Fertility and Preconception Planning

If you’re a woman thinking about starting a family or actively trying, it can be a strange time. After spending your whole adult life trying not to get pregnant, it can seem as if once you start trying things will go off without a hitch-and they often do. But when it comes to optimizing your and your future baby’s health, it can be a bit more complicated than ditching the birth control and taking a prenatal.

The good news: Your health and your fertility are largely in your hands, regardless of age. By optimizing nutrition, lifestyle, supplement regimens, and planning ahead, you can feel confident that you will be doing everything in your power to have a healthy pregnancy! So what can you do to prepare yourself (and your partner)? I’ve broken it down into the different stages of preconception planning. And don’t worry, if you’re already trying to conceive or currently pregnant, it’s never too late to adopt healthy strategies for you and your little one!

Starting About 1 Year Prior to Conception:

1 year?! Yes, ideally, women should start preparing their bodies at least one year prior to pregnancy. This is because certain chronic conditions, nutritional imbalances, and health optimization strategies take time to come into balance, or should not be completed too close to pregnancy. This is a valuable window of opportunity for women who are in the beginning stages of planning for a family. 

At this stage is the optimal time to work with a functional medicine practitioner to get a pre-pregnancy checkup, where they can test your levels of heavy metals, your nutrient status, your genetic SNPs, and any other functional testing that can help determine what steps you need to take to optimize your nutrient status, decrease your toxic load, and support any genetic polymorphisms that may have a clinical impact. This is the ideal time to identify any underlying conditions that might make pregnancy more difficult, and address them well ahead of time. 

Now is also the time to start thinking about ways to reduce your toxic exposures. Start to gradually replace plastics in the kitchen, shop for cleaner versions of personal care products, cleaning supplies and fragrances, and look for a good water filter. This is also the perfect time to achieve a healthy weight (for both men and women), begin a moderate exercise program, and focus on a healthy diet. A Mediterranean Diet that focuses on fish, fruits, vegetables, whole grains, legumes, and olive oil is an excellent foundation for most people. If you’re feeling up to it, there is evidence that avoiding alcohol in the year before conception may prevent congenital heart defects, and it would certainly help your liver detoxify more efficiently during this time.

About 6 Months Prior to Conception:

Emerging data on sperm health indicates that men may do well to avoid alcohol for six months prior to conception to prevent congenital heart defects. Just like for ladies, it certainly wouldn’t hurt, and at the very least it will help your ability to detoxify more efficiently. 

This is also a good time for women to start taking a prenatal supplement. Most doctors will advise women to start prenatal multivitamins 3 months prior to conception to ensure adequate stores of key vitamins needed to prevent birth defects and miscarriage in early pregnancy, but there’s no harm in giving your body a little extra time to stock up-especially if you uncovered any nutrient deficiencies in your functional testing. Certain vitamins may even boost fertility by restoring ovulation and improving egg quality, so the earlier you start the better. I recommend a multivitamin offering at least 800 mcg. of methyl-folate, the more bioavailable form of folate, and avoiding any supplements with the synthetic form, folic acid. 

If you haven’t started getting serious about a healthy diet yet, now is the time to start. Men and women need at least 3-6 months of good nourishment prior to conception, so adopting a plant-based, Mediterranean style Diet now is ideal. Starting to reduce red meat consumption around this time may also be a good idea since red meat consumption is associated with decreased fertility. If you’re a red meat lover, and particularly if you regularly consume processed red meats (bacon, sausage, hot dogs), you can do your health and your fertility a huge favor by swapping out red meat for fish, chicken, eggs, or plant-based proteins such as legumes, nuts, and seeds. 

3 Months Prior to Conception (The Golden Window):

Here’s where things get crucial! It takes about 2-3 months for sperm to develop, and approximately three months for an immature egg to develop into a mature egg ready for ovulation, (Fett, Rebecca. It Starts with the Egg (Second Edition): How the Science of Egg Quality Can Help You Get Pregnant Naturally, Prevent Miscarriage, and Improve Your Odds in IVF (p. 24). Franklin Fox Publishing. Kindle Edition.)  so the decisions you make during this time will have a direct impact on the sperm and egg that will eventually be used to make your baby! That’s both an exciting and daunting thought, but either way, it leaves a whole lot of power in your hands.

Here, a lot of the recommendations for men and women are quite similar. I recommend both partners take a daily multivitamin with methyl-folate, get daily moderate exercise (not too intense, or too frequently, as this can disrupt normal hormone regulation. Around 30 minutes most days of the week is a good target.), manage stress, and focus on eating a clean (ideally organic), plant-based, Mediterranean style diet. I recommend everyone supplement with vitamin D3/K2 to achieve optimal blood levels, and most everyone take an omega-3 fish oil supplement (good for men but most important for women). 

There may be cases where additional supplementation is needed, especially for older moms and dads to be, or women with specific health conditions. A good percentage of men and women with fertility issues associated with advanced age may be helped by antioxidant supplementation. Both eggs and sperm can become damaged by the oxidative stress that accumulates from chemical exposures, poor diet, and certain lifestyle habits. Luckily, there are several antioxidant supplements that can be useful for combating this oxidative stress, and creating healthier sperm and eggs. CoQ10, vitamin C, vitamin E, Alpha-lipoic acid, and N-acetyl cysteine are all antioxidants that benefit both male and female fertility. Selenium (high in Brazil nuts) and zinc (found in pumpkin seeds) are two antioxidants more specific to sperm health, and therefore male fertility. 

One supplement specifically for moms-to-be to consider is choline. Choline, an essential nutrient during fetal brain development, influences brain and spinal cord function, and influences risk for neural tube defects and lifelong memory function. If you’d rather not add another supplement to the list, it is also found in high amounts in eggs.  One study found that without regular egg consumption, it is extremely difficult for the average person who is not taking dietary supplements to achieve an adequate daily choline intake, so if you’re not an egg fan, a supplement would be your best bet. 

I’d advise men and women at this stage of planning to continue with their healthy eating habits, and focus on increasing daily consumption of high-antioxidant foods as well as the supplements previously listed; Blueberries, raspberries, nuts, and dark green vegetables top the list of antioxidant-rich foods. 

While Actively Trying To Conceive:

Congratulations! You’ve done all the hard work of preparing your and your partner’s bodies for conception, and now you can move on to the fun part. Remember, while you’ve established some excellent habits to give your baby the best possible start, your job is just beginning, and a whole new set of recommendations come into play once you’re actually expecting. I highly recommend the book Feeding Baby Green, by Dr. Alan Greene, for any pregnant mamas out there who are interested in how you can train your baby to love eating healthy foods from before they are even born!

If you are overwhelmed with where to begin, or which supplements are most important for your unique situation, schedule a meeting with a reliable practitioner to customize your preconception plan for you. The decisions you make prior to conception will determine the health of your baby for years to come. You can make a difference!