying to become pregnant naturally, eating a healthy diet is a good idea for both men and women. Extra folic acid, B12, and omega-3 fatty acids might be helpful for women in addition to any prenatal vitamin being taken is recommended for women trying to get pregnant. As well as an aid to conception folic acid supplementation has long been known to reduce the risk of developmental neurologic problems in the developing foetus.

It is important however to bear in mind that the potential beneficial effects of a healthy diet on fertility are limited and cannot successfully address all infertility causes (like age, previous surgeries, etc). Diet, therefore can play a major role in influencing fertility but it is not the sole determinant. It is important to remember the adage, ‘You are what you eat’ therefore a good diet can contribute significantly not only to your chances of conceiving but also to your general, good health – both physical and psychological. As clinicians we have a responsibility for encouraging patients to proactively engage with activities and lifestyles which encourage and contribute towards fertility enhancement and a healthy diet is one such activity, which, when modified can help the fertility process.

Based on my experience and the results of widespread empirical evidence I have put together some lifestyle and diet recommendations for couples seeking a pregnancy (naturally or with assisted reproductive technology). 

Eat fresh vegetables and fruit daily, which should be half of your plate in all your meals. Aim for colour and variety and remember that potatoes don’t count as vegetables!

Avoid prepared products and fast foods, which usually contain trans fats.

Use unsaturated vegetable oils, such as olive oil.

Eat more vegetable protein, like beans and nuts, and less animal protein. 

Avoid red meat. 

Choose whole grains and other sources of carbohydrates that have lower, slower effects on blood sugar and insulin rather than highly refined carbohydrates that quickly boost blood sugar and insulin.

Take a multivitamin that contains folic acid and other B vitamins.

Stay hydrated. Good quality water is the best source of hydration for your body. Avoid sugary drinks.

If you do drink tea and coffee – do so in moderation.

The evidence relating to alcohol and health is very clear. There is some work to suggest there is a link between consumption and fertility but more work needs to be done to identify a direct causal relation. In the meantime it would be advisable to take alcohol in moderation if at all. 

Try to maintain  a healthy weight. Ideally, your BMI should be between 20 and 25 if you are trying to conceive. If you are overweight and you do suffer from anovulation, losing between 5% and 10% of your weight can jump-start ovulation.

Be active. If you aren’t physically active, start a daily exercise plan. It is recommended to do at least 150 to 300 minutes a week of moderate-intensity aerobic activity, like brisk walking or fast dancing. If you already exercise, pick up the pace of your workouts. But avoid overdoing it as too much exercise can have a negative effect on the odds of conception.

If you smoke: quit. Smoking has a detrimental effect on both male and female fertility. 

Modifying your lifestyle can make a significant impact on your general and fertility health – small changes can lead to big outomes!   

Dr Maria Arque, is a Specialist in Obstetrics/Gynaecology and Reproductive Medicine at Fertty International in Barcelona. Dr Arqué is currently finalising her PhD on the impact of lifestyle in the outcome of IVF and ICSI at the Universitat Autonoma de Barcelona. 

You can more information on their website ferttyinternational.com