Visit any fertility forum and one of the main topics of discussion is likely to be what to eat to increase your chances of conceiving.
In addition to the abundance of supplements that are promoted as fertility boosters, there is also a whole range of foods that are supposed to help achieve a healthy pregnancy.
Amidst all the myths and marketing, what does the real evidence look like for using certain foods to enhance male and female fertility and aid fetal development?
For starters, when it comes to supporting a healthy pregnancy and fetus, certain nutrients make a difference—such as folic acid.
When taken before and during pregnancy, it has been shown to help prevent anencephaly, the undeveloped brain of a baby at birth, just like spina bifida, which affects the baby's spine.
Because these defects develop very early in pregnancy, often before a woman even knows she is pregnant, the US Centers for Disease Control and Prevention recommends that all women of childbearing age take 400 micrograms of folic acid every day.
Fortifying staple foods such as cereal with folic acid may provide even stronger protection, as many pregnancies are unplanned.
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It is estimated that in 2019, the basic food fortification programs around the world are effective prevented 22 percent of potential cases spina bifida and anencephaly that could have been prevented by folic acid.
There may be another additional benefit to folic acid: when taken as a supplement by women trying to conceive, it can increase the chances of pregnancy, although there is a need for additional tests to finally confirm this.
What about other foods and supplements?
Is there a "fertility diet" that will maximize your chances of conceiving?
To get an answer to that question, it helps if we analyze the main reasons for infertility.
In the United States of America, after one year of unprotected sex, 15 percent of couples are unable to initiate.
There are many potential causes.
On the female side, the ovaries may not be able to produce healthy eggs, or the eggs may not be able to pass from the ovaries to the uterus - for example, due to blocked fallopian tubes.
Even if the egg successfully makes the journey, it may not implant in the uterine wall or survive once implanted.
On the male side, sperm quality is key to fertility.
These include their ability to move efficiently (motility), their shape and size (morphology), and how many are in any given amount of sperm (sperm count).
A wide range of factors can compromise sperm quality, including environmental issues such as pollution.
Even after testing, the cause of infertility may not always be obvious: about 15 percent of infertility cases remain unexplained.
While no single food or supplement will be a quick fix for these potential problems, experts say nutrition can play an important role during and after the process of trying to conceive.
Most obviously, eating healthy is crucial.
The consequences of malnutrition can be devastating for prenatal health.
Probably the most important findings in this area come from a study of babies conceived during the so-called "Dutch Hunger Winter" of 1944, the eight-month mass famine that occurred when the Nazis cut off food supplies in the Netherlands at the end of World War II.
Expectant mothers survived on their own 400 calories per day, which is only a fraction of the food intake necessary for a healthy pregnancy.
Babies conceived during this period faced a whole range of negative health consequences including being shorter and thinner than those born before or after them, as well as having smaller heads.
As adults, they had higher rate of obesity, diabetes and schizophrenia, and were prone to they die younger.
For those who have access to sufficient food, it is still important to get the right mix of nutrients.
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Although discussions about beneficial foods often focus on female fertility, there is a growing awareness that nutrition can also affect male fertility.
A 2015 study of couples undergoing IVF found that meat intake in men, especially the type of meat they eat, affects the outcome, measured by the fertility rate.
When they ate more poultry, it had a positive effect on fertility rates, while intake of meat products (such as bacon and sausage) had a negative effect.
Men who ate the least processed meat, on average less than 1,5 servings per week, had an 82 percent chance of getting pregnant with their partner - while men who ate the most processed meat, averaging 4,3 servings per week, had only a 54 percent chance. chances.
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Even after conception, the father's diet can indirectly affect the unborn child.
A study conducted by researchers from the University of Queensland, Australia, showed that what fathers eat it has a lasting effect on the future health of their unborn child.
The team analyzed dietary data from nearly 200 couples receiving antenatal care at Australia's largest maternity hospital, the Mother Mater Hospital in Brisbane.
A study found that what men eat is significantly influenced the woman, and that this, in turn, affected the development of the baby.
Other studies suggest that the father's weight may have intergenerational effect, affecting the child's weight.
"Men's health and their nutrition for fertility is overlooked, but they are very important," says Shelley Wilkinson, a dietician who co-authored the study at the University of Queensland and now works at Lifestyle Maternity, a private clinic in Australia specializing in improving fertility.
"It can even affect the health of grandchildren."
Wilkinson also emphasizes the importance of introducing nutrition as a couple.
"If one person is following dietary guidelines, the other person is likely to be as well," she says.
"We need to support women just like men in making changes to their diet. Otherwise, we lose half the battle."
One helpful change can be to increase the amount of fat in a couple's diet - as long as it's the right kind of fat.
Healthy fats can be found in nuts, seeds, salmon, avocado and olive oil.
However, trans fatty acids - which can come from natural or industrial sources, and can be found, for example, in margarine, doughnuts, fried foods and other processed foods - are associated with higher risk of infertility.
A diet rich in herbs can also be beneficial.
Researchers from the Harvard School of Public Health studied the diets of a group of 18.555 women over an eight-year period while they were trying to conceive or became pregnant.
Intake of plant-based protein such as legumes, rather than animal-based protein such as red meat, was associated with more than 50 percent lower risk of uterine infertility, they found.
The authors of the research review on possible connection between nutrition and female fertility from 2021 concluded that although their recommendations referred to women, "diet and eating patterns are undoubtedly important to both male and female fertility."
The researchers provided a detailed overview of the effects of individual nutrients and foods containing them.
They also emphasized the importance of involving a clinical dietitian in the care of couples planning a pregnancy.
Broadly speaking, their recommendation included foods such as vegetables, fruits, whole wheat pasta and whole wheat bread (for carbohydrates); sources of healthy fats such as oily fish; and legumes, eggs and lean protein.
They also highlighted the importance of the role of certain nutrients that may sometimes be overlooked: these include iodine, which helps the proper development of the fetus and thyroid function in the mother-to-be.
As for alcohol, the advice is unequivocal and consistent throughout the research.
The CDC states: “There is no known safe amount of alcohol to drink during pregnancy or trying to conceive."
This applies to all types of alcohol, including all wines and beers.
The advice is to avoid it completely.
If you have any concerns or questions about diet and how it might affect your fertility, the best step is to consult your doctor.
And while some foods do seem to have a positive role in fertility, it's important not to overstate their power.
Infertility is complex, just like its cause.
Worrying about eating can cause unnecessary stress, as can feelings of guilt and shame.
Those who have trouble getting started can rest assured that the problem is unlikely to stem from one particular thing they ate or didn't eat.
Wilkinson says people with fertility issues often look for one type of fertility-boosting food — but it's better to aim for overall healthy eating habits.
"In fertility forums, there's a lot of talk about pineapple as some kind of magical fertility food if you want to get pregnant. However, there is no one type of food or supplement that works that way."
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