Written by Alex Ballard, UK Registered Dietitian (as seen on the Fit For Fertility blog)
Women are, unfortunately and unhelpfully, often reminded about the uncontrollable fact that egg quality declines as the years tick away. However, we are very rarely told that there are other impacting factors or given any advice about what we can actually be doing to help.
Folate and folic acid
Dietitian’s will always go for a ‘food first’ approach before dishing out recommendations for pills, potions and lotions. However, when it comes to conception and egg quality, having a folate rich diet alongside appropriate folic acid supplementation is a necessity.
Vitamin B9 can be described in two ways. ‘Folate’ is the form naturally present within foods and ‘folic acid’ is the synthetic version used in supplements.
This micronutrient may seem small but it is packed full of power. It is vital for forming red blood cells, helping nerves to function effectively and allows the DNA within even the teeny, tiniest of cell to replicate. It is also fundamental in reducing the risk of neural tube defects as a foetus develops. So, it’s safe to say we would be in a bit of pickle without it!
Dietary rich sources of folate include:
· Brussels sprouts
· Yeast extracts
· Beans and legumes
· Fortified foods (e.g. some brands of breakfast cereals)
Because folate is a water-soluble vitamin it can easily dissolve if we over cook our veggies. Therefore, try to keep a bit of crunch to your greens and opt for steaming or microwaving (instead of boiling) to cut the cooking time.
Then there is the other side of the coin. Any women considering pregnancy, or donating eggs, are recommended to take a 400 microgram per day folic acid supplement. This is ideally for 3 months beforehand, and up until week 12 of their pregnancy.
For some women, they may be advised to be on a higher dose prescription supplement; for example, if you are diabetic, are prescribed anti-epileptic medications or have previously had a pregnancy affected by neural tube defects. Please discuss the dose you require with your GP or fertility centre.
So, what else can we do for egg-cellent eggs? Omega-3 has been shown to assist with egg maturation and aids embryo implantation. It is a family of fabulous fats often found in fish. This commonly involves oily fish but does also include some white fish options.
We are therefore encouraged to consume 2 portions of fish per week, including 1 of an oily variety (no more than 2 portions when pregnant); such as mackerel, kippers, sardines, salmon, trout, sprats, herring, whitebait and pilchards. Tinned fish can also provide omega-3, but just take a peek at the label first before diving in. An adult size portion is either 140g of fresh fish (roughly the size of the palm of your hand) or 1 small can.
Shark, swordfish and marlin can contain concentrated sources of mercury and consequently should be avoided by women who are pregnant or planning a baby, and by all children under the age of 16. All other adults, including breastfeeding women, should limit these particular species to a maximum of one portion per week. Canned tuna should also be limited to no more than 4 medium sized cans per week during pregnancy
If fish is off your menu; alternative omega-3 rich foods include nuts and seeds, rapeseed and linseed oil, soya products, green leafy vegetables and omega-3 enriched eggs, breads, yogurts and spreads.
Achieving or maintaining a healthy weight
Although a lot of research suggests it is more about the nutritional content of our diet than the weight we see on our scales, achieving or maintaining a healthy body weight is also very important for improving egg quality.
Everyone is different and therefore we will all have an individual weight that will be healthy for us. However, a general guide is reaching a Body Mass Index (BMI) between 19 kg/m²- 30 kg/m². This is also important for male fertility too.
If you are donating eggs, or planning on getting pregnant, it is safest to avoid extremely restrictive diets that cut out large food groups or that have you running on next to no calories.
Finding a healthy, well balanced approach that still enables you to obtain all of the necessary nutrients for fertility is the best route. Start by trying to reduce intakes of processed foods, sugar sweetened beverages and any unnecessary snacking.
After this, appropriate dietary methods for weight loss may include the Mediterranean approach or a moderate to lower carbohydrate method.