Conception is the first step of parenting. Most couples can conceive naturally without any special effort, but some have infertility issues. I and my husband are in the second group. Luckily, we get conception naturally after 2 years’ research and preparation without seeking medical help.
Some may don’t know the truth that to have your body and mental well prepared is not only beneficial for conception but also important for fetal development in pregnancy. Even if you may not have infertility problem, you still need to prepare your body before pregnancy to support both of you and your fetus’s health.
In this post, I would like to share our experiences on how to prepare your body in pre-pregnancy stage. Then talk about mental preparation separately in another post.
- Nutrition
Human body relies on vitamins, minerals, carbohydrates, protein and fat for many functions, including reproduction, growth and development. Most of your nutritional needs may be met through food, while supplements can fill the gap of everyday diet.
- Diet
Eating healthy foods are important for cell growth, lean tissue development and overall good health. Healthy foods contain less toxin and higher concentrations of beneficial nutrients, which is critical for faster organ recovery and healthier development.
Organic food is always our first choice. Organic food means non-genetic modified, natural substances allowed, and most synthetic prohibited. Organic food is produced without using most conventional pesticides; fertilizers made with synthetic ingredients or sewage sludge; bioengineering; or ionizing radiation.
Recent study concludes that pesticides from fruits and vegetables could affect male sperm quality and density. It is widely agreed in scientific studies that organic agriculture produces have less pesticide residues (both detected amounts and frequencies) than conventional. Although some researchers argued that the difference is not risk significance, and most conventional samples meet FDA allowance (only 1-3% violence, according to FDA report in 2000), organic is still our favorite as the price is usually no more than twice of the conventional and the amount of pesticide residue is much less than half in conventional. In additional, organic means non-GMO, which is a safe choice since no complete long-term testing has been conducted on humans.
Organic meat, poultry, eggs, and dairy products come from animals that are given no antibiotics or growth hormones. Although inverse influence of Implanted hormones in red meat on male fertility is concerned, studies in both Europe and United States showed unrelated results between male semen quality and implanted hormones in red meat. Researches didn’t find significant difference in health wise, between organic or conventional in both contaminants and nutrition, but both results are in favor of organic, as organic food sources for animals has higher nutrition level of the key nutrients such as Omega-3s, B vitamins and less contamination. To eat organic animal-based food source is optional, but it did bring some benefits on better nutrition and slower accumulation of pesticides. We still recommend to consume organic meat products when it is financially possible.
Organic foods can be easily found almost in every grocery store national wide. If you have any difficulty in finding those or just too busy to go shopping, amazon carries large varieties of dairy products and their fresh program has almost everything you need.
Whole grain has been recognized as healthy food as early as 1800s. Researchers have found more and more benefits from whole grain intake since then, including protection against obesity, diabetes, CVD and cancer. A 2016 study concludes a supportive link between whole grain intake and reproductive health. The mechanism on these beneficial effects are built upon whole grain’s food structure and nutrition facts. The structure of whole grain results slower digestion and thus a more steady and lower blood sugar level. The key bioactive nutrients especially in bran and germ include fiber, minerals, trace elements vitamins, carotenoids, polyphenols, and alkylresorcinols are involved in varies protective bioactivities of human body, including cell signaling, gene regulation, cardiovascular, lipid metabolism, DNA methylation, nervous system and mental health, skeleton health. Grain refine process removes bran and germ from whole grain and at the same time removes big portion of above nutrients from grain. A comparison of key nutrients between refined wheat flour and whole grain flour based on same serving amount is listed in the following table (data source from USDA Food Composition Databases).
Loss of key nutrients in refined wheat flour comparing to same amount of whole grain
| mineral | less % per serving | Vitamins | less % per serving | animo acids | less % per serving | others | less % per serving |
| Magnesium, Mg | 84% | Lutein + zeaxanthin | 92% | Proline | 42% | Fiber, total dietary | 75% |
| Manganese, Mn | 83% | Vitamin E (alpha-tocopherol) | 92% | Aspartic acid | 40% | Total lipid (fat) | 61% |
| Zinc, Zn | 73% | Vitamin B-6 | 89% | Lysine | 36% | Sugars, total | 34% |
| Potassium, K | 71% | Vitamin K (phylloquinone) | 84% | Arginine | 36% | Protein | 22% |
| Phosphorus, P | 70% | Thiamin | 76% | Histidine | 36% | Genistein | 100% |
| Iron, Fe | 68% | Riboflavin | 76% | Glycine | 35% | Total isoflavones | 100% |
| Total lipid (fat) | 61% | Niacin | 75% | Alanine | 32% | ||
| Calcium, Ca | 56% | Choline, total | 67% | Tryptophan | 27% | ||
| Selenium, Se | 45% | Folate, total | 41% | Valine | 26% | ||
| Vitamin E (alpha-tocopherol) | 48% | Phenylalanine | 24% |
Except the widely known vitamins and minerals, whole grains also contain another important nutrient for productive health -vitamin B8. Recent research showed promising clinical results of vitamin B8 –myo- inositol intake for treatment of polycystic ovary syndrome (PCOS). 75% of the patient with infertility had ovulation restored and 15% of the patients successfully conceived within 3 months of use. Whole grain is beneficial for male semen quality because of they are fully packed with antioxidants and micronutrients, such as zinc, vitamin E, vitamin B, and folate. Research study found the intake of whole is positively associated with progressive sperm motility.
Eating whole grain is recommended for productive health. FDA definition of whole grain is: Grains that consist of the intact, ground, cracked or flaked caryopsis, whose principal anatomical components – the starchy endosperm, germ and bran – are present in the same relative proportions as they exist in the intact caryopsis – should be considered a whole grain food. Make sure to look at ingredient labels when you are purchasing whole grain. Some manufactures use whole grain term while the product is actually only a whole grain blend containing only a portion of whole grain.
Here are some whole grains that you'll probably find at your supermarket, and online retailers:
- Brown rice
- Oats
- Whole-wheat flour
- Rye flour
- Barley
- Buckwheat
- Bulgur (steamed and dried cracked wheat)
- Millet
- Quinoa
Cooking whole grains does not have to be difficult and time-consuming, and cooking technics are almost the same as refined grains. It’s always easy to find recipes online with a simple search.
Vegetables and fruits
Vegetables and fruits, such as kale, spinach, beans, tomato, carrot, orange and avocado are excellent sources of antioxidants, iron, zinc, magnesium, selenium, Vitamin A, Vitamin E, Vitamin. Some of vegetables and fruits such as olive, avocado and potato carries about 10% monounsaturated fatty acids, which has powerful health benefits.
The vitamins and co-factor metals are essential and have to be supplied with nutrition. Folate (vitamin B9) is important in facilitating regular, healthy ova production and helping to prevent neural tube defects during early pregnancy. Deficiencies of vitamin A, D, E are responsible for inhibits several human body functions, including men and women fertility function. Other antioxidants other than vitamin A and E such as polyunsaturated fatty acids flavonoids, and CoQ10 can work as a reductant to prevent oxidative damage. Positive effects of antioxidants and micronutrients on human reproductive health of both man and women have already been widely confirmed. CoQ10 is known as an antioxidant protecting egg and sperms. Vegetables and fruits are also important sources of myo-inositol, which is necessary for a healthy ovulation as discussed in last section.
Recent researches (( 1, 2, 3, 4 ) on the impacts of diet on male fertility revealed that vegetables and fruits such as kale, lettuce, carrot, tomato and orange improve male semen quality.
A study on a healthy male population carried out by Harvard University found positive linear relation between carotenoids (beta-carotene and lutein), lycopene and semen quality. Based on USDA Food Composition Databases, beta-carotene mainly exists in sweet red pepper, carrot, sweet potato, dandelion greens, kale, spinach, pumpkin. Lutein mainly exists in kale, spinach, sweet potato leaves, dandelion greens, turnip greens, cress, chard, collard. Lycopene mainly exists in tomato, guava, watermelon, papaya, grapefruit.
2018 published study of food consumption and risk of endometriosis suggests that higher intake of fruits, particularly citrus fruits, are associated with lower risk of endometriosis, which is a hormone-dependent disorder affects 10% of the reproductive women. Endometriosis often associates with infertility. Beta-cryptoxanthin in citrus fruits may play an important role in this association.
Fat plays important role for all functions of human body, and is an important part of a healthy diet. Potato, olive and avocado carries about 10% of monounsaturated fatty acids, which have protective effects to human body. As stated by mono, they have only one double carbon bond in their chemical structure. Plant and animals may both provide sources of monounsaturated fatty acids. Oleic acid is a common monounsaturated fatty acid occur in food sources. It’s protective effects on heart diseases, type 2 diabetes, ulcerative colitis and stroke has been verified by numerical studies. Oleic acid is one of the important brain fat compositions, study found reduced oleic acid levels in the brains of Alzheimer patients. Higher oleic acid level in brain is also found to associate with positive personality traits in adolescent boys with attention deficit hyperactivity disorder. A 2018 review concluded that available data suggest that oleic acid can contribute to normal oocyte and preimplantation embryo development, and it may play a significant role in oocyte and early embryo development. Although oleic acid is not an essential fatty acid, which can be produced in human body, its production might be limited by different conditions. Increasing oleic acid intake from food source is important for us to maintain adequate oleic acid level in our body.
Overall, including adequate amount of vegetables and fruits in your diet as recommended by USDA Dietary Guidelines for Americans could help to improve productive health.
Fish, Meat, dairy products and eggs containing high protein and high fats are our major diet sources of protein and fat. Although both protein and fats can be obtained from both plant source and animal source, animal-based foods are unreplaceable by plant-based.
Protein is one of major energy sources in our diet. Human body needs 22 specific amino acids to build proteins for varies organs and functions, such as muscles, red blood cells. With the fact that human body can only produce 13 amino acids on its own, obtaining 9 other types from diet is necessary. Some of these 9 types of amino acids can be found in plant source, and all could be obtained from animal source. This fact makes animal source protein is necessary for your diet.
Fats do not only provide energy to our body, but are also essential for organs to maintain and develop normal functions. When consume fat, we prefer unsaturated fat to saturated, and want to avoid trans-fat. Lots of researches have confirmed the benefits of unsaturated fatty acids on heart disease, diabetes, cancer, inflammatory conditions, fetal and infant development, cognitive functions. While excessive saturated fatty acid intake
Most studied beneficial unsaturated fatty acids are Omega-3, and Omega-6 which are polyunsaturated fats(PUFA). Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) and alpha-linolenic acid (ALA) are important forms of Omega-3 fatty acids in human body. EPA, DHA can be developed from ALA, and are required by development and maintenance of normal brain function. ALA can be converted to DHA/EPA but conversion rate is greatly limited by the enzyme required for this reaction. Since EPA and DHA can only be found in animal-based foods, and the Omega-3 acid found in plant is mainly ALA, it is important to include animal-based foods in your diet.
One research found EPA+DHA intake was significantly associated with fewer depressive symptoms, which is a common symptom in pregnancy. Human reproductive health has close relation to blood Omega-3 levels. A study proved that fertile men has higher blood and spermatozoa levels of omega-3 compared with the infertile male. Omega-3 intake does not only affect male fertility, but also beneficial for female reproductive health. A 2012 study demonstrated significant positive associations between omega-3 Long chain PUFA intake and women hormone levels, number of follicles and embryo morphology. A 2017 study tested fatty acids levels in serum for interfile women before intracytoplasmic sperm injection, and found the patients became pregnant had higher unsaturated fatty acids and omega-3 fatty acid than others. Recent research also found probability of live birth for assisted reproduction has a positive relation to serum levels of long-chain omega 3. Short chain omega-3 – alpha-linolenic acid (ALA) is not as good as the long chain omega-3s, ALA was found to associate negatively with women productive health in one study. Plant developed omega-3 is mainly ALA. According to USDA National Nutrient Database for Standard Reference Release 28, fish is the type of food containing most long chain omega-3 especially DHA and EPA. Mackerel, roe, shad, salmon, sablefish, whitefish, anchovy and tuna contain high level of omega-3. However, some fish and shellfish contain higher levels of mercury that may harm an unborn baby or young child's developing nervous system. It is advised to choose fishes that is low in mercury for our diet. Mercury levels in some species of commercial fish and shellfish are monitored by FDA, you may find it here. Following is the FDA recommendations for choosing fish,
- Do not eat Shark, Swordfish, King Mackerel, or Tilefish because they contain high levels of mercury.
- Eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury.
- Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish.
- Another commonly eaten fish, albacore ("white") tuna has more mercury than canned light tuna. So, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces (one average meal) of albacore tuna per week.
- Check local advisories about the safety of fish caught by family and friends in your local lakes, rivers, and coastal areas. If no advice is available, eat up to 6 ounces (one average meal) per week of fish you catch from local waters, but don't consume any other fish during that week.
Follow these same recommendations when feeding fish and shellfish to your young child, but serve smaller portions.
Increasing omega-3 intake is a healthy trend for our diet, however omega-3 intake shouldn’t be looked at separately from omega-6 intake. Omega-6 is another essential PUFA performs varies protective functions in human body. As omega-3 and omega-6 compete in certain reaction pathways in human body, excessive intake of omega-6 will result lower omega-3 utilization, thus can contribute to inflammation and result in heart disease, cancer, asthma, arthritis and depression. The ideal omega-6/ omega3 intake ratio should be 1:1, but in American diet, the ratio is about 6:1. One study found the ratio of serum omega-6/omega-3 was significantly higher in infertile male compare to healthy controls. It is important to balance omega-6 and omega-3 intake in our diet. In a 2016 published study, increased preconception Omega-6/ Linoleic acid intake with a trend for an elevated intake of omega-3 positively affected pregnancy rate of overweight /obese women undertaking in vitro fertilization.
Major omega-6 source in our diet is cooking oils. If you dine out or eat processed food frequently, then your omega-6 intake is most likely higher than heathy level. Reduce the intake of cooking oil, such as sunflower oil, soybean oil, and nuts, such as walnut, almond, pistachio, which are cooking oils and nuts containing most Omega-6 according to USDA National Nutrient Database for Standard Reference Release 28. Again, fish is the ideal protein source with high omega-3 level and lower omega-6 level.
Saturated fatty acids are one type of major energy sources in our diet. All carbons are saturated with single bonds in their chemical structure. They are neutral for human health. Saturated fats themselves are neither as harmful as trans fats nor as protective as unsaturated fats. Saturated fats were believed to cause heart disease and other health issues, but recent studies( 1, 2, 3) revealed that there is no direct link between undifferentiated saturated fat acid intake with mortality caused by heart disease, cancer or diabetes. However, Palmitic acid, which is a saturated fatty acid commonly found in both animals and plants, was directly associated with mortality in a most recent cardiovascular health study. According to USDA Food Composition Database, palm oil and palm shortenings contains large amount of palmitic acid (from 36.5% to 42.5%). It is recommended to avoid palm products added food to avoid excess palmitic acid intake. In addition, as we can’t consume unlimited food, higher saturated fatty acids intake most of time results lower unsaturated acids intake, we recommend reduce saturated-fats based food intake, and replace it with unsaturated-fats based food from both plant and animal. According to USDA Food Composition Database, fat contents in beef products, lamb products, pork, veal, nutmeg oil, babassu oil, soy oil, palm oil, shortening, coconut oil, are mostly saturated fats.
Trans fatty acids are uncommon in nature but commonly produced industrially. They are made by exposing polyunsaturated vegetable oils to a chemical process that involves high heat, hydrogen gas and a metal catalyst. Industrial trans fats often exist in partially hydrogenated vegetable oils, margarines, and fried food and are added to packaged prepared foods to increase shelf life. Only small amounts of trans fats occur naturally in food. It has been widely confirmed by scientific studies that trans fat intake increases the risk of some chronic diseases such as cardiovascular disease and type 2 diabetes and associates with pro-inflammatory states in the human body. Recent studies have also found trans fats intake is associated with higher rate of fetal loss, failure of implantation and ovulatory dysfunction. A 2018 published paper further confirmed trans fats intake decrease women pregnancy rates, and omega-3 unsaturated fats intake results higher fecundity. Not only female reproductive health, male fertility is also associated with trans fats intake. Studies showed increased trans fats intake results lower sperm counts, lower fertilization rates. According to USDA Food Composition Databases, foods containing most added industrial trans fats including shortenings, margarines, industrial partially hydrogenated oils, vegetable oil spreads, cream substitute, cookies, pie. Beef and lamb are the foods containing most natural trans fats. Although effects of natural trans-fats on human health are still not well studied, we still recommend to limit beef and lamb intake.
In conclusion, animal source foods are necessary for us to obtain nutrient that does not have sufficient density in plant foods. We recommend to
- Consume adequate amount of animal source foods including both protein and fats. Animal protein and fats are both essential for human body. Diet including proper animal source foods could help us improve reproductive health.
- Include 2 of 4 oz serving of fish in your diet every week. Fish is an ideal food rich in high quality protein, high level unsaturated fats especially omega-3 fatty acids (DHA, EPA) and micronutrients, low in trans fats and saturated fats.
- Reduce red meat and related product intake and replaced it with more healthier options such as fish, shrimp, chicken and duck.
- Choose a healthy cooking oil for your diet such as olive oil, peanut oil and canola oil.
- Limit dining out. Reduce unhealthy cooking oil intake to cut trans fats, saturated fats intake, and balance a healthier omega-3/omega-6 ratio.
- Read package labels for processed foods to avoid unhealthy ingredients.
About 3% of US adults are vegetarian, consume animal foods are not realistic for this population. We will cover vegetarian foods later.
Nuts contain high density of fat contents. They are also a good source of dietary fiber, protein and packed with essential nutrients, such as Vitamin Bs, Vitamin E, minerals such as calcium, iron, zinc, potassium, magnesium and selenium, and other antioxidants.
Monounsaturated fatty acids (mainly oleic acid) are the largest group of fatty acids in nuts. Health benefits of oleic acid has been discussed in “Fruit and Vegetables”, including its positive effects on brain function maintain and development, productive health, heart diseases, type 2 diabetes, ulcerative colitis and stroke. However, high energy density of nuts is worried by people who are watching body weight closely. The fats which contribute to biggest portion of nuts energy profile are mainly the beneficial unsaturated fatty acids. Most of the nuts contain high level oleic acid, which has been proven to improve fat oxidation, increase lean mass and reduce fat mass when saturated fatty acids energy intake was largely replaced by oleic acid enriched diet (1, 2, 3). Thus, consuming nuts does not have to result body weight increase, but it may help weight management if eaten in a proper way. A healthy diet should include certain portion of nuts to balance nutrition intake. Not all nuts have the same compositions. In American diet, we’ve already have more than sufficient omega-6 intake, so we should eat nuts with low omega-6 and high oleic acid. According to USDA Food Composition Databases, macadamia nuts (Hawaii nuts) contain highest oleic acid but lowest omega-6. Hazelnuts almonds also contain good amount of oleic acid and relatively low omega-6.
Nutrients comparison of Kale, Whole grain wheat, whole milk, chicken, Salmon, orange and hazelnut
| Nutrient | Unit | Raw Kale per 100 g | whole wheat per 100g | Whole milk Per 100 g | Roasted chicken Meat Per 100 g | Tuna Salad Per 100g | Orange Per 100 g | Hazelnut per 100g | FDA Rec daily value |
| Calcium, Ca | Mg | 150 | 34 | 113 | 12 | 17 | 40 | 114 | 1000 |
| Iron, Fe | mg | 1.47 | 3.6 | 0.03 | 1.21 | 1 | 0.1 | 4.7 | 18 |
| Magnesium, Mg | mg | 47 | 137 | 10 | 21 | 19 | 10 | 163 | 400 |
| Phosphorus, P | mg | 92 | 357 | 84 | 192 | 178 | 14 | 290 | 1000 |
| Potassium, K | mg | 491 | 363 | 132 | 229 | 178 | 181 | 680 | 3500 |
| Zinc, Zn | mg | 0.56 | 2.6 | 0.37 | 1.31 | 402 | 0.07 | 2.45 | 15 |
| Vitamin C | mg | 120 | 0 | 0 | 0.56 | 53.2 | 6.3 | 60 | |
| Thiamin | mg | 0.11 | 0.502 | 0.046 | 0.062 | 2.2 | 0.087 | 0.643 | 1.5 |
| Riboflavin | mg | 0.13 | 0.165 | 0.169 | 0.147 | 0.031 | 0.04 | 0.113 | 1.7 |
| Niacin | mg | 1 | 4.957 | 0.089 | 7.881 | 0.07 | 0.282 | 1.8 | 20 |
| Vitamin B-6 | mg | 0.271 | 0.407 | 0.036 | 0.41 | 6.7 | 0.06 | 0.563 | 2 |
| Folate, DFE | µg | 141 | 44 | 5 | 5 | 8 | 30 | 113 | 400 |
| Vitamin A, IU | IU | 9990 | 0 | 162 | 41 | 97 | 225 | 20 | 5000 |
| Vitamin E | mg | 1.54 | 0.71 | 0.07 | 0.3 | 0 | 0.18 | 15.03 | 18 |
| Vitamin D | IU | 0 | 0 | 2 | 10 | 0 | 0 | 0 | |
| Vitamin K | µg | 704.8 | 1.9 | 0.3 | 1.5 | 0 | 0 | 14.2 | 80 |
| inositol | mg | 64 | 142 | 4 | 8 | 12 | 307 | 1600 | N/A |
| Fatty acids, total saturated | g | 0.091 | 0.43 | 1.865 | 1.81 | 1.544 | 0.015 | 4.464 | <20 |
| Fatty acids, total monounsaturated | g | 0.052 | 0.283 | 0.812 | 2.5 | 2.887 | 0.023 | 45.652 | N/A |
| Fatty acids, total polyunsaturated | g | 0.338 | 1.167 | 0.195 | 1.51 | 4.122 | 0.025 | 7.92 | N/A |
Data source: 1. USDA National Nutrient Database for Standard Reference Release 28 2. Clements RS, Jr, Darnell B. Myo-inositol content of common foods: development of a high-myo-inositol diet. Am J Clin Nutr. 1980;33(9):1954–67. [PubMed] 3. Nutrient Metabolism: Structures, Functions, and Genes. Martin Kohlmeier. 2015
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- Body weight
- Up to date medical care - nnual check-up, dental care