Fueling Fertility: Nutrition for Your Journey

Infertility affects many patients who struggle with their weight, as excess weight can lead to hormonal imbalances that impact ovulation. For example, PCOS, a common cause of female infertility, is commonly linked to excess weight and insulin resistance. Weight loss is often recommended for those who have excess weight and are struggling to conceive.

To achieve weight loss, the focus will be on lifestyle changes as most weight loss medications are not recommended for those actively trying to conceive. We’ll be discussing lifestyle changes to support weight loss in individuals trying to get pregnant, but if you have questions about medications be sure to discuss this with your medical clinician.

A healthy mom is essential for a healthy baby. Optimizing maternal health before, during, and after pregnancy is important. Research has shown that fertility can be impacted by the foods we eat, and our nutritional recommendations below highlight foods that should be emphasized and those that should be reduced during your weight loss journey. Keep in mind, each person’s individual nutrition plan is unique to their own needs and preferences, and your Form Health Care Team will work with you on finding a personalized plan that is sustainable for you.

Nutritional recommendations

The Mediterranean dietary pattern has been linked to improved fertility and increased birthrates among those undergoing fertility treatment. It emphasizes eating whole foods, including vegetables, fruits, olive oil, nuts/seeds, whole grains, beans, low-fat dairy, poultry, and fatty fish. Meanwhile it is low in refined (processed) carbohydrates (think foods made with white flour and sugar) and red meat. Compared to the Form Health Plating Method, the Mediterranean dietary pattern incorporates larger portions of healthy fats and high fiber carbohydrates. Many of our patients find reducing carbohydrate intake to be a helpful method to decrease overall calorie intake, and instead we favor larger portions of produce, which also provide fiber yet for fewer calories.

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Here are some suggestions to get started:

Focus on Fiber. High fiber carbs will cause a slower blood sugar response in your body and are linked to lower levels of inflammation in the body. Meanwhile, refined carbohydrates (low fiber, typically more processed carbs) are linked to insulin resistance which can negatively impact fertility.

  • Look for carbs with 5g+ of fiber per serving at meal times. These can include whole grains such as quinoa, brown rice, and oats, beans, and starchy vegetables such as peas, corn, potatoes, and winter squashes. The recommended fiber intake for women is at least 25g per day.
  • While fiber is helpful in stabilizing your blood sugar, it is still important to be mindful of serving sizes of these high fiber carbs. Ask your Registered Dietitian for specific recommendations for you!

Incorporate healthy fats such as avocados, nuts, seeds, avocado/olive oil. Healthy fats help with hormone regulation, vitamin absorption, and are anti-inflammatory!

  • Chia seeds, ground flaxseeds and/or walnuts added to yogurt can give it a boost of healthy fat!
  • Fatty fish such as salmon is a good source of DHA/EPA, essential omega-3 fatty acids that play a role in brain health. While it is important to consume fatty fish, limit intake to 8-12 ounces per week from low-mercury sources while pregnant.
  • Note that fats contain more calories per gram than other sources of nutrients (e.g. carbs and protein), which is why we recommend them in moderation to help achieve a calorie deficit.

Protein is an essential nutrient that is helpful for weight loss as it helps us feel full.

  • There may be a fertility benefit if consuming more plant-based proteins (e.g. soy/tofu, beans, whole grains, etc.).
  • Better choices for animal-based proteins include fish (see above), white meat poultry, eggs and dairy (especially fermented products like Greek or Icelandic yogurt).
  • Limit processed meats (e.g. sausage, hot dogs, deli meat, etc.) which can negatively affect fertility.

Limit processed foods as much as you can.

  • Research shows that a diet high in trans fats, refined (simple) carbohydrates, and added sugars can negatively affect fertility.
  • Sugar is added to many products and may not be listed as “sugar” on the ingredient list as it comes in many forms. That’s why it can help to check the nutrition panel for “Added Sugars” and try to minimize this.

Reduce alcohol and caffeine consumption.

  • High caffeine consumption may prolong time to becoming pregnant. Importantly, it’s recommended not to exceed 200 mg caffeine per day if trying to become pregnant. Note that caffeine is not just in coffee, but also tea, sodas and chocolate.
  • Some caffeinated beverages may be a source of added sugar and calories that do not contribute to feelings of fullness which could affect weight loss progress.
  • Alcohol intake is associated with lowered fertility with one study showing as alcohol intake increased, it continued to have a greater impact on lowering fertility. Many women are aware of the need to avoid alcohol during pregnancy, but it is also important to consider how this may impact fertility.
  • Alcohol is also considered a source of “empty calories” and its inhibition-lowering effects could result in episodes of unplanning eating.

Don’t forget about movement! Moderate activity such as brisk walking, biking, swimming, or yoga, can help to improve insulin sensitivity, help to regulate menstrual cycles and are great for reducing stress- all of which can support fertility! If you are actively undergoing any fertility treatment, be sure to discuss if there are any activity restrictions with your fertility specialist.

Supplement with a prenatal vitamin if you are trying to get pregnant. Prenatal vitamins should contain 400 μg folic acid, 27 mg iron, 600 IU Vitamin D and 1,000 mg calcium.* Folic acid is an important part of brain development that is required very early on in the pregnancy, even before a person might know they are pregnant. Therefore, it’s best to start this even before you become pregnant. Also note that Vitamin A in excess (>10,000 IU/day) can cause birth defects, so if you are taking additional vitamin A separately from your prenatal vitamin you should discuss this with your OBGYN. If your OBGYN or fertility team has preferred prenatal multivitamin, then please use their recommendation.

*Some women require more than these amounts depending on their medical history (e.g. history of bariatric surgery). Please discuss this with your medical clinician/OBGYN.

Tips for finding a prenatal vitamin

  • Look for assurance seals from USP (U.S. Pharmacopeia), NSF (NSF International), ConsumerLab and UL (Underwriter Laboratories). They test to ensure that a supplement's contents match its label, that it is free of tested contaminants (e.g. heavy metals), and that it disintegrates fast enough to get absorbed.
  • Avoid gummies. Gummy vitamins often contain little to no iron and their reported vitamin levels may not actually be accurate.

Important nutrients that may be missing from your prenatal

  • DHA: DHA is an Omega-3 fatty acid important for fetal development. Current recommendations vary, in some cases only recommending 2 servings of fatty fish (8 oz) per week and others recommend supplementing with 200-300 mg DHA daily.
  • Choline: This is an essential nutrient that can be found in different foods, but most women who are pregnant do not consume enough in a day. Daily recommended intake during pregnancy is 450 mg and during lactation is 550 mg.

Dietary sources of choline (per 100 g serving)

  • Whole eggs: 250 mg (choline is in egg yolks)
  • Liver: 200-300 mg
  • Meat/fish: 80 mg
  • Whole grains: 70 mg
  • Nuts/seeds (esp flaxseed): 50 mg
  • Legumes/veggies (soybeans, cauliflower, peas, spinach): 35 mg
  • Milk: 20 mg
  • Iodine: It's recommended women get 150 μg iodine daily from their multivitamin to ensure proper development and thyroid function. Note that there are risks with excess iodine consumption.

Recommended prenatal:

MegaFood Baby & Me 2™ Prenatal Multi

  • Meets requirements for vitamins A, C, D, E, K, B vitamins and iodine.
  • Contains 300 mg choline.
  • Contains iron bisgylcinate which may cause less stomach upset. Note that it has 18 mg iron (not the recommended 27 mg) but additional 9 mg iron can come from food.
  • Does not contain calcium or DHA so may need to supplement if not getting sufficient amounts from food.

Ingredients are subject to change. Please review the supplement contents before purchasing.