October 20, 2014
Meeting Fertility Challenges With Nutrition

The moment is now. It's time to get pregnant, so you try, again, and again, and again, until you feel so stressed that the very thought of not ever becoming pregnant consumes you. Often, women and men go through this cycle. Unfortunately, infertility is all too common. 1 in 8 couples (or 12% of married women) have trouble getting pregnant or sustaining a pregnancy. (2006-2010 National Survey of Family Growth, CDC). Approximately one-third of infertility is attributed to the female partner, one-third attributed to the male partner and one-third is caused by a combination of problems in both partners or, is unexplained. (www.asrm.org) Our hope is to help guide you toward reproductive balance and fertility health with lifestyle management and nutritional guidance.

General Causes of Infertility

There are known causes of infertility. Some have to do with your physiological makeup, others are factored in due to imbalanced nutrition, exercise, sleep, and stress, some are genetic, and many are due to toxic exposure through pollutants, food, drugs, alcohol, and even caffeine. Here is the breakdown:

  • Male factors including endocrine disorders, anatomical disorders, sperm abnormalities, sexual dysfunction: 25%-40%*
  • Ovulation Defect: 20%-30%*
  • Fallopian Tube Defect: 20%-30%*
  • Endometriosis: 5%-10%*
  • Other Factors, including genetic: 10-20%*
  • Under or Overweight: Women with <17% body fat frequently do no menstruate—Women with <22% body fat frequently do not ovulate. In fact, 12% of all infertility is rooted in weight issues (too much, or too little). Did you know that for every 20lbs you are overweight, you have a 10% decreased ability to conceive?
  • Excessive Exercise
  • Inactivity
  • Eating Disorders: Anorexia, Bulimia

*Percentages are estimates only

Nutritional Causes of Infertility

  • Vitamin D Deficiency in both men and women
  • Calcium Deficiency in males
  • Poor GI health—you are what you absorb, not what you eat. GI health is of helps to ensure that you give your body a chance to absorb all the nutrients in your food choices, to reap the benefits for your health.
  • Insufficient levels of common and important vitamins and minerals: Zinc, Folate, B6, B12, Niacin, Iron, Magnesium, Antioxidants--Vitamins A, E, C, and Selenium in both men and women
  • High Glycemic Diet—White foods, sugar, trans fat, too much saturated fat, and more sugar.
  • Alcohol Use
  • Caffeine Use: Guys-Did you know that just 1 cup (8 oz) of coffee can decrease your fertility by 55%? (13). Gals-Did you know that women who drink >200mg of caffeine during pregnancy have an increased risk of miscarriage?
  • Intravenous and Recreational Drug Use
  • Tobacco Use
  • Toxic Exposure: Check out our Preconception Series, Part 1: What to Avoid For Preconception Health, where you find a comprehensive list of endocrine disruptors in reproductive health.
  • Chronic Stress: Currently 5-10% of all infertility is stress related (2), making stress management an integral part of conception. Stress is a necessary part of your hormonal process, but left unmanaged and out of balance, it can lead to adrenal fatigue, chronic fatigue syndrome, depression, insomnia, inflammation, anxiety, and poor fertility health. Did you know that in one study, 34% of infertile women became pregnant after being trained in a relaxation technique? (3)

A Theory: Teaching Nutrition as Reduction (12)

Before we launch into nutrients that improve fertility health, we feel compelled to address the theory of Reductionist Nutrition. The current approach to teaching nutrition is to reduce individual nutrients down, isolate their role, and often omit how they work in conjunction with the rest of the systems in your body. An example of Reductionist Nutrition is the idea that supplements can replace food. If you take enough supplemental vitamin C, then you don't have to eat strawberries, when in fact, the strawberry is playing a multitude of other roles in your body beyond just providing you with Vitamin C. Go one step further and the idea is if you take 2,000mg of Vitamin C, then your body absorbs that 2,000mg. It's simply not so. Your body will absorb what your gut/cells allow, and what they need at that moment.

We want to address the idea of Reductionist Nutrition for three reasons:

  1. We will talk about nutrients as individuals, however, they are part of a complex system working in coordination with other nutrients in your body. Addressing them individually offers an opportunity to learn about their roles in bite-sized ways.
  2. We often get asked, how much of "that" food do I have to eat, to get "the right amount" of nutrients? We try not to break down food so much that we are focusing on micronutrient amount the same way that some people focus on calories. It's too simple! Food, nutrients, our body, do not work that simply. Furthermore, we are individual in how we absorb nutrients. The right amount for one person may not be the right amount for you.
  3. Food is always going to be where we turn to first—knowing that sometimes we do have to use supplementation to meet increased nutrient needs, like in the case of infertility and pregnancy.

Here is our approach:

  • Eat food first.
  • Meet the needs of the individual.
  • Highlight daily food intake that has known vitamin/mineral levels to promote health.
  • Supplement only if needed.

We will address fertility nutrition in reduced form for purposes of learning only. Here we go!

Fat Soluble Vitamins and Their Roles in Reproductive Health (14)

Vitamin A: Necessary for maintaining the endometrium and can help improve the quality of cervical fluid (4). Remember that vitamin A is an antioxidant, but it is fat-soluble. Too much vitamin A supplementation can lead to infertility. We suggest taking in Vitamin A in the carotenoid form, vs. through supplementation. Food first!

Vitamin E: Like vitamin A, vitamin E is an antioxidant with known benefits in the prevention of miscarriage, endometrial development, and placental health (5). Choose foods that are high in vitamin E daily.

Vitamin D: A recent study published in The Journal of Clinical Endocrinology and Metabolism found that higher vitamin D levels may help improve markers of fertility. It was found that "Vitamin D is an emerging factor influencing female fertility and IVF (in vitro fertilization) outcome, (www.ncbi.nlm.nih.gov)" showing that women with a vitamin D deficiency were 50% less likely to conceive through IVF than women with sufficient vitamin D levels. Optimize your vitamin D levels prior to conception. Remember that we recommend Vitamin D levels reach an optimal 50-60 on your blood test.

Water Soluble Vitamins and Their Roles in Fertility Health (14)

Vitamin C: An important antioxidant that works to decrease free radical damage. It works in conjunction with other antioxidants to decrease your toxic load, allowing for a healthier fertile environment. Vitamin C is a necessary water-soluble vitamin during pregnancy, but too much supplementation during preconception can cause insufficient cervical fluid (6). If you struggle with insufficient cervical fluid, it's best to keep your supplementation and vitamin C rich foods to 500-1,500mg daily (7).

Vitamin B Complex: Choose methylated (activated) B vitamins like thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5) pyrodoxal 5-phosphate (B6), methylfolate (B9), and methylcobalamin (B12). We know that B vitamin deficiencies can cause high levels of estrogen, but in turn, increased estrogen (from imbalanced body composition, for example) can cause vitamin B deficiencies (8). "Tests in the early 1930s proved that the flow of estrogen through the liver could be turned on or off by feeding or withholding B vitamins from the diet" (8). For fertility health, meet your B vitamin needs through foods like dark green leafy vegetables and legumes. Limit or eliminate foods that deplete the body of B vitamins, by avoiding alcohol and sugar. Your hormones will thank you for it!

Vitamin B6: Vitamin B6 plays many roles in your body for preconception health. It can help balance estrogen and progesterone, decrease fatigue by helping your cells make energy, help make red and white blood cells, and help you keep prolactin levels down if you are not lactating. Prolactin is a hormone needed during breastfeeding to help women make milk. In one study, 12 infertile women were able to become pregnant after supplementation of vitamin B6 at 100-800mg daily (9). A cautionary note: >100mg of vitamin B6 is linked to an increased risk of neuropathy.

Folate (Folic Acid): Folate has a complex and necessary role in your reproductive health, as well as your overall health. We know that folic acid is well documented as a vitamin that is protective during pregnancy, especially in the case of the prevention of common neural tube defects. But what happens when we know that 50% of the documented clinical population has a genetic error that impedes their ability to use folic acid? If you have a genetic hindrance to make the conversion from folate (folic acid) to methylfolate then you leave the protective benefits of this important nutrient behind. This genetic error is called MTHFR. Choosing foods that are high in folate will provide you with at least 70% methylated folate—the activated form you can use.

Minerals and Their Roles in Reproductive Health (14)

Calcium: Men need to pay particular attention to calcium, as calcium acts as a "central signaling molecule for sperm" (11). Calcium deficiency is also linked to infertility, osteoporosis, vitamin D deficiency, muscle pain/spasms, bone deformities and growth retardation in children.

Iron: Women should choose iron rich foods around the time of menstruation, as they will lose iron as they bleed. Iron will have better absorption in your body when taken with Vitamin C, in fact, in one study infertile women were able to gain their fertility by supplementing with iron and Vitamin C (6).

Selenium: "Selenium deficiency can contribute to infertility because selenium protects the egg from free radical damage" (3). Selenium is a known antioxidant that works with other antioxidants like Vitamins A, E, and C to help decrease damage being done to the body by toxins.

Zinc: In one study done by Joseph Pizzorno, N.D., he found that "Zinc deficiency lead to impaired synthesis and secretion of follicle stimulating and luteinizing hormones, abnormal ovarian development, disruption of the menstrual cycle, frequent abortion, prolonged gestation, teratogenicity (fetal abnormalities caused by teratogens—toxic substances for baby during fetal development), stillbirths, difficulty in parturition (childbirth), preeclampsia, toxemia, and low birth-weight infants" (3). Zinc also plays a large role in immune system health, helping to decrease inflammation—an integral part to improving your reproductive health.

Essential Fats' Role in Reproductive Health

We are not sure which fats we are hearing more about in the nutrition world, coconut oil or butter, salmon or flaxseeds? Whatever the case, we SHOULD be hearing about them! Fats are necessary, and some are essential for our overall health. Healthy fats, like the essential fats, Omega-3 fatty acids, have the remarkable ability to improve energy, support mucosal membranes, balance hormones, improve joint health, balance mood, improve lipid levels, and create a fertile environment. Women who take in omega 3 fatty acids have better uterine blood flow, increased cervical mucous, and improved ovulation, all of which aid in fertility (15). Men who take in omega 3 fatty acids have improved circulation to the genitals, which help support the prostate and the other element needed for reproduction, lower blood pressure, which helps with erectile dysfunction, and finally improved sperm production (16).

Steps towards Fertility Health

After seeing the list of the potential causes of infertility, and the list of nutrients that can improve fertility, we can understand if you feel overwhelmed. Not to worry! Let's break it down. There are plenty of action steps that you can take to work towards a healthy fertile environment. Many of these steps require a primary care provider to order lab tests and interpret results, however, looking deeper into the cause of your infertility may help you find your solution.

Male Physical Plan of Action (1)

We suggest the following:

  1. Medical History
  2. Physical Examination
  3. Nutrition Analysis—Including Allergy Panel for both food and inhalant IgG and IgE response
  4. Nutrition Analysis for adequate absorption of nutrients and functionality of your cells—This test is called NutraEval
  5. Semen Analysis
  6. Genitourinary Infection Screening (Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Neisseria gonorrhea)
  7. Heavy Metal Testing (Blood work)
  8. Male Hormone Panel
  9. Adrenal Stress Index (ASI)

Male Nutrition and Lifestyle Plan of Action

  1. Intake antioxidant rich foods.
  2. Consume colorful fruits, vegetables, nuts and seeds, herbs and spices daily.
  3. Ensure adequate protein intake for detoxification support.
  4. Eliminate alcohol, sugar, caffeine, tobacco use, recreational drug use
  5. Avoid gluten and dairy.
  6. Be cautious of toxins in food, water, soil, and your environment
  7. Manage your stress daily with moderate exercise and relaxation

Female Physical Plan of Action (1)

We suggest the following:

  1. Medical History
  2. Physical Examination
  3. Basal Body Temperature Charting
  4. Nutrition Analysis—Including Allergy Panel for both food and inhalants for both IgG and IgE response
  5. Nutrition Analysis for adequate absorption of nutrients and functionality of your cells—This test is called NutraEval
  6. Female Hormone Panel
  7. Thyroid Panel
  8. Heavy Metal Testing
  9. Adrenal Stress Index (ASI)
  10. Genitourinary Infection Screening (Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma homnins, Neiserria gonorrhea)

Female Nutrition and Lifestyle Plan of Action

  1. Intake antioxidant Rich Foods.
  2. Choose colorful fruits, vegetables, nuts and seeds, herbs and spices daily.
  3. Ensure adequate protein intake for detoxification support.
  4. Eliminate alcohol, sugar, caffeine, tobacco use, recreational drug use.
  5. Avoid gluten and dairy.
  6. Be cautious of toxins in food, water, soil, and your environment.
  7. Manage your stress daily with moderate exercise and relaxation.

You CAN improve your fertility, but it takes both partners. Start with an optimal preconception and fertility nutrition plan at least 3 months prior to trying to conceive. Download our Comprehensive Food Guide to Reproductive Health. We believe that with the right nutrients, balanced lifestyle, and positivity, you will be able bring life to your reproductive health. Have a happy and healthy day!

1: Romm, Aviva, Hywood, Angela. (2010) Botanical Medicine For Women's Health. Fertility Challenges. Chapter 12, p. 355. St. Louis, MO: Churchill Livingstone

2: Rosenthal, M. (1998) The Fertility Sourcebook. Lincolnwood, IL: Lowell House

3: Pizzorno, J. (1998). Total Wellness. Rocklin, CA: Prima Publishing

4: Weschler, T. (1995). Taking Charge of Your Fertility. New York, NY: Harper Collins Press

5: Bradstreet, K. (1995). Overcoming Infertility Naturally. Pleasant Grove, UT: Woodland Books

6: Reiss, F. (1999). The Infertility Diet: Get Pregnant and Prevent Miscarriage. Newton, MA: Peanut Butter and Jelly Press

7: Murray, M. (1996). Premenstrual Syndrome. Rocklin, CA: Prima Publishing

8: Ojeda, L. (1983). Exclusively Female: A Nutrition Guide For Better Female Health. Claremont, CA: Hunter House

9: Goldberg, B. (1998). Alternative Medicine Guide to Women's Health 2. Tiburon, CA: Future Medicine Publishing

10: Stone, M.S., M.D., Michael, Rydbom, C.N., L.E., Emily, Diagnosis: MTHFR Polymorphism, GrowBaby Pro App, 2014.

11: D. Ren and J. Xia, "Calcium signaling through CatSper channels in mammalian fertilization," Physiology, vol. 25, no. 3, pp. 165–175, 2010

12: Campbell, PhD, T. Colin, Whole: Rethinking the Science of Nutrition, Benbella Books: Dallas, Texas, 2014.

13: Keene, Iva, 10 Ways to Address Your Root Causes of Infertility Naturally, http://goo.gl/Y3cebw

14: Bauman College of Holistic Nutrition, Therapeutic Nutrition: Feeding the Moon, A Nutritive Approach to Feminine Fertility, Men and Women's Health, 2013.

15: Saldeen, P. Saldeen T. Women and Omega-3 Fatty Acids, Obstet Gynecol Survey, 2004 Oct;59(10):722-30; quiz 745-6.

16: Rodriguez, C.H., C.M.T., Hethir, Omega 3-6-9, Essential Supplement for Fertility and Pregnancy, Natural Fertility Info., http://natural-fertility-info.com/essential-fatty-acid-fertility