There are many reasons for conception and pregnancy to elude seemingly fertile couples, but ‘Unexplained Infertility’ is a common label given to many undergoing investigations. However, many of these couples, when initially presenting to GPs, are directed straight towards pharmacologically ‘assisted conception’ and IVF, without any other consideration. Should this be the case?
– I don’t think so, because research is confirming that the nutritional status of both male and female has a strong bearing on the health of the sperm and egg, and therefore their ability to become a viable blastocyst/embryo. (1,2)
And really – this is just common sense. If your diet is lacking the basic nutrients required to make egg and sperm, then the fundamental foundations of fertility are not in place.
We are what we eat Today, many people are aware of what constitutes real, nutritious food, but they don’t connect the dots and see that what they actually eat, becomes the building blocks of their body and all its functions. Over millennia, natural whole-foods enabled humans to become arguably the most successful species on the planet. These foods, occurring naturally in our environment, contain nutrients upon which our physiology depends. Today, many people eschew these foods in favour of manufactured, nutrient-depleted pseudo-food.
Pseudo-food? Yes, you know what it is – processed, chemically altered, confectionary foods. They tend to be heavily marketed and sold in eye-catching packaging with a long list of unpronounceable ingredients! We in the West have become reliant on their convenience. We over-indulge, turning what was an occasional treat for our grandparents, into something we expect in our daily diet. We are allowing pseudo-foods to replace real foods, and regular consumption can result in ever higher intakes of refined carbohydrate, at the expense of protein and vegetables, the very foods that contain the essential nutrients required to form viable eggs and sperm.
High intakes of Carbohydrate can impact a woman’s fertility via another route too. The resulting high blood glucose and therefore high insulin levels have been implicated in Polycystic Ovary Syndrome,(3) whereby the cells developing within the follicles on their way to becoming eggs, differentiate too quickly under the influence of glucose, fail to ovulate and remain stuck to the ovary to form cysts. How many women with PCOS are told bad luck, there’s nothing you can do, when research has clearly shown diet can be a factor?
Protein Research has also shown the importance of protein for both healthy egg development and successful IVF outcomes,(4) and deficiency of several micronutrients has been shown to negatively impact sperm count, their motility and morphology, as well as egg maturation, with the potential to impact embryonic development thereafter.(2,5) It remains unlikely that Vegetarian couples presenting with ‘unexplained infertility’ will have their diet properly assessed to ensure all the essential amino acids are being consumed from vegetable sources, before a GP refers them on to IVF.
Folate v Folic Acid Deficiency of folate has an established association with foetal structural defects, which is why all pregnant women are advised to take folic acid supplements. But suboptimal intakes of folate has also been implicated in miscarriage and failure to conceive.(6) So what of the (roughly) 20% of the population who struggle to metabolise the synthetic folic acid? It’s not inconceivable surely (excuse the pun) that some of those unexplained failure to conceive and miscarriages might be emanating from this group? It’s a question worth asking. Folate, effective in its natural, food-based form is essential for that minority who struggle to metabolise folic acid. Folate and folic acid also need vitamins B6 and B12 to work effectively, but few vegetarian women are advised they risk B12 deficiency when they omit animal protein from their diet.
There are many nutrients with specific roles to play in the successful development and maturation of egg and sperm. And there are pseudo-foods and dietary habits that inhibit fertility and conception. How can we expect our reproductive function to perform optimally, when we supply it with the poorest quality fuel and building blocks and deprive it of the very nutrients it needs? And with new research revealing that genetic differences equate to everyone requiring differing levels of nutrients, there has never been a more appropriate time to seek individual, tailored nutritional assessment. Anyone considering getting pregnant either naturally or with assistance, has a 3 month window of opportunity to optimise their fertility and lower their risk of miscarriage.
With this in mind, surely a couples diet is worth investigating first, before expensive IVF is embarked upon?
(1) M et al., (2012) Improvement of sperm quality after micronutrient supplementation European e-journal of Clinical Nutrition & Metabolism 7(1):e50-e53
(2) Cetin et al., (2010) Role of micronutrients in the periconceptional period. Human Reprod Update 16(1):80-95.
(3) Chakrabarti J (2013) Serum leptin level in women with polycystic ovary syndrome: correlation with adiposity, insulin, and circulating testosterone. Ann Med Health Sci Res. 3(2):191-6.
(4) American Congress of Obstetricians and Gynecologists (ACOG) 61st Annual Clinical Meeting: Abstract 96. Presented May 6, 2013.
(5) O’Flaherty C et al., (2004) L-arginine promotes capacitation and acrosome reaction in cryopreserved bovine spermatozoa. Biochim Biophys Acta. 1674(2):215-21.
(6) Soldo V et al., (2012) Defect of methylenetetrahydrofolate reductase in a patient with ten habitual miscarriages: a case report. Clin Exp Obstet Gynecol. 39(4):556-8.