Maximizing Female Fertility
Infertility is generally defined as the failure to conceive after a full year of unprotected intercourse, although women over 35 are advised to speak to their doctor after just six months of unsuccessfully trying to conceive.
There are many factors that may contribute to reduced fertility, including damage to fallopian tubes, irregular ovulation, and conditions such as endometriosis and polycystic ovarian syndrome (PCOS). One of the main risk factors for infertility is increasing age. It is estimated that at least 20% of women now wait until after the age of 35 to have their first child. Because more women are waiting to start a family, age-related infertility has increased in recent years. A woman’s peak fertility occurs in her 20s. From age 30 to 35, women experience a gradual decline in fertility. After age 35, fertility begins to decline more quickly. By age 40, pregnancy potential is reduced by up to 50%.
The most important factor affecting fertility with increasing age is a decrease in egg quality. This decrease in quality impairs fertilization and embryo development, and reduces the chances of achieving a healthy pregnancy. The same factors that reduce egg quality also increase the risk of miscarriage and chromosomal abnormalities such as those that cause Down Syndrome. New research suggests that there are things you can do to improve egg quality, which will increase the ability to conceive and improve your chances for a healthy baby.
Nutrients for Women Trying To Conceive
Coenzyme Q10 for Improved Egg Quality
Ovulation is an energy-intense process. Mitochondria are the energy production factories in the body’s cells, and the human egg contains more mitochondria than any other cell.
Coenzyme Q10 (CoQ10) plays a crucial role in energy production inside the mitochondria. As people age, cellular production of CoQ10 decreases, so an older woman’s eggs are less efficient at producing energy. This reduced energy production can lead to poorer fertilization and early embryo loss.
Emerging research shows that taking supplemental CoQ10, as a form of “mitochondrial energy nutrition” for the egg, can help improve egg quality and potentially lead to a better chance of achieving a healthy pregnancy.1, 2
CoQ10 is a large fat-soluble nutrient. This means that it has to be specially processed by the body for proper absorption, and it is best to take CoQ10 with a meal containing fat. Even so, most CoQ10 supplements are not very well absorbed, especially those in tablet form. Some claim to be formulated for better absorption, but without any proof. Look for a CoQ10 supplement formulated with VESIsorb®, a colloidal delivery system that has been shown to improve the absorption and bioavailability of supplemental CoQ10 by more than 600% compared with other CoQ10 supplements.3
Dehydroepiandrosterone (DHEA) for Improving Ovarian Reserve
Ovarian Reserve (OR) is the ability of a woman’s ovaries to produce high-quality eggs. As women age, OR naturally decreases, and that is often the reason some women have a harder time getting pregnant.
Dehydroepiandrosterone (DHEA) is a hormone produced in the adrenal glands. DHEA levels typically peak at about 20 years of age, and decline rapidly after age 25. Research has shown that DHEA improves OR in women who previously responded poorly to in vitro fertilization (IVF).4,5 Studies indicate that 75 mg of micronized DHEA per day may increase the number of eggs and embryos, improve embryo quality, and increase live birth rates in women undergoing IVF.6 Because the effects of DHEA take some time, it is thought that DHEA should be supplemented for at least six weeks prior to starting an IVF cycle.
Inositol for Women with Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome (PCOS) is a condition affecting as many as one out of fifteen women in the U.S. It is caused by hormonal imbalances that prevent ovulation and make getting pregnant more difficult for women of any age. This imbalance contributes to weight gain and other symptoms such as acne and excess facial hair. Most women with PCOS develop small cysts on their ovaries.
Inositol is a vitamin-like carbohydrate compound. Studies have shown that taking 4 grams of a certain form of inositol, myo-inositol, helps induce ovulation in women with PCOS by improving the way the body uses insulin.7
Vitamin D and Pregnancy
Achieving an optimal vitamin D level is important before and during pregnancy. A recent study showed that women who became pregnant through IVF had significantly higher vitamin D levels than women who didn’t get pregnant. Women with a normal vitamin D level were four times more likely to get pregnant than women who were vitamin D deficient.12
Low vitamin D levels are common among pregnant women, and have been associated with complications of pregnancy.9-11 Typical prenatals provide only 400 IU of vitamin D, which is likely an inadequate amount for most women. Speak to your doctor about whether you should have your vitamin D level checked, and how much vitamin D you should take. Recent research has found that doses of 2,000 and 4,000 IU of vitamin D per day were safe for pregnant women and effective in achieving normal vitamin D levels.10
Diet and Lifestyle Choices for Maximizing Fertility
Diet and lifestyle choices can have a big impact on your fertility. A large study conducted by Harvard researchers showed that women who adhered to a combination of five or more lifestyle factors, including specific changes to their diets, were at a 69% lower risk of ovulatory disorder infertility than women who did not engage in any of these factors. The women with the highest fertility scores ate more monounsaturated fats rather than trans fats, more vegetable rather than animal sources of protein, more low-glycemic, high-fiber carbohydrates, more iron from vegetable foods and supplements, and surprisingly, more high-fat rather than low-fat dairy. The women with better fertility also took a daily multivitamin, had a lower body mass index (BMI), and exercised more.13
Other studies have associated a Mediterranean diet (rich in vegetables, vegetable-based oils, legumes, and fish) with increased chances of pregnancy. One study found that following a Mediterranean diet pattern increased the chances of pregnancy in couples undergoing IVF.14
The following guidelines will help you prepare for a healthy pregnancy.
- Limit foods containing trans fats, such as vegetable shortenings, some margarines, baked goods, pie crusts, frostings, and fried foods. Trans fats will be listed on the Nutrition Facts Panel, or in the ingredients list as “hydrogenated” or “partially hydrogenated” vegetable oil.
- Increase foods rich in monounsaturated fats, such as olive oil, avocados, nuts and seeds, and canola oil.
- Replace a serving of meat each day with vegetarian sources of protein such as beans, lentils, legumes, quinoa, nuts, seeds, and nut butters.
- Choose slowly digested carbohydrates that are rich in fiber, such as whole grains, vegetables, fruits, beans, lentils, and legumes.
- Eat more vegetarian sources of iron, such as spinach, beans, legumes, raisins or raisin bran, prunes, and cashews.
- Start taking a high-quality prenatal vitamin as soon as you begin trying to conceive. A good prenatal should provide a complete range of nutrients including extra folic acid, choline, and vitamin D. Folic acid and choline are important for the early development of a baby’s nervous system, which occurs during the first few weeks of pregnancy, often before a woman knows that she is pregnant. Maintenance of a normal vitamin D level is also important for fertility and a healthy pregnancy.
- Choose whole milk, full-fat yogurt, or treat yourself to a small bowl of ice cream each day while trying to conceive.
- Achieve a healthy body weight. Being over- or underweight can interrupt normal menstrual cycles and impair ovulation and thus fertility. Research indicates that it takes longer for overweight or obese women to conceive,16 and they are at a higher risk of miscarriage than normal-weight women. Fertility treatment is generally less successful in obese women.17 The best range for fertility seems to be a Body Mass Index (BMI) of 20 to 24.18
- Get active. Moderate physical activity is best while trying to get pregnant. A recent study found that for women who are overweight or obese, adding any type of physical activity improves fertility. For women who are underweight or normal weight, too much vigorous activity increased the time it took to conceive. When these women switched to moderate activity, their fertility improved.18
- Limit caffeine. Caffeine is a stimulant found in food and beverages such as coffee, tea, chocolate, soda, and “energy” drinks. Although research is inconclusive, some studies show that even 300 mg daily (the amount in a 16-ounce Starbucks® coffee) can decrease your chances of conception and increase the risk of miscarriage. It is best for women trying to conceive to keep their caffeine intake at 200 mg per day or less.19
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