Dr. Ali Ainsworth: That part is obvious to patients and to me. When I think about stress causing infertility, extremes of stress that impact the way the brain talks to the ovaries, such how the menstrual cycles space out or become absent—that seems like a pretty clear connection.
But the general day-to-day stress that we all have, which is a lot, and infertility adds to it, that’s not it. The neighbor or the family member who says “Just relax and it will happen,” no.
Tara Schmidt: You kind of just want to punch that person even though they have good intentions. One in six people struggle to conceive, but a lot of factors like age or having irregular menstrual cycles are outside of your control. While you can control your actions and diet, there’s not much evidence that pomegranate, mucinex, womb warming and other strategies will work, though it doesn’t hurt to try them with your doctor’s blessing.
There’s no optimal diet to get pregnant. The only real guidance is to aim for a Mediterranean diet, fresh fruits and veggies, healthy fats, and limit ultra processed foods. Essentially focusing on nourishing your body adequately so that if you do become pregnant, you’re set up for a healthy delivery. But don’t stress yourself out trying to eat a perfect fat-free plant-based diet.
Enjoy those french fries every once in a while. You never know what could end up helping. Now let’s talk about what foods to limit supplements and subfertility (the difficulty to conceive.)
I’m hearing that there are no specific groups, certainly that people will need to avoid. So we don’t want them going on extreme diets, protein, high protein, low protein, high carb, low carb, etc. Nothing that you’re having people avoid necessarily is what I’m hearing.
Dr. Ali Ainsworth: Right. And often, my patients and I talk about where a middle ground is. If you have regular cycles in those first two weeks of the month before you ovulate, you are by definition not pregnant. If you’re going to a wedding and want to have a glass of wine or you had to pull an all nighter for your exam, such is life, right? Maybe after ovulation, when you could be pregnant, it’s the time not to make yourself crazy, but to be a little bit more thoughtful, maybe that’s when you avoid alcohol for two weeks. But I think there’s nuance to all of this, depending on length of fertility and what the treatment is, and history too.
Tara Schmidt: Do we have to worry about caffeine in pregnancy?
Dr. Ali Ainsworth: There is a little bit of data that two, three cups of coffee—probably, four, five, maybe, does begin to have a negative impact on fertility during pregnancy. The recommendation is 200 mg a day. It’s a little more generous in the preconception period, I think.
Tara Schmidt: You got to stay up to do all the things!
Dr. Ali Ainsworth: Yeah, it’s exhausting after a while.
Tara Schmidt: Do you see nutritional deficiencies in your patients that you need to address or to treat prior to conception?
Dr. Ali Ainsworth: Different fertility practices have different perspectives on this. There are some groups who check vitamin D levels. Low vitamin D has been associated with subfertility, if you will. Our group has decided we live in Minnesota and nobody gets outside. Let’s just supplement everybody 2000 internationally today over the counter. But to be honest, I’m not checking more than that, which is, again, acknowledging [the differences] between Western medicine from more holistic practices.
Tara Schmidt: You’re having your patients take vitamin D because of the latitude that we live at. Are you also having your patients take a prenatal during this time?
Dr. Ali Ainsworth: Yes, and this is more specific to pregnancy—preventing birth defects, neural tube defects, defects in the way the spinal cord forms, associated with deficiencies in folic acid. The most important ingredient in a prenatal vitamin is folic acid, and 400 micrograms, by definition. A prenatal vitamin has that.
I tell my patients, those really expensive ones, the ones that taste horrible that you saw on Instagram, aren’t better. If you hate them, and they are twice as expensive, don’t use them. There’s really no right or wrong when it comes to a prenatal vitamin because they all have folic acid in them.