Why is a prospective mother or father’s health so important when preparing to get pregnant?
We have some control over the future health of our offspring. While we cannot change the genetics given to our children, we can impact their future health through epigenetic changes or fetal programming. Behaviors and environment can cause changes that affect how our genes work. This includes having an impact on the viability of a pregnancy as well as the long term health of a child. For example, a father or mother’s nutrition preconception can impact the child’s growth, metabolism, and predisposition to various diseases into adulthood. Paternal nutrition status and environment can predispose offspring to cancers, pancreas dysfunction, obesity, and sperm alterations. Maternal nutrition status and environment can predispose offspring to cardiovascular disease, kidney disease, pancreas dysfunction, obesity, and endocrine changes.
The first trimester of pregnancy can notoriously be quite rough. This is often when symptoms like pregnancy-induced nausea and food aversions are at their worst. However, if the time has been spent preconception to optimize health and nutrition status, there is less stress on the mother to eat “perfectly” during the first trimester and she has more wiggle room with her nutrient needs. Before the placenta is formed and takes over nourishing the baby (around week 12), the baby is supplied with vital nutrients via the lining of the uterus or endometrial lining. That lining and the nutrients within that lining are built up preconception.
Pregnancy and breastfeeding take massive withdrawals from the body’s nutrient stores so it is helpful to build up those stores before conception. Preventing nutrient depletion during pregnancy and postpartum can ensure the baby gets what it needs but also reduces the risk of the mother developing postpartum anxiety and depression, autoimmune conditions, thyroid disorders, and osteoporosis later in life.
1 in 7 couples struggle with conception and past fertility doesn’t guarantee future children (secondary infertility is fairly common). The two most common impediments to pregnancy include problems with ovulation and infertility for which no obvious cause can be found. Lifestyle changes, including nutrition, can improve fertility in both of these cases. Additionally, the most common cause of ovulatory infertility is polycystic ovarian syndrome (PCOS) of which nutrition and lifestyle changes can improve tremendously.
Cervical mucus facilitates rapid sperm transport and filters out defective sperm. This is a vital part of fertility but many women may have suboptimal cervical mucus. Factors that can negatively impact cervical mucus include folate, vitamin A, and zinc deficiencies. A nutrient rich diet can improve cervical mucus production and function.
Defective sperm can be a result of poor nutrition and lifestyle behaviors. The female body is designed to accept only the best sperm to access the egg for fertilization. The more defective sperm there are, the less chance of fertilization. When a less-than-optimal sperm does fertilize the egg, chances of implantation issues or miscarriage are higher.
Who should consider preparing their bodies for a baby?
For all of the reasons listed above, everyone thinking about becoming a parent should consider preparing their bodies for pregnancy. Both women and men, young and old. It is ideal to take the preconception trimester (3 months) at minimum to prepare for conception. This correlates to the amount of time it takes for a female egg to mature and a male sperm to form. During those processes, it is possible to improve the health and function of those cells. This is also when epigenetic changes or fetal programming can occur, impacting how the future child’s genes function.
Interestingly, it takes similar time for an oocyte to reach maturity as it does for spermatogenesis. Roughly 3 months. This should be considered the minimum time period necessary to make impactful change but a year may be necessary for those who need to make major lifestyle changes. It is also helpful to stop hormonal contraceptives and use another method of contraceptive (example: barrier methods or FAM) a year prior to trying to conceive. This allows adequate time to address any hormonal imbalances that were present prior to starting hormonal contraceptives or that have developed since.
Hormonal contraceptives may mask those issues if they are present. Additionally, hormonal contraceptives deplete many of the nutrients in the female body vital to fertility including folate, magnesium, selenium, vitamin B2, vitamin B6, vitamin C, and vitamin E. Those with thyroid conditions or endocrine conditions may consider taking a longer time period to prepare for optimal fertility and health of the future child.
What should a prospective dad be doing to prepare his body to help make a baby?
Male factor is involved in half of all infertility cases. This means that the male partner is at least part of the cause of half of infertility cases. As a precaution or when infertility does occur, a semen analysis is the easiest first step to determine why infertility is occurring and how to improve it. Male infertility can come from low sperm production, poor sperm motility, abnormal morphology, or other issues. Sperm DNA contributes half of the baby’s genetic material so if the DNA is damaged, the success of the pregnancy may be affected. As noted above, nutrition and lifestyle do impact the health of the sperm.
Where in the female body should one focus on improving their health?
While a woman should be focused on improving her overall health preconception, there are certain areas that require a bit more attention. It is very helpful to have a comprehensive thyroid screening prior to conceptionbecause suboptimal thyroid function can increase miscarriage risk. During pregnancy the thyroid increases hormone production more than 50% to provide enough for the developing baby. Until week 16-20 the baby’s thyroid gland isn’t mature enough to produce its own hormones so it relies on the mother’s. Maternal thyroid hormones continue to be transferred across the placenta throughout the entire pregnancy.
Hypothyroidism is associated with miscarriage, low birth weight, anemia, pregnancy-included hypertension, preeclampsia, postpartum hemorrhage, fetal distress, and possibly neuropsychological defects in the child. A baby’s brain is highly dependent on thyroid hormones for development in utero.
It is estimated that half of US women have insufficient iodine intake which is needed for thyroid hormone production. Women who are deficient in iodine are half as likely to conceive in any given cycle.
Other areas of concern include a women’s microbiome. The baby’s microbiome is seeded by a mother’s microbiome via delivery and breastfeeding. Disruptions in the normal population of an infant’s gut microbiome is associated with increased risk of allergies, eczema, asthma, childhood obesity, type 1 diabetes mellitus, and celiac disease. Eating fermented foods regularly and maintaining a healthy fiber intake (25-30 grams daily) can support a healthy microbiome.
What environmental issues hinder getting pregnant?
Endocrine disrupting chemicals can hinder fertility in both females and males. Unfortunately, these substances are everywhere in our environment and impossible to avoid completely but limiting exposure is important and supporting the body’s natural detoxification pathways is helpful. Endocrine disrupting chemicals can be naturally occurring or synthetically derived chemicals. Examples include dioxins, PCBs, chlorinated pesticides, brominated flame retardants, BPA, triclosan, perfluorinated compounds, parabens, and phthalates.
While these toxins can hinder fertility, they can also induce genetic and metabolic changes that can impact lifelong health of the baby. For example, babies exposed to triclosan may be at increased risk of sexual differentiation and development problems particularly in boys. BPA exposure can increase miscarriage risk. Glyphosate, a herbicide, can impair female reproductive development in utero.
- Limit exposure to scented products such as air fresheners, dryer sheets, or anything with “fragrance” or “parfum”
- Choose paraben free personal care products
- Buy organic food when possible
- Avoid nonstick pans
- Opt for stainless steel or cast iron instead
- Use a water filter that filters PFCs
- Avoid household or personal care products with words like “fluoro” or “perfluoro” or “PTFE” in the ingredients
- Avoid aluminum foil or aluminum pans, deodorant with aluminum, and aluminum containing antacids
- Avoid plastic food containers and especially do not reheat food or store hot food in plastic
- Glass contains are good alternatives
This list can get overwhelming so if these things aren’t something you have considered yet, start slow and just make 1 change at a time.
Everyone should consider preparing their bodies for pregnancy. Even 3 months of simple lifestyle changes can make a significant impact on fertility, reduce risk of miscarriage, improve the enjoyment of the pregnancy, reduce complications during pregnancy, and set the child up for a healthier life into adulthood. Things will never be perfect and you’ll always have an area to work on so no need to be overwhelmed. Start simple, what is the easiest change that will make the biggest impact? Start there. Maybe that is simply putting extra focus on preparing food at home and eating out less. Once those things have become a habit, dive deeper. Does the quantity of fruit and vegetables need to increase? Does consumption of alcohol need to decrease? Does a supplement need to be added? Could the choice of which fruit and vegetables you’re eating be improved? Individual care working with a fertility dietitian may be necessary.
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