Wholesome Nutrition During Pre-Conception

When Should Pre-conception Care Begin?

Pre-conception is the time before and during the moment of conception. This care is for both the female and the male, this should ideally take place four to six months prior to attempting conception. There is often emphasis on only the female with regards to conception, however 40% of infertile couples the issue is a male factor. 40% of infertility issues is a female factor, 10% is a joint factor, and 10% is due to causes unknown. Pre-conception care is relevant as the final stages of gamete production have the ability to be influenced and altered.

Preconception Objectives for Fertility

• To provide the client(s) with nutritional nourishment to support well-being and health.

• Improve any fertility restrictions, such as hypothyroidism, endometriosis, fibroids, compromised sperm function etc.

• Provide education around avoidance of particular dietary foods/beverages that can negatively impact fertility such as trans fatty acids, alcohol, sugar and caffeine.

• Acknowledge micro/macronutrient deficiencies- specifically look at optimal hydration intake and protein requirements.

Specific Foods to Include for Female Fertility

• ω 3 fatty acids- These are necessary to provide energy production to the oocyte and cell membrane fluidity. ω 3 fats (DHA, EPA) in particular DHA are crucial central nervous system development which begins 21-28 days following conception. These foods include, salmon, herring, whiting, flaxseed oil and walnuts. *As many oily fish contain high amounts of ω 3, clients must be aware of the high methyl mercury content in some fish. Those under pre-conception care should avoid, swordfish, shark, and king mackerel while limiting the intake of tuna to 85g per week.

• Protein- Every cell in the body needs protein. Building gametes (eggs and sperm) requires substantial protein for infrastructure. Foods high in protein are red and white meats, eggs, nuts, seeds, and dairy products.

• Antioxidant- rich foods- Oxidative stress can place harmful effects on female fertility. Oocyte health can be benefited with the inclusion of antioxidants. Foods include tomatoes, garlic, ginger, turmeric, grapes, and berries.

• Filtered water- Water is a major component of the human body. Every system in the body depends on water. Water is used to digest and absorb food and nutrients. Hydration is necessary for the elimination of digestive wastes. The client should aim for 33mL per kg of body weight daily.

• Vegetables and fruit- These will provide a variety of nutrients that are needed for the development and maturation of a healthy oocyte. If possible try to eat organic to avoid pesticides and chemicals which can influence hormones. If this not possible ensure to thoroughly wash fruit/veg before consumption. Have a maximum of 1-2 serves a day of fruit to limit sugar intake.

• In cases of subfertility conditions like PCOS, it may be advised for patients to follow a specific diet for their condition. In the case of PCSOS patients for example they may be recommended to follow a low G.I. diet.

The Mediterranean Diet

A study done recently on couples undergoing IVF or ICSI (intracytoplasmic sperm injection) who followed a Mediterranean diet during preconception had an increased chance in attaining a successful pregnancy. A Mediterranean diet encompasses a strong focus on whole foods (think foods from the earth) , plant based, and high fibre foods such as fruit, vegetables, grains, nuts, seeds, essential fatty acids (from foods like olive oil), fresh fish, and moderate amounts of poultry and eggs.

Specific Foods to Exclude for Female Fertility

• Caffeine- Consumption of coffee has been linked to causes of infertility, like endometriosis, and poses a risk for spontaneous abortion. High caffeine intake is associated to an increased conception time.

• Alcohol- While there is mixed information regarding fertility and alcohol consumption, there are some studies stating the detrimental effects. In a particular study on 430 women, those who consumed alcohol in preconception had more difficulty in conceiving over six menses cycles in comparison with those who abstained from alcohol.

• Sugar- Healthy glycaemic control is necessary in pre-conception to prevent macrosomia, negative effects on the fetus and gestational diabetes.

• Trans Fats- These foods provide minimal nutrition and are linked to negative health outcomes. These foods can elevate the risk of ovulatory infertility especially when eaten instead of unsaturated fats or carbohydrates. These foods include, deep-fried foods, takeaways, manufactured cakes, pies and biscuits.

Supplements to Consider in Preconception- Female

• Folic acid/ Folinic acid- Folate deficiency is one of the most common deficiencies and the requirements during pregnancy double. Supplementation reduces neural tube defects. Folic acid/folinic acid supplementation should begin 3 months prior to conception ideally as neural tube defects occur in the first 22-28 days of pregnancy.

• Iodine- This is needed for healthy thyroid function and is essential in nervous tissue and brain development in the foetus. Research has shown that iodine deficiency in pregnancy is common. However, excess iodine can be problematic for both baby and mother so testing iodine status in preconception is recommended.

• EPA/DHA- ω 3 fatty acids can regulate the cell membranes and produce effects on reproduction. In miscarriage prevention ω 3 fatty acids at 4g/day have shown to improve the acceleration of blood flow in the uterine artery in those with defective uterine perfusion causing recurrent miscarriage.

• Iron- Iron is needed to form red blood cells and transport oxygen via haemoglobin. Severe anaemia in pregnancy can cause negative outcomes like premature birth, maternal mortality and low birth weight. However like iodine excess iron can interfere with fertility therefore testing is recommended.

Specific Foods to Include for Male Fertility

• Selenium- rich foods- Selenium is a powerful antioxidant that protects the nervous system and DNA. The highest concentrations of selenium amongst the reproductive organs are the testes. Foods to consume are brazil nuts, poultry, wholegrains, fish, eggs, and cashews

• Zinc- rich foods- Zinc is critical in male fertility. Each time a man ejaculates he loses roughly 2.5mg of zinc. Zinc deficiency can cause low testosterone and low sperm count. Zinc rich foods include oysters, sunflower seeds, tahini, sesame seeds, beef, turkey, and dahl.

• Tomatoes- These are rich in lycopene and research has shown the lycopene can improve fertility, and protect the sperm from DNA damage.

• Walnuts- Walnuts can improve semen quality, sperm vitality, morphology, and motility. Walnuts contain potassium, magnesium, iron, zinc, copper, selenium and a range of B vitamins.

• Avocadoes- Considered among the Aztecs as the ultimate fertility fruit. They are high in vitamin E, and can help in infertility in men. Avocados can increase sperm motility and assist in keeping sperm from gathering together as they proceed to the egg.

Specific Foods/Substances to Exclude for Male Fertility

• Processed/junk foods- Fatty, fried, and sugary foods can impair male fertility. Erectile dysfunction is linked to poor nutrition. An overweight male can increase sperm DNA damage.

• Smoking- Passive and active smoking can damage sexual and reproductive health. Smoking can deplete the body of vitamin C making it more difficult to detoxify the body.

• Alcohol- Drinking alcohol can generate testicular atrophy, reduce libido, and cause deterioration of sperm count. Alcohol can adversely affect the function of the testicular Sertoli cells which are vital in sperm maturation.

• Excess caffeine- Those who drink large amounts of coffee could be harming their sperm at a molecular level. Sperm count, motility and abnormalities can occur in men that are heavy coffee drinkers.

Supplements to Consider in Preconception- Male

• Vitamin C- This improves all semen parameters. A slight deficiency in vitamin C can cause oxidative stress to sperm which can result in sperm suffering oxidative damage. Supplementing vitamin C can improve motility, viability, decrease the number of abnormal sperm and decrease sperm agglutination.

• Zinc- A healthy level of zinc is necessary for the development of sperm. A deficiency in zinc can cause abnormalities in chromosomes and can lower testosterone levels.

• Coenzyme Q10- CoQ10 is found in seminal fluid and plays a role in sperm motility. CoQ10 is a potent free radical scavenger which is beneficial as free radical damage can cause defective functioning of sperm.

• Selenium- Is a trace element that is a powerful antioxidant, and plays a role in testosterone synthesis, healthy sperm maturation and motility. Evidence shows selenium encourages healthy spermatozoa.

*Please note please speak with your healthcare provider/Naturopath before beginning any supplements to determine if they are right for you.

**References available on request.