So much to do, so little time…
If you’re like most women, you’ve probably spent a lot of time researching things online and maybe talking with friends, relatives, or even near strangers, about the best things you could do to support your fertility.
My advice is to avoid magic bullets and think big picture: diet, exercise, rest, and emotional support. If a self-care practice makes you feel better, then do it. If it makes you feel stressed or obsessive, then give it a pass. Do what you can and be kind to yourself. Pick changes that you think you’ll enjoy because you’re more likely to stick with them.
The best self-care practices give immediate and long-term benefits. Pay attention to how you feel after you eat a healthy meal or take a twenty minute walk or listen to a guided meditation. That immediate feeling of greater relaxation, focus, energy, etc., is what will keep you coming back to a practice day after day, month after month. The long-term benefits to your health and fertility will begin to manifest after a few months.
Diet
There are many different healthy diets that you can follow. I’ve included the information below on the Mediterranean diet because it has been well-researched. It also clearly demonstrates that a healthy diet can improve your chances of natural conception. Don’t radically alter your diet because that hardly every works. Start with a couple small changes, give them time to become habits, and then incorporate a few more small changes.
Women adhering to a Mediterranean diet are thirty percent more likely to conceive either naturally or through fertility treatment. Women who adhere to a fast-food diet (heavy in meat and fried foods) are fifty percent less likely to conceive naturally. Dietary choices can make a huge impact on a woman’s fertility.
The Mediterranean diet has been studied the most. Adherence to the diet lowers the risk of infertility, leads to better sperm quality, as well as greater success for women undergoing fertility treatments. The higher the amount of fast food consumed, the lower the chance of getting pregnant. Eliminating fast food to the greatest extent possible is the best advice.
The intake of meat can negatively impact fertility by affecting ovulation. However, most of the detriment of consuming meat comes from the fact that you are eating less fish. Overall, the benefits of omega 3 fatty acids outweigh the risk of consuming too much mercury. It’s helpful for both partners to eat seafood. Most of the seafood we consume in the US is low in mercury. Shrimp, salmon, and canned tuna are all great. Light canned tuna has low levels of mercury. Two servings of seafood a week is fantastic.
Some women are concerned about caffeine and alcohol. The highest quality studies show no link between caffeine intake and fertility, so 1-2 cups of coffee a day is fine. Similarly, one drink a day appears to be fine in terms of potential impact on fertility, although alcohol consumption does increase your risk for various types of cancer, including breast cancer. Consuming alcohol is very much a personal choice. For myself, I usually save alcohol for a special meal or drinks out with friends.
Supplements
Fish Oil
If you don’t like seafood, consider supplementing with fish oil or Omega-3 fatty acid supplements. Higher blood serum levels of Omega-3 is associated with improved embryo morphology, and improved outcomes for women undergoing fertility treatment. Omega-3s might also help men improve sperm counts. Dosage is generally 1000mg.
Vitamin D
Vitamin D is a good choice. There appears to be some low threshold that women need to be above in order to conceive naturally. For women going through fertility treatments, being deficient probably leads to worse outcomes. Once you maintain a sufficient level, you don’t need to go above and beyond. There are no added benefits. 1000 IUs is generally recommended.
Folic Acid
There is consistent evidence that folic acid supplementation is helpful for natural conception and IVF success. It’s helpful for ovulation and other markers of conception. In IVF studies, folic acid seems to have an impact on fertilization and embryo development. It also helps maintain pregnancy. We absorb this nutrient better in supplement form, but it’s in lots of healthy foods like legumes and green leafy vegetables, so eat those too. Research shows benefit above and beyond the recommended 400 IU daily. It’s a water soluble vitamin, so if you consume more than your body needs, it is going to be flushed out in the urine. 600-1000mg is recommended.
Ubiquinol/Co-Q10
Some studies suggest that this supplement can potentially improve egg and sperm quality by protecting against free radical damage and enhancing mitochondrial function. The suggested dosage of Co-Q10 is 100-600mg/day. Ubiquinol is a more bioavailable (and expensive) form of Co-Q10, so you would take less of it. This might be a supplement worth considering if you have concerns about egg quality.
Exercise
If you’re worried that amount you are exercising (too much or not enough) is negatively impacting your fertility, there are some general, evidence-based guidelines you can follow.
#1) Weight is a tricky subject. We all come in different sizes and that is normal. Research shows that heavier people often experience medical bias and don’t receive the same level of care as people who are not considered overweight. That is inexcusable. At the same time, being overweight, particularly if you have PCOS, can negatively impact your fertility. If you have PCOS, adding some vigorous cardio and/or resistance training can make a difference, helping to improve hormone levels and improve the menstrual cycle. If you feel you fall into this category and would like to chat more about your options, please let me know!
#2) For women going through fertility treatments for other diagnoses (not PCOS), exercise has little to no impact on treatment outcomes. If you fall into this category, continue with whatever is normal for you. Keep in mind that if you don’t exercise much at all, a daily walk or 15-20 minutes of yoga is a great stress buster.
#3) If you are engaging in a lot of strenuous exercise, for example if you are a distance runner, it’s important to look at your health history a little more closely. In some women, frequent, vigorous exercise can have an impact on ovulation. If you were an athlete in high school and stopped menstruating or your cycles were irregular during your athletic season, if you are currently having issues with late or irregular ovulation, or if your luteal phase is short (10 days or less), you might want to consider cutting back on the amount you exercise. There are no hard and fast rules about this, but something to consider.
Finally, if you are working to establish or re-establish a workout routine, it doesn’t need to be complicated. The single best exercise for most people is walking. Most chronic disease would be eliminated if we all walked for thirty minutes a day. It doesn’t need to be all at once, either. Ten minute “exercise snacks” throughout the day will get the job done. I love this video from public health expert Dr. Mike Evans whenever I need a little motivation. If you want to add in strength training, yoga, etc., go right ahead. Just remember, if and when you fall off the wagon, you can easily get back on track by taking a walk.
Rest
Over my years in practice I’ve noticed that people will try all sorts of things to improve their health, but will often skip over the most obvious—sleep. Our bodies and minds heal at night while we sleep. Chronic sleep deprivation can cause or exacerbate a host of health problems, including infertility. That’s because sleep helps regulate hormone balance. One of the best ways to increase your sex drive is to simply get more sleep. If you have a hard time prioritizing sleep, see if you can slowly tack on an additional 30 minutes to your sleep schedule over the course of a month. You’re likely to see improved mood, energy, and overall sense of well-being. If you have problems falling asleep or staying asleep, be sure to let me know. That’s something we can work on with acupuncture!
Emotional Support
Going through infertility can be a tough path. Many women experience levels of stress similar to women undergoing treatment for cancer. Infertility is also deeply personal, and often difficult to share with others. Friends and family members may inadvertently say hurtful things, a spouse or partner may be supportive but not on the same page as you, etc. I am here to support you, but this journey will be easier if you have a few other people you can talk to about what’s going on in your life. If you’re not sure where to look for support, start here: Resolve and Fruitful
Physical intimacy, and I mean sex but other things as well, is an important way couples connect and support each other. It’s also something that can become challenging for both partners when there are fertility challenges. If it’s a goal for you to recapture some of your sex drive, please let me know when we talk during your appointment. That’s both a valid and reasonable goal.
Questions?
I’m here to help. Feel free to give me a call at 920.574.0447 or send me an email at leah@wholefamilyacupuncture.com