Trying to Conceive (TTC)? Here is what you need to know.
If you are flirting with the idea of having a baby, seriously trying to conceive, or simply tossing around your future options, welcome! You are in the right place. This two part blog series will provide you with all the information you need to know to start your preconception to pregnancy journey, no matter what your time line looks like.
As a Naturopath, it is not only my job to assist your pregnancy journey, but it is also to ensure that you of optimal health and fertility before you fall pregnant, during the preconception period. It’s a big job! And one I love to support and watch unfold.
First of all, what exactly is preconception care?
Preconception care involves dietary, lifestyle, supplementation and other support system interventions to future parents before conception occurs. The aim is to improve the health status of the individuals involved, and reduce factors that contribute to poor maternal, paternal and child health outcomes. The ultimate goal is to improve the health of all involved in the conception process, in both the short and long term.
Why do preconception care?
In 2013 the World Health Organisation (WHO) reported that preconception care has positive impacts on maternal and child health outcomes. It encourages health promotion before pregnancy, and mitigates risk prevention, thereby improving pregnancy outcomes for all involved.
Evidence shows that good maternal health and nutrition before and during pregnancy can have a positive effect on the long-term risk of non-communicable diseases (NCDs) in the next generation. NCDs are the leading cause of death of most countries in the world.
Preconception care can improve the health and fertility of men and women involved, and assist in the increasing the likelihood of a normal, healthy, full-term pregnancy, reducing the chance of miscarriage, premature birth and stillbirth.
A 2018 Lancet study published the conclusion that a woman who is healthy at the time of conception is more likely to have a successful pregnancy and a healthy child.
What time frame is involved?
The preconception period does differ between individual to individual, depending on their current health status. Someone with a health condition that needs managing or supporting in order to assist a successful conception and then pregnancy, will be looking at a longer time frame than someone with no health complications.
However, the preconception period is generally considered, from a biological perspective, in terms of the days/weeks/months needed for embryo and sperm formation.
- Egg formation takes around 90 – 100 days.
- Sperm formation can take up to 116 days (not 4 – 5 days like many people believe!)
Each partner donates one cell to the future baby, meaning that the health of the DNA in those cells determines the ultimate health of the baby. It is during preconception time that both men and women have a huge role to play.
Based on the above, I ask clients to prioritise at least 4 months of preconception care for those coming to see me with conception and fertility goals.
The Fertile Window
Once ovulation has occurred, that egg lives from 12 – 24 hours. That’s it! Sperm can live in the uterus and fallopian tubes for about 6 days once ejaculation has occurred. If we combine these, this means that a woman is fertile for only around 7 days of her cycle. It’s not a very long period of time! I suggest familiarising yourself with your individual menstrual cycle, determining your pattern of ovulation so that you are familiar with your fertile window – the days of your cycle you have the best chance at falling pregnant.
For more information on how to track your cycle and determine your ovulation, see this blog.
The Preconception Diet
What to eat when trying to conceive is a big topic, and one that is hotly debated across all corners of the internet. There are a few well-researched, evidence-based ways of eating that I recommend to clients who are looking to conceive. An individualised prescription is essential for preconception nutrition, however I will touch on a few important macro and micronutrients that apply across the board.
Firstly, ensuring that you are eating enough is key. In order to be in a place of health to ovulate regularly, your body requires:
1. Enough body fat
2. Enough carbohydrates
3. Enough calories!
The Mediterranean diet is the most researched eating plans for overall and maternal health. The Mediterranean diet focuses on fruits, vegetables, extra virgin olive oil, wholegrains, beans, and nuts and seeds. Seafood is the main source of protein here, followed by beans and legumes. Dairy and red wine intake is moderate, and red meat is a rare occurrence.
This way of eating is high in fibre, omega-3 fatty acids (from the seafood intake), phytonutrients, and antioxidants (from all of the plant foods). There is nothing overly revolutionary about this diet – my tip would be to focus on wholefoods instead of packaged and takeaway foods, ensure plants are abundant in most of your meals, and treat animal protein as a condiment.
The Australia Dietary Guidelines are to aim to eat 5 serves of vegetables, and 2 serves of fruit daily. Although I don’t always agree with what the guidelines say, I do think this is a fantastic place to start!
Protein
Adequate protein is absolutely essential for conception. Aim for at least 1g per kg of body weight of protein, from a combination of animal and plant sources. Ideally protein is in every main meal, and high-protein snacks can be helpful to reach your daily target.
Protein needs increase drastically throughout pregnancy, so it is a good idea to get started on a protein-rich diet in preconception!\
Carbohydrates
Are necessary for ovulation! Whether you need to increase, decrease, or stay the same with your carbohydrate intake is dependent on your health status.
I suggest choosing wholegrain and vegetable sources. This includes starchy vegetables such as pumpkin, sweet potato, potato, carrot, beetroot, parsnips, turnips etc, as well as wholegrains such as rice, quinoa, buckwheat, millet etc.
Fats
Are critical for hormonal health and fertility. Ensure an intake that balances different types of fats – include avocado, fatty fish and seafood (wild caught if possible), extra virgin olive oil, olives, dairy and/or coconut yoghurts, nuts and seeds.
What about micronutrients?
Ideally you want to fall pregnant without any nutrient deficiencies. Deficiencies will be individual and must be corrected for healthy conception and pregnancy outcomes.
The below nutrients are contained in most good quality, practitioner only prenatal supplements. However, you can start including sources of these foods in your diet today! Include a variety of the foods I have listed above daily and know that you are supporting your health and fertility through what you eat. The key micronutrients involved in preconception care are:
Zinc
High amounts contained in oysters, red meat, liver, chicken, hard cheeses, nuts and seeds
Selenium
Brazil nuts (enjoy 3 – 4 daily), mushrooms, egg yolks, seafood, sunflower seeds
Iodine
Only abundant in seaweed – Kombu is best, and there is some contained in seafood. Fortified salt and commercial bread contains iodine also
Choline
Liver, wheat germ, eggs, meat
Folate
Liver, spinach, black-eyed peas, white rice, asparagus, Brussels sprouts, broccoli
And of course, focusing on any nutrient you are deficient in is necessary. All-too-common nutrient deficiencies I see in clinic include B12, vitamin D, iodine and iron. Test, don’t guess! Stay tuned for part 2 of this blog which will focus on what pathology to do in your preconception care journey.
What about things to avoid?
Essentially there is no one food that alone will hinder your conception journey. Thank goodness! However, you can certainly optimise your diet to aid your conception journey. I suggest focusing on including an abundance of the above foods mentioned, so that there is less room for refined sugars and processed foods.
Avoid recreational drug use and smoking during preconception care. It is also ideal to avoid or minimise alcohol intake, and ensure your caffeine intake is less than 2 standard shots of coffee max daily. A 2016 study showed a link between caffeine consumption in the preconception period with pregnancy loss.
Check that your medications and supplements are safe for use during preconception and pregnancy with your health care practitioner.
I hope that you feel armed with some knowledge to start supporting your preconception and fertility journey today! In part 2 of this blog series I discuss what to look for in a prenatal supplement, key nutrients, pathology and blood tests, as well as supporting conception through microbiome and nervous system health.
If you are looking for individualised support for your preconception or pregnancy journey, please get in touch by booking in a session here.
Jaclyn is a qualified Naturopath with a focus on hormonal complaints, cycle health, reproductive and fertility care, skin issues, and adrenal health.
Author
Jaclyn Cave
BHSc (Nat), BComm (Soc)
Masters Womens Health Med (UNSW - completing)
References
https://www.who.int/maternal_child_adolescent/documents/preconception_care_policy_brief.pdf
https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30981-4/fulltext
https://reproductive-health-journal.biomedcentral.com/articles/10.1186/1742-4755-11-S3-S6
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6075697/