Infertility is a deeply sensitive and personal obstacle that should be addressed as a couple for greatest success. Preconception nutrition can empower partners to make healthy dietary choices for themselves and their future children.
Fertility may be a reflection of one’s level of health and both partners carry an equal weight. The hindrances to conception are only 40% of the time from the woman, 40% of the time from the man, and the other 20% of the time both persons attribute obstacles (Godfrey, & Nachtigall, 2009). Maintaining a healthy weight, managing stress level, low alcohol and caffeine consumption, elimination of gluten, and diets rich in vitamins, minerals, and antioxidants will boost fertility and provide optimal health for future parents and child.
Women’s Preconception Nutrition. The dietary intake of a prospective mother will alter her fertility level and determine future offspring’s survival rate and health (Mathews, Johnson, & Neil, 2008). For example, women with higher ratios of dietary protein specifically during preconception lead to a significant increase in birth weight (Cuco, Arija, Iranzo, Vila, Prieto, & Fernandez-Ballart, 2006). A study in Britain revealed that women with higher energy intake at conception were more likely to have boys (Mathews, Johnson, & Neil, 2008). A mother’s body weight and body mass index (BMI) upon conception directly impacts her risks for high blood pressure during pregnancy and gestational diabetes. Those maternal physical conditions also increase the offspring’s risk of heart disease and diabetes (Wyness, 2014).
Gluten. According to a case study conducted in 2011, when gluten is removed from the diet the fertility was restored (Ghadir et al., 2011). This may be related to the decrease in inflammation within the lower digestive tract and throughout the body (Ghadir et al., 2011; Stephansson, Falconer, & Ludvigsson, 2011).
Caffeine. According to Liebmann-Smith, Egan, & Stangel (2006) more than 250mg of caffeine a day increases a woman’s risk of infertility through estrogen dominance. Studies show that women who consumed 500 mg or more of caffeine per day took longer to conceive and also increased risk of miscarriage. On the other hand, one half cup of black or green tea a day doubles the rate of conception per cycle (Liebmann-Smith et al., 2006). Therefore, tea in moderation, below 250 mg caffeine, may actually help women conceive.
Supplementation. Herbal teas and supplements should be taken with caution. Many herbs have been linked to miscarriage. Peppermint tea and raspberry leaf tea are just two examples of this danger. Large amounts of gingko biloba, Echinacea, and St John’s wort may cause damage to reproductive cells and hinder the ability for sperm to fertilize egg (Liebmann-Smith et al., 2006).
Vitamins & Minerals. There are many vitamins and minerals that are beneficial for women interested in conceiving. Folic acid is a well-established nutritional need during preconception (Liebmann-Smith et al., 2006). However, statistics show that, although 70% of pregnancies are planned, only 30% of those women took folic acid before conception (Rezaei, et al., 2013). Folic acid or vitamin B9 is essential for the offspring’s neutral tube formation and DNA synthesis. Deficiencies in B9 can cause defects and deformities in the fetus’ brain, spinal cord, meninges, skull, and vertebral column. Inadequacy of B9 can even cause infertility or fetal death (Rezaei, et al., 2013). Folate, the food source of folic acid, can be found in green leafy vegetables, such as broccoli, organs, grapefruit, banana, and lentils (Edwards, Thomas, & Wyn-Davies, 2009; Unites States Department of Agriculture). It is recommended that all women planning a pregnancy should consume 400mcg of folic acid a day. The most alarming levels of deficiency in women planning pregnancy are found with Folate and Vitamin D (Aden, Johansson, & Haglin, 2007; Edwards et al., 2009).
Vitamins and minerals act as antioxidants and are extremely profitable to a woman’s health and fertility rates. A study done in Scandinavia showed the majority of women are below recommended levels of antioxidants (Aden, Johansson, & Haglin, 2007). Selenium, vitamin B12, C, D, and E are antioxidant rich and essential for preconception (Mier-Cabrera, 2009). When the dietary intake of infertile women were compared to that of fertile women, selenium levels were lower and sometimes toxic, while copper and cadmium levels were higher (Nichols, Curtis, Rayman, & Taylor, 2008). Women interested in conceiving should also consume adequate amounts of DHA (omega 3), calcium, and iron (Roizen, & Oz, 2009). Finally, vitamin A is essential for conception; however, too much is toxic so levels of intake should be monitored (Roizen, & Oz, 2009).
Alcohol. Consumption of alcohol within a given cycle can play a role in conception rate. Chances of conceiving in a given cycle decrease with above moderate levels of alcohol consumption. That means if a woman is trying to conceive, she should consume less than 4 drinks a week. This alcohol should only be consumed in the first 2 weeks of her cycle, before ovulation (Liebmann-Smith et al., 2006).
Men’s Preconception Nutrition. The choices partners of women with endometriosis make will have a direct effect on conception success. Life style choices and dietary intake affect spermogenesis. According to the world health organization (WHO), there are factors considered to increase or decrease sperm quality in humans: environment, occupation, nutrition, stimulants, ejaculation frequency, and lifestyle choices.
Dietary Fat. In a study by Tina K. Jensen et al. (2013) saturated fat, which has only been associated with cardiovascular disease and cancer risk, now shows a decreased sperm concentration. In this cross sectional study, 701 fertile men that were under fitness evaluation for the Danish military had a physical exam, food frequency questionnaire, and delivered a semen sample. After analyzing the foods consumed 3 months before recruitment, the men with the highest dietary intake of saturated fats had the lowest sperm concentrations. No association between semen quality and intake of other types of fat was found.
Caffeine. High coffee intake reveals a significant decline in sperm morphology. In a study by Wogatzky et al. (2012) 1683 males treated at an Austrian fertility clinic received a Motile Sperm Organelle Morphology Examination (MSOME) and an extensive WHO questionnaire. The questionnaire explored levels of BMI, age, smoking, stress perception, exercise, sauna, frequency of sexual activity, consumption of alcohol and caffeine, and nutrition behavior. With consideration of disease states, previous fever, medications, allergies, and operations, the study determined high coffee intake caused a significant decline in sperm size and shape.
Supplementation. A man’s supplements may increase or decrease fertility. For example, including zinc between 15- 30 mb a day improves conception rates (Liebmann-Smith, Egan, & Stangel, 2006). St. John wort, on the other hand, has been shown to cause mutation in sperm cells (Liebmann-Smith, Egan, & Stangel, 2006).
Prescription medications can have negative impact upon sperm health. For example, a popular methylphenidate for maintaining alertness and improving attention, Ritalin, lowers body weight, testosterone levels, and spermogenesis. Methylphenidates also alter morphometrical characteristics of seminiferous tubules as well as causing epididymal sperm determent in an 11 week study on rats (Davoud, Shapour, & Leila, 2013). Long-term use of methylphenidate can adversely damage male fertility, and medications should be reviewed for possible side effects when planning conception.
Alcohol. Alcohol consumption can interfere with a man’s fertility as well. More than 10 drinks in a week for men can cause a reduction in testosterone and decrease the volume and density of sperm (Liebmann-Smith, Egan, & Stangel, 2006). These men may also suffer from reduced libido and erectile dysfunction (Liebmann-Smith, Egan, & Stangel, 2006).
Other. Exercise can decrease a man’s level of stress and anxiety and improve autonomic functions (Sengupta, Chaudhuri, & Bhattacharya, 2013). Peaceful exercise such as yoga triggers neurohormonal mechanisms by suppression of sympathetic activity. Regular practice specifically proves to enhance reproductive health and produce pregnancy.
High temperatures interfere with sperm production so men who are trying to conceive should avoid hot tubs, saunas, and Jacuzzis (Liebmann-Smith, Egan, & Stangel, 2006). The function of the scrotum is to keep the temperature of the testes a few degrees lower than the rest of the body, 95-96.6 degrees Fahrenheit, and higher temperatures may damage the sperm count. Laptop computers also reach high internal operating temperatures. This too can cause a significant level of heat exposure to scrotum. This negative effect on spermatogenesis is specifically found in teenage boys and young men (Shenynkin, Jung, Yoo, Schulsinger, & Komaroff, 2004).
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