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A very conceivable diet

Catherine McDiarmid-Watt | Thursday, November 08, 2007 | 0 comments

Infertility affects one couple in six, but simple lifestyle measures can help many couples conceive, say US researchers.

In our parents' day most women were married and had at least one kid by the age of 25. That seems like a lifetime ago.

These days in Australia most women give birth in their 30s. While they may be in a better position financially and perhaps mentally – in a more stable relationship, with a higher income – they're much less likely at that age to actually fall pregnant.

Women are most fertile between 17 and 25. Over the age of 35, one woman in three will have trouble getting pregnant.

It's not always the woman's fault – in 40 per cent of cases the finger can be pointed at the male. (In 40 per cent of cases the problem lies with the woman; in 10 per cent there is a problem with both partners and in another 10 per cent, the cause is unknown.)

There are various reason why a woman finds it harder to conceive in these later years – there may be a structural problem with the reproductive organs, like blocked fallopian tubes, or a disease of the uterus like fibroids or endometriosis.

Most cases, though, are due to a failure of ovulation – eggs just don't ripen and release when they're supposed to. This is usually because of a hormonal imbalance – at an older age, the body isn't producing enough sex hormones at the right time and in the right amounts to ovulate successfully.

For these women, IVF (In Vitro Fertilisation) is an option, but it's not the preferred one: apart from anything else, it's time consuming, expensive and has a high failure rate.

But there's some good news this month from the US. Researchers from the Harvard School of Public Health and Harvard Medical School say that adopting a few lifestyle measures can drastically improve the chances of getting pregnant, at any age.

They followed a group of 17,544 married women who were infertile due to ovulation failure but who were trying to get pregnant. The women were part of a larger study of women's health called the Nurses' Health Study II, based at the Brigham and Women's Hospital at Harvard. The researchers followed them over an eight-year period, looking in particular whether or not they followed a range of dietary and lifestyle measures. They looked at:

the ratio of mono-unsaturated to trans fats in their diet
protein consumption (and whether it came from animals or vegetables)
carbohydrate consumption (including the amount of fibre they ate, and whether high or low glycaemic index)
consumption of dairy products (and whether low or high-fat)
iron consumption
use of vitamin supplements
body mass index (BMI, i.e. weight in kilograms divided by the square of the height in metres)
degree of physical activity.

The researchers took into account whether a woman smoked, drank alcohol or coffee, and/or had used oral contraceptives in the past.

Those women with the lowest rate of infertility (and most likely to fall pregnant) were those who ate less trans fat, less sugar, ate food with a low glycaemic index such as pasta and whole grains, ate more protein from vegetables than from animals, had a good iron intake, took multivitamins, exercised daily, kept their BMI between 20 and 25, and (surprisingly) consumed more high-fat dairy products and less low-fat dairy products.

The more of these measures they adopted, the lower the infertility rate and the higher the pregnancy rate. This was regardless of the woman's age, or whether she'd had children before.

For example, those who adopted just five of these measures had a 69 per cent reduced risk of infertility compared to those who adopted none of the measures.

Even following just one of these lifestyle measures reduced the risk of infertility by 30 per cent compared to those women who followed none. Of all the lifestyle measures, weight and diet, rather than exercise, were the most important.

Blood sugar and insulin
Why should these measures improve fertility? It's believed they improve insulin resistance – that is, they help regulate insulin and blood sugar levels and this in turn may help the sex hormones to regulate ovulation successfully.
Why high fat dairy products help remains a mystery though.

Now adopting these measures won't necessarily work for other types of infertility, such as blocked fallopian tubes. But what it does mean is fertility due to ovulation problems – which account for most infertility cases – can be partly prevented through modifications of diet and lifestyle, the authors say.

As an added bonus, these measures are also good for the pregnancy if a woman does conceive, they say. Taking multivitamins containing folic acid helps prevent neural tube defects in the foetus. And keeping weight down reduces the chances of pregnancy complications like gestational diabetes or pre-eclampsia.

Not to mention avoiding having to explain, when the boy or girl gets a bit older, how some babies come from test tubes.


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About Catherine: I am mom to three grown sons, two grandchildren and two rescue dogs. After years of raising my boys as a single mom, I remarried a wonderful man who had never had a child of his own. Unexpectedly, I found myself pregnant at 49!
Sadly we lost that precious baby at 8 weeks, and decided to try again. Five more losses, turned down for donor egg, foster care and adoption due to my age and losses - we have accepted that there will be no more babies in our house.

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