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Optimizing Health Before Conception


As moms, we would do anything for our children.  Many times, we are all guilty of putting the needs and health of our children over our own.  Myself included! I just went for my optometry check up, only to find out it was 6 years since my last visit and the dentist was a full 2 years between visits.

Between feeding, cooking, cleaning,  kids activities, and working full time there just doesn’t seem to be enough hours in the day to fully take care of ourselves.

When it comes to conception, woman many times go to great lengths to prepare for their first child, but by the time the 3rd one comes along there just is not the same amount of time.  It is common for women to say that they ate so much better before their first baby, or why bother losing all of my pregnancy weight when I am just going to get pregnant again.

Don’t get me wrong, there are plenty of healthy babies that get born to women that haven’t been having the “perfect” lifestyle.  One of the courses I took from a Reproductive Endocrinologist once said; “It is a miracle that any child is born healthy, but luckily it happens everyday”. When you look into the intricate steps that go into healthy conception, implantation, pregnancy, and delivery I couldn’t agree more with this statement.

However the reality is that many couples are suffering with greater infertility rates. The latest Canadian statistics reveal that 1 in 6 couples are struggling to conceive, and many of them already have a healthy child.  Many times patients come to see ND’s to help optimize their fertility once they have already determined there is a problem, or have undergone multiple IVF/IUI procedures.  While I have the greatest amount of respect and interest in the field of Reproductive Endocrinology, there is still a great number of patients that have unexplained infertility.  We also know that certain factors such as oxidative stress (think of a rusting car) have a great role to play in reducing fertility rates in both men and woman.

My hope in this article is to get men and women that are trying to conceive to think about their preconception health. This is essentially what they are consuming and being exposed to for the 4 months prior to conception.  The health of both partners is crucial as well, as it has been found that male factor infertility is as high as 40% of total infertility cases. Many times this has to do with poor sperm count, or poor quality sperm. Luckily dietary and lifestyle interventions will help with this as well.

A study of 161 couples from the Netherlands that were undergoing IVF participated in a study that was published in 2010 in the Journal of Fertility and Sterility. It was found that the couples that consumed a Mediterranean diet, full of good fats, veggies, fruits, whole grains and lean means had greater conceptions rates during IVF than those on a Standard North American Diet. While this was an IVF study, the researchers extended this to be helpful in unassisted conception as well. The woman that consumed a Mediterranean diet during preconception also had higher levels of folate and B6 in their red blood cells and  follicular fluid.   There is currently a trial underway called the PREPARE trial in which different interventions are being looked at for their positive benefit on fertility patients undergoing IVF. Researchers are looking at variables like diet, omega 3 and vitamin D on early embryo development and intra-uterine nutrition environment.

I see this so often, that women are busy and don’t take the time to lose their pre-pregnancy weight. I completely get it…with so much to do, is that weight really worth the effort?

Here are the latest stats on the link between obesity and fertility, and I will let you be the judge.

According to the Journal of Fertility and Sterility, compared to a women with a normal BMI (18-24.5), woman with a BMI of 25-29 have a 3% lower pregnancy rate and a 10% lower live birth rate. Compared to women with a normal BMI, woman that have a BMI over 30 are found to have a 14% reduction in pregnancy rates and a 25% reduction in live birth rates. Considering healthy woman have a 20% chance of becoming pregnant each month, and this rate considerable reduces after the age of 35 these results become more significant.

Now this article is not meant to be doom and gloom. It is also not meant to mean that every single women needs to be optimal weight to have a healthy baby. To be honest, while obesity is an easy factor for researchers to track, many times I think that the hormonal balance that is associated with an inflammatory diet is more to blame than the obesity itself. Yes we know that the more body fat one has, the greater the inflammation and the greater the oxidative stress. We also know that the body responds quite quickly from a hormonal perspective, like insulin and inflammatory markers to changes in lifestyle.

Lifestyle Tips to Maximize Fertility – General Guidelines for Men and Woman

  • Eat a Mediterranean Diet – Rich in vegetables, fruits, good fats, whole grains, nuts and seeds and lean meats
  • Optimize Body Composition (ratio of body fat to lean muscle tissue)
  • Avoid/Limit Alcohol
  • Avoid/Limit Caffeine
  • Reduce Stress
  • Sleep 6-8 hours per night
  • Since many pesticides have been linked with infertility, try to eat organic as much as possible especially the dirty dozen
  • Drink filtered water – Reverse Osmosis is the best
  • Watch your exposure to endocrine disrupting chemicals in skin care products and sunscreens. Use this website from Environmental Working Group as a resource

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