Fertility & Preconception
Preconception Care
Where possible, it is recommended to begin preconception care at least 3 months before trying to conceive, as sperm development takes approximately 75 days, while female follicle maturation takes 100 days. This means that dietary and lifestyle choices made during this time directly impact the quality of sperm and eggs involved in conception.
Prioritising preconception care, where possible, is important to ensure adequate nutrient levels in the mother pre pregnancy, and to improve pregnancy outcomes through improving the quality of eggs and sperm. While 3-12 months is an ideal timeframe for preconception care, it is never too late to begin preconception care, the body is incredibly responsive and a little support goes a long way in this process.⠀⠀⠀⠀⠀⠀
To support conception:
Menstrual Cycle Health
First things first, we need to ensure you have a regular menstrual cycle and are ovulating! Begin to track your cycle, observing any signs of ovulation such as changes in cervical mucous and a rise in basal body temperature.
If there are any underlying factors, such as PCOS or Endometriosis, working with a practitioner can help to regulate the menstrual cycle and identify your fertile window to optimise chances of conceiving.
Preconception Testing
Undertaking some preconception testing can assist with assessing & addressing any nutritional deficiencies prior to pregnancy, as well as identifying any factors that may contribute to difficulty conceiving. Standard preconception testing can be done through a GP, however Naturopaths often utilise functional testing including hormone testing, gut testing & gene testing to support conception.
High Quality Pre-Natal Supplement
A pre-natal supplement can be thought of as an insurance policy, ensuring that you are covering all of your bases nutritionally. There are specific nutrients that we need for a healthy pregnancy, including folate, choline & iodine to support foetal growth and increased nutrient requirements during pregnancy. The quality of pre-natal supplements is important, therefore taking a practitioner-grade pre-natal supplement, prescribed by a Naturopath is advised.
Support Your Liver
Eating a well balanced diet, eliminate alcohol, reduce caffeine and ensure adequate water intake.
Stress Management
Incorporate stress management practices such as daily movement, meditation, deep breathing, time in nature. Stress plays a large role in infertility.
Review Your Environment
Eliminate any toxic substances from your diet and environment, including alcohol and household chemicals.
Preconception Diet
Optimise your diet & nutrient status prior to pregnancy is important to ensure adequate intake of nutrients, support a regular menstrual cycle and support egg health. Opt for a whole food diet, avoid refined sugar, and incorporate plenty of protein, complex carbohydrates and healthy fats.
Nutrients For Preconception
Iodine - promotes healthy thyroid function which promotes the formation and development of foetal organs and tissues. Iodine is also important for brain development, skeletal formation and the nervous system. Iodine is found in seaweed, wakame flakes, eggs, yoghurt & prunes
Folate - reduces the risk of pre-eclampsia, prevents neural tube defects, assists with embryo development and is important for ovarian responsiveness which will assist with improving egg quantity. Food sources of iodine include spinach, broccoli, asparagus, Brussel sprouts, rainbow chard, avocado &eggs
Vitamin D - helps the body to tolerate the growth of a baby who contains 50% foreign genetic material (from the sperm). Vitamin D supports embryo implantation into the uterus, and adequate levels prior to conception and pregnancy are associated with reduced risk of the baby developing asthma, allergies and developmental issues. Sources of Vitamin D include cod liver oil, organic liver, eggs, mackerel, salmon & sunshine
Omega 3 fatty acids - required for healthy brain, heart, eye and nervous system development. Adequate Omega 3 reduces the risk of pre-term birth, and has been shown to reduce post-natal depression and baby brain. Food sources of omega 3 fatty acids include oily fish, chia seeds, hemp seeds, linseeds, walnuts, extra virgin olive oil & flaxseeds
Choline - supports brain development and healthy gene expression, reduces the risk of neural tube defects and supports foetal development. Food sources of choline include eggs, organic liver and red meat.
Iron - iron is needed to carry oxygen in the blood to a developing foetus and support increased maternal blood volume. Iron enhances fertility by improving ovulation. If there is a deficiency before pregnancy, it can be difficult to reach adequate stores during pregnancy and can put the baby at risk of deficiency. Food sources of iron include cooked lentils, cooked spinach, red meat, tempeh, organic liver, spirulina & sesame seeds
Zinc - supports fertility by maintaining regular hormone function and ovulation. Food sources of zinc include pumpkin seeds, oysters, beef, legumes, chicken
CoQ10 - a potent antioxidant, CoQ10 protects DNA from oxidation and has shown to support egg quality and fertilisation. Food sources of CoQ10 include grapes, citrus fruits, berries, turmeric, green tea, brassica vegetables
Vitamin E - regulates the synthesis of sex hormones and optimises the health of the ovum. Vitamin E also improves endometrial thickness which results in increased rates of pregnancy. Food sources of Vitamin E include sunflower seeds, spinach & almonds
Vitamin B12 - deficiency has been linked to reduced ovulation and birth defects. Food sources include beef, salmon, eggs, organic liver & nutritional yeast
Preconception Care for Male Partners
In up to 50% of cases, infertility issues stem from the male, and the quality of human semen has declined by 50-60% over the last 40 years due to a variety of factors. Addressing the male partner is important when it comes to preconception care as it takes two to tango! Sperm is a reflection of the overall health of the male, and is impacted by factors including hormonal status, heavy metal exposure, stress, immune function, diet & exercise, weight, smoking and drug use. Important nutrients for male fertility include:
• Zinc - has an important role in sperm physiological functions and decrease of zinc in seminal plasma is associated with sperm quality
• Vitamin C - low levels of semen vitamin C concentrations is directly related to decreased amount of normal morphology of sperm and increased sperm DNA damage
• CoQ10 - has been shown to increase sperm concentration, motility and morphology
• Selenium - is essential for normal spermatogenesis
• Vitamin D - plays an important role in male fertility and serum levels of vitamin D are positively associated with semen quality
• Omega 3 - supplementation with DHA has the ability to improve sperm motility
Infertility & IVF
Infertility
Infertility is defined as the inability to conceive a pregnancy after 12 months of unprotected sexual intercourse. Infertility currently affects approximately 1 in 6 Australian couples of reproductive age.
There are many factors involved in infertility and may involve male, female or a combination of factors.
Causes of female infertility may include:
• A woman’s age
• Structural abnormalities
• Ovulation disorders
• Endometriosis
• Fibroids
• Polycystic Ovarian Syndrome
• Pelvic inflammatory disease
Causes of male infertility may include:
• Dietary & lifestyle factors such as smoking, recreational drug use and alcohol intake
• Environmental factors
• Chemotherapy or radiotherapy treatment
Testing for infertility may involve:
• Female - blood tests, ultrasounds
• Male - blood tests, semen analysis
Options to address infertility:
• Ovulation cycle tracking - to help confirm ovulation and identify your fertile window
• Ovulation induction - the use of medication to encourage ovulation
• Artificial insemination & intrauterine insemination (IUI) - involves inserting the male partner’s (or donor) sperm into the uterus at time of ovulation
• In vitro fertilization (IVF) - a procedure during which an egg and sperm are joined together outside of the body in a laboratory. The fertilised egg (embryo) is then transferred into the uterus, increasing the chance of a pregnancy occurring
• Fertility surgery - such as laparoscopy, tubal surgery or microsurgery to further investigate the cause of infertility, or address any underlying drivers that may be present
IVF
Below is a brief overview of the IVF process:
• Egg stimulation - through daily injections of FSH (follicle stimulating hormone) to over-stimulate the ovaries in order to develop eggs
• Once it appears as though there are enough follicles to proceed with a retrieval, HcG is then injected to induce ovulation and release the eggs
• Egg retrieval surgery - a day surgery performed under general anaesthetic to collect the viable eggs
• Eggs are then taken to a lab where they are fertilised with the chosen sperm (partner or donated)
• Once the embryo begins to develop, it is then inserted into the uterus via the vagina in a process known as insemination
• A pregnancy test will then be undertaken to ascertain if the process was successful