Written by Karina Knight, Guest Blogger
I have always looked back and wondered if I could’ve done anything differently to improve the chances of having a successful pregnancy. What did I do wrong? Maybe I shouldn’t have had that extra cup of coffee? Guilt, pain and unbearable sadness is what best describes the moment they told us “there is no heartbeat” when we arrived at the ER immediately after my water broke with our full-term, healthy baby boy. And then it doesn’t get any better when doctors would say “we don’t know what happened”, “there is nothing we could’ve done”, “it is a statistic, happens in 1 out of 25,000 pregnancies”. In a way, it was a blessing that there was nothing “wrong” when trying to get pregnant with our first born, at some point you just must see your glass as half-full.
As soon as we got the green light from the doctors to get pregnant again, I tried Clomid, estrogen, took hundreds of dollars’ worth of supplements but it still took us 1 year, 1 month and 12 days to get pregnant. Interestingly though, I got pregnant when I discontinued all of these interventions, I just “let go”.
I was extremely careful with everything related to my pregnancy, and more meticulous about my diet. But because sometimes no matter what precautions you take, there are always uncontrollable factors. Our second baby was born at 32 weeks because I had complete placenta previa and began preterm labor due to placental abruption. I was immediately hospitalized and put under magnesium drip for a couple of days to buy time while the steroid shots kicked in to speed up the baby’s lung development. Three days later, we were incredibly blessed to conceive a BREATHING and healthy baby boy who only spent 10 days in the NICU. Despite our fears of complicated pregnancies, we really wanted to have another baby. So, the third time around doctors did not want to use any medications because they felt I did not have difficulties getting pregnant, rather maintaining the pregnancy. This time it took us only 2 months to conceive, we were ecstatic! Everything seemed normal until my 10-week follow-up when we heard again those terrible words “there is no heartbeat”. We were devastated! What was I doing wrong? Were my iron storages low, did I have low levels of folic acid? Endless unanswered questions. We decided to take one last chance, we couldn’t bear the idea of losing another baby. I got back on track with very healthy eating nutrient-dense foods, exercising, hydrating and fast forward 4 months later, we got pregnant again! Finally, the last pregnancy was a “normal” pregnancy where I had no complications and our healthy baby girl was born at 38 weeks.
Like me, there are many stories, all unique which I have been fortunate to be part of for my patients who are trying to conceive and/or carry a healthy pregnancy. The reason for my personal story is to let you know that there is a science behind improving the odds for pregnancy in terms of diet. However, remember that everyone is unique and there are still a lot of gray areas for which there no reasonable explanations. We cannot control all the factors, but we can at least try. The most popular diet is called, the Fertility Diet and about 80% of my patients trying to conceive, get pregnant about 6-months after following the diet. I’m not saying this is the only factor influencing the outcome, but it can help. The diet was developed by Drs. Jorge Chavarro and Walter Willett, both from Harvard School of Public Health. It is based on a comprehensive examination of diet and fertility, an 8-year study of more than 18,000 women without a history of infertility. In another study of women in Spain, those who followed a Mediterranean-style diet (high intake of vegetables, fish, and healthy fats), had 44% lower odds of seeking medical help for difficulty getting pregnant compared to the control group.
The diet improves the ovulation cycle and prevents ovulatory dysfunction which is one of the causes of infertility. It concluded that by following this diet, the probability of infertility is reduced by 28% and by 68% the probability of ovulatory dysfunction. They also found that those who regularly consumed refined carbs, white rice, and potatoes were associated with an increased risk of ovulation infertility. While current evidence on the role of dairy, alcohol, and caffeine is inconsistent, saturated fats, and sugar have been associated with poorer fertility outcomes in women and men. Moreover, women and men with obesity [body mass index (BMI) ? 30 kg/m2] have a higher risk of infertility. This risk is extended to women who are underweight (BMI <20 kg/m2). If a woman is overweight and trying to conceive, the main goal is to lose weight. By losing 10% of your weight, it can improve insulin sensitivity which helps women with PCOS ovulate. But woman who are lean and with PCOS, they can still be insulin-resistant, which can interfere with ovulation. In that case, eating fewer processed carbs and more whole-grain carbs can result in a slower rise in blood sugar and a lower insulin production, which is favorable for fertility.
What does the fertility diet recommend?
- Avoid trans fats, usually found in baked goods.
- Opt for healthy fats. Monounsaturated and polyunsaturated fats help improve the body’s sensitivity to insulin and lower overall inflammation. Include avocado or olive oil, nuts, seeds, and cold water fish such as salmon and sardines. Cut back on saturated fat.
- Turn to vegetable protein. Switch 50% of your proteins from animal origin to plant-based, this can reduce the risk of ovulation infertility by 50%.
- Choose low-glycemic carbs, not no carbs. The type of carbs are more important than they amount. Opt for complex carbs such as whole grains, vegetables, whole fruits, and beans, avoid refined flours. Total carbohydrates do not matter as much if it is a diet with moderate (60%) or low (40%) carbohydrates.
- Use whole milk and yogurt (it you eat it).
- Take a prenatal vitamin with 400 micrograms of folic acid, start 3 months before you are trying to conceive.
- Get plenty of iron from plants, such as dark greens, beans, lentils and combine with vitamin C (critics, red bell peppers, etc.) to increase absorption. Tea and coffee inhibit iron absorption when consumed with a meal or shortly after a meal.
- Aim towards a healthy weight per your BMI.
- Stay hydrated, about 1 ml per 1 kilocalorie.
- Stay active.
In a recent review, antioxidants, vitamin D, dairy products, soy, caffeine, and alcohol appeared to have little or no effect on fertility.
Talk to your healthcare provider before taking any supplements as they may negatively interact with other supplements or medications. Search for a local dietitian in your area who is familiar with the fertility diet to help guide you towards a personalized nutrition plan that tailors your caloric needs and lifestyle.
Gaskins AJ, Chavarro JE. Diet and fertility: a review. Am J Obstet Gynecol. (2018) 218:379–89.
Toledo E, Lopez-del Burgo C, Ruiz-Zambrana A, Donazar M, Navarro-Blasco I, Martinez-Gonzalez MA, et al. . Dietary patterns and difficulty conceiving: a nested case-control study. Fertil Steril. (2011) 96:1149–53.
Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Caffeinated and alcoholic beverage intake in relation to ovulatory disorder infertility. Epidemiology (2009) 20:374–81.