Does Nutrition Affect Fertility?
In one simple word, yes. In two simple words, absolutely yes! Let’s consider the very basic and bare minimum your OB/GYN tells you to do, take a prenatal to help ensure a healthy baby. And what exactly is a prenatal? It’s a tiny capsule full of vitamins and minerals – i.e. nutrition – and she tells you to do this because it will help cover the gaps of a subpar diet.
But let me assure you, that it goes soooo much deeper than that…
Let’s take one example: The B vitamins, pregnancy and methylation
B vitamins, especially folate, are essential to the development of the early embryo and fetus. Research shows that optimal blood folate levels of women trying to conceive (TTC) are needed before pregnancy in order to prevent neural tube defects (NTDs). Craniofacial anomalies, including neural tube defects (NTDs) and oro/facial clefting constitute one of the most prevalent types of congenital dysmorphologies a baby can be born with.
The worst part is, research shows that most women who are TTC do not have optimal blood levels of folate before attempting conception!! In fact, 88% of the 2065 women enrolled in this particular study fell below 18 nmol/L, the proposed optimal plasma folate level for the prevention of NTDs.
The science is so strong for the need for folate during embryo development that in 1998 the U.S. Institutes of Medicine recommended that women of childbearing age supplement their diet with 400 mcg of folic acid daily, a recommendation that has subsequently been increased to 800 mcg daily.
Also in 1998, the U.S. Government mandated that cereal grains (mostly wheat flour) be fortified with folic acid, to ensure even those women who are not taking a prenatal vitamin – or don’t know they are pregnant – get enough folate.
That’s because having enough Folate and B-Vitamins on board is the most important BEFORE CONCEPTION. That’s because by day 28 after conception, the neural tube should be closed and fused. That’s extremely important because the central nervous system of a growing fetus starts with the ‘neural groove’ that folds in to form the ‘neural tube’ that then develops into the spinal cord and brain.
I REPEAT DAY 28 – that is 4 weeks after conception – and likely before you ever even know you are pregnant!! The preventive effect of folate is not effective after that period. More important is that achieving the highest serum folate levels requires at MINIMUM of three weeks of folate support. And depending on your genetics, disease state and health of your intestines it can take much longer.
The take away here is to begin thinking about your nutritional status far in advance of trying to conceive. But what many people don’t know is that their genetics – and specifically their epigenetics – may make it harder for their body to maintain good folate status.
Your body needs to go through a process called methylation in order to produce the active form of folate, tetrahydrafolate (THF). You need folate in this active form to support a wide array of normal physiological functions; cardiovascular, neurological, and liver function amongst many others.
Now here’s the kicker and why a functional nutritionist is so crucial to your fertility journey…. the methylation process can be affected by numerous factors such as drug and alcohol use, exposure to heavy metals and environmental toxins as well as poor diet (taking in too little vitamin B6 or vitamin B12 that work as cofactors in the methylation cycle). However, the most common cause of impaired methylation is due to variations in the MTHFR gene, known as single nucleotide polymorphisms (SNPs).
Most importantly for the audience I am speaking to now, low folate status as a result of a SNP – which can also be intensified by poor dietary intake of folate – can affect spermatogenesis (the making of healthy sperm) and oocyte maturation (the ovulation of healthy eggs) resulting in chromosomal anomalies of the egg and sperm.
If the egg and sperm with chromosomal anomalies make it to embryo status (fertilized human eggs) they often result in failed births due to embryonic arrest, implantation failure, miscarriage, or intrauterine fetal death.
Additionally, SNPs in your genes that are responsible for DNA methylation have also been shown to play a role in pregnancy complications such as pre-eclampsia, hypertension, GDM, early pregnancy loss and preterm birth.
Finding out where your nutritional, genetic and toxin vulnerabilities lie is something we will uncover when we go through your advanced functional nutrition and functional medicine labs. When we test (NOT GUESS) we can provide a targeted, individualized approach to better fertility that gets you to your family goal in an expedited manner.
To come full circle, and in short, nutrition DOES affect fertility in so many ways. B-vitamins are just one example of how nutrition can have an impact on your fertility and pregnancy.
Pre-conception prepping, aka preparing your body for pregnancy months in advance of attempting conception, is the absolute best way to improve your health and provide the most optimal home to your growing fetus.
I look forward to working with you!
In Fertile Health,
Madison Milmeister, MS, M.Ed. RD
References:
1. Dias et al. Front Clin Diabetes Healthc. 2022; 3: 982665. The role of maternal DNA methylation in pregnancies complicated by gestational diabetes.
2. Clement et al. Biomolecules. 2022 Aug; 12(8): 1086. MTHFR SNPs (Methyl Tetrahydrofolate Reductase, Single Nucleotide Polymorphisms) C677T and A1298C Prevalence and Serum Homocysteine Levels in >2100 Hypofertile Caucasian Male Patients
3. Schwahn and Rozen. Am J Pharmacogenomics. 2001;1(3):189-201. Polymorphisms in the methylenetetrahydrofolate reductase gene: clinical consequences
4. Samura et al. Biomolecules. 2023 Jun; 13(6): 1010. Sperm and Oocyte Chromosomal Abnormalities
5. Das, J., Maitra, A. Maternal DNA Methylation During Pregnancy: a Review. Reprod. Sci. 28, 2758–2769 (2021). https://doi.org/10.1007/s43032-020-00456-4
6. Ponziani FR, Cazzato IA, Danese S, Fagiuoli S, Gionchetti P, Annicchiarico BE, D'Aversa F, Gasbarrini A. Folate in gastrointestinal health and disease. Eur Rev Med Pharmacol Sci. 2012 Mar;16(3):376-85. PMID: 22530356.