Getting pregnant and pregnancy are some of the most important life stages in many men’s and women’s lives. The importance of the right nutrition during these periods is highlighted by the widely spread message that you should be taking Folic Acid supplement, ideally three months before you conceive, but optimal nutrition goes way beyond this single nutrient approach.
The need for optimal nutrition has never been more important in the current context where research suggests that the fertility rate has halved in the last 50 years (1) with more recent research suggesting that over 60% of young male Swiss residents had abnormal semen (2). Here in the UK, 1 in 7 couples currently struggle with infertility (3) with unexplained infertility (where semen and female reproductive organs appear ‘normal’) accounting for nearly half of the cases (4).
Below, I would like to focus on some of the main imbalances and nutritional factors, which may affect fertility in men and women.
What is Methylation?
Before I delve into listing these, however, I would like to explain the very important process of Methylation, which is an epigenetic (phenotype changes that do not involve alterations in the DNA sequence) mechanism. When a Methyl group gets added to your Cytosine, one of the four bases of your DNA, your DNA becomes ‘methylated’ and this process might turn on and off certain genes, without the DNA sequence being changed. The process of Methylation is important in many processes, but it is particularly linked to both fertility and pregnancy outcomes (5). This important process is linked to diet as it its status depends on certain nutrients such as Folate, Choline, B12, B6, Methionine etc.
Imbalances in Men
Here are some of the more common imbalances affecting male fertility:
- Hormones – imbalance between testosterone/oestrogen
- Immune System Imbalances – STIs, mumps/shingles, anti-sperm antibodies
- Impaired Methylation – through diet, lifestyle or genetic SNPs (MTHFR)
- Impaired Detoxification – phase 1 and 2 liver detoxification, gut disruption
- Environmental disruptors – hormone disrupters such as plastics, medications, alcohol, mobile phone use, nutrient deficiencies, iron overload, tight underwear, over exercise, lipophilic toxins affecting sperm quality, etc.
- Energy Imbalances – obesity, diabetes, thyroid function disorders
- Stress – high stress, depression, HPA axis imbalance
Imbalances in Women
Here are some of the more common imbalances affecting female fertility:
- Hormone Imbalances – linked to conditions such as PCOS, Endometriosis, Fibroids, Anovulation etc.
- Immune System Imbalances – STIs and auto-immunity
- Energy Imbalances – obesity, diabetes, thyroid function disorders
- Stress – high stress, depression, HPA axis imbalance
- Impaired Methylation – through diet, lifestyle or genetic SNPs (MTHFR)
- Impaired Detoxification – phase 1 and 2 liver detoxification, gut disruption, constipation
- Environmental disruptors – hormone disrupters (plastics, silicone implants, non-organic sanitary products, make up, other personal care products) medications (including long-term use of contraceptive pills), alcohol, caffeine, smoking, excessive exercise and nutrient deficiencies.
Therapeutic Window
New sperm takes about 86 days to go through the spermatogenesis process, therefore, ideally pre-conceptual or pregnancy care should start at least 3 months BEFORE trying to conceive.
Of course, in this timeframe the nutritional status of the mother to be has to be considered too, however, the maturation of the egg in women takes much less time.
Nutritional Therapy Therapeutic Approach to Fertility
The wholistic approach first of all considers both partners, the outdated archaic views that the focus should be just on the future mother is well – OUTDATED!
Here is an outline of my approach when I’m working with a couple trying to conceive:
- Optimise Nutrition for both partners through personalised diet and supplementation plans
- Assess Toxic Load in both partners and potentially work to detoxify (xenoestrogens, heavy metals, etc.)
- Assess and Support Methylation
- Assess and Optimise Lifestyle – exercise, sleep, stress reduction techniques
- Consider Functional Testing to identify imbalances – complete hormone analysis (DUTCH Test), Organic Acids test, MTHFR gene test etc.
Bibliography:
- Levine H, Jørgensen N, Martino-Andrade A, Mendiola J, Weksler-Derri D, Mindlis I, et al. Temporal trends in sperm count: A systematic review and meta-regression analysis. Hum Reprod Update. 2017;
- Rahban R, Priskorn L, Senn A, Stettler E, Galli F, Vargas J, et al. Semen quality of young men in Switzerland: a nationwide cross-sectional population-based study. Andrology. 2019;
- National Institute for Health and Care Excellence N. Fertility: assessment and treatment for people with fertility problems. NICE CLincal Guidel. 2013;
- Moghissi KS, Wallach EE. Unexplained infertility. Fertility and Sterility. 1983.
- Roost MS, Slieker RC, Bialecka M, Van Iperen L, Gomes Fernandes MM, He N, et al. DNA methylation and transcriptional trajectories during human development and reprogramming of isogenic pluripotent stem cells. Nat Commun. 2017;