I am always happy when I see a client who comes in prior to pregnancy, with the intention of being in the best possible health by the time of conception. These future parents are highly motivated and aware that their health has a direct effect on the child, not only at birth, but for the rest of their lives. This is not something we make up to try and scare people into being healthy, but is well known and widely accepted- check out the Barker hypothesis or look up the term Epigenetics.
There are, of course other reasons for a couple to come in, such as those with unexplained infertility. It is estimated that 1 in 7 couples will have issues with conception. This is where we try and do our best detective work and find that root cause lurking in the background.
So here are a few important health aspects to keep in mind, as well as some pointers for those of you who are struggling to conceive.
HEALTHY SPERM IS VITAL
Let’s start with the men. Yes gentlemen, it’s not all up to the ladies, you need to ensure those sperm are of top quality. Women are born with all the eggs she is going to have and although she can protect them from damage, she can’t change their health. Men on the other hand can directly influence the health and strength of their sperm as well as the quality of the DNA the sperm are carrying. There are millions of sperm produced every day and it takes up to 74 days to mature, all of them are influenced by nutritional status. It is therefore suggested men ensure a good health status at least 3 months prior to conception.
What nutrients are required by sperm? They require higher amounts of omega 3 fatty acids . This helps provide membrane fluidity-essential at fertilisation. Unfortunately this high amount of fatty acids also makes them more prone to oxidation, not a good thing as this can cause damage. To avoid this, address lifestyle factors such as high intensity exercise, smoking, eating BBQ foods etc. all of which increase free radical damage. Other essential nutrients include Zinc for structure, Vit E to protect the DNA and help increase sperm count, Vit D- if this is low it may lead to a lower sperm count as may a deficiency in Selenium.
Does age of a man really matter? It is common to hear about how risky it is for older women to have a baby, but we rarely hear about the risks from men over 40. As men are continuously producing new sperm, the DNA is constantly being replicated. The older the man the more times the DNA has been divided, therefore it is more likely that there will be mistakes made in the replication. Some mistakes may lead to genetic diseases in the offspring .So yes, age does matter for men too!
Toxins. This is very important and should be addressed by both men and women trying to conceive. It has been shown that toxic metals such as lead, mercury, cadmium and arsenic do not fare well with fertility. The higher the exposure, which could be environmental or occupational, and concentration, the more detrimental the effect on hormonal balance and sperm production as well as quality . Another great reason to do that cleanse!
PRIOR PREPARATION LADIES!
There has never been a more important time for prior preparation. Most women will receive a prescription for folic acid once pregnancy is confirmed, but research has shown that it is preferable to start with supplementation prior to pregnancy. By ensuring you have optimal levels of this B vitamin, you dramatically decrease the chances of neural tube defects, which occur in the first 28 days of pregnancy, usually before a woman even knows she’s pregnant .
Since about 50% of us genetically can’t convert folic acid, which is synthetic, to a usable form, the best option is to take FOLATE. Folate is the body ready form and labelled as 5-MTHF. Top tip- ensure your multi has 400mcg of folate. This genetic defect has also been linked to variety of pregnancy related issues including difficulties conceiving, unexplained infertility, elevated homocysteine levels and recurrent miscarriage. DNA is easily tested for through a qualified functional practitioner trained in genetics.
Ensuring that your body is sufficiently topped up with all required nutrients and toxins are removed would be optimal. A cleanse may be a good idea, but should only be done if contraception is in place and at least 3 months prior to conception. The release of toxins may be damaging to a developing foetus.
Hormone balance. This is a big topic that can take books to cover, but in a nut shell, this is where many women with unexplained infertility may be struggling. Hormones are all influenced and balanced by each other. For example: high insulin production, which is a primary concern for women with PCOS, can in turn decrease sex hormone binding globulins (SHBG). This is a protein produced in the liver that binds excess hormones and is essential to control both oestrogen and testosterone. Insulin also stimulates the ovaries to make more testosterone. Not something we want ladies!
There is however a little known naturally occurring, vitamin like substance called Myo-inositol, which is playing a big role in helping women with PCOS and others with poor insulin control. It helps the body in its handling of insulin and supports hormonal balance and ovarian function. Not only this, but it has also been found to positively affect the well-being of follicle and oocytes.
Oestrogen dominance which occurs when we have higher levels of oestrogen than progesterone, disrupts the process of ovulation and plays a key role in the development and proliferation of endometriosis, uterine fibroids and ovarian cysts, which are all issues that can dramatically affect fertility.
The factors contributing to oestrogen dominance include- added hormones in our diet, stress, weight gain, xenoestrogens-these are external compounds that mimic oestrogen found in personal care products and plastics . Luckily these are factors that are in our control. Dietary changes such as eating organic and grass fed meats, increasing fibre and balancing blood sugar along with stress reduction and avoiding plastics can have a huge impact.
When it comes to supplements DIM is a powerhouse in helping the liver in oestrogen clearance .DIM is found in vegetables like broccoli, Brussels sprouts and cauliflower, but in order to get just 10-30 mg of DIM you would have to eat one-and-a-half pounds of these cruciferous vegetables! While that amount is better than none, it is not the therapeutic dosage. Most experts recommend taking 100 to 200 mg of DIM a day.
Stress- When we are stressed our bodies lean toward making more cortisol and less progesterone- This is a big fact to take into account when it comes to hormone imbalance. For those who are struggling to conceive it can be very stressful. Sometimes it’s good to just get a drink, forget about it and have some good sex!
In order to get the best possible picture of hormone interaction and balance in the body we can use functional testing, such as the DUTCH test, considered to most comprehensive hormone panel available. This is a great place to start in order to fully assess what is happening and what lifestyle, dietary and supplement changes can be made in order to help you on your way to pregnancy.
Further functional test are based on your specific requirements and may include a full mineral panel or toxic load.
To ensure an optimal environment for your future baby, you may simply need a good clean and optimal nutrient intake.
If you would like any further advice on supplements, functional or genetic testing, how to find a functional practitioner in your area or about any of our upcoming programs, please do get in touch.
Kerry Fugard is a Nutritional therapist practising in Functional medicine. She has a passion for mental health for all ages and women’s health. In practice she conducts One-on-one consultations, which can be done in person or virtually, as well as group talks and cooking demos with her chef husband- you can find out more about her practice Nutri 360 here.
Wathes, D.C., Abayasekara, D.R.E. & Aitken, R.J., 2007. Polyunsaturated Fatty Acids in Male and Female Reproduction1. Biology of Reproduction, 77(2), pp.190–201. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17442851 [Accessed August 4, 2017].
Vigeh, M., Smith, D.R. & Hsu, P.-C., 2011. How does lead induce male infertility? Iranian journal of reproductive medicine, 9(1), pp.1–8. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25356074 [Accessed August 10, 2017].
Wirth, J.J. & Mijal, R.S., 2010. Adverse Effects of Low Level Heavy Metal Exposure on Male Reproductive Function. Systems Biology in Reproductive Medicine, 56(2), pp.147–167. Available at: http://www.tandfonline.com/doi/full/10.3109/19396360903582216 [Accessed August 10, 2017].
Hirschberg, A.L., 2009. Polycystic ovary syndrome, obesity and reproductive implications. Women’s health (London, England), 5(5), pp.529–40; quiz 541–2. Available at: http://www.ncbi.nlm.nih.gov/pubmed/19702452 [Accessed August 3, 2017].
Czeizel, A.E. & Dudás, I., 1992. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. The New England journal of medicine, 327(26), pp.1832–5. Available at: http://www.ncbi.nlm.nih.gov/pubmed/1307234 [Accessed July 9, 2014].
Papaleo, E. et al., 2009. Contribution of myo-inositol to reproduction. European journal of obstetrics, gynecology, and reproductive biology, 147(2), pp.120–3. Available at: http://www.ncbi.nlm.nih.gov/pubmed/19800728 [Accessed August 3, 2017].
Auborn, K.J. et al., 2003. Indole-3-carbinol is a negative regulator of estrogen. The Journal of nutrition, 133(7 Suppl), p.2470S–2475S. Available at: http://www.ncbi.nlm.nih.gov/pubmed/12840226 [Accessed August 10, 2017].