Fertility and Pregnancy
Fertility

Focus on Female Fertility

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Focus on Female Fertility

Fueling Your Path to Parenthood

20 MINUTE READ

Published August 2024

AUTHOR

Megan Lyons
Owner of Lyons’ Share Wellness, Double Board Certified as a Clinical Nutritionist and Holistic Nutritionist & Doctorate of Clinical Nutrition (Cand)

Navigating the journey to parenthood can be challenging and frankly…confusing. Whether you’re just starting to think about kids, you’re actively trying to conceive, or you’ve been diagnosed with fertility complications…it’s important to consider the lifestyle and nutrition factors.  This guide provides evidence-based insights and practical steps to enhance fertility through nutrition and lifestyle.

Nurturing your fertility

Fertility can be a complex and deeply personal journey. Whether you’re reading this guide from the perspective of “just getting started” or from many months into the fertility journey…it’s never too late to incorporate healthy diet and lifestyle choices.  This guide is designed to provide you with the knowledge and tools to navigate your fertility journey with confidence and hope.

We know it’s been a few years since your high school sex ed class, and they probably didn’t really explain how to GET pregnant. Many of us have spent most of our lives trying NOT to get pregnant…so now that we’re at the point of being ready to start a family we ask ourselves…so what exactly is happening in my body?

Understanding the menstrual cycle and pregnancy

The menstrual cycle is an amazing interplay of hormones that prepares the body for potential pregnancy each month, but the conception window is actually quite small. The whole cycle typically spans about 28 days, though cycles can range from 21 to 35 days in healthy women. The cycle starts with the follicular phase, where follicle-stimulating hormone (FSH) rises, stimulating the growth of ovarian follicles (tiny sacs that contain unfertilized eggs). As the follicles mature, they produce estrogen, which thickens the lining of the uterus so that it can hold an egg if the egg is fertilized. Around mid-cycle, a surge in another hormone, called luteinizing hormone (LH), triggers ovulation, the release of a mature egg from the ovary. This egg travels down the fallopian tube, where it can meet sperm and become fertilized. After ovulation, the luteal phase begins, characterized by a rise in progesterone, which further prepares the uterine lining for implantation. If fertilization does not occur, progesterone levels fall, leading to the shedding of the uterine lining, or menstruation, marking the start of a new cycle.

For pregnancy to occur, several key events must align. 

  1. First, ovulation must take place, releasing a viable egg. Did you know that many women have anovulatory cycles (they still bleed, but actually didn’t ovulate) based on conditions like PCOS, thyroid disorders, obesity, or hypothalamic amenorrhea caused by overexercise, overstress, or low body weight)?  

  2. Next, sperm must be present in the fallopian tube around the time of ovulation. This means you cannot get pregnant on the days far away from ovulation, because there is no egg in the fallopian tube to be fertilized!  

  3. Finally, the sperm must successfully fertilize the egg, creating a zygote (the very beginning of a baby). This fertilized egg must travel to the uterus and implant into the thickened uterine lining, where it can develop into a pregnancy.

Hormonal balance is crucial throughout this process; any disruption can impact ovulation, fertilization, or implantation. The  process can be easily interrupted by a number of factors including those we cannot control (e.g. genetics, age, infertility) and those we can control (e.g. diet and lifestyle). We’re going to talk about how to optimize your diet and lifestyle in order to optimize your fertility. Here are some of the “levers” we can pull to help prepare your body:

  • A healthy diet pattern and balanced lifestyle can regulate hormones and make ovulation more predictable, which makes timing conception easier

  • Diets rich in antioxidants and other nutrients from vegetables and fruits and omega-3 fatty acids, and low in sugar and alcohol, can improve egg quality and make it more likely that the egg released in ovulation can get fertilized¹.

  • Foods rich in healthy fats (like avocados, nuts, seeds, and olive oil) and B6 (like bananas, chickpeas, and poultry) support adequate progesterone, which is important for uterine thickening.

  • An anti-inflammatory diet rich in whole foods, vegetables, fruits, lean proteins, and healthy fats, supports a healthier uterine lining, which is important to reduce risk of implantation failure².

Getting pregnant can feel like a marathon…

Unfortunately our societal norms reinforce a-typical expectations in terms of getting pregnant. We’ve all seen the couple who has sex 1 time, and boom! They’re having a baby. Of course…this DOES happen, but statistically it’s not the norm. In fact only 30% of couples will conceive within their first month of trying (75% within 6 months, 90% within 1 year and 95% within 2 years)³. Bottom line…it can take a while. We know it’s so hard to wait. What if you could do something every day that improved your chances of conceiving (and the health of you AND your future baby)? 

Before we get into the suggestions…we know that there are factors outside of our control that can impede fertility. First and foremost, if you’ve been struggling to get pregnant, you’re not alone. The statistics reveal that 186 million individuals and 48 million couples worldwide are dealing with infertility, defined as inability to conceive after 12 months of trying¹. For the approximately 10-15% of couples experiencing infertility², the challenges can take an emotional and physical toll on parents-to-be. Fortunately and unfortunately there are many factors that contribute to infertility and one significant element is your diet and lifestyle. While you are reading this guide, it’s also essential to have your partner read our guide on Male Fertility. Did you know that approximately one out of every three cases of infertility is caused by male reproductive issues and another one out of every three cases is BOTH male and female reproductive issues⁴? Men play a critical role in the process!

Now back to what you CAN control - your diet and lifestyle! Focusing on your basic health can significantly enhance fertility outcomes. Research indicates that women who adopt a healthy lifestyle, including proper nutrition, regular exercise, and stress management, are more likely to achieve pregnancy⁵.  In fact, a large scale study of over 17,000 women showed that those who consumed healthy fats, low glycemic carbohydrates, adequate intake of vitamins and minerals through supplementation, and adequate physical activity had 69% lower risk of infertility than those who didn’t meet the study’s characteristics³. Study after study shows that healthy diets favoring vegetables, seafood, poultry, whole grains, and fruits, can facilitate better fertility in women and better semen quality in men⁴. This guide will delve into the nutrients crucial for fertility, lifestyle changes that can boost reproductive health, and practical tips to implement these strategies in your daily life. Every step you take in the direction of becoming a parent is something to celebrate, so try to focus on what you can do rather than chastising yourself for imperfections!

Essential nutrients for fertility

Each day our body uses dozens of micronutrients and all three macronutrients to perform functions from metabolism to tissue repair.  It’s amazing to think about how much goes on inside that we never even consider!  When we’re looking to optimize fertility, though, there are 7 micronutrients that are most important to incorporate consistently and persistently. We’ll dive into each here: 

4 Nutrients to find in a prenatal (and food!)

    • Why we need it: Folate, also known as vitamin B9, is crucial for DNA synthesis and repair, which are vital for cell division and growth, particularly during early pregnancy. Adequate folate levels help reduce risk of neural tube defects in babies; in fact, 8 in 10 cases of neural tube defects would have been preventable if folate levels were adequate⁶. Unlike synthetic folic acid, naturally occurring folate and methylfolate are better absorbed and utilized by the body, especially for individuals with the MTHFR gene mutation, which affects folate metabolism and is present in about 25% of the global population⁵. Studies have shown that adequate folate intake can significantly reduce the risk of neural tube defects in babies and reduce the risk of pregnancy loss⁷, making it essential for women trying to conceive.

    • Sources: spinach, kale, black-eyed peas, Brussels sprouts, avocado, broccoli, mustard greens, eggs, beets, citrus fruits, walnuts, almonds, sunflower seeds and beef liver.

    • Supplementation: If you aren’t absolutely positive you’re getting enough folate in your diet, we recommend a prenatal multivitamin that includes methylfolate. We strongly suggest this over folic acid…which many prenatal vitamins substitute. You have to be SUPER careful when selecting a prenatal to ensure you’re getting methylfolate! See resources below for our recommendations - either of the prenatals included contains the correct format.

    • Why we need it: Iron is a key mineral needed for the production of hemoglobin, which carries oxygen in the blood. In one study, women with the highest intake of nonheme iron from sources like multivitamins and iron supplements had a significantly lower risk of infertility compared to those with the lowest intake, reducing their risk by 61%⁸.  Adequate iron levels are necessary to support increased blood volume during pregnancy and to prevent anemia, which can lead to fatigue and complications.

    • Sources: Red meat, poultry, fish, beans, lentils, tofu, spinach

    • Supplementation: If you know your iron levels are already optimal from bloodwork, there’s no need to add more.  If you’ve been anemic before, don’t eat much red meat or foods listed above, or have shown low iron in recent bloodwork, including iron in your prenatal is a good strategy. See resources below for our recommendations - either of the prenatals included contains iron. 

    • Why we need it: B12 is important for maintaining healthy nerve cells and producing DNA and RNA, which are the “blueprint” for your new baby!  It's also essential for red blood cell formation, ovulation, regular menstrual cycles, sperm and egg quality, cell division, and even early fetal development.  It’s safe to say that B12 is a fertility superstar!

    • Sources: beef, pork, lamb, chicken, turkey, eggs, dairy, fish

    • Supplementation: Like folate, we need B12 in the methylated form (methylcobalamin).  If your prenatal contains this format, and you are not vegan, you should be covered.  If you are vegetarian or vegan, consider additional B12 supplementation. See resources below for our recommendations - either of the prenatals included contains the correct format. 

    • Why we need it: Zinc is involved in several processes that are important for fertility, like DNA synthesis, cell division, and protein synthesis. All of these are important to be able to create new cells that will turn into your baby! It also supports the immune system and hormone production. Zinc deficiency has been linked to reduced fertility in both men and women; on average, those deficient in zinc take 1 month longer to conceive⁹.

    • Sources: oysters, beef, lamb, crab, beans, nuts, seeds (especially pumpkin seeds)

    • Supplementation: If your prenatal has 10mg or more of zinc, and you focus on getting in zinc-rich foods when you can, you are likely all set. See resources below for our recommendations - either of the prenatals included contains this amount or more.

2 other important nutrients to consider

    • Why we need it: Omega-3 fatty acids, particularly EPA and DHA, play a vital role in reducing inflammation and promoting hormonal balance. These healthy fats are also essential for the development of a baby’s brain and eyes during pregnancy. Omega-3s can also improve egg quality and support overall reproductive health, so they should be a staple in any fertility-focused diet¹⁰.

    • Sources: Salmon, mackerel, anchovies, sardines, herring, walnuts, chia seeds, flaxseeds, algae for vegans.

    • Supplementation: Not everyone eats the foods above, so a good quality fish oil supplement, containing at least 1,000mg of combined EPA and DHA, is a great way to make sure you’re getting Omega-3’s. See resources below for our recommendations - the fish oil included contains the correct amount. 

    • Why we need it: Magnesium plays a crucial role in fertility by regulating hormone levels and supporting the production of reproductive hormones like progesterone, which is essential for maintaining a healthy menstrual cycle and pregnancy. It also helps reduce inflammation and oxidative stress in the body, which can improve overall reproductive health and increase the chances of conception. Additionally, magnesium aids in energy production and cellular function, reduces anxiety, improves digestion, and is good for cardiovascular health.

    • Sources: Leafy greens, nuts, seeds, whole grains, fish, dark chocolate, avocado.

    • Supplementation: If you are going to supplement, we love magnesium glycinate. See resources below for our recommendations -we include one with the correct format. 

2 bonuses!

    • Why we need it: Vitamin D is essential for immune function, bone health, and inflammation reduction. It also plays a role in hormone production, including sex hormones. Research indicates that vitamin D deficiency is associated with decreased fertility and pregnancy outcomes⁴. 

    • Sources / Supplementation: Since vitamin D is synthesized through sun exposure, supplementation may be necessary, especially in areas with limited sunlight.

    • Why we need it: Dehydrated women are likely to have vaginal dryness, which makes the entire process of conception much more difficult (and uncomfortable)¹¹. Plus, it’s essential for digestion, which is important for hormone balance. 

    • Sources: We recommend drinking at least half of your bodyweight in ounces per day (so, a 150-pound person should drink 75 ounces per day). 

Overall dietary pattern for fertility

Research consistently highlights the importance of a whole foods and an anti-inflammatory diet for optimizing fertility⁴. Consuming a diet rich in fruits, vegetables, lean proteins, healthy fats, and whole grains supports hormonal balance and reduces inflammation, which is critical for reproductive health. Reducing intake of processed foods, added sugars, and refined carbohydrates can help maintain stable blood sugar levels and promote a healthy weight, both of which are essential for fertility¹². By focusing on 3 meals per day, each containing adequate protein, healthy fat, and complex carbohydrates, you can stabilize blood sugar and optimize hormones including cortisol, insulin, and leptin, all of which work in conjunction with sex hormones. 

In research, breakfast eaters have more stable blood sugar all throughout the day, and when their breakfast was focused on protein, healthy fat, and fiber, they did even better¹³!  Specifically, eating a protein-rich breakfast within the first 2 hours (or so) of waking up is better for hormone balance than excessive fasting. 

Additionally, limiting alcohol and caffeine consumption has been shown to improve fertility outcomes; excessive intake of these substances can disrupt hormonal function and negatively impact ovulation.

Lifestyle changes for fertility

Lifestyle choices also play a significant role in enhancing fertility. Managing stress through techniques like mindfulness, meditation, and regular physical activity can positively impact hormonal balance and reproductive health. One study of women trying to conceive measured alpha-amylase, an enzyme that indicates high stress, and showed that women with higher levels of the enzyme took 29% longer to get pregnant than those with lower levels⁶. 

Adequate sleep is also crucial, as it regulates the hormones involved in the menstrual cycle and supports overall well-being. We recommend aiming for 8 hours of sleep, which may feel tough to prioritize, but can start to feel very enjoyable if you work it into your schedule! In recent research, women who slept 7 hours or less had an 8% lower chance of conceiving compared to those who got 8 hours of sleep¹⁴. Think of it as early training for what will likely be an earlier bedtime once baby arrives!

In addition to reducing stress, we want to reduce exposure to harmful substances. The key here is to focus on reducing, not eliminating, because the truth is, we live in a toxic world.  We’re constantly breathing pollution, putting chemicals on our skin, consuming chemicals from food, and using toxic products in cleaning, and it’s impossible to avoid all of this.  However, reducing the toxic burden your body is experiencing can free up resources to focus on fertility.  They key is reducing exposure to endocrine disruptors, which are chemicals that can directly contribute to infertility and also lead to chronic diseases like diabetes, obesity, and cancer, which also decrease fertility¹⁵.  These endocrine disruptors are found in everything from pesticides to plastics, from personal care products to household chemicals. As the name implies, these chemicals disrupt the way your endocrine (hormone!) system works and can compromise fertility, among other things.  You can start to look at labels of food and household products, and notice which products are taking these out.  Words like “organic,” “phthalate-free,” “fragrance-free,” and “BPA-free” are all great signs that this is less likely to disrupt your endocrine system. Some primary steps you can take to reduce exposure to these toxins are: choosing organic produce, using natural cleaning products, filtering your air and water, reducing or eliminating alcohol, and reducing use of plastics. 

Engaging in regular exercise, but avoiding excessive physical strain, helps maintain a healthy weight and improves blood flow to the reproductive organs. Again, there’s no need for perfection, but doing your best to focus on stress, sleep, toxins, and exercise can improve your fertility and shorten the time to conception.

What the research says

🧘 Managing stress through mindfulness and relaxation techniques can improve hormonal balance and increase fertility⁷.

😴 Adequate sleep is crucial for regulating reproductive hormones and supporting overall fertility. Optimizing circadian rhythm and maintaining a normal bedtime and wake time are important for fertility⁸.

🥦 Eating an anti-inflammatory diet rich in whole foods supports hormonal balance and reduces inflammation, improving fertility³.

🍾 Reducing alcohol and caffeine intake helps to prevent hormonal disruptions and supports healthy ovulation.  High consumption of alcohol is associated with reduced fertility⁹.

Putting it together

Sure, there are hundreds of things you could be thinking about when it comes to taking action for your fertility on a daily basis.  But you’ll get the most bang for your buck when you focus on the 10 items below.  This is a great activity to work on with your Coach. We suggest using a simple scorecard for yourself: there are 7 days per week, and 10 items below.  Give yourself a checkmark or smiley face for each item you accomplish, and aim for 70 checkmarks or more per week.  At the end of each week, look back and review your progress.  Where did you excel?  Where can you refocus this week?  One more reminder: we don’t need perfection to conceive, and every step we take is worth celebrating!

  • Take a high quality prenatal multivitamin containing methylfolate and methylcobalamin, as well as other nutrients listed above.  Best to take this with breakfast!

  • Eat breakfast within 2 hours of waking up, and include at least 20 grams of protein (such as a serving of protein powder, 3 eggs, 4 ounces meat, 1 cup yogurt or cottage cheese) and micronutrients from fruit or vegetables.

  • Enjoy a plated lunch with at least 20 grams of protein (such as 4 ounces of meat or fish, or 1 serving tofu or tempeh) and 2 fist-sized servings of vegetables.  Add some healthy fat like olive oil, olives, nuts, seeds, or avocado to keep you full. 

  • Encourage yourself to choose a vegetable, fruit, or high protein item (like a clean turkey jerky or hardboiled egg) as your first snack of the day.  Nourishing our bodies before digging into the chips or candy helps support blood sugar stability.

  • Enjoy a plated dinner with at least 20 grams of protein (such as 4 ounces of meat or fish, or 1 serving tofu or tempeh) and 2 fist-sized servings of vegetables.  Add some healthy fat like olive oil, olives, nuts, seeds, or avocado to keep you full.

  • Aim to have no more than 2 cups of coffee per day, and limit your alcohol to the extent that you can.  No alcohol is the best option, but 3-4 drinks per week is great progress for many.

  • Take 10 minutes per day to do whatever is soothing for you: journaling, meditating, stretching, praying, cuddling a pet, breathing, being outside in nature, or taking a bath.

  • Aim for 8 hours or more in bed each night, and limit blue light before you go to bed.  Aim to fall asleep and wake up within 30-60 minutes of the same time each sleep cycle. 

  • Do your best to reduce usage of plastic as you’re on your fertility journey.  Find one item per week to replace with a non-plastic item. If you want to go one step further, look at the ingredients of your detergent, cleaning supplies, personal care products, and make up … can you swap one per week of those, too?

  • Aim to get at least 15 minutes of movement per day.  If you already exercise regularly, more than that is great, but too much intensity or endurance is not optimal.  Exercise follows the “Goldilocks” pattern for fertility: not too little, not too much!

About the author

Megan Lyons

Doctor of Clinical Nutrition (cand), Board Certified Clinical and Holistic Nutritionist

As owner of her own wellness business, Megan has completed over 12,000 hours of 1-to-1 nutrition consulting, spoken on hundreds of stages, and reached hundreds of thousands through her…

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Resources our Experts Love

  • Our recommended supplements for fertility ↗

  • Rupa Health Fertility Guide ↗

  • Institute for Functional Medicine fertility interview ↗

  • Dr. Mark Hyman podcast on foods for fertility ↗

  • Real Food for Fertility book ↗

Nutritionists

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Adult mental health

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Couples mental health

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Infant & child mental health

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Sleep coaching

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Nutritionists • Adult mental health • Couples mental health • Infant & child mental health • Sleep coaching •

When to get
expert support

Sometimes you might need more support, and that's okay! Here are times you may consider reaching out to a specialist:

  • Persistent infertility: If you’ve been trying for over a year without a pregnancy, it’s a good idea to get more support.

  • PCOS management: Because PCOS complicates the fertility journey, there is often a need for specialized care and treatment plans in those with PCOS.

  • Suspicion of endocrine dysfunction: If you have symptoms like irregular periods, unexplained fatigue, severe PMS, temperature dysregulation, or drastic blood sugar swings, getting labs run will help a practitioner guide you more directly.

🤸 Nicely done…you’re making this look easy! 🤸