Fertility Endocrinology

When a pregnancy is sought, previous endocrinological problems need to be looked at to improve the efficiency of assisted fertility treatments

The relation between nutritional status and fertility

Nutrition is regarded as one of the main environmental factors affecting both female and male reproductive ability. Underweight women may experience menstrual disorders and, as a consequence, alterations in ovulation that may make it difficult to achieve pregnancy. Likewise, obesity and overweight alter women’s reproductive ability. Evidently, fatty tissue (adipose) plays an important role in sex hormone metabolism, and obesity in women seems to affect reproductive ability. The likelihood of having a spontaneous pregnancy declines linearly as the Body Mass Index (a way of measuring if there is overweight) grows.

Nutrition in the periconceptional period (around the exact moment of conception) seems to be a significant conditioning factor in the potential appearance of birth defects, complications in the mother and the foetus during pregnancy, and even long-term consequences for offspring. In the case of women who are planning conception in the near future, an “extra boost” of certain elements that will be subsequently defined as dietary supplements should be ensured

A healthy diet before pregnancy

Our advice to those women and men who are considering taking a fertility treatment regarding nutrition is to try and normalise body weight before and after treatment by means of a diet where the amount of kilocalories ingested is adapted to their body weight. This way, they will ensure the minimum amount of each nutrient needed in every case and add those supplements recommended by scientific societies.

An adequate diet should include dairy products (milk, yoghourt,…), vegetables and fruits, as well as foods in the flours group (legumes, pasta, rice, bread, cereal), protein and fat. Dairy products are important because they are rich in calcium and fat-soluble vitamins (vitamin D), which are necessary to ensure an optimal bone health for both the prospective mother and baby. The importance of fruits and vegetables lies in their vitamin, antioxidant and fibre content. The flours group is important because it is rich in vegetable sources of protein and as your main source of energy. Vegetable and fish sources of protein (as opposed to animal sources) are the healthiest. Fats should also be healthy (olive oil, fish, nuts).

As a general rule, sweets and sugar (sugary drinks), pre-packaged pastries, fried foods, sauces (mayonnaise, ketchup,…) and red meats should be avoided.

Non-elaborated cooking is recommended. In other words, boiling, steaming or grilling are preferable to deep-frying and pan-frying.

Dietary supplements and vitamins

Folic acid is present in legumes, green vegetables, nuts,… In addition to a comprehensive diet, a dietary supplement of 400 micrograms a day (5 milligrams if there is a high risk of birth defects) is recommended at least one month prior to conception and during the first month of pregnancy. It is also recommended for the prospective father.

Iodine is essential. Thus, in addition to ensuring consumption of iodized salt and increasing consumption of ocean fish, we recommend taking a daily supplement of approximately 200 micrograms at least one month before conception and through pregnancy and breastfeeding.

As for Iron, because of the high frequency of iron deficiency in fertile women, we recommend analysing the reserves of women seeking pregnancy and add a supplement if necessary.

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