Pre-conceptual diet & lifestyle tips

March 2011

We are often asked about how to improve diet and lifestyle whilst undergoing fertility treatment. After many years treating patients and advising on the best tips for a healthy lifestyle that encourages fertility, we have developed a few pre-conceptual diet and lifestyle tips which you may find helpful. These tips are useful for both men and women.

The following tips should help you on your way to a healthy body and mind:

Improve your diet three months to a year before you conceive

For both men and women, foods and fertility are linked. If you both stick to a balanced diet, you can boost your chances of conceiving and of having a healthy baby.

Reach your ideal body weight

You may choose to lose some weight (or gain a little if you're underweight) before trying to get pregnant. It is a good idea to be as close as possible to your recommended weight when trying for a baby as being overweight or underweight can reduce your chances of conceiving.

If you are overweight, a sensible eating plan could include lower fat and higher fibre foods, but don't forget to exercise. Extreme weight loss from crash dieting can deplete your body's nutritional stores, which isn't a good way to start a pregnancy.

Follow a healthy eating plan

Healthy eating means eating a balanced diet. The Food Standards Agency (FSA undated: a) recommends eating a variety of foods while trying to conceive, including:

Fruit and vegetables - these can be fresh, frozen, tinned, dried or a glass of juice. Aim for at least five portions a day.
Carbohydrate foods such as bread, pasta, rice (preferably wholegrain) and potatoes.
Protein such as lean meat and chicken, fish, eggs and pulses (beans and lentils).
Fish, at least twice a week, including some oily fish, but don't have more than two portions of oily fish a week. This includes fresh tuna (not canned tuna, which does not count as oily fish), mackerel, sardines and trout.
Dairy foods such as milk, cheese and yoghurt, which contain calcium.
Iron-rich foods, such as red meat, pulses, dried fruit, bread, green vegetables and fortified breakfast cereals, to build up your resources of iron in preparation for pregnancy. It helps your body to absorb iron if you have some food or drink containing vitamin C, such as fruit or vegetables, or a glass of fruit juice with any iron-rich meals.

In general, you should aim to reduce the amount of high-fat, high-sugar foods you eat (such as cakes, pastries, fizzy drinks, some takeaway and fast foods). Make time for breakfast every day, and keep an eye on your portion sizes at mealtimes and snacks between meals.

Take a vitamin supplement

While you can meet almost all your nutritional needs through a balanced diet, some experts believe that even the healthiest eaters could do with some extra help.

It is worth noting that a supplement is a safeguard, not a substitute for a sound diet. And since over-the-counter supplements may contain large doses of vitamins and minerals that could be harmful to a developing baby, it's sensible to switch to a pill formulated for pregnant women even before you conceive. Or choose a supplement that contains about 100 per cent of the RDA (recommended daily allowance) so that it does not contain mega doses of vitamins or minerals.

For men, a vitamin preparation containing Selenium Coenzyme Q and zinc may be beneficial for sperm health and production.

Take folic acid

Everyone could do with more folic acid, not just women - this B vitamin has been linked to a lower incidence of heart attacks, strokes, cancer, and diabetes. It also reduces a baby's risk of neural tube birth defects such as spina bifida (a serious congenital condition, which occurs when the tube around the central nervous system fails to close completely).

Women who are trying to conceive (or who might become pregnant) should take a supplement of 0.4 milligrams (mg) daily - also written as 400 micrograms (mcg). You should take this from the time you stop using contraception until the 12th week of pregnancy. Make sure that the supplement you use does not contain vitamin A or fish liver oil.

In addition, it's wise to eat folate-rich foods such as dark green leafy vegetables (such as spinach or kale), citrus fruits, nuts, whole grains, brown rice, fortified breads and cereals.

Cut back now on alcohol

It is sensible to cut out or only occasionally drink alcohol when trying for a baby. The current advice is to drink no more than one or two units of alcohol once or twice per week. A unit is half a pint of standard strength beer, lager or cider, or a pub measure of spirit. A glass of wine is about two units and alcopops are about 1.5 units (FSA undated: a). The main risk here is to a developing fetus, which can be harmed by heavy or binge drinking.

If you have stopped using contraception there is a chance that you could already be pregnant - it's better to be safe than sorry and avoid worrying later about how much you drank early in pregnancy.

Think ahead about caffeine

There is no consistent evidence to link caffeinated beverages (tea, coffee and colas) to fertility problems. However, the Food Standard Agency (FSA undated: b) advises that pregnant women should limit their intake of caffeine - having more than 200 mg of caffeine per day has been linked to miscarriage and low birth weight. As part of your preparation for pregnancy you could start to wean yourself from caffeine in chocolate, cocoa, fizzy drinks and coffee so that you are used to a lower intake before you become pregnant.

To check how much you are consuming now - 200 mg of caffeine is roughly equivalent to:

2 mugs of instant coffee (100mg each)
2 cups of brewed coffee (100mg each)
4 cups of tea (50mg each)
5 cans of cola (up to 40mg each)
4 (50g) bars of plain chocolate (up to 50mg each)

What else to avoid:

The Food Standards Agency (FSA undated: a) recommends that women who are trying to conceive should also avoid the following:

Too much vitamin A. This means you should avoid eating liver and liver products such as pate and avoid taking supplements containing vitamin A or fish liver oil. You need some vitamin A, but if you have too much during pregnancy, this could harm your baby.
Fish containing mercury, such as, shark, swordfish and marlin. It is also suggested to not eat any more than two tuna steaks a week (weighing about 140g cooked or 170g raw) or four medium-size cans of tuna a week (with a drained weight of about 140g per can). High levels of mercury can harm an unborn baby's developing nervous system.
Avoid smoking and smoky places as the cigarette smoke contains harmful substances to both, eggs, sperm and developing embryos.
Excessive stress may have an impact on the body and affect the way it functions. For example, the symptoms of Premenstrual Syndrome are exaggerated. Prolonged periods of stress affect pre-conceptual health and need to be avoided to promote the ideal conditions for conception and improve fertility.
Identify what situations you find most stressful and try to avoid these or, if this is not possible, take time to relax and de-stress at every opportunity.
Changing your mood can be as easy as changing the scene, for example, to walk away from a difficult situation rather than confront. Pausing to make a drink, or taking a few deep slow breaths can make a difference to your stress levels.
A hectic, busy life with little time for relaxation, attention to diet or socialising will affect a woman's pre-conceptual health and general sense of happiness and well-being. Other aspects of a busy lifestyle, such as not getting enough sleep and a reliance on alcohol to relax, are not beneficial to health and need to be addressed if pre-conceptual health is to be improved.