Many women struggle with becoming pregnant. The American Society for Reproductive Medicine says problems affect 6.1 million women at some point.
Jessica, who asked that her last name not be used, is one of them. She has been trying to conceive for about seven months without success. She is not overweight and exercises three to five times a week. She said that her difficulty arises because she does not ovulate regularly, a problem known as anovulation.
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"It is our goal to naturally get pregnant without using fertility drugs," said the 30-year-old Minnesota resident.
Like other women who want to start a family, she is interested in new research linking fertility to diet.
Looking At Diet
Harvard researchers Dr. Jorge E. Chavarro and Dr. Walter C. Willett tracked body weight, physical activity, multivitamin supplements and other dietary factors in about 18,000 women to study their correlation to ovulatory function.
The study found that exercising, eating vegetables, drinking water and treating yourself to a few scoops of ice cream may just be the key to conception. They put the results in a book called "The Fertility Diet."
Jessica is willing to follow the diet to help her become pregnant.
"It is very disappointing and discouraging month after month to either experience a negative pregnancy test or to have your menstrual cycle come, especially after basically holding your breath from the time ovulation takes place until the time you find out yay or nay," she said.
The Specifics
Chavarro and Willett's work was excerpted in Conceive Magazine, which highlighted the main points of the diet.
The changes include:
- Avoiding trans fats
- Using more unsaturated vegetable oils, such as olive and canola oils. This also includes avocados, pumpkin and nuts
- Eating more vegetable protein, like beans, peas, tofu and soybeans
- Choosing whole grains
- Drinking water
- Taking a multivitamin
- Eating iron-rich foods, such as vegetables and beans
- Aiming for a healthy weight. Women who are overweight should lose between 5 and 10 percent of their weight. If too lean, possibly gaining 5 to 20 pounds can restart ovulation
- Starting a daily exercise plan.
The researchers said they found a connection between carbohydrates and high insulin levels, so that is why highly refined carbohydrates, such as potatoes, are not suggested.
Chavarro and Willett noted that when the insulin level rises too high, it disrupts the balances of hormones needed for reproduction.
"One of the most common causes of infertility polycystic ovary syndrome affects millions of women. Many women with PCOS have insulin resistance, a breakdown in the cells' ability to respond to insulin," they wrote.
The research also stressed the importance maintaining a body mass index between 20 and 24. The exercise regimen should also be at least 30 minutes and include aerobic exercise, strength training and stretching.
Food After Conception
Dr. Steven Lindheim, a San Diego reproductive endocrinologist, talks about the ability to conceive and BMI as Goldie Locks and the Three Bears -- "too little, too much and just right."
He said the ideal BMI is 20 to 24, while a BMI below 20 is too low. Obese is a BMI over 30.
Maintaining a healthy weight will also help most woman ovulate regularly, the experts said.
He added that the diet will help minimize obstetric complications, such as gestational diabetes and Cesarean section births.
What You Already Know
Dr. Frederick Licciardi, the founding partner of the New York University Fertility, pointed out in his blog that many parts of the diet are based on information that doctors and even patients already knew.
"I can't believe that one person on this planet doesn't know that you need to eat sensibly," he said.
Licciardi said he does not typically address weight unless a patient is extremely overweight. He added that if a woman who is overweight is receiving a menstrual cycle regularly, the weight is not necessarily viewed as an issue. It is only an issue when a patient is not receiving a period regularly.
But a woman with problems in her cycle needs to visit a physician because anovulation could be caused by problems related to the thyroid, pituitary and adrenal glands.
"Therefore, if you are not ovulating, you are better served by a basic simple workup," he writes. "If everything is OK, at least you know and then you can make a decision on how to proceed."
Licciardi fears that some women may not get the help they need.
He suggested if a woman is 32 and overweight and does not ovulate much, it is OK to get on a program and lose weight over a six-month period, start to ovulate, and avoid seeing a doctor. Women who are 38, however, may lose too much valuable time if they wait for a diet to take effect.
"Someone who is older doesn't have time to experiment," he said.
Diet Not Totally New
Dr. Jeremy Groll, an Ohio expert in reproductive endocrinology and fertility treatment, wrote a book titled "Fertility Foods" in 2006 that provides information about nutrition, exercise and emotional support to help increase the rates of spontaneous ovulation and improving the uterine environment while decreasing the potential for miscarriage.
Groll pointed out that the water recommendation of the Fertility Diet is just a good lifestyle change.
"It is, in and of itself, not going to promote fertility," he said. "By drinking water you will remain hydrated, and it will serve as a filler and help with portion control."
For women trying to conceive, the diet may provide a glimmer of hope.
While diet may be a contributing factor to fertility, it is important to keep in mind age and other possible causes of infertility. Diet is a good place to start, but only a fertility specialist can determine if there are other problems precluding couples from becoming pregnant.