Wellbeing

1. Eat at least five portions of fruit and vegetables every day
2. Eat enough essential oils
3. Drink plenty of water
4. Go for high-fibre whole foods
5. Eat good-quality protein with every meal
6. Always eat breakfast and stop eating after 8pm
7. Keep your blood sugar levels balanced by eating little and often – every three hours or so
8. Limit caffeine and sugar intake
9. Choose organic food where possible
10. Limit your intake of red meat, saturated fat, convenience foods, refined foods and foods that are high in additives and preservatives

If you have any specific concerns regarding your diet we can discuss them during your consultation with us. Our One-Stop Fertility Assessment checks your general well-being, as well as assessing your fertility, as part of your first appointment.

Please call us on 01992 78 50 60 to arrange an appointment.

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The general advice for eating to achieve healthy eggs and sperm is to have a well-balanced diet which includes:

• Plenty of fruit and vegetables a day
• Complex carbohydrates – whole grains like brown rice, oats and wholemeal bread
• Organic foods where possible
• Oily foods such as fish, nuts, seeds and oils
• Avoid trans fats
• Increase your intake of fibre
• More fish and organic eggs than red meat
• Avoid additives, preservatives and chemicals such as artificial sweeteners
• Reduce or avoid sugar, both on its own and hidden in food
• Reduce or eliminate caffeine, e.g. coffee, tea, chocolate, colas and alcohol
• Eliminate processed foods as much as possible.

Carbohydrates

Carbohydrates are your key energy source. There are two types – complex and simple. Complex carbohydrates include vegetables and whole grains, such as rye, oat and wheat, and legumes, such as peas and beans. Simple carbohydrates include white sugar, fruit and fruit juices.

For optimum fertility you should limit your intake of simple carbohydrates (with the exception of fruit) and eat plenty of unrefined complex carbohydrates. This means choosing whole grain bread, brown rice, whole grain cereals and pasta instead of the refined white versions, as well as eating at least five portions of vegetables a day. Whole grains are packed with fertility boosting nutrients such as zinc, selenium and many B vitamins and they are an essential part of a hormone-balancing, fertility-boosting diet.

Steer clear of white flour and other refined grains which have little or no nutritional value because of the processing. In order to digest and absorb refined foods your body has to use its own vitamins and minerals, thus depleting your stores. Refined carbohydrates in the form of sweets, cakes, pies, pastry, white flour and white sugar all produce a sudden rise in blood sugar and trigger hormonal imbalances, so it is important to avoid them. Fruits are the exception here as although they are simple carbohydrates they are also packed with fertility-boosting nutrients. You shouldn’t cut fruit out but make sure you eat it with proteins, such as nuts or seeds, which can slow down the effect on blood sugar. Make sure too that fruit juices are diluted.

Fibre

Fibre is needed to keep your bowels healthy. It isn’t difficult to increase your fibre intake. You don’t need to add bran to everything (bran can actually block the absorption of vital nutrients such as iron and zinc) – just eat more unrefined carbohydrates.

Eat a mixture of soluble fibre, such as fruit, oats, vegetables and beans, and insoluble (meaning it doesn’t dissolve in water), found in whole grains and nuts. Meals loaded with vegetables, cereals, whole grains, nuts and seeds should provide you with all the fibre you need.

Protein

Protein is important for your fertility because it helps to maintain blood sugar balance and gives your body the even supply of amino acids it needs for building and repairing cells, manufacturing hormones and a healthy reproductive function. Since your body can’t store protein the way it does carbohydrates and fat, you need a constant supply and should aim to eat some high-quality protein with every meal.

Different protein sources vary in the amount of other nutrients they contain, so it’s important to eat a wide variety. Good sources of protein include oily fish, eggs, pulses, beans, nuts and seeds. Try to have a handful of nuts and seeds every day or use a salad dressing made with a good-quality nut or seed oil. Instead of meat eat beans such as lentils, nuts and seeds like sunflower, sesame and quinoa, which are good sources of fertility-boosting protein. Research shows that eating an egg for breakfast not only gives you a protein boost but also keeps you feeling fuller for longer. Up to five eggs a week is perfectly safe for most people. Choose organic, free range eggs when possible.

Red meat consumption has been linked to fibroids and endometriosis, both of which are oestrogen-dependant conditions that can affect fertility. The saturated fats in red meat and poultry produce inflammatory prostaglandins – hormone-like substances which can trigger symptoms of endometriosis. High intake of beef, red meat and ham increase the risk of endometriosis by 80 per cent, whereas women with the highest intake of fresh fruit and vegetables lowered their risk by about 40 per cent.

Fats

Unfortunately, fat in general has a bad reputation and many women especially tend to avoid it as a matter of course. But it is the saturated fats found in animal meat and the trans fats found in processed food that are harmful and can reduce fertility. Essential fatty acids found in nuts, seeds and oily fish, on the other hand, play a crucial role in fertility and the development of a healthy baby.

If you don’t eat enough essential fats, hormone production may be compromised.

Fats which have undergone a chemical process called hydrogenation can contain trans fats and should always be avoided. Found in fried foods, cakes, biscuits, chips and pastries, they can cause problems with ovulation. And because semen is rich in prostaglandins which are made from essential fats it is especially important for men to avoid trans fatty acids too as they interfere with absorption of essential fats.

If a product has the words ‘hydrogenated vegetable oil’ on the list of ingredients then choose another brand.

Unsaturated fats

Unsaturated fats are divided into monounsaturated and polyunsaturated fats. Monounsaturated fats, such as olive oil, are thought to lower the risk of heart disease. Polyunsaturated fats (classed as essential fats) can also be split into omega 6 oils (found in sesame, corn and sunflower oils) and omega 3 oils (in fish, linseed or flax oil). The body makes hormone-regulating substances called prostaglandins from Omega 3 and Omega 6 oils and they are extremely important for boosting fertility. Symptoms of an essential fatty acid deficiency include dry skin, dry hair, irritability, brittle nails, fatigue, weight gain, high blood pressure, PMS, arthritis, poor wound healing, hair loss and cracked skin, especially on the heels and fingertips.

Fish that are predatory and live a long time can contain higher levels of mercury because the heavy metal accumulates over time and the fish also feed on other mercury-contaminated fish. So it’s best to avoid shark, swordfish, and marlin. The Foods Standards Agency recommends no more than two portions of oily fish a week during pregnancy and to limit tuna to either two fresh tuna steaks a week or four medium cans of tuna (canned tuna does not count as an ‘oily’ fish because the oils are lost in the canning process). Fish oil supplements (not cod liver oil because of the high vitamin A) are fine as long you know they are from a reputable company so that you know they have been screened and are free from contaminants. It really is worthwhile paying a bit extra to get the best.

Phytoestrogens

Phytoestrogens are substances found in food which are thought to have a hormone-balancing effect. They are mainly found in legumes such as lentils, soya beans and chickpeas. Phytoestrogens are being studied all around the world for their effectiveness in lowering cholesterol and preventing heart disease, but they also play a role in balancing male and female sex hormones.

There has been concern in recent years that eating soya harms female fertility but this is only when consumed in large doses. Have soya products no more than five times a week and avoid any soya products that contain the word ‘isolate’, which means they are not made from the whole beans and are not in the form traditionally eaten.

Research has also suggested that soya could negatively impact on the ability of the sperm to fertilise eggs. However, the way in which this was tested (by exposing sperm to genistein – an isoflavone in soya – in a dish) does not replicate the effects that might be experienced by eating the foods.

Vital Minerals and Vitamins

Vitamin A: You need good levels of vitamin A at the point of conception because it is essential to the developing embryo. High doses of vitamin A from animal sources, e.g. liver, are not advised as this can also cause birth defects, but vegetable sources of beta carotene, which your body can turn into vitamin A, are safe. Vitamin A as beta-carotene is found in carrots, tomatoes, mangoes, pumpkins, cabbage, egg yolk, parsley, red peppers, carrots, and broccoli.

Vitamin B6: This is important for reproductive health, the formation of female sex hormones and the regulating of oestrogen and progesterone levels. Women who have plenty of vitamin B6 in their diet are also only half as likely to miscarry in the critical first weeks of pregnancy. It is thought that B6 – found in high levels in potatoes, bananas, eggs, peanuts, mushrooms, oat flakes, soya beans, seaweeds, sunflower seeds, salmon and mackerel – plays a key role in the development of the placenta.

Vitamin B12: Another B vitamin that is important for your fertility. Vitamin B12 is found in eggs, seaweeds, sardines and tuna.

Other B vitamins: Vitamins B5, B1 and B2 are all essential for a healthy pregnancy. Vitamin B5 or pantothenic acid is found in whole grains, mushrooms, green vegetables, beans, chickpeas, soya beans and brown rice; B1 is found in whole grains, dried beans, peas, lentils, soya beans, eggs and green leafy vegetables; and B2 is in whole grains, green vegetables, eggs, soya beans, peas and mushrooms.

Folic acid: Until recently this B vitamin was known mainly for its role in preventing spina bifida in babies but now conclusive research has shown its vital role in fertility. Food sources include green beans, leafy vegetables, broccoli, green peas, asparagus, salmon, alfalfa sprouts, chickpeas, tomato juice, orange juice, oranges, strawberries, bananas, grapefruit and wholemeal bread. However, this is such an important nutrient that all experts recommend taking it as a supplement in the preconception period.

Vitamin C: This is a powerful antioxidant that can be helpful for both male and female fertility. Vitamin C is found in raw fruits and vegetables, especially citrus fruits, blueberries, kiwi fruit, mangoes, red peppers, strawberries, green sprouting vegetables like Brussels sprouts, watercress and parsley.

Vitamin E: Another powerful antioxidant and important for both male and female reproductive health. Food sources include cold-pressed unrefined oils, whole grains, egg yolk, green leafy vegetables, avocados, lettuce, peanuts, sesame seeds, soya beans, unrefined cereals, nuts, oily fish and broccoli.

Calcium: An important mineral when aiming to conceive as the woman needs adequate calcium for the baby’s teeth and bones. Although many of us do rely on dairy products for our calcium intake always bear in mind that there are many other non-dairy sources, such as sardines, salmon, prunes, almonds, oranges, papayas, watermelon, spinach, nuts, sesame seeds, pulses, leafy green vegetables, and whole grains.

Zinc: This mineral is vital for the health and maintenance of reproductive hormones in both men and women. Zinc is needed for the production of sperm and male hormones. Food sources include eggs, apricots, whole grains, dried fruit, seaweed, sunflower seeds, all vegetables, watermelon, mushroom, beetroot, oily fish, onions, nuts, peas, and beans.

Selenium: A good antioxidant. Good food sources for selenium include herring, tuna, garlic, eggs, carrots, mushrooms, whole wheat, broccoli, and garlic.

Magnesium: Needed along with calcium for healthy bones and teeth. Food sources include dairy products, nuts, green vegetables, eggs, avocado, dried apricots, brown rice, bananas, and sunflower seeds.

Water

Water is an essential but often forgotten ingredient in a healthy eating plan. Not only is your body two-thirds water but water intake and distribution are essential for hormonal balance. Water also provides the means for nutrients to travel to all your organs, including your reproductive organs, and for toxins to be removed. In addition, it helps your body to metabolise stored fat so it is crucial for weight management.

Try to drink at least 1½ litres (or six to eight glasses) of water a day. Herbal teas such as peppermint and chamomile will count as a glass of water or have hot water with a slice of lemon.

Organic Foods

Organic foods often contain higher levels of nutrients and are free from pesticides. The concern is that pesticides can act as Endocrine Disruptor Chemicals and have a negative effect on reproductive hormones for both men and women. So buy organic where possible.

What to avoid

There are some things that can have a negative impact on fertility and should be either eliminated completely or reduced.

Caffeine

Researchers have found that caffeine can have an adverse effect on female fertility and may increase the risk of a miscarriage, so it makes sense to cut caffeine out altogether. Men aren’t immune either and studies indicate that problems with sperm health seem greater with increased coffee intake.

Caffeine is found in regular coffee, black tea, green tea, colas and chocolate. Tea contains tannin as well as caffeine and tannin blocks the absorption of important minerals, so if you drink tea with your meals you are preventing vital nutrients from being absorbed in your digestive tract.

Chocolate contains caffeine too and you can’t cheat by switching to organic dark chocolate! It does have less sugar than milk chocolate but its percentage of cocoa solids will be higher, making the caffeine effect even stronger.

Decaffeinated options for tea and coffee aren’t really a good substitute as we have no idea how many chemicals are involved in the decaffeination process. However, you can use them in the weaning stages to get you off the caffeinated drinks. Begin by substituting decaffeinated coffee for half of your total intake a day and then gradually change over to all decaffeinated. Then, slowly substitute again with other drinks, such as herbal teas and grain coffees. You should, ideally, eventually eliminate decaffeinated coffee as well because coffee contains other stimulants (theobromine and theophylline), which are not removed when the coffee is decaffeinated.

Experiment with herbal teas. Try peppermint, chamomile and also grain coffees which contain chicory and barley.

Alcohol

This is a complete no-no when it comes to fertility for both men and women. It acts as a diuretic (causing valuable fertility nutrients like zinc and folic acid to be excreted) and a toxin to the sperm and egg and to the baby once you are pregnant.

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Folic acid

An essential B vitamin, folic acid is absolutely crucial for a healthy pregnancy, but it is also one of the vitamins in which we are most commonly deficient. Your body needs folic acid to produce DNA. Folic acid protects the neural tube – which will go on to form the spine and spinal cord – and helps to close it properly to ensure normal brain and spinal cord function. Folic acid can help to protect an unborn baby from developing spina bifida. The neural tube should close between the 25th and 30th day after conception, when women may still not realise they are pregnant, which is why all women aiming to get pregnant should take folic acid each day for up to three months before conception.

High levels of an amino acid called homocysteine which should be detoxified by the body has been found in women who miscarry. Homocysteine is controlled not only by folic acid but also two of the other B vitamins, B6 and B12. So having a fertility supplement containing not only folic acid but also these other B vitamins is important.

Men should also consider taking folic acid supplements as new evidence suggests that folic acid deficiency reduces fertility in men and may damage the DNA carried by sperm. And we know that a combination of folic acid and zinc can increase sperm counts by up to 74%.

Zinc

Zinc is the most widely studied fertility-boosting nutrient for both men and women. It is an essential component of genetic material and a deficiency can lead to reduced fertility, hormone imbalance and an increased risk of miscarriage. Zinc is found in high concentrations in the sperm. It is needed to make the outer layer and tail of the sperm and is, therefore, essential for its health.

Research suggests that zinc deficiency in men causes a temporary but reversible reduction in sperm count and a reduced testosterone level; giving zinc to men with low testosterone levels increases sperm count. Other studies comparing men with low sperm counts with those whose sperm counts are normal show that zinc levels are significantly lower in men with low sperm counts.

Zinc is vitally important for growth and proper cell division in the embryo. During IVF treatment, after the egg has fertilised the doctors have to wait for the cells to divide healthily before transferring the embryo back.

Selenium

This mineral is used to make antioxidants called selenoproteins which help protect your body from free radical damage – very important in the process of cell division. With its protective effect selenium can prevent chromosome breakage which is known to cause birth defects and miscarriages. Selenium deficiency in women has been linked to a higher risk of miscarriage.

Good levels of selenium are also essential for sperm formation and testosterone production in men. A lack of selenium in men is associated with poor sperm motility, selenium being essential for making their strong whiplash tails. In one double-blind trial selenium supplementation resulted in an increase in fertility from 17.5% to 35.1% in sub-fertile men. Other studies show that blood selenium levels are lower in men with low sperm counts.

Research suggests that the antioxidant activity of selenium may even make sperm more fertile. An interesting study looked at men with good sperm counts but low fertilisation rates during IVF treatments. They were given selenium and vitamin E supplements each day and one month after starting treatment their fertility rate increased from 19% to 29%

Omega-3 fatty acids

Over the last century there has been an 80 percent decrease in the consumption of omega-3 fatty acids. It is now thought that we are getting too many omega-6 fats from our diet and not enough omega-3s.

Omega-3 fats are important for regulating reproductive hormones and boosting your baby’s brain, eye and central nervous system development. Omega-3 fish oils have also been shown to help prevent blood from clotting inappropriately, so it can be beneficial to women in whom recurrent miscarriages have been linked to a clotting problem.

For men, omega-3 supplementation is important because semen is rich in the prostaglandins produced from these fats. Research has shown that men with higher levels of abnormal sperm tend to have lower than normal levels of omega-3 fatty acids.

Because our Western diet is usually high in omega 6s, found in abundance in many vegetable oils, you should decrease your intake of vegetable oils and boost your intake of less abundant omega-3s. We are aiming for a ratio of about twice as much omega-6 in our blood to omega-3 (2:1). But it is estimated that the ratio many people are getting nowadays is as high as 25:1. Women also tend to take evening primrose oil supplements which are omega-6, so that is making the situation worse.

The Department of Health recommends that we should all double our intake of omega-3s by eating oily fish (such as salmon) two to three times a week and more green, leafy vegetables, and beans. But more and more research indicates that it is wise to use supplements for these fatty acids and not to rely on dietary intake. It is recommended that all couples trying for a baby start supplementing with essential fatty acids several months before conception.

Avoid cod liver oil capsules. Oil taken from the liver of the fish – the organ of detoxification – can contain high levels of heavy metals like mercury and also carcinogens like dioxins. Cod liver oil will also contain high levels of vitamin A, which is not recommended during pregnancy. Choose fish oil capsules that are from the body of the fish rather than the liver.

Vitamin B6

Vitamin B6 is important for the development and maintenance of a healthy immune system and consequently protects against cancer as well as infection. It can help to prevent damage to chromosomes which is obviously crucial at the point of conception. Many women use vitamin B6 for the relief of premenstrual syndrome and irregular periods with some success and it also plays a critical role in fertility. In addition, vitamin B6 is intricately involved in the function of many enzymes and in protein metabolism and formation.

Vitamin B12

Vitamin B12 is a water-soluble vitamin, like the other B vitamins, so your body is unable to store extensive amounts and must, therefore, get a regular supply from the diet. This can be difficult for some people, either because they absorb vitamin B12 poorly or because their diet is deficient, especially in the case of vegans.

Vitamin B12 is vital for cellular reproduction and a number of studies have shown its potential for reducing the risk of miscarriage.

Vitamin E

Vitamin E is a powerful antioxidant and has been shown to increase fertility when given to both men and women. With men, vitamin E helps to increase fertilisation rate. If you are a woman and over 35 and you have been told that your fertility problems are caused by your age, then you are likely to benefit from taking both vitamins E and C. These antioxidants have been shown to significantly reduce age-related ovulation decline.

Vitamin C

This key antioxidant is good for your general health but research has shown that giving vitamin C to women undergoing IVF treatment significantly increases the pregnancy rate.

Studies have also established that deficiencies in vitamin C can decrease sperm quality. In one study, when a group of men had their vitamin C intake reduced to 5mg a day their sperm had double the normal DNA damage. In another it was shown that supplementing with 1000mg of vitamin C increased sperm quality and quantity. Vitamin C reduces agglutination (when sperm stick together, affecting fertility) and can increase sperm counts by up to a third.

Antioxidants in general, which include not just vitamin C but also vitamin E, zinc and selenium, can have a significant impact on male fertility. One large review in 2011 showed that men undergoing assisted conception like IVF or ICSI, the men taking antioxidants were five times as likely to have a successful treatment resulting in a live birth compared to those men taking a placebo.

Vitamin D

This fat-soluble vitamin is important for fertility for both men and women. For women, it is known that having good levels of vitamin D helps the body maintain a pregnancy by effectively switching off the part of the immune system that could reject the baby because only half its DNA is the mother’s.

Vitamin D is also important for male fertility as low levels of this nutrient is associated with low sperm motility and more abnormal forms.

But the problem is that many people, and women especially, are deficient in vitamin D and won’t even know it. We have alarmingly low levels of vitamin D in the UK, more than 50% of adults have insufficient vitamin D levels.

You are most at risk in the UK if you do not go out much in the daytime, do not expose your skin to the sunlight and if you constantly wear make-up or cosmetics with in-built sun protection factors and may not realise they are in the beauty products. The tone of your skin affects vitamin D production. The darker your skin the less vitamin D production and covering up large areas of skin for religious reasons will also reduce vitamin D production. It is estimated that we need about 30 minutes exposure to the sun up to three times a week to produce enough vitamin D.

Natural food sources of vitamin D are few. It is found in oily fish and eggs. 100g of grilled salmon contains 284ius of vitamin D and 100g of tinned pilchards contains 560ius of vitamin D. The yolk of one egg contains about 20ius of vitamin D. Other sources would include fortified foods such as margarine and breakfast cereals, but it is better to choose butter and the fortified breakfast cereals are likely to contain added sugar.

L-arginine

Amino acids have been proven to be important supplements for men in addressing infertility problems. The head of the sperm contains a large amount of L-arginine – an amino acid found in many foods and one that is essential for sperm production. A great deal of research has shown that L-arginine deficiency should be considered when there are problems with sperm and male fertility. Studies suggest that increasing levels of L-arginine can increase sperm count and quality.

L-carnitine

Another amino acid that appears to be crucial for healthy sperm function is L-carnitine and studies have shown that supplementing with it helped to increase sperm count.

Co-enzyme Q10

This is a vitamin-like substance that is contained in nearly every cell of the body. It is important for energy production and normal carbohydrate metabolism (the way the body breaks down the carbohydrates you eat in order to turn it into energy).

Because of its role in energy production it is a significant nutrient for men if sperm motility is poor. Co-enzyme Q10 is concentrated in area between the head and tail of the sperm; the energy for movement and all other energy-dependent processes in the sperm cell depend on it. Lower levels of co-enzyme Q10 have been found in men with poor sperm motility and supplementing with this nutrient led to a significant improvement.

As co-enzyme Q10 also functions as an antioxidant it can help sperm cells in protecting membranes from free radical damage and so would be suggested for those who have a higher proportion of abnormal sperm or high DNA sperm damage.

You can learn more about how to improve your fertility fitness by visiting our dedicated health, fitness and lifestyle website www.Fit-for-Fertility.com

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For women, being over or underweight can both cause fertility problems. You need to be the correct weight in order to produce the appropriate amount of hormones to regulate ovulation and menstruation. Having a BMI of under 20 is a problem for fertility and a BMI of over 30 can affect your response to IVF treatment and reduce the success rate of a cycle.

It is not only having the right BMI that is critical for fertility. The amount of body fat you have is just as important. In healthy adults, women’s fat comprises about 28 percent of body weight and if it drops below 22 percent ovulation could stop. Women with an average or above-average body weight, or who exercise very rigorously, may have lower body fat and a higher muscle content, which may lead to their periods becoming irregular or stopping altogether. Sensible advice for these women would be to reduce their exercise until their body fat returns to the normal range.

If your BMI is under 20 you may have problems conceiving and the risk of miscarriage is higher than normal. Your body does not have enough fat stores to sustain a pregnancy and so ovulation is shut down. When you gain enough weight your body senses that fat stores are more plentiful and pregnancy is a viable option and you become fertile again.

If your BMI is over 30 research has shown that just losing even 10% of your body weight can be all that’s needed to trigger ovulation, make your periods more regular, and increase fertility. And this is particularly important if you have polycystic ovary syndrome (PCOS).

Being overweight can affect male fertility too, reducing both the quality and quantity of sperm. Having a BMI of over 25 for men is associated with poor sperm motility. Obese men also produce substantially less sperm than average which contains higher levels of abnormalities. Obviously, when both the man and woman are overweight this can have a combined effect on fertility. But the good news is that when men lose weight it results in a significant increase in not only the sperm count but also the number of normal sperm. Being overweight for men also increases the risk of having higher levels of sperm DNA fragmentation which can cause low fertilisation rates in IVF, poor embryo quality, and implantation failure. We know that when BMI is over 25 fragmentation rises and becomes even more of a problem when the BMI is over 30.

If you need to reduce your BMI changing your diet to one that is nutritious and healthy and taking regular exercise is often enough to kick-start weight loss.

If you require more information about the effects of BMI on your fertility or you would like to book an initial consultation with one of our medical team, please call 01992 78 50 60 or email us at enquiries@hertsandessexfertility.com

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