Once the decision has been made to start your family, attention to your diet and lifestyle can improve your fertility and increase your chances of having a healthy baby. There are several important diet and lifestyle factors that should be considered.
Folate is a B-group vitamin that is important in the developing baby’s brain and spinal cord. Having sufficient folate in your body reduces the risk of neural tube defects, such as spina bifida. It is recommended that you start taking folate three months prior to conception at a minimum daily dosage of 500 micrograms. Folate may be taken on its own, or as part of a pregnancy multivitamin.
Iodine is an essential mineral for the developing baby’s brain and body. It is used in the production of thyroid hormone, which regulates body temperature, metabolic rate, growth, blood cell production and nerve and muscle function. The recommended daily dosage in pregnancy is 150 micrograms.
A healthy diet (for both female and male partners) can boost fertility and help to ensure a healthy pregnancy.
Dietary recommendations include: * Ensuring daily intake of fresh fruit and vegetables * Consuming fresh, unprocessed foods * Eating good sources of protein such as fish, dairy, eggs and lean meat * Reducing intake of fish high in mercury * Reducing intake of saturated fats * Incorporating essential ‘good’ fats into your diet, such as avocado, tuna, green leafy vegetables, nuts and extra virgin olive oil * Reducing portion sizes of meals * Substituting sugary drinks for water * Choosing healthy snacks, such as fruit, low fat yoghurt or small portions of nuts * Incorporating ‘good’ carbohydrates into your diet, such as whole grains, vegetables, nuts, whole fruits, legumes and seeds * Reducing intake of refined carbohydrates, such as white bread, white pasta and white rice.
If you need assistance regarding changes to your diet, seeking advice from a dietitian can be helpful.
Increasing your daily physical activity can improve your chances of pregnancy – for example, incorporating 30–40 minutes of moderate-intensity exercise, 3–4 times a week can be beneficial. However, it is very important to maintain the right balance of exercise. Too much exercise at high intensity can actually inhibit conception.
Ideally, the body mass index (BMI) of both males and females should be between 20–25 kg/m2. Being overweight or underweight can reduce the chances of pregnancy. For those who are overweight, even a small amount of weight loss (e.g. 5 kg) has been shown to significantly improve fertility rates.
The environment in which eggs and sperm develop can also influence the future of the baby’s health. Having a lot of excess body fat is harmful to this environment, and being overweight is associated with an increased risk of miscarriage.
Caffeine is a stimulant present in coffee, tea, energy drinks, chocolate and certain soft drinks. Some studies indicate that women who consume large amounts of caffeine can take longer to conceive and may have a higher risk of miscarriage. A general recommendation is to limit daily consumption of caffeine to 100 mg per day (1 cup of coffee per day).
Cigarette smoke contains harmful chemicals that can affect all parts of the body, including the reproductive organs. This may lead to damage of both the eggs and the sperm.
In males, smoking can lead to damage of the DNA in the sperm which may not be detected on a standard semen analysis. However, DNA damage can lead to reduced fertility and increased miscarriage rates. Additionally, heavy smoking (>20 cigarettes per day) by males at the time of conception can also increase a child’s risk of developing leukaemia. Fortunately, after stopping smoking, the damage done to sperm is reversible.
Quitting in both males and females will increase the chance of conceiving and having a healthy baby. Ideally, couples should stop smoking a few months prior to considering conception.
In women, large amounts of alcohol consumption can be associated with irregular or heavy periods, and a longer time to conceive. In men, alcohol can affect sperm quality and lead to impotence and reduced libido.
During pregnancy, any amount of alcohol consumption can lead to miscarriage, stillbirth, premature birth, low birth weight and foetal alcohol spectrum disorder.
For women who are pregnant or planning a pregnancy, not drinking alcohol is the safest option.
Couples with infertility may be taking Chinese herbs and supplements or having acupuncture. If this is your desired approach, it is important to be managed by a practitioner specialised in fertility.
Whilst completing an IVF cycle, it is recommended that you stop taking Chinese herbs and supplements. They have possible interactions with IVF medications, which could negatively influence the outcome of your IVF cycle. If you are utilising acupuncture during your IVF treatment, this should be managed and tailored according to the IVF protocol with an appropriate practitioner.
Many nutrients can be obtained from a healthy, balanced diet. Multivitamins not designed for pregnancy should be taken with care, as there can be dangers associated with excessive doses of certain nutrients, such as vitamin A.
Low iron levels in early pregnancy have been linked to premature birth and low birth weight. It is not uncommon for women to become iron deficient during pregnancy. Therefore, it is important to have an appropriate intake of iron to build and maintain iron levels in the body. The average requirement in pregnancy is 27 mg a day and typical pregnancy multivitamins contain iron.
Melatonin, commonly known as the ‘sleep hormone’, is important in regulating the 24-hour sleep cycle (circadian rhythm). It also plays a role in regulating the female reproductive hormones. Some small studies have suggested improved egg quality with melatonin and CoQ10 supplementation. While the evidence is limited, both supplements appear to be safe.