One in six people struggle to conceive. Factors like age and irregular menstrual cycles are out of their hands — but their diet, however, is completely under their control. That said, is there actually any correlation between what we eat and our fertility?
On this episode of On Nutrition, we talk with reproductive endocrinologist Dr. Ali Ainsworth about subfertility, supplements, and whether pomegranate can help you get pregnant.
Read the Transcript:
Tara Schmidt: This is “On Nutrition,” a podcast from Mayo Clinic where we dig into the latest nutrition trends and research to help you understand what’s health, and what’s hype. I’m Tara Schmidt, a registered dietician with Mayo Clinic in Rochester, Minnesota. This episode: “Fertility.”
In the U.S., about nine percent of men and 11 percent of women deal with infertility. Having issues conceiving is a common and sensitive topic for many hopeful parents. It can bring up so many questions about strategy, environment, and diet. Do I need to avoid microplastics? How many supplements should I be taking? Do I need to lose weight?
Here to answer some of those questions is Dr. Ali Ainsworth, a reproductive endocrinologist at Mayo Clinic in Rochester, Minnesota. Dr. Ainsworth advises patients dealing with subfertility and infertility about their many options. Good morning, Dr. Ainsworth. Thank you for being with me today.
Dr. Ali Ainsworth: Morning, I’m happy to be here. Thanks for the invitation.
Tara Schmidt: Of course. There are a few wives’ tales out there about certain foods that may help you get pregnant. Pomegranate, the core of a pineapple. Is there any merit to these?
Dr. Ali Ainsworth: I did an updated search of the literature before we talked. I can’t find anything. In reading articles, I don’t know that any of us have found a published study that shows a higher likelihood of pregnancy. That being said, I don’t think they’re harmful by any means, but it’s probably not the magic answer if pregnancy isn’t happening.
Tara Schmidt: Yes, if it gives you some hope and some joy to eat pomegranate. I don’t know if eating the core of a pineapple is very joyful. They’re kind of woody. But yeah, you go for it. Fruit, we’re all for it over here at “On Nutrition.” We’ve also heard about womb warming in traditional Chinese medicine. It’s essentially making sure that your uterus is warm by eating hot foods, wearing thick socks, to ease blood circulation and possibly boost fertility. Any evidence in your lit review around that?
Dr. Ali Ainsworth: I didn’t find, again, any studies. But also, Western medicine is one part of a much broader approach to health and to life, really. Again, do I think it’s harmful? No. Can I guarantee or provide data that it is definitely helpful? Also, no.
Tara Schmidt: We are at Mayo Clinic and we do a lot of things, whether or not there’s a lit review to be done or whether there’s a meta analysis. This is not that we disagree with these things. This is not that they are or cannot be true. As long as they are potentially safe, that would be, I’m assuming, the most important thing to talk to someone, your OB or your medical provider about—but it’s not to say that it’s not out there. And not to say that getting cozy and having some soup and wearing thick socks isn’t. Sounds lovely.
Dr. Ali Ainsworth: General stress reduction. If that’s the answer, then it, may very well be helpful,
Tara Schmidt: Is there any evidence that a diet that’s higher in fat and protein would improve fertility for either parent?
Dr. Ali Ainsworth: Oh, not that I know of.
Tara Schmidt: What about taking Mucinex? People usually take it to loosen mucus in their upper airway. Could it also thin your cervical mucus and make it easier for sperm to travel through?
Dr. Ali Ainsworth: The thought is true. I did find one study from the 80s.
Tara Schmidt: Oh, wow.
Dr. Ali Ainsworth: In that era of fertility care, there was a post-coital check, where people would come in for a physical exam and they would examine the cervical mucus and look for sperm. Not part of our current practice, but in the 80s, there was a study and it did seem that people who took Mucinex had a difference in their cervical mucus in that one study, which is a pretty small group of patients.
There were plenty of people who got pregnant, so I still put it in the vein of things that might help, probably not harmful. Do I think we need to do it exhaustively, every day for a month or months on end? No. But that was the one study from the 80s.
Tara Schmidt: Interesting. Have you heard any other stories or theories from your patients about certain foods or diets that have allegedly increased their fertility?
Dr. Ali Ainsworth: The one that comes to mind is actually after embryo transfer, which is pretty far down the path of infertility, but there is, I haven’t seen a study on it. But there’s a myth, at least, that eating McDonald’s french fries improves the embryo transfer outcome. I laugh with my patients that that was a good marketing campaign.
It’s not any french fry, but McDonald’s. Does it hurt? No but I, I don’t think there’s a difference in our embryo transfer outcome from that.
Tara Schmidt: Yeah, maybe I was gonna say we should do a study.
Dr. Ali Ainsworth: Lots of patients do this.
Tara Schmidt: I have a feeling that they have enough money to sponsor it over there at Mickey D’s.
Dr. Ali Ainsworth: Yeah.
Tara Schmidt: Okay. There’s no magical food that will help you get pregnant, but that doesn’t mean there aren’t a ton of other factors that can complicate conception. First, let’s stick into the scientific definition of infertility. Is there a difference between infertility and just having trouble or struggling to conceive?
Dr. Ali Ainsworth: Infertility is really common. The World Health Organization came up with an update, I think it was last year, that one in six people trying for pregnancy will struggle to conceive. Really common, but not that often talked about. The infertility differs depending on age, female age, and to acknowledge that we often talk about male and female, which is somewhat binary.
For people with ovaries, age under 35, if they have been trying for over a year, and in that time, have regular cycles, no risk factors for blocked fallopian tubes—to have a partner with sperm, a year without pregnancy, under age 35, is infertility, over age 35, six months, it’s a shorter window because as we age, the likelihood of conception decreases, and over age 40.
Recommendations are at least to be seen for a fertility evaluation, because that reproductive window really is much shorter than in our younger years,
Tara Schmidt: You want to get seen sooner if you are less likely to be able to conceive because of your age being a risk factor.
Dr. Ali Ainsworth: There are other risk factors. I mentioned a year of regular menstrual cycles, meaning regular ovulatory events. But if you don’t have that, if you have polycystic ovary syndrome and you have two periods a year, it’s going to be really hard to get pregnant. You don’t need to wait a year, you could be seen sooner.
Tara Schmidt: Is there any counseling that you give on what to eat and kind of the connection between what we eat and fertility?
Dr. Ali Ainsworth: The way that I generally frame it to patients is, first of all, diet is hard to study. There’s a lot of different diets marketed to all of us and different diets marketed to people trying for pregnancy. There is no specific fertility diet. In general, the studies land on the Mediterranean diet, fresh foods, fruits, vegetables, healthy fats, avoiding processed foods. But it’s not different, than overall health and many other conditions that come to the same conclusions.
Tara Schmidt: Yeah, and we talk about this when we talk about nutrition and pregnancy because a lot of people won’t necessarily know when they are becoming pregnant per se. We can set you up the best we can for when you do become pregnant. Let’s get all of the macro and micronutrients in you. Let’s start taking a prenatal just in case, to cover those bases. It’s not a direct link but it’s certainly going to set you up to be a healthy pregnant person and healthy baby.
Dr. Ali Ainsworth: As it ties into weight, especially, PCOS (polycystic ovary syndrome) is common. For people who have irregular cycles and are overweight, losing even 10 percent of their body weight can bring regular cycles back, which makes trying for pregnancy easier and makes pregnancy safer .There’s a link in that way, but not so specific to exact diets or prescriptive diets, if you will.