According to research a couple’s nutritional status should be assessed 3 – 4 months prior to getting pregnant so dietary changes can be made to optimize health of the mother and child. Nutritional counselling and assessment should also continue across pregnancy and during lactation to ensure both mother and baby are receiving adequate nutrient intake for each stage of pregnancy and in addition to any medical issue arising such as hypertension or gestational diabetes.
Women who routinely take a prenatal multivitamin and eat three meals a day to include a variety of vegetables, fruits, whole grains, low fat dairy products and protein sources (e.g. meat, poultry, seafood, beans, peas, eggs, processed soy products, nuts and seeds) may meet recommended daily intakes. However, the best multivitamin or nutrient dense diets do not necessarily meet the nutrition goals for everyone. Nutrients that are commonly found to be deficient despite one’s best efforts include but are not limited to Iron, protein, vitamin D, CoQ10, iodine and Omega 3 fatty acids and choline.
Protein
The foetal/placental unit utilizes approximately 1 kg of protein during pregnancy. The National academy of medicine recommends a dietary reference intake for pregnant women of 1.1 g/kg/day protein which is moderately higher than the average 0.8 g/kg/day. Protein is required for health of the egg and sperm, glucose and insulin balance and the growth and development of the baby.
Vitamin D
Most pregnancy multivitamins have some Vitamin D however your levels may be low despite supplementation. I always recommend testing for Vitamin D as the correct dose to ensure Vitamin D levels are adequate is imperative to boost fertility. As studies have shown women with normal levels of vitamin D are four times more likely to conceive through IVF than those with low levels. Other observational studies have shown that a deficiency resulted in reduced fertility and various adverse pregnancy outcomes.
Omega -3 Essential Fatty Acids
Omega – 3 fats cannot be made by the body, so they must be ingested through diet and/or supplementation. Food sources include fatty fish such as salmon, herring, mackerel, sardines or other fish 2x per week. Women who do not eat fish should consider supplementation. The Department of health national pregnancy care guidelines now recommends assessing omega-3 fatty acid status in women and supplementing accordingly to enhance fertility and reduce adverse pregnancy outcomes.
Iodine
Iodine is essential for the functioning of the thyroid gland and is required for conception and pregnancy. Iodine is found in seaweed products (nori, kelp, wakame) fish and iodized salt. Daily supplementation with 150 micrograms of iodine is recommended in all women considering pregnancy or are pregnant. Studies have found that women with an iodine-creatine ratio lower than 50 ug/g had a 46% lower chance of becoming pregnant. In addition, a mild iodine deficiency may increase risk of miscarriage and adverse birth outcomes as iodine is needed for early brain and nervous system development in the baby.
Ubiquinol (Coenzyme Q10 or CoQ10)
CoQ10 is an antioxidant that is found in many foods such as liver, kidney, beef, chicken, fatty fish, legumes and nuts. CoQ10 occurs naturally in the body to protect cells from damage, neutralize harmful compounds and promote energy in our cells. In clinical trials Ubiquinol at a dose of 300mg twice a day has shown to improve ovarian response to stimulation, improve egg health and fertilisation rates. Whilst ubiquinol in men has shown to enhance fertility by increasing sperm motility, health and count. Ubiquinol is the best form of CoQ10 as it is better absorbed. Do not opt for a cheaper CoQ10 with cheap fillers such as sulphites and soy that may harm your fertility.
Choline
Choline is found in both animal and plant sources however is in higher amounts in animal sources. Beef, eggs, chicken, fish and pork are concentrated sources providing 60 mg per 100g. Choline like vitamin D and DHA found in fish can be made by the body but not in amounts required for high metabolic demand such as pregnancy and prenatal issues. For fertility, pregnancy, and lactation an upward adjustment of 450 – 550 mg is recommended. Choline is critical for development of the placenta, reducing risk of miscarriage, healthy brain development and health of the egg and sperm.
If you need help making changes, or would like a nutritional assessment or testing to ensure you and your partner are not deficient in any nutrients thereby affecting your fertility, IVF and pregnancy then please contact us to make an appointment