5 fertility “must-knows”
When Google seems horribly contradictory (or straight up lacking) and you’re just looking for the best things to do while you wait, here are 5 of the top things to know before you start trying - with the most current evidence to back it up!
There’s no “one size fits all” optimal fertility diet (let’s talk gluten & dairy)
As a nutrition scientist, this is one of my favorite questions to get asked - and one I’m asked very frequently: “Should I be avoiding gluten and dairy?” And this seems to come up even more in the fertility space. This is a highly nuanced topic that does not have a blanket “yes” or “no” answer. Nuance and personalization are everything in good nutrition, and I want to provide you with the information you need to determine if these are foods you can comfortably eat, or should consider eliminating from your optimal fertility diet.
Let’s start with gluten. The main argument for why this is recommended to cut from the diets of women looking to get pregnant is because it’s considered part of an inflammatory diet. (This is usually the case for why dairy is recommended to be avoided as well - more on that later.) Gluten is a bit special because it can be quite inflammatory, and especially in cases of digestive issues or other inflammatory reproductive conditions like endometriosis - when avoiding gluten is a good idea.
If you are experiencing symptoms commonly linked to gluten intolerance and Celiac’s Disease, but not limited to: diarrhea, bloating, IBS, itchy skin, eczema, acid reflux, fatigue, hair loss, joint pain, anxiety, depression, migraines, or menstrual problems - eliminating gluten might be a good idea. Gluten intolerance can directly impact fertility - mainly due to the chronic inflammation it causes and the nutritional deficiencies that ensue.
Gluten intolerance and Celiac’s are notoriously under-diagnosed, and to make it even tricker... these issues can show up later in life even if you’ve tolerated gluten just fine for years. But there is a very simple way to see if you may be suffering from gluten-related issues, and that’s a full elimination diet. To really see if your symptoms disappear without gluten, commit to removing all potential sources for at least 3-6 months. There are many wonderful resources online from dietitians that can assist you on a full elimination diet. Just be careful not to needlessly remove foods from your diet without reason, as the result (like nutrient deficiencies) could cause more harm than good.
Next up is dairy. Similar to gluten, if you can tolerate dairy and do not have symptoms that correspond to when you eat dairy, then you likely don’t need to remove it from your diet. In fact, dairy is a wonderful protein source that actually promotes fertility. The most recent review on fertility-promoting foods found that full-fat diary (up to 2 servings a day) was linked to better fertility outcomes!
This may conflict with what you have heard before about full-fat dairy. But when fat is removed from dairy it disrupts the balance of the natural hormones within the dairy product, and unfortunately this can create issues for our hormonal balance as well. When we choose full-fat sources of dairy (whole milk, higher %’s of fat content in milks & yogurts), we are getting the full nutritional benefit of dairy. In terms of fertility, the fat in dairy helps build and transport hormones effectively through our body, and helps regulate our blood sugar along with the protein. Lastly, there is no scientific consensus that dairy is actually inflammatory. In fact, recent evidence has clearly shown that dairy does not increase markers of inflammation, and can potentially even be anti-inflammatory.
Beyond this though, there are certainly foods that are wonderful sources of key fertility nutrients. A few highly evidence-backed fertility foods to check out are: eggs, salmon, bivalves (oysters, mussels, clams), avocados, nuts, fibrous foods (oats, beans, lentils), probiotic foods (kimchi, sauerkraut, kefir), and berries.
2. Get your thyroid levels checked
Our thyroid is a wildly important endocrine gland in our neck that produces hormones that affect all of our cells and body systems, which means it really impacts our menstrual cycle and fertility. Even a mild reduction in thyroid activity (one that still comes up in the “normal” range on a clinical blood test) affects fertility. Getting your provider to run a thyroid panel for you or getting one through an at-home testing company will give you major insight into how your thyroid is functioning. Treated reduced thyroid function is linked to significant improvement in egg quality.
One thing you can start doing to day to support thyroid levels is making sure you’re getting enough iodine in your diet. Our bodies cannot make iodine and our thyroid need it for proper functioning. Great sources of iodine are: iodized salt (must be labeled “iodized'“ as sea salt does not contain iodine), fish, shellfish, seaweed, dairy, eggs, and beef liver. One of my favorite salt alternatives is Dulse Sea Seasoning, just 1 teaspoon has 189% our daily value of iodine.
Doing this now can save you a lot of time, money, and stress in the future. A study that looked at 394 women at an infertility clinic advocates for early measuring of TSH (thyroid stimulating hormone - included in a thyroid panel) because “simple, oral hypothyroidism treatment for 3 months to 1 year can be of great benefit to conceive in otherwise asymptomatic infertile women.”
3. What you eat in the preconception phase can make your baby even cuter
Nothing like cute baby motivation, am I right? But this concept is actually deeply rooted in developmental biology. I first encountered the baby-specific application of this idea in Dr. Catherine Shanahan’s Deep Nutrition where she poses the burning question: “‘If I do everything right, how beautiful and healthy can I expect my child to be?’…of course, all children are beautiful. But if you’re asking if your child will have extraordinary health, excel scholastically and in sports, and be so physically striking as to elicit the envy of peers, then the answer is, It depends. It depends on how much genetic wealth you gave him.”
What she’s talking about is epigenetics, or how our diet, lifestyle, habits, and environment affect the way our genes are read. Epigenetics is a huge part of my work and a pillar of the personalized fertility diets I design for my clients. We know you can’t change your actual DNA, but you can change how your genes express themselves. And taking the time before you have children to positively influence how your genes are read dramatically increases your chances of a fast and healthy conception.
Negative changes to our genetic expression result from stresses from our environment (poor diet, high emotional and physical stress, low physical activity, toxicant exposure, poor sleep, etc). The good news is: this damage is something you can manage and ultimately reverse! Eating more antioxidant-rich fruits and vegetables, prioritizing sleep, moving more during the day, and seeking out stress relief practices are wonderful places to start.
4. Sleep isn’t just a nice idea
Hopefully this topic seems a lot less boring after identifying how good sleep is a factor in promoting our healthiest genetic expression! We know that getting enough good-quality sleep is one of the easiest and most impactful ways to balance your hormones. On top of that, fertility research shows us that melatonin is found in our ovarian follicles (and even more so as they develop), and plays a role in ovulation!
Modern life has definitely disrupted our circadian rhythm as we no longer live and sleep by the sun’s say-so. And the exposure to bright lights (blue light from electronics especially) inhibits our production of melatonin in the evening. Since our melatonin cycles on this this 24-hour circadian rhythm, there are things we can do throughout the day to make sure we’re getting more of this wonderful “darkness hormone” that helps us with our sleep and our egg quality.
My own efforts to get better sleep include: getting an eye mask to wear to bed (which helps block out all light and allows for stimulation of melatonin production), finding calming breath work and meditations to play as I’m falling asleep (free on Youtube), and reading more at night to minimize blue light exposure from screens. This is also why you may have heard the advice to get sunlight in your eyes within an hour of waking up. Doing this will let your brain know that it’s morning, and support the 24-hour melatonin pattern for the rest of the day.
5. Sperm health is just as important (and male diet matters)
Time for a surprising statistic: of all infertility cases, 40-50% of them are due to male factor infertility, aka issues with making healthy sperm. This effort is not ours to carry alone, ladies! Now of course we can appreciate the relationship between a male’s diet and their sperm number and quality…but research is revealing this goes a lot further than that. The concept of epigenetics we discussed above applies here too - with male epigenetic modifications influencing fetal development, and even the risk of chronic diseases for the child well into their adulthood.
A 2022 review looking at the effect of paternal diet on sperm and subsequent offspring health recommends focusing on consumption of bioactive food compounds (BFCs). BFC is a term for healthy and active food compounds like coenzyme Q10, polyunsaturated fatty acids, trace elements, and NAC, among others. You can get these from a balanced diet rich in a diversity of fruits, vegetables, protein, and herbs and spices. The review also underscores the need for these nutrients in the preconception window to maximize the epigenetic integrity of the sperm.
If you reverse engineer an antioxidant-rich diet with enough protein and healthy fats to support healthy reproductive function in both men and women - it looks a lot like a Mediterranean diet: quality protein; healthy fats like olive oil, nuts, seeds, avocado, and animal fats; starchy fruits and vegetables; eggs; whole grains; and full-fat dairy. Finding the foods that work best for you from this list and increasing your intake of them will start to nurture your reproductive health right away.
Looking for other “must-knows”?
Feel free to check out the Essential Fertility Wellness Checklist which covers all the surprising and mind-easing to-do’s for everything you’d want to think about pre-trying for a baby!
This checklist covers every area of preparation: fertility-boosting foods, best workout routines, mindfulness tips, helps pinpoint your fertile window, what tests to ask your doctor for, partner conversation starters, book & podcast recommendations, and MORE.
Written by Michelle Cawley, MS. 1/2/23
The information on this website is provided for educational purposes only and should not be treated as medical advice. WTT Nutrition makes no guarantees regarding the information provided or how products may work for any individual. If you suffer from a health condition, you should consult your health care practitioner for medical advice before introducing any new products into your health care regimen. For more information, please read out terms and conditions.
REFERENCES
Krawczyk A, Kretek A, Pluta D, Kowalczyk K, Czech I, Radosz P, Madej P. Gluten-free diet - remedy for infertility or dangerous trend? Ginekol Pol. 2022 Feb 14. doi: 10.5603/GP.a2021.0223. Epub ahead of print. PMID: 35156701.
Alecsandru D, López-Palacios N, Castaño M, Aparicio P, García-Velasco JA, Núñez C. Exploring undiagnosed celiac disease in women with recurrent reproductive failure: The gluten-free diet could improve reproductive outcomes. Am J Reprod Immunol. 2020 Feb;83(2):e13209. doi: 10.1111/aji.13209. Epub 2019 Nov 24. PMID: 31709662.
Panth N, Gavarkovs A, Tamez M, Mattei J. The Influence of Diet on Fertility and the Implications for Public Health Nutrition in the United States. Front Public Health. 2018 Jul 31;6:211. doi: 10.3389/fpubh.2018.00211. PMID: 30109221; PMCID: PMC6079277.
Hess JM, Stephensen CB, Kratz M, Bolling BW. Exploring the Links between Diet and Inflammation: Dairy Foods as Case Studies. Adv Nutr. 2021 Oct 11;12(Suppl 1):1S-13S. doi: 10.1093/advances/nmab108. PMID: 34632478; PMCID: PMC8502778.
Ulven SM, Holven KB, Gil A, Rangel-Huerta OD. Milk and Dairy Product Consumption and Inflammatory Biomarkers: An Updated Systematic Review of Randomized Clinical Trials. Adv Nutr. 2019 May 1;10(suppl_2):S239-S250. doi: 10.1093/advances/nmy072. PMID: 31089732; PMCID: PMC6518147.
Verma I, Sood R, Juneja S, Kaur S. Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility. Int J Appl Basic Med Res. 2012 Jan;2(1):17-9. doi: 10.4103/2229-516X.96795. PMID: 23776802; PMCID: PMC3657979.
Tiffon C. The Impact of Nutrition and Environmental Epigenetics on Human Health and Disease. Int J Mol Sci. 2018 Nov 1;19(11):3425. doi: 10.3390/ijms19113425. PMID: 30388784; PMCID: PMC6275017.
Kanherkar RR, Bhatia-Dey N, Csoka AB. Epigenetics across the human lifespan. Front Cell Dev Biol. 2014 Sep 9;2:49. doi: 10.3389/fcell.2014.00049. PMID: 25364756; PMCID: PMC4207041.
Blume C, Garbazza C, Spitschan M. Effects of light on human circadian rhythms, sleep and mood. Somnologie (Berl). 2019 Sep;23(3):147-156. doi: 10.1007/s11818-019-00215-x. Epub 2019 Aug 20. PMID: 31534436; PMCID: PMC6751071.
Gaine ME, Chatterjee S, Abel T. Sleep Deprivation and the Epigenome. Front Neural Circuits. 2018 Feb 27;12:14. doi: 10.3389/fncir.2018.00014. PMID: 29535611; PMCID: PMC5835037.
Pascoal, G.d.F.L.; Geraldi, M.V.; Maróstica, M.R., Jr.; Ong, T.P. Effect of Paternal Diet on Spermatogenesis and Offspring Health: Focus on Epigenetics and Interventions with Food Bioactive Compounds. Nutrients 2022, 14, 2150. https://doi.org/10.3390/nu14102150