Does Diet Affect Fertility?

Photo by Kelly Sikkema on Unsplash

When you think about the relationship between diet and pregnancy, most people focus on what to eat (and what to avoid) while actually pregnant. But what many people don’t realize is that your diet may also affect your ability to get pregnant in the first place. 

Worldwide, infertility rates are on the rise while healthy eating patterns decline.

In the United States, about 12% of women aged 15 to 44 years old have difficulty getting pregnant or carrying a pregnancy to term (3). Worldwide, an estimated 186 million people are affected by infertility (7). Meanwhile, unhealthy diets have become increasingly common in men and women of reproductive age. Preconception nutrition may benefit the many couples worldwide who are struggling to conceive.

Is there a relationship between diet and fertility?

• Certain foods have been found to increase both female and male fertility, while other foods have been found to reduce your chances of getting pregnant.

• Some hypothesize that the “Western Diet,” characterized by low intakes of fruits and vegetables and high intakes of saturated fat and sugar, may be negatively affecting the health and fertility of couples worldwide (13).

• Poor diet can also affect your hormone levels, which can thus impair a woman’s ability to ovulate and conceive (19).

Studying dietary patterns vs nutrients

In recent years, most studies have focused on the effect of individual micronutrients or antioxidants (i.e. folic acid or vitamin E) on fertility rather than dietary patterns as a whole (13). These studies have produced inconsistent results, which may be because they ignore the way that nutrients work together synergistically within our foods (5). I don’t know about you, but I enjoy food, not isolated nutrients. The study of dietary patterns may offer a more realistic approach to help the average person who struggles with fertility.

Which dietary patterns affect fertility?

The Mediterranean Diet

• High intake of plant foods (vegetables, fruits, nuts, whole grains, and legumes).

• Olive oil as the main source of fat.

• High-to-moderate intake of fish.

• Reduced intake of eggs, dairy, and poultry.

• Very low intake of red meat (1).

In numerous studies, the Mediterranean diet has been found to enhance both female and male fertility:

• Improves embryo yield and oocyte quality and quantity (20).

• Increases the chance of pregnancy after IVF treatment (15, 22).

• Improves body fat composition and reduces weight gain (1).

• Increases sperm concentration (6, 14).

• Improves total sperm count and sperm motility (the ability of sperm to move and swim efficiently) (6, 14).

A Prudent Diet

• High intake of plant foods (vegetables, fruits, nuts, whole grains, and legumes).

• Lean meats, such as chicken and fish, and a reduced intake of red meat.

• Moderate intake of low-fat dairy products (13).

• Similar to the Mediterranean diet, but with less focus on olive oil and fish.

A prudent diet may also improve both female and male fertility:

• Increases the average number of oocytes (immature eggs) in women undergoing assisted reproductive technology (ART) treatment (12).

• Lowers the risk of polycystic ovary syndrome (PCOS), an endocrinology disorder and the most common cause of anovulatory infertility (11).

• Increases sperm concentration and sperm count (6, 13, 17).

• Improves testosterone levels, sperm motility, and sperm morphology (the size and shape of sperm) (6, 8, 13, 18).

The Western Diet

• High intake of red meat, processed meats, and high-fat dairy products.

• High intake of refined grains, sugar, fried foods, and processed snacks.

• Low intake of fruits and vegetables (13).

In many studies, the Western diet has been found to negatively affect fertility:

• Reduces fertility and increases the time it takes to get pregnant (9, 13).

• Lowers sperm count (5, 16, 17).

• Impairs sperm morphology (5, 16).

• Reduces sperm motility (5).

So what should I eat to improve my fertility?

• Fruits, vegetables, legumes, whole grains, and nuts. These plant foods are high in antioxidants, vitamins, minerals, and fiber, as well as favorable for blood sugar maintenance and body weight.

• Olive oil. Vegetable oils are rich in omega-6 fatty acids, which may benefit ovulation, implantation, and pregnancy (22). Replacing saturated fats with unsaturated sources (like olive oil) may also benefit fertility.

• Fish. Regular fish consumption (1-2 times per week) may benefit both female and male fertility due to its high omega-3 fatty acid content (14, 21).

• Low to moderate intake of eggs, dairy products, and poultry. These foods are healthy in moderation for fertility, but it is generally advised to limit saturated fat intake from animal proteins (4).

• Reduce sugar intake. High sugar intake has been linked to a reduced ability to get pregnant, as well as an increased risk of premature birth and gestational diabetes (2, 10).

• Limit red meat consumption. Red meat intake is generally very low on the Mediterranean or Prudent diet, and may impair fertility.

• Avoid trans fats whenever possible. The typical Western diet is high in trans fats, which may harm female and male fertility. Trans fats are found in fried fast foods, vegetable shortening, packaged baked goods, and non-dairy creamers.

The benefits of preconception counseling

With more couples waiting to start their families until later in life, preconception nutrition counseling could have huge ramifications for the many couples worldwide who struggle to conceive. Adopting a more healthful diet before pregnancy may increase your chances of natural conception, prevent pregnancy complications, lessen the financial burdens of assisted reproduction, and reduce the mental stress associated with infertility. Furthermore, what you eat before pregnancy can affect the genetics of your future child and the quality of their health for the rest of their life. Dietary approaches may function as non-invasive and natural methods for treating infertility and should be a central component of fertility counseling.

For more information, check out my video: Dietary Patterns to Improve Fertility Parameters in Women and Men.

References

1. Boghossian, N.S., Yeung, E.H., Mumford, S.L., Zhang, C., Gaskins, A.J… Schisterman, E.F. (2013). Adherence to the Mediterranean diet and body fat distribution in reproductive aged women. European Journal of Clinical Nutrition. Retrieved from: https://0s21i3gba-mp01-y-https-search-proquest-com.proxy.lirn.net/central/docview/1314814030/2CD6BA31EC8E4D62PQ/1?accountid=158302

2. Casas, R., Castro Barquero, S., & Estruch, R. (2020). Impact of sugary food consumption on pregnancy: A review. Nutrients. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700555/

3. CDC, Centers for Disease Control and Prevention. (n.d). Reproductive health: Infertility FAQs. Retrieved from: https://www.cdc.gov/reproductivehealth/infertility/index.htm

4. Collins, G.G. & Rossi, B.V. (2015). The impact of lifestyle modifications, diet, and vitamin supplementation on natural fertility. Fertility Research and Practice. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5424364/

5. Danielewicz, A., Przybyłowicz, K.E., & Przybyłowicz, M. (2018). Dietary patterns and poor semen quality risk in men: A cross-sectional study. Nutrients. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165100/

6. Efrat, M., Stein, A., Pinkas, H., Unger, R., & Birk, R. (2018). Dietary patterns are positively associated with semen quality. Fertility and Sterility. Retrieved from: https://www.fertstert.org/article/S0015-0282(18)30010-4/pdf

7. Fontana, R. & Della Torre, S. (2016). The Deep Correlation between Energy Metabolism and Reproduction: A View on the Effects of Nutrition for Women Fertility. Nutrients. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772050/

8. Gaskins, A.J., Colaci, D.S., Mendiola, J., Swan, S.H., & Chavarro, J.E. (2012). Dietary patterns and semen quality in young men. Human Reproduction. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442634/

9. Grieger, J.A., Grzeskowiak, L.E., Bianco-Miotto, T., Jankovic-Karasoulos, T., Moran, L.J…Roberts, C.T. (2018). Pre-pregnancy fast food and fruit intake is associated with time to pregnancy. Human Reproduction. Retrieved from: https://academic.oup.com/humrep/article/33/6/1063/4989162

10. Hatch, E.E., Wesselink, A.K., Hahn, K.A., Michiel, J.J., Mikkelsen, E.M…Wise, L.A. (2018). Intake of sugar-sweetened beverages and fecundability in a North American preconception cohort. Epidemiology. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882510/

11. Hosseini, M.S., Dizavi, A., Rostami, H., Parastouei, K., & Esfandiari, S. (2017). Healthy eating index in women with polycystic ovary syndrome: A case-control study. International Journal of Reproductive BioMedicine. Retrieved from: https://0s21i3ity-mp01-y-https-search-proquest-com.proxy.lirn.net/central/docview/1958359533/F3908BC45CB94748PQ/1?accountid=158302

12. Jahangirifar, M., Taebi, M., Nasr-Esfahani, M.H., & Askari, G. (2018). Dietary patterns and the outcomes of assisted reproductive techniques in women with primary infertility: A prospective cohort study. International Journal of Fertility and Sterility. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186288/

13. Jurewicz, J., Radwan, M., Sobala, W., Radwan, P., Bochenek, M., & Hanke, W. (2018). Dietary patterns and their relationship with semen quality. American Journal of Men’s Health. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987950/

14. Karayiannis, D., Kontogianni, M.D., Mendorou, C., Douka, L., Mastrominas, M., & Yiannakouris, N. (2017). Association between adherence to the Mediterranean diet and semen quality parameters in male partners of couples attempting fertility. Human Reproduction. Retrieved from: https://academic.oup.com/humrep/article/32/1/215/2513723

15. Karayiannis, D., Kontogianni, M.D., Mendorou, C., Mastrominas, M., & Yiannakouris, N. (2018). Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility. Human Reproduction. Retrieved from: https://academic.oup.com/humrep/article/33/3/494/4828066

16. Liu, C.Y., Chou, Y.C., Chao, J.C.J., Hsu, C.Y., Cha, T.L., & Tsao, C.W. (2014). The association between dietary patterns and semen quality in a general asian population of 7282 males. Plos One. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4517920/

17. Nassan, F.L., Jensen, T.K., Priskorn, L., Halldorsson, T.I., Chavarro, J.E., & Jørgensen, N. (2020). Association of dietary patterns with testicular function in young danish men. JAMA Network Open. Retrieved from: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2761546?utm_source=applenews&utm_medium=referral&utm_campaign=article_alert-open_access_feed

18. Oostingh, E.C., Steegers-Theunissen, R.P.M., de Vries, J.H.M., Laven, J.S.E., & Koster, M.P.H. (2017). Strong adherence to a healthy dietary pattern is associated with better semen quality, especially in men with poor semen quality. Fertility and Sterility. Retrieved from: https://www.fertstert.org/article/S0015-0282(17)30222-4/pdf

19. Russell, C. (2018). Can my diet really affect my fertility? Dr. Chris Russell. Retrieved from: https://drchrisrussell.com.au/omfg/can-my-diet-really-affect-my-fertility/

20. Sun, H., Lin, Y., Lin, D., Zou, C., Zou, X…Qian, W. (2019). Mediterranean diet improves embryo yield in IVF: A prospective cohort study. Reproductive Biology and Endocrinology. Retrieved from: https://0s21i3ity-mp01-y-https-search-proquest-com.proxy.lirn.net/central/docview/2292705412/3A57240BE37740EAPQ/2?accountid=158302

21. Tabernero-Rico, P.M. & Garcia-Velasco, J.A. (2019). Observational study of the social determinants of health in subfertile versus nonsubfertile women. Journal of Human Reproductive Sciences. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764228/

22. Vujkovic, M., de Vries, J.H., Lindemans, J., Macklon, N.S., van der Spek, P.J…Steegers-Theunissen, R.P.M. (2010). The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization/ intracytoplasmic sperm injection treatment increases the chance of pregnancy. Fertility and Sterility. Retrieved from: https://www.fertstert.org/article/S0015-0282(09)04338-6/pdf