Influence of diet on conception

When trying to conceive, often even the smallest thing, like the food that one eats, makes a difference. What one eats certainly affects the sex drive. But it can also impact the chances and the quality of conception. Lifestyle factors, like the diet and ways of life, can greatly influence overall health and well-being, including fertility. The good things is that these can be easily modified to suit one’s objectives.

The results of a 8 year study covering over 18,000 women published in The Fertility Diet (McGraw-Hill) by Jorge E. Chavarro, M.D., Walter C. Willett, M.D., and Patrick J. Skerrett “uncovered evidence based suggestions for improving fertility”. Instead of the many traditionally suggested fertility food items like oysters, ginseng, yam and garlic, ovulatory infertility, which is the underlying cause in almost a quarter of all cases of infertility, is now believed to be prevented much more through a complete and balanced diet.

At least five servings of fruits and vegetables: Inclusion of fresh fruits and vegetables in the diet not only ensures overall health and fitness, but also fulfills the requirement of essential vitamins and minerals in the body, required for both male and female fertility. Some deficiencies, especially those of folic acid and certain minerals, can play havoc with the fertility of both sexes, reducing the quality of sperm in males and abilities to sustain a pregnancy in women.

Plenty of unrefined carbohydrates: Whole grain cereals in multi-grain breads, pasta or chapatti helps meet the requirement of carbohydrates while also providing the body with essential fiber. Sufficient carbohydrate is important not only to ensure adequate energy levels and overall fitness but also to maintain the appropriate biochemical balance in the body.

High quality proteins: While non-vegetarians can include fish, sea-foods and poultry, as sources of protein, in their diets, people with vegetarian diets also have a wide choice of pulses, soya products, milk and milk-products for sourcing their protein requirement. One should also include eggs in the diet if it is an option. It is advisable to include at least 2 servings of protein rich foods in the daily diet. Besides strengthening the muscles and improving stamina, some protein sources like certain pulses and meats also help in meeting the requirement of folic acid in the body.

Adequate water: The adequate intake of water per day depends on various factors like gender, activity level, health and of course the environmental conditions. Though there are various recommendations on the right quantity of water to be consumed per day, the Institute of Medicine recommendation, for temperate climates, is fluid intake per day of 3 liters for men and 2.2 liters for women. This is almost the same as the often mentioned thumb rule of “8 glasses” per day. Just remember that the intake covers all fluids.

But besides ensuring that one switches to a diet that is appropriate for supporting a healthy conception, one must also be aware of certain things that need to be avoided for the same.

AlcoholConsumption of alcohol, especially if not strictly regulated, affects not just the overall health and fitness but also both male and female fertility. Since it is not often easy to regulate, couples trying to conceive should attempt to completely stop alcohol consumption.

Smoking: Couples trying to conceive should abstain from smoking and generally any kind of tobacco use. Smoking inevitably affects both the sperm quantity and quality in males and thereby the chances of a conception. In women, smoking affects how receptive the uterus is to the egg.

Cessation of smoking and alcohol consumption are lifestyle modifications which apply to to both the partners if they are desirous of having a baby. For dads-to-be, limiting alcohol is even more important when compared to moms-to-be. According to a research study, ‘Effects of caffeine, alcohol and smoking on fertility’, published in the journal of The Fertility Society of Australia, the mechanisms by which alcohol impairs fertility are unclear, but in men it has been found to cause impotence, reduction of libido and poorer sperm quality.

Caffeine: Caffeine is present in tea, coffee and in some soft drinks. It is known to drastically reduce the chances of conception. Studies have shown that consumption of even 200 mg of caffeine per day almost doubles the average risk of miscarriage of 12.5%. This doesn’t mean that one has to altogether give up their coffee or tea if they want to conceive…just limit it to a reasonable level. While some experts suggest during pregnancy a limit of 100 mg of caffeine per day from all sources (1 cup of brewed coffee or 2 cups of tea), there is no specific basis for the same.

It is important to note here that alcohol consumption and smoking are undesirable not only during the phase of conception, but also throughout pregnancy. So when it comes to planning a baby, the first step should be a decision to abstain from both of them. According to National Health and Medical Research Council and National Institute of Clinical Studies, pregnancy is a time when smoking cessation advice has been found to be most effective.

Mercury: While it may sound a bit bizarre, we may unknowingly intake a lot of mercury by consuming certain soft water fishes, which are known to have high mercury content. High mercury levels can lead to Menamata disease, which interferes with fertility and can also cause miscarriage and preterm delivery.

To summarize… A healthy, complete and balanced diet, that includes lots of carbohydrates, good quality proteins, fruits and vegetables and less refined foods and fats, when combined with abstinence from alcohol and tobacco consumption and moderation with caffeine, can support a successful and healthy conception.

Female Infertility: Cause and Treatment

The worst news that a woman trying to conceive can receive is that she is infertile. In the United States, 10 per cent of the women face the nerve-racking problem of infertility, which is the inability to get pregnant naturally. This is not solely a curse for women as men can be infertile as well.

The Center for Disease Control (CDC) states that out of all instances when infertility causes distress to a couple; female and male infertility each account for one third of those instances. A combination of problems from both the man and the woman who are trying to conceive, account for the rest of the cases after accounting for 20 per cent of the cases, where the doctors are unable to identify any obvious cause of infertility.

Causes of Female Infertility

Cervical Issues – In some cases, an abnormal mucus production or a previous surgical procedure performed on that area can cause a blockade that prevents the sperm from passing through the cervical canal. There is a workaround for this problem – intrauterine inseminations. In this process, the sperm is placed inside the uterus artificially to help with fertilization. This procedure increases the number of sperms that reach the egg.

Damage to Fallopian Tubes – A damaged fallopian tube can prevent the egg from reaching the uterus where it can met by the sperms. The fallopian tubes are responsible for carrying the eggs from the ovaries to the uterus. A damage to the tube can be caused by pelvic surgeries, pelvic infections and endometriosis.

Uterine Problems – In this case, the structure of the uterus is not hospitable for the foetus. This is caused by the presence of polyps and fibroids. Polyps are the abnormal growths of tissue that are most commonly present in the uterus, nose or colon. They can be present in any organ that has blood vessels. Fibroids are specific to the uterus. They are also abnormal growths that affect 70 to 80 per cent of the women of African-American descent who are above the age of 50. The incidence among Indian women is about 25% as per a study conducted by the National Institute of Health.

Hormonal Causes – The hormonal causes involve problems with ovulation (when a matured egg is released from the ovaries). Because of some hormonal changes, this transfer of the mature egg does not take place. Blood tests to detect the hormone levels beside ovulation predictor kits and basal body temperature charts can be used to detect this ovulation problem.

Unexplained Reasons – As the name suggests, an unexplained infertility is when the causes are not clearly identifiable. This happens in 20 per cent of infertility cases. More advanced methods of investigation are required to analyse such other causes.

Diagnosing Infertility

Blood Tests – Can be used to detect a number of potential causes including improper hormonal levels.  The level of testosterone in men is also analysed through a blood test.

Laparoscopy – This procedure involves looking at the outside of the uterus, ovaries, and fallopian tubes by inserting a fiberoptic camera attached to a thin tube through an incision near the belly button. Laparoscopy helps doctors look for abnormal growths in the area. This happens in the case of endometriosis which is due to the formation of endometriotic tissues in other parts of the body apart from being present in the uterus.

Hysterosalpingography (HSG) – An HSG involves inserting a dye or saline into the cervix. Thereafter through X-ray or ultrasound, doctors can find out whether the fallopian tubes are open or blocked.

Semen Analysis – Is performed in the case of male infertility to determine the strength and number of the sperms.

Treating Female Infertility

In vitro fertilization (IVF) – IVF is a method of artificial insemination. In this case, the egg and sperm are combined outside the body and then placed in the uterus after the embryo forms. Since 1981, when the procedure was first introduced, it has been successfully used to give birth to over 200,000 babies.

Medical therapy – Special drugs can be given to women facing problems with ovulation. These drugs are also known to improve fertility. Gonadotropins can also be used in case of an unexplained infertility. Women with insulin resistance may receive additional drugs.

ICSI – Intracytoplasmic Sperm Injection or ICSI is done in case of male infertility. The sperm is injected directly into the egg in a dish and then placed in the uterus.

Egg donation – Egg donation involves the removal of oocytes from the ovary of a woman who has taken fertility drugs for ovarian stimulation. After the eggs have been extracted, in vitro fertilization is performed, using the sperm from the recipient’s partner.

Intrauterine insemination – This procedure involves placing the sperm in the uterus when the female is ovulating. The sperm is first rinsed with a special solution and then, using a thin plastic catheter, placed in the uterus through the cervix.

Hysteroscopy – Similar to laparoscopy, a hysteroscope is placed in the uterus through the cervix. Doctors can then use it to locate and remove scar tissue, treat endometriosis, open blocked fallopian tubes and remove ovarian cysts.

GIFT and ZIFT  In Zygote Intrafallopian Transfer or ZIFT, the fertilized eggs are placed in the uterus of the mother after IVF within 24 hours while in Gamete Intrafallopian Tube Transfer or GIFT, the sperm and eggs are mixed before insertion.

Women facing infertility need not panic as it can be treated in several ways. As a last resort, if none of the above mentioned treatments work, a couple can always go in for adoption or surrogacy. In surrogacy, the surrogate mother is inseminated with the sperm from the recipient’s partner. The surrogate mother then carries the baby and delivers it on behalf of the recipient.

Ailments affecting conception & pregnancy

If one is facing difficulty in getting pregnant i.e. suffering from unexplained infertility, then probably it’s time to look at some underlying medical causes  like obesity, hypothyroidism and asthma, which can interfere with one’s reproductive health, in many more ways than imaginable. Addressing these conditions can not only improve an individual’s overall health and fitness but also increase the chances of successful conception and pregnancy:

  • Hypothyroidism– Despite the recent increase in the problem of under-active thyroid gland, little is understood when it comes to its implications on our body and its functioning. While hypothyroidism can be managed with the right medication and lifestyle modifications, it can be very challenging to attain the exact level of thyroid activity  required to achieve and sustain pregnancy.

Also, during pregnancy fetal growth and development is controlled by the hormones produced in the thyroid of the mother. Hence, it is advisable to get your thyroid checked, and if you are already on medication for thyroid, get it rechecked even after you have conceived, as levels can vary during the course of pregnancy.

  • Diabetes- The presence of diabetes on this list may take you by surprise, but the fact is that deranged blood glucose levels can seriously lower your chances of having a baby. While high blood sugar level itself does not prevent someone from getting pregnant, it hinders the retention of pregnancy. This is because diabetes can prevent the implantation of the embryo in the uterus, causing a miscarriage sometimes even before a woman can realize that she has conceived.

For the same reason, multiple miscarriages can be a red flag for undiagnosed diabetes in women. As per the American Diabetes Association, high blood glucose levels are reported to increase a woman’s chance of miscarriage by 30-60%.

  • Obesity- While there is no direct correlation between obesity and infertility, the extra body weight inflicts physical complications like insulin resistance and hormonal imbalances, which not just reduce the chances of getting pregnant but also of maintaining it. So, maintaining a healthy body weight should be your first priority if you are trying to get pregnant.
  • Asthma- According to a research paper by Juul Gade, Elisabeth et al. “Female asthma has a negative effect on fertility: what is the connection?.” ISRN allergy 2014 (2014), asthma in the lower airways in women, due to a systemic reaction, can simultaneously cause inflammation in the mucosa of their uterus. If not treated correctly, this inflammation can inhibit normal implantation of the fertilized ovum, thereby leading to infertility. Hence in cases of unexplained infertility, especially if you have asthma, a more effective management of the condition can help achieve pregnancy.
  • Lupus- Lupus is an autoimmune disorder that can negatively influence female fertility. Due to the potential risks to the mother and baby, until sometime back, doctors used to advise women with this condition to avoid getting pregnant. But with advanced medical technology, having a child while suffering from Lupus is not that difficult.

However, the first step towards getting pregnant, in this condition is to have a complete control over the disorder. Regular review of the medication and timely consultation with the experts is also important because few medications may need to be stopped just before pregnancy.

  • Migraines- The benign migraine, which apparently has no direct relation to fertility, also reduces the chances of getting pregnant. This is because the adverse effects of the medications used to treat migraine has not been clearly identified for pregnant and breastfeeding women. Hence women who are taking long-term suppressive therapy for migraine are first advised to stop the medications for a few weeks, after consultation with their doctor, before planning a pregnancy.

It is observed that women with endometriosis are more than twice as likely to suffer from migraine as compared to women without the condition. While recurrent migraine attacks and its medication could directly interfere with fertility, it could as well be a associated with undiagnosed endometriosis,

So if you suffer from frequent migraine attacks and have difficulty  in conceiving, then it is high time to get your migraine medication reviewed and to also get a diagnostic test done for endometriosis.  Endometriosis is a disease that involves growth of endometriotic tissue in places outside the uterus. Endometriosis may grow on the lining of the abdomen and pelvis, that may sometimes cause scarring, involving the ovaries and blocking the tubes, thereby leading to infertility.

  • Epilepsy- According to the study by Singh, Pratibha et al. “Effect of epilepsy on female fertility and reproductive abnormalities.” Journal of human reproductive sciences 4.2 (2011): 100., compared to the general population, reproductive abnormalities and infertility are two to three times more common in epileptic females. This is because epileptic seizures can lead to an increase in the serum prolactin level and fluctuation in women’s reproductive hormones (Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH). Around 50% of all epileptic women are also reported to have menstrual abnormalities and a higher frequency of anovulatory cycles, which also adversely impact fertility.

People with epilepsy desirous of conceiving, should talk to their doctors to get epilepsy medications prescribed that do not impair fertility, are safe in pregnancy and seek hormone therapy under proper medical advice, if required.  

  • Male Infertility – Even though women may obsess over their inability to conceive, the reason for the same may often lie in various degrees of male infertility in their partners. Obesity and Diabetes are well known for causing sexual disorders like erectile dysfunction, late ejaculation and low sperm counts. Lupus in males can also cause infertility. Epilepsy medication can reduce testosterone levels or cause impotency (reduction in amount or quality of sperms).

So, if you are facing problems in getting pregnant and you or your partner already have or suspect any of the above medical conditions, then it is high time to take some corrective steps, especially because the right medical advice and action can significantly increase your chances of conceiving. After all when it comes to becoming a parent you don’t want to leave any stone unturned.