FAQ | Working With a Nutritionist for Fertility

What are good foods for fertility?

What is the fertility diet?

See full explanation of the Fertility Diet, on my blog. To get started, here are the Cliffs Notes:

The Fertility Diet (read the book), as coined by Researchers at Harvard School of Public Health, includes the following nutrition guidelines:

Eat healthy fats (like olive oil, avocado oil, nuts and seeds)
Eat more plant-based protein (you don't have to be vegetarian, just less meat-centric) (Note: quality counts. Meaning, high-quality meat that's raised on grass and not loaded with growth-hormones and pesticides is not the concern. As long as you get grass-fed and/or organic, red meat 1-4 times per week is fine - potentially even good - for your fertility.)
Eat fiberful carbohydrates (more whole grains like quinoa, brown rice and lentil pasta) (Note: carbs are not bad - in fact, they're good for you (your ovaries need carbs to function properly!), as long as you choose the ones that are full of fiber, and less of the highly refined varieties.)
Eat full-fat (organic) dairy. There are a few nutrients essential to fertility - like vitamin E for a healthy endometrial lining, vitamin A for cell differentiation and vitamin D for hormone balance - that need fat for absorption. Dairy (yogurt, cheese, etc.) is a good source of the vitamins A and D, but only in the full-fat version. Just avoid artificial growth hormones by getting organic!
Take high quality prenatal supplements. Yes, real food comes first. But, even the best of intentions to eat well easily fall by the wayside amidst the hustle & bustle of your full life. Make sure you're getting the best supplements for fertility to fill in the gaps.

The big picture:

A healthy, fertility diet, does not have to mean anything extreme, like going vegan, counting each gram of carb or treating refined sugar like toxic waste.

It does mean eating like your life is a vacation on a Mediterranean beach. Most meals are a colorful abundance of fresh fruits and vegetables, with tons of fish, seafood, nuts, seeds, whole grains and olive oil.

See a template for each meal based on the fertility diet.

What are the best foods for infertility?

What are the best fertility superfoods?

Can nutrition improve fertility?

Can a nutritionist for fertility actually help me get pregnant?

Can diet affect IVF success?

In short, yes! (Read the research)

The best nutrition approach for you will, of course, depend on the cause of your infertility.

That said, there is a considerable amount of research showing how blood sugar balance, reduced inflammation and nutrient repletion, all achieved through a healthy nutrition plan, can improve IVF outcomes.

Particular nutrients shown to be helpful for IVF include:

Vitamin B12: Women undergoing IVF with a deficiency in B12 are more likely to have fewer eggs retrieved, lower quality eggs, and lower quality embryos.
Folate: Sufficient folate is not just for prevention of neural tube defects. It's also a key component of fertility - for healthy follicular fluid, cell division and reducing inflammatory homocysteine levels.
Selenium: Selenium is involved in follicle growth and maturation, egg development as well as preventing chromosomal damage due to oxidative stress (think miscarriage prevention). It is found within the follicular fluid which nourishes the eggs. Supplementation with selenium and other antioxidants has been shown to improve IVF outcomes.
Vitamin D: Research has found lower pregnancy rates in women who are deficient in vitamin D and undergoing ART (IUI or IVF).
Omega-3 fatty acids (DHA & EPA) play a critical role in improved insulin response, progesterone production and increased blood flow to the reproductive organs. Some research suggests that Omega-3s may even delay ovarian aging and improve egg quality at advanced maternal age.
Probiotics. Although not a nutrient, a healthy microbiome could be helpful for better IVF outcomes. Research shows that women undergoing IVF are more likely to have bacterial vaginosis (BV) and abnormal vaginal flora, both can interfere with IVF. Probiotics also help reduce inflammation and regulate blood sugar, both of which help IVF.

Other important considerations:

Caffeine: 200-300 mg per day of caffeine - whether from coffee or tea - has not been shown to interfere with IVF. However, it can cause anxiety and disrupt your circadian rhythm, which could have a roundabout impact on your IVF outcomes.
Alcohol: More than 1 drink/day for women may decrease ovulatory infertility by as much as 50%! Research shows that the ideal is to have less than 4 drinks per week and 1 drink or less per day.
I recommend reducing exposure to hormone disrupting chemicals like BPA and phthalates, chemicals shown in repeated studies to result in fewer eggs retrieved, fewer eggs maturing each cycle and fewer eggs fertilized.

What foods improve IVF success?

Folate vs folic acid for pregnancy

I cover the best supplements for fertility and prenatal supplements here. But I know folate vs folic is a big question, so wanted to address it for you right off the bat.

(I also covered this topic thoroughly on the Modern Fertility blog)

Here's what you need to know:

Folate, also known as vitamin B-9, is the umbrella term for all forms of the nutrient.

Folic acid is the synthetic form commonly found in processed foods and prenatal vitamins.
Methylfolate (aka L-methylfolate, 5-MTHF, 5-methyltetrahydrofolate) is a biologically active form of folate, meaning it's easy for your body to absorb.

I recommend prenatal supplements with folate not folic acid because, unfortunately, folic acid is not as easily absorbed for many of us, and the unabsorbed molecules can accumulate, which poses some health risks.

Your body needs to break down folic acid into the metabolically active form, 5-MTHF, before it's usable.

Each individual’s ability to make this conversion to the bioavailable 5-MTHF varies based on liver function, genetics, alcohol consumption, and gut health (those with poor absorption due to conditions like Celiac Disease or IBD are at greater risk of folate deficiency).

This can result in unmetabolized folic acid accumulating in the blood stream, as well as a slight, about 4%, increased risk of having a baby with a NTD.

Although this sounds frightening, the solution is relatively simple: Take a prenatal multi that provides the most bioavailable form of folate, the 5-MTHF (a.k.a. methyl-folate), rather than folic acid.

What if I don’t have, or don’t know if I have, the MTHFR variation?

If unsure as to whether or not you have this MTHFR genetic variation (most of us do not know since this genetic testing is not standard practice), or even if you know you do not, the cautious approach is to choose a prenatal multi with methyl-folate instead of folic acid. This naturally-occurring form poses no known side effects, if taken in appropriate doses.

I recommend* the FullWell or the Needed prenatal supplements, which both include methylated folate.

^{*These are both affiliate links, meaning if you purchase using these links, you get a discount and I get a kickback. I appreciate your support!!}

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