Preconception Care: My Top Tips for Improving Fertility

I work with many patients in my practice who would like to start a family or add to their already existing family. It’s an area I am passionate about and it’s the most rewarding aspect of my job, to be a part of such a significant, personal journey in people’s lives. Nothing brings me more joy than to share in the happiness of a person or couple bringing a child into their family. It’s truly the most joyful work. However, it can also be the most challenging, heart-breaking work, as fertility is the most complex, complicated journey for some people.

I work with women and couples who have been trying to conceive for a long time, and I work with patients who come to see me well before they’d like to conceive. I work with patients who have diagnosed conditions causing their fertility challenges, and I work with patients who have no tangible cause for their challenges.

There are of course many possible factors affecting a person’s fertility, however the purpose of this blog is to give you practical advice that is relevant to all couples or people wanting to conceive, whatever the situation. It is my hope that after reading this post, you will have a better understanding of the importance of preconception care (for both parties involved!) so you can improve your own chances of conceiving a healthy baby.

Jing – A Chinese Medicine Concept
To begin, I’d like to talk about a Chinese medicine concept called Jing. Bear with me, I promise it’s important! Jing, which can be translated as Essence, is stored in our Kidneys and is made up of two parts: the prenatal Jing and the postnatal Jing. The prenatal Jing is what we’re born with: our DNA. The postnatal Jing is what we acquire through our diet and lifestyles, similar to the concept of epigenetics – how our lifestyles affect our genes and our health. Our prenatal Jing and our postnatal Jing determine a large part of our health and wellbeing throughout our lives, but they also play a significant role in our fertility. After all, fertility is just an extension of our overall health and if we are healthy, it means our cells are healthy (including egg and sperm cells!) and if we are healthy overall, our reproductive health should also be in good shape.

Now obviously we can’t do much about the genes that we were born with (thanks Mum and Dad), but we can influence our postnatal Jing (that is; the fuel we either fill our tanks with or drain from our tanks) in the way we live our lives. In my opinion, our lifestyles are the number one factor involved in whether a person or couple has optimal fertility or not. Therefore, this blog will be focused on all the ways we can influence our postnatal Jing (the aspect of health we do have control over), to improve our health and therefore, improve our fertility.

Now whilst we can only impact our own postnatal Jing, we can have an impact on our future children’s prenatal Jing by ensuring that we (and our cells) are as healthy as can be at the time we conceive! I could write a whole essay on Jing alone, but I think that covers the basics for the purpose of this post.

It seems pretty logical right? Improve your health in order to improve the health of your cells, and therefore your fertility. How do you do that? Let’s get into it!

1. Eat a Whole Foods-based Diet
This should come as no surprise, as by now I’d say most people understand the relevance of food for our health (or ill-health), and it’s the same for fertility. Food is either our most powerful medicine or our slowest form of poison. What do I mean by this? Food can either contribute to inflammation or it can help to reduce inflammation. It can either support our cellular health, or it can hinder it. And why is this important for fertility? Well, inflammation and cellular health are involved in every disease, condition or imbalance in our bodies, and fertility is no exception, so making sure we reduce inflammation and support cellular health is essential. Inflammation can lead to SO many unnecessary health issues, but in regards to fertility, it can lead to hormone imbalances, pelvic inflammation and thyroid dysfunction just to name a few. It can also lead to less-than-optimal mitochondrial function of the egg (aka the ‘energy’ of the egg) and poor sperm quality. Therefore, reducing inflammation is the first step in improving the health of your fertility.

Additionally, it is also important to fuel our bodies with nutrient-rich foods, to nourish our cells and to ensure we’re not deficient in any major nutrients necessary for healthy conception. Eating a wide variety of foods, and aiming to eat lots of different coloured fruits and vegetables, will ensure that we are getting a wide range of vitamins, minerals and antioxidants.

Now don’t panic, it really is quite simple when it comes to the food you eat!
My advice to patients: eat a whole foods-based diet and avoid the processed stuff!

Processed foods, aka junk food/fast food/packaged foods are a sure-fire way to promote inflammatory processes in the body and leave you deficient in essential nutrients, so cutting them out or reducing them is a no-brainer when it comes to your reproductive health.

So what should you eat?
Don’t over complicate it, keep things simple.
- Eat fresh, home-cooked meals as often as possible, with plenty of vegetables, good quality protein such as fish, chicken and eggs, pulses and legumes, nuts and seeds and some fruit.
- Avoid highly processed foods such as fast food, sweets, chips, donuts and anything with highly processed, unhealthy vegetable oils.
- Use good quality oils in your cooking (coconut or avocado oil for heating, olive oil at room temperature) and avoid using vegetable oils such as canola oil or seed oils (they are highly inflammatory).
- Reduce or remove other inflammatory agents such as gluten and wheat if you find you react to them or don’t feel well after eating them.
- Add healthy fats to your meals such as avocado, olive oil, walnuts and fatty fish.
- Drink plenty of water.

Blood sugar stabilisation is also essential in balancing hormones (which is a factor for many couples with fertility challenges) so making sure you’re including a serving of protein at every meal is a good place to start. (Protein creates a more steady release of glucose rather than causing rapid spikes that many carbs do). Avoiding sugar or high GI carbs like white flour products and choosing lower GI foods instead will also help to stabilise blood sugars and balance hormones.

Food is one of the most important factors in building our postnatal Jing, and eating well is important for both Mum and Dad’s reproductive and cellular health, so if you do one thing in your preconception care, let it be this.

2. Reduce or Eliminate Caffeine

In Chinese medicine, caffeine, particularly coffee, drains our Kidneys; our Jing.

Just as whole foods can improve our postnatal Jing, coffee can deplete it, and studies have shown that women who consume caffeine may take longer to fall pregnant than those who don’t, and male fertility may also be affected by caffeine intake. Research also shows there is an increased risk of miscarriage for women who consume caffeine compared to those who don’t, with higher amounts of caffeine associated with a higher risk of miscarriage.

So what’s my advice? Ditch the caffeine, it’s not worth the risk!
If you’re struggling to remove it completely, start by cutting down slowly and maybe replace one cup with a cup of green tea (slightly lower in caffeine), or herbal tea, which is naturally caffeine-free.

3. Reduce stress

We all know stress isn’t good for us. But what does this mean for our fertility?

Well, our bodies are intelligent and are only working to protect us. When we are stressed, this signals to the body that we are in danger, and in an attempt to protect us and help us ‘survive’, things like reproduction can be down-regulated. It makes sense - if we were in actual danger, getting pregnant would be dangerous for our survival, so ovulation is down-regulated and energy is diverted to other more vital areas to our survival. This is helpful if we really are in danger, but what about for the majority of us who are not in actual danger, but rather in a perpetual state of chronic stress? There is no difference! Our bodies can’t distinguish between actual danger or the chronic stress associated with our modern lifestyles. There is no real difference from a physiological point of view, so addressing chronic stress is imperative.

Chronic stress also increases inflammatory processes in the body, and as we’ve already discussed, inflammation is the driver for many disease processes or imbalances in the body, including hormonal imbalance or fertility challenges. Therefore, doing our best to reduce stress will have a huge impact on our fertility, by signalling to our nervous systems that we are safe; that it is safe to reproduce.

How do we do this? Firstly, by analysing our lives and making changes where we feel the most stressed. For example, if your long work hours are making you stressed, can you cut back slightly? Or if you’re stressed out trying to make it to the gym before work at 5am every morning, can you change up your exercise routine to be a little more nurturing? Or if your caffeine habit is heightening your feelings of stress, can you cut back?

Secondly, engaging in stress-moderating activities such yoga and meditation can be hugely beneficial. Or maybe it’s about spending more time with family or friends that makes you feel less stressed. Acupuncture is also a wonderful therapeutic tool to utilise if you feel that stress is an issue for you. Whatever your situation, spend some time reflecting on the areas in your life you need to change, or the activities you need to include to feel a little calmer.

4. Reduce Chemical Exposure

This is an area I believe few people are educated about, but it’s an important one.

If you’re not actively trying to avoid chemical exposure by using organic, chemical-free cleaning products, personal care products and food storage products, then you are probably being exposed to many chemicals every single day unknowingly.

The endocrine system is the system made up of all the hormone secreting glands and organs in the body, such as the pituitary, thyroid, adrenal glands, ovaries and the testes. This system maintains and controls many normal bodily functions and when one aspect of the system is thrown out of balance, many aspects of the body and health can be impacted, so keeping this system in balance is important not only for health in general, but also for reproductive health. One thing that can throw this system out of balance is the ingestion or absorption of endocrine-disrupting chemicals.

Endocrine-disrupting chemicals can significantly impact the delicate balance of hormones and their functions in the body. This can affect a person’s reproductive health, as fertility is so reliant on having the right amounts of specific hormones at the right times of the month. This is why I recommend avoiding them as much as possible.

So what do I recommend?
- Do a big clean out of your personal care products, cleaning products and detergents and swap over to chemical-free alternatives.
- Opt for organic skincare and makeup that doesn’t contain chemicals or nasty SLS, and natural wash products that don’t contain parabens or chemicals.
- Store your food in glass or stainless steel containers and don’t use plastic where possible.
- Buy organic produce where possible, or at least check out the “dirty dozen” list released each year for the foods sprayed with the highest amount of pesticides and chemicals, and buy these organic.

Smoking also exposes you to chemicals and toxins, so I always recommend the cessation of smoking for both males and females in preconception care, as the toxins involved have significant effects on both egg cells and sperm cells. It is important to stop smoking at least 3-4 months prior to conceiving to ensure the DNA of the egg or sperm cells involved in conception haven’t been impacted by the toxins from smoking.

5. Work With a Practitioner to Manage Any Underlying Health Issues
It might seem obvious, but healing or managing any underlying health issues or symptoms that may contribute to issues with fertility is important, especially if you have an underlying condition that is directly associated with fertility challenges, such as Polycystic Ovarian Syndrome (PCOS) or endometriosis. For example, for a patient with PCOS and the associated insulin-resistance and long or absent cycles, working with a qualified practitioner to help improve metabolic and menstrual cycle health is crucial, as lack of ovulation will make it very difficult to conceive! Similarly, for patients with endometriosis, it can be incredibly helpful to work with a practitioner to reduce the inflammation associated with the disease.

In other cases, it might be helpful to work with a practitioner on regulating cycles, or resolving hormone imbalances and PMS, or improving progesterone levels. There are so many possible scenarios, which is why it’s important to work with a qualified practitioner who knows how to address your issues.

Whilst dietary and lifestyle changes are an important step for all people who would like to conceive, sometimes a more specific treatment protocol from a practitioner is required, where a range of treatment methods, such as acupuncture and herbal medicine can be utilised.

6. Supplementation
Again, work with a qualified practitioner here to make sure you’re taking the right prenatal supplements and/or herbs for you. I don’t recommend taking supplements without consulting a practitioner first, as some supplements may not be the best option for your specific situation. I have worked with several patients who have taken the wrong supplements for a period of time, which actually hindered their efforts to conceive, so it’s always best to talk this through with a qualified practitioner.

In an ideal world, I would suggest starting your preconception care at least 3-6 months prior to trying to conceive. Why? The journey of an ovarian follicle to full maturation takes around 120 days, and the health of this follicle and the egg contained inside, is determined by your dietary and lifestyle choices for those 120 days leading up to ovulation. Similarly, sperm production takes around 60-90 days, so the health of Dad in the lead up to conception can affect the quality of the sperm cells too. (Please note: if you don’t have time on your side and you don’t have 3-6 months to prepare, just start wherever you are in the journey! It can never hurt to be a little healthier, whatever stage you’re in).  

After reading this blog post, I hope it is now clear that the things that impact fertility the most, are the things that impact overall health the most. At the most basic level, the health of your fertility is an extension of your health in general, so at its core, it really is about making small, yet significant changes to your diet and lifestyle to improve your fertility. Of course, there are more complex factors at play in some instances, however the purpose of this blog is to provide you with the general advice I give to all fertility patients, regardless of their situation. When working with patients one-on-one, I am able to give more individualised support, so please reach out if you’d like to dig deeper.

Yours in health, Georgia x