Infertility affects millions of couples around the world and its causes are diverse. It is known that older maternal age is an important issue, but there are others, like inadequate eating habits, overweight or underweight, nutritional deficits, sleep disorders, stress exposure to environmental toxins, among others. In many cases, nutrition can play an important role in increasing the likelihood of pregnancy. This is the case, for example, of women with polycystic ovarian syndrome (PCOS) or endometriosis, inadequate body mass index, some thyroid diseases, allergies, food intolerances, men with compromised sperm quality, among others. Folic acid When it comes to pregnancy and metabolic programming, folic acid intake and supplementation (ideally in the form of methylfolate) has been consistently linked to lower subfertility, lower risk of pregnancy loss, and greater success in infertility treatments such as in vitro fertilization. Coenzyme Q10 (CoQ10) Coenzyme Q10 is also one of the most important nutrients in the couple's fertile potential, ovarian aging and mitochondrial health, both due to its impact on the preservation of ovarian reserve and sperm health, being one of the most important supplements in the IVF process. Vitamin D Vitamin D is essential for folliculogenesis and spermatogenesis, and ovarian reserve (translated by anti-Müllerian hormone). Its correct levels (> 30 ng/mL) are associated with higher fertilization rates. Furthermore, it is essential in placentation and in reducing the risk of gestational diabetes and pre-eclampsia during pregnancy. Polyunsaturated fatty acids Polyunsaturated fatty acids, in particular omega-3, appear to promote female fertility. They are present in foods such as fatty and oilseed fruits, seeds, and fatty fish. In the case of fish, there are species with a greater potential for methylmercury accumulation (for example, fresh tuna and swordfish, among others), whose consumption should be avoided, since mercury is a heavy metal with neurotoxic potential. Choosing olive oil also ensures a good supply of monounsaturated fat and contributes to the anti-inflammatory potential of the diet. Alcohol and caffeine The harmful effects of alcohol and caffeine on the ability to get pregnant are consistent, especially for amounts greater than 2 standard doses per day in the case of alcohol and 1-2 doses per day in the case of caffeine. Therefore, it is very important to moderate or even avoid its consumption. Polycystic ovarian syndrome (PCOS) and endometriosis In the case of polycystic ovary syndrome, in which insulin resistance may be one of the predominant characteristics, a diet with a low glycemic index and a more limited supply of carbohydrates (with a preference for complex carbohydrates over simple sugars) are essential to promote metabolic control and adequate ovulation. As for endometriosis, an estrogen-dependent disease, it is crucial to ensure good gut health, as well as limiting the consumption of red meat and reducing exposure to xenobiotics (found in plastic, cleaning products and foods contaminated with pesticides, for example) which act as endocrine disruptors, being capable of harming the woman's hormonal balance and the fertility of both members of the couple. Male fertility In the case of males, there is evidence of the importance of supplementing with antioxidants and their intake through a variety of fruits and vegetables, including vitamin C, coenzyme Q10 and vitamin E. There is also clear evidence that the consumption of saturated and trans fatty acids, present for example in red meat and pastry products and processed foods, harm male fertility . Like what happens in women, omega-3 fatty acids seem to have a positive effect on men too. Body mass index Nutritional status and body mass index also have an impact on fertility, with excess weight (maternal and paternal) and thinness (maternal) associated with a lower probability of conception. A healthy diet From a more global point of view, choosing healthy eating patterns, such as the Mediterranean diet, has been associated with an improvement in female fertility and semen quality . An increase in the consumption of fish and fatty fruits, legumes, olive oil, fruit and vegetables (of different colors), spices, aromatic herbs and whole grains, limiting red meat and processed products, constitutes an added value in this process, in addition to the benefit which affects many other parameters of the couple's health, such as lipid profile and inflammation. Nutritional care for optimizing fertility should be started at least 3 months before trying to get pregnant , as this is the period necessary for the development and maturation of the oocyte and sperm that will give rise to the future embryo, which is intended to be as healthy as possible. Author: Maria Inês Cardoso The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
