Boost your fertility by taking care of your health

Why and how to ensure a healthy and balanced diet during the preconception period?

Studies on the relationship between diet and human fertility have multiplied in recent decades. The results of this research have clearly identified that a balanced and healthy diet during the preconception period improves fertility in both women and men. To function optimally, the body requires macronutrients in specific proportions: carbohydrates should represent 40 to 55% of total energy intake (TEI), proteins 10 to 20%, and lipids 35 to 40%. Based on this scientific data, several key recommendations emerge.

Focus on good fats

Lipids are mainly represented by fatty acids , the distribution of which must respect a balance necessary for the proper functioning of the body. They provide us with energy, contribute to the synthesis of our hormones and cell membranes, and allow the absorption of vitamins A, D, E and K. But current diets generally contain too many saturated fatty acids and not enough monounsaturated and especially polyunsaturated fatty acids (including the famous omega 3). The latter are particularly essential for cardiovascular and cerebral health and fight against inflammation.

It is therefore important to consume oilseeds such as almonds, hazelnuts, walnuts, oily fish such as salmon, tuna, mackerel, sardines as well as vegetable oils rich in unsaturated fats such as rapeseed, flax, soybean.

Ensure stable blood sugar levels

Studies show a link between excessively high glycemic loads and ovulation disorders. Blood sugar spikes cause excessive insulin production. This excessive stimulation can, over time, lead to insulin resistance , a condition in which cells respond less effectively to the action of this hormone. Insulin, at high levels, unbalances the hormonal axis, increasing the production of androgens (male hormones) by the ovaries. This imbalance can disrupt ovulation , or even cause anovulation (absence of ovulation). This phenomenon is well documented, particularly in women with polycystic ovary syndrome (PCOS) , a common ovulation disorder linked to insulin resistance in 50 to 70% of cases. Conversely, better controlled insulin levels (through a low glycemic index diet and regular physical activity) can promote better insulin sensitivity, rebalance sex hormones, improve the regularity of menstrual cycles and ovulation.

To limit blood sugar spikes, it is advisable to favor foods with a low glycemic index : starchy foods, whole grains and flours, legumes (lentils, chickpeas, kidney beans), fruits (apples, pears, berries), vegetables and oilseeds (walnuts or Brazil nuts, flax seeds, chia seeds). Conversely, confectionery and products made with refined white sugar should be limited as much as possible. It is better to opt for alternatives such as stevia sugar, which has a more moderate impact on blood sugar.

Stock up on protein

Proteins play a key role in fertility, as they are the essential building blocks for the formation of cells and reproductive hormones (estrogen, progesterone, testosterone, etc.). It is important to favor proteins from plant sources , which are lower in saturated fatty acids than animal proteins, and rich in fiber, antioxidants, vitamins, and minerals. However, moderate consumption of animal proteins remains beneficial, particularly for the intake of vitamin B12 and heme iron, a form better absorbed than iron from plant sources. Fish and red meat can therefore be consumed approximately twice a week.

What roles do micronutrient supplements play in boosting fertility?

Specific micronutrient supplementation has proven effective in the area of fertility. Some play an essential role in both women and men.

Folic acid

This is the best-known supplement recommended for women during preconception and pregnancy. Folic acid (or vitamin B9) is one of the B vitamins essential for the healthy growth of the unborn baby. Numerous studies have shown that folic acid helps reduce the risk of brain malformation (neural tube defects) during pregnancy. Similarly, folic acid intake is associated with a lower incidence of infertility.

However, dietary sources are not sufficient to provide the folate required to protect against these malformations. In fact, 75% of women of childbearing age have folate intakes below the nutritional recommendations. If you are planning to become pregnant, it is therefore recommended to take the supplement at least three months before becoming pregnant.

Discover our advice on folic acid supplementation

Myo-inositol

Myo-inositol is a molecule naturally present in cell membranes. Once released inside the cell, it acts as a secondary messenger :

• by mimicking the action of insulin , notably by activating glucose transporters
• by promoting the action of FSH, follicle stimulating hormone.

This mechanism makes it a key player in reproductive physiology, with positive effects on oocyte development. In follicular fluid, myo-inositol is recognized as a marker of good oocyte quality, promoting follicle maturation and embryonic development. In medically assisted procreation (MAP), it improves ovarian sensitivity as well as oocyte maturation. Furthermore, its association with folic acid in the preconception period has shown a reduction in the risk of neural tube closure defects. Its beneficial effects are demonstrated at 4 g per day.

Iodine, selenium and zinc: 3 essential trace elements for fertility

Iodine is essential for the synthesis of thyroid hormones , which regulate cell growth and maturation. Its role in fetal brain development, particularly during the first months of pregnancy, is crucial. However, 75% of women of childbearing age have insufficient intake. Iodine deficiency can cause mild hypothyroidism, affecting fertility, delaying the age of first birth, and increasing the risk of miscarriages and unexplained infertility.

Selenium is involved in the development of ovarian follicles responsible for egg production. It also acts as an antioxidant, protects against heavy metals, and contributes to the proper functioning of the thyroid. Present in optimal concentrations in the ovaries, it promotes a cellular environment conducive to follicular development and egg quality. In men, it supports sperm production and motility , explaining its high presence in the testicles.

Finally, zinc , involved in more than 300 enzymatic reactions, contributes to protein synthesis and hormonal regulation. Recent studies confirm its role in reproductive health. It participates in the maturation of oocytes as well as the proper course of fertilization in women and improves the quality of spermatozoa in men.

Other B vitamins, vitamins C, D and E

Vitamin D3 contributes to the production of sex hormones and helps regulate cell growth . It also supports insulin synthesis and facilitates the entry of glucose into cells. Vitamins C and E act as antioxidants and participate in the regeneration of other antioxidants such as glutathione. B vitamins , for their part, play an essential role as cofactors in many metabolic reactions in the body, particularly in the folate and methylation cycles, and can help support antioxidant defenses.

What lifestyle habits should we change to promote fertility?

The lifestyle of the couple, both in the man and the woman, also has a significant influence on fertility.

Tobacco

Smoking by one of the partners reduces fertility. Cigarettes are even considered the number one enemy of fertility. In women, smoking is linked to a decrease in ovarian reserves, delayed conception, and a higher risk of miscarriage. In men, it significantly reduces sperm quality. Given these factors, quitting smoking or, failing that, reducing your consumption becomes essential. In this context, you should not hesitate to seek help and support. Note that passive smoking is also harmful.

Overweight and malnutrition

Obesity, like malnutrition, is associated with an increase in ovulation disorders. Obesity leads to a risk of anovulation (absence of ovulation), which compromises attempts at conception. It has been shown that a 5% weight loss can normalize certain factors , the effect of which leads to the restoration of normal egg maturation and, in some cases, avoid the need for assisted reproduction procedures.
Conversely, insufficient food intake or severe dietary restrictions lead to body weight loss, an overall lack of nutrients, and increased infertility. Therefore, it is advisable to aim for a BMI (Body Mass Index) between 19.5 and 24.9.

Other important parameters

The psychological aspect must also be taken into consideration. Stress creates a less favorable environment for conception. Regular and appropriate physical activity then offers numerous benefits, all of which help optimize the chances of pregnancy.

Another essential point, which is rarely discussed: the frequency of sexual intercourse. Regular intercourse (2 to 3 times per week), at the right time of the cycle, is an important condition for promoting conception. However, it is just as important to maintain spontaneity and balance in the couple.
Fortunately, there are several simple methods for identifying your ovulation period: using ovulation tests available in pharmacies, measuring your temperature every morning, observing changes in vaginal discharge, or even calculating your menstrual cycle.

If you would like advice or would like to ask us a question, please contact us by following this link: https://densmoregynecologie.com/pages/contact

This article is for informational purposes only and does not replace consultation or advice from your doctor. Seek professional advice before starting any dietary supplement.

Scientific references

Public Health France: recommendations relating to diet, physical activity and sedentary lifestyle for adults, 2019

World Health Organization: WHO Report on Infertility, 2020

"PCOS and Insulin: Dangerous Liaisons" Thursday, September 14, 2023. Part 1 PCOS: Is Insulin to Blame? Dr. Geoffroy Robin

Chiu YH, Chavarro JE, Souter I. Diet and female fertility: doctor, what should I eat? Fertil Sterile. Sep 1, 2018;110(4):560‑9.

Safarinejad MR, Hosseini SY, Dadkhah F, Asgari MA. Relationship of omega-3 and omega-6 fatty acids with semen characteristics, and anti-oxidant status of seminal plasma: a comparison between fertile and infertile men. Clin Nutr Edinb Scotl. Feb 2010;29(1):100‑5.

Wilson RD, Wilson RD, Audibert F, Brock JA, Carroll J, Cartier L, et al. Pre-conception Folic Acid and Multivitamin Supplementation for the Primary and Secondary Prevention of Neural Tube Defects and Other Folic Acid-Sensitive Congenital Anomalies. J Obstet Gynaecol Can. June 1, 2015;37(6):534‑49.

Chiu TTY, Rogers MS, Law ELK, Briton-Jones CM, Cheung LP, Haines CJ. Follicular fluid and serum concentrations of myo-inositol in patients undergoing IVF: relationship with oocyte quality. Hum Reprod Oxf Engl. June 2002;17(6):1591‑6.

Mintziori G, Mousiolis A, Duntas LH, Goulis DG. Evidence for a manifold role of selenium in infertility. Hormones. March 1, 2020;19(1):55‑9.

Künzle R, Mueller MD, Hänggi W, Birkhäuser MH, Drescher H, Bersinger NA. Semen quality of male smokers and nonsmokers in infertile couples. Fertil Sterile. 1 Feb 2003;79(2):287‑91.

Silvestris E, Lovero D, Palmirotta R. Nutrition and Female Fertility: An Interdependent Correlation. Front Endocrinol. 2019;10:346.

Anderson K, Nisenblat V, Norman R. Lifestyle factors in people seeking infertility treatment – A review. Aust NZJ Obstet Gynaecol. 2010;50(1):8‑20.

Carlsen E, Giwercman A, Keiding N, Skakkebaek NE. Evidence for decreasing quality of semen during past 50 years. Br Med J. Sep 12, 1992;305(6854):609‑13.

Chiu TY et al, Follicular fluid and serum concentrations of myo-inositol in patients undergoing IVF: relationship with oocyte quality. Human Reproduction Vol.17, No.6 pp. 1591–1596, 2002.

Caprio et al. Myo-inositol therapy for poor-responders during IVF: a prospective controlled observational trial. Journal of Ovarian Research. 2015; 8:37.

Myoinositol: The Bridge (PONTI) to Reach a Healthy Pregnancy. Pietro Cavalli and Elena Ronda. Int J Endocrinol. 2017; 2017: 5846286.