Q: I got pregnant with my first child without even trying. My partner and I are trying for another baby and not having success. I didn’t know women could suffer infertility after successfully and easily conceiving a first child. Any support is appreciated!
Signed,
Waiting for Baby
A: The inability to conceive or have a full-term pregnancy after having had children without difficulty before is the definition of secondary infertility. It is a diagnosis that comes with its own set of stigma and support needs.
Sadly, couples with secondary infertility tend to receive far less social support from others than couples who have primary infertility because the couple already has a child(ren). But the need for support should not be ignored. A family can be extraordinarily thankful for their existing child and still long for more children.
Advocate for Your Fertility
Clinicians can often downplay the possibility of secondary infertility in what was their previously fertile patients and encourage them to “keep on trying.” Advocate for your fertility! If you and your partner have been actively trying to conceive for over a year or you are over 35 and have been actively trying for over six months. Or if you are over 30 and have a history of pelvic inflammatory disease, painful periods, miscarriage, irregular cycles, or if you know that your partner has a low sperm count, do not wait one year. It may be time to consult a specialist such as a Reproductive Endocrinologist or fertility specialist!
How Nutrition and Lifestyle Impact Your Fertility
However, nutrition and lifestyle choices can have a huge impact on fertility – in both men and women! Balanced blood sugar is the foundation of hormonal balance and optimized fertility. It starts with what and how we eat – every single day. We also know that to optimize our fertility we need to minimize stress. By ‘stress’ we are not talking just about everyday stressors like driving in heavy traffic or running late to catch a flight; it can be any perceived stress your body experiences (such as worry and anxiety to mismanaged blood sugar). And nowadays this can occur daily, sending our bodies into overdrive and keeping us in fight/flight/freeze mode. When we are under stress our body puts reproduction and digestion on the back burner in order to direct all resources toward survival. These tips are applicable to all genders, and can support reproductive health, and overall health too.
- Stress less. Stress hormones and sex hormones are made of the same building blocks. Chronic stress can “steal” those building blocks from reproductive organs, resulting in low or imbalanced hormone levels. What are the building blocks, you may be asking? Well, the answer is fat. That’s one of the reasons why low-fat diets are not typically fertility-promoting.
- Healthy fats: Butter, cream, cheese, lard, tallow, shmaltz, fatty cuts of meat, egg yolks (all from organic, pasture-raised animals*), fish and fish oil from deep-waters (sardines, wild salmon, mackerel, anchovies, etc.), olive oil, avocados, whole nuts and seeds, coconuts and coconut oil. *When animals are raised on their natural diet, the quality of fat they produce is measurably different than if they are fed things they aren’t evolved to digest. For example, grain-fed beef and dairy products are not as healthy as grass fed because grain causes inflammation and other problems for ruminant animals. Additionally, the toxic chemicals used in non-organic agriculture are concentrated in the fat of animals raised this way. It’s true, pasture-raised and organic meat and dairy is more expensive and not everyone can afford it. If this is the case, it may be a better choice to get healthy fats from fish and plant sources instead.
- Movement and rest. Too little or too much exercise can have negative impacts on health and reproduction. Additionally, not getting enough sleep can lead to imbalances in reproductive hormones. Balance is key when it comes to both exercise and rest. Sometimes trying to “do it all” sends the body a message of crisis mode. As a result, the body (wisely) shunts energy from “secondary” functions, like reproduction, into basic survival.
- Eat enough food, on a regular basis. For many women, just plain not eating enough can negatively impact fertility. For your body to conceive and grow a baby, it needs to know that there will be fuel coming in to make the whole process possible. If you are trying to conceive it is helpful to eat as if you are pregnant. Calorie counting, chronic meal-skipping, and low fat diets can all end up telling your body that it’s not a good time to grow a baby.
Also helpful is focusing on warm cooked foods, lots of broth such as bone broth soups and consuming warm or room temperature beverages. It is also important to stay hydrated. This also means ditch the caffeine, coffee can negatively impact fertility and studies have shown that if you’re undergoing IVF it can reduce your success rate by as much as 50%. Even though green tea seems like a healthy choice since it is high in antioxidants it can actually decrease blood flow to the uterus. That is something we definitely don’t want for conception!
- Eat a varied diet with as much whole foods as possible. For balanced blood sugar the Mediterranean diet has been found to be the most supportive. This focuses on healthy fats, lean proteins, nuts, seeds, and lots of fresh veggies. Here the slow burning carbohydrates keep your blood sugar stable and prevent the crash and burn you can experience from sugar laden products For men lycopene-rich foods like tomatoes help to support sperm count and eating a diet rich in antioxidants will help with sperm motility and morphology.
- Micronutrients are important. A lot of us think of foods as being carbohydrates, fats, and protein. In fact, there’s a lot more to the story. Minerals and other micronutrients are crucial to every single physiological function, especially those of the endocrine (hormone) system. We may not need a lot of them, but they have very important jobs to do. Here are some specific micronutrients that play a known role in fertility, along with some of their best whole food sources:
- Zinc (Red meat, shellfish (especially oysters), pumpkin seeds, chocolate)
- Iodine (Ocean fish and shellfish, seaweed, eggs, diary products)
- Vitamin B6 (Liver, ocean fish, chickpeas)
- Magnesium (dark chocolate, leafy greens, cashews, almonds, Brazil nuts, shellfish)
- Vitamin D (D3) (ocean fish and fish liver, exposure to sunlight)
- Selenium (Ocean fish, Brazil nuts, eggs, sunflower seeds)
- Support Your Microbiome. Focus on probiotic rich foods such as sauerkraut, kimchi, yogurt, or kefir. A healthy microbiome will ensure the estrobolome (the collection of microbes capable of metabolizing estrogens) works well, helping your body metabolize and get rid of excess estrogen through phase 1 and 2 detoxification. Also, cruciferous vegetables (cabbage, broccoli, cauliflower, kale brussel sprouts etc.) are full of fiber and contain DIM (is a compound called indole-3-carbinol, which our bodies metabolize upon digestion into diindolylmethane (DIM).DIM is well-known for supporting healthy hormone levels in both men and women) to help with estrogen metabolism. Many studies have also shown that if you’re trying to conceive, eating full fat dairy is beneficial for the estrobolome too.
- Eat for Each Phase of your Cycle If you are in a place in your life to take all of this a step further you may consider to support hormones throughout your menstrual cycle. During menses you will want to eat more blood building foods such as dark berries, beets, mushrooms, black sesame seeds, kidney and black beans, and sea vegetables as well as lean proteins. During the follicular phase and ovulation phase focus will be on egg development and building a good endometrial lining to support a strong and successful implantation. This is the time to eat more raw vegetables to support estrogen metabolism. During the luteal phase you may notice you feel more hungry, this is because your body has a lower resting blood sugar rate. Here the need for more slow burning carbohydrates increases and foods such as sweet potatoes, root vegetables, brown rice, and quinoa are optimal choices. These slow burning carbs will help to boost progesterone production which is necessary for a healthy pregnancy.
To learn more about fertility and nutrition and lifestyle choices that may help improve fertility, check out these books:
The Fifth Vital Sign by Lisa Hendrickson-Jack
Feed your Fertility by Emily Bartlett and Laura Erlich
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