There are various modifiable risk factors that exist which may affect your chances of becoming pregnant and having a healthy baby. Follow these guidelines when you are trying to conceive, as well as during pregnancy, to optimise your health for fertility and pregnancy.
If you are overweight, it is advised that you lose weight.
• A reduction of 5 – 10% of your body weight or weight loss of 0.5 – 1.0 kg per week can make a significant difference to your overall health and wellbeing and improve your chances of becoming pregnant.
• Being overweight or obese increases anovulation, decreases oocyte yield with controlled stimulation, decreases the rate of pregnancy, increases pregnancy loss and increases your chances of developing or worsening other conditions (such as PCOS) that can decrease your fertility.
• Men who are overweight also have decreased quality and quantity of sperm.
• Being underweight is also problematic when you are trying to fall pregnant. We determine your ideal body weight by calculating your body mass index (BMI) (weight/length2). A healthy BMI is between 18.4 – 24.9 kg/m2.
Lifestyle & Habits
Lifestyle plays a very important role while you are trying to become pregnant, as well as during pregnancy.
• Alcohol can be consumed in moderation (1 drink per day) when you are trying to fall pregnant, but should be avoided completely once you are pregnant.
• Avoid smoking completely. Active and passive smoking decreases male and female fertility. It has a direct negative impact on sperm and oocyte quality.
• Increasing levels of physical activity to at least 150 minutes of exercise per week is advised.
• Start by including 10 minutes of physical activity per day and build it up as you increase your tolerance for exercise.
• Exercise can be aerobic, such as walking or running, cycling, swimming or playing team sports or it can be resistance training (weights, Pilates, yoga) or a combination of both.
Hygiene & Food Safety Guidelines
Take note of the following when trying to fall pregnant or during pregnancy to avoid getting sick:
• You can become infected with toxoplasmosis if you work with cat litter. Try to avoid this or work with gloves if you need to.
• Always work with gloves if you work in the garden and try to avoid pesticides.
• Avoid getting infected with salmonella, campylobacter or listeria by always practicing good hygiene such as washing your hands; washing fruit and vegetables before you eat it; and placing food in the fridge immediately.
• Avoid unpasteurised dairy products (i.e. fresh from the farm dairy; all shop-bought dairy is pasteurised)
• Avoid raw pâtés, eggs, processed meats, for example polony (unless you know the origin) and raw fish (sushi may be eaten if it is from a reputable establishment).
• Increase intake of fruits and vegetables. Try to include at least 6 – 10 portions of fruit and vegetables per day. Focus specifically on different bright coloured fruits and vegetables. Fruit and vegetables are good sources of fibre and micronutrients.
• Preferably enjoy fresh fruit and vegetables and try to avoid especially fruit juice (high in sugar) and dried fruits with added sugar. Try to always have your fruit with a full meal or combine fruit with a source of protein or fat such as yogurt, biltong, nuts and seeds or cheese.
• Include more low glycemic index (GI) carbohydrates in your diet. This would include carbohydrates that are high in fibre such as whole grains, whole wheat bread and cereal, brown rice and pasta, vegetables, legumes and fruit.
• Avoid refined or simple starches such as white bread, -sugar, -rice and -pasta, sweets, chocolates, chips and all food containing sugar and white flour, including cakes, pastries, biscuits and other baked goods.
• Avoid sugary drinks and beverages such as energy and fizzy drinks. Also watch out for vitamin water and iced teas that may contain hidden sources of sugar. You can rather opt for the “light” version of drinks, such as Iced Tea Light, Oros Light, Coke Zero/Light, Tab, Sprite Zero, Fanta Zero, etc.
• The scientific research on the intake of caffeine when you are trying to conceive is inconclusive. However, some studies show that if you drink too much caffeine it can increase the time it takes to conceive. Therefore, drinks containing caffeine, such as coffee/tea should be limited to a maximum of 2 – 3 cups per day.
• Lean proteins are good sources of iron, zinc, Vitamin B12 and other B-complex Vitamins. Choose lean meat, chicken, fish and legumes. It is important to remove the skin and excessive visible fat before cooking. Do not add extra creamy sauces and gravies that are high in fat.
• Processed meats like viennas, sausages, polonies, ham and salami are high in fat and should be limited.
• Milk is also a good source of source of protein and micronutrients such as phosphorous, B-complex Vitamins, and Vitamins A and D. You should eat or drink a source of dairy on a daily basis. Ensure that you drink low fat or fat free milk, yogurt or dairy products (aim for at least 500 ml per day).
• Certain fats are high in fat-soluble Vitamins (A, D, E and K) and essential fatty acids. These fats should be included in your diet as your body cannot produce them on its own.
• You should reduce the intake of saturated animal fats (organ meat, meat and chicken fat, cream, full cream milk, butter) as well as trans fat (baked goods, food fried in oil) and foods high in cholesterol (organ meat, meat fat, full cream milk, shellfish, butter). Trans fatty acids especially (hydrogenated / partially hydrogenated oils) found in processed and fried foods increase your risk of ovulatory infertility and should be avoided.
• Methyl mercury can have a negative effect on male and female fertility. During the preconception period, as well as during pregnancy, it is advisable to avoid foods containing high amounts of methyl mercury such as shark, swordfish, king mackerel and tilefish. Tuna can be eaten twice a week.
• Unsaturated fats, particularly monounsaturated fats (Omega-9), should be included daily, in moderation. This can be found in olive or canola oil, avocado pear and olives. Polyunsaturated fatty acids (Omega-3 and Omega-6) also play a vital role and should be included. Omega-3 specifically has a positive effect on embryo quality and fertility. Three portions of oily fish (fatty fish such as sardines, salmon and tuna – not fried in oil), flaxseed or Omega-3 enriched eggs should be included weekly, as well as nuts and seeds.
• Cooking methods of foods are vital to reduce total and type of fat in the diet. Rather steam, boil, microwave, roast and bake food and avoid fried and fast foods as far as possible.
Vitamin, Mineral & Micronutrient Recommendations
• It is not necessary to take a multi-vitamin and -mineral supplement if you enjoy a varied, balanced diet that includes 4 – 6 portions of fruit and vegetables per day. If you do not include a variety of foods, fruit and vegetables, you can include a multi-vitamin and -mineral supplement. Consult your doctor/dietitian for good options.
• If you are not consuming oil-rich fish 3 – 4 times per week, you should consider taking an Omega-3 supplement. Omega-3 has a positive effect on embryo quality and fertility. Ensure that the supplement you are taking contains only Omega-3 (not Omega-6 or -9 and no additional vitamins such as Vitamin A, D, E or K). You can take up to 400 – 500 mg of EPA+DHA per day.
• Folic acid is an important nutrient to prevent neural tube defects in the fetus. The most important time to take folic acid is 3 months before you fall pregnant and the first three months of pregnancy. Include a folic acid supplement containing 400mcg of folic acid per day. If you are taking a pregnancy multivitamin it might contain the right amount of folic acid. If not, supplement accordingly to reach 400mcg per day. Folic acid can also be found in green leafy vegetables, fruit and whole grain products.
• Vitamin D: There is some scientific data showing that a Vitamin D deficiency can have a negative impact on reproductive outcomes. Increase the utilisation of vitamin D by ensuring you have enough calcium (milk, cheese, yogurt, cottage cheese, green vegetables) and phosphorus (protein foods such as milk and milk products, meat and alternatives such as beans, lentils, nuts and grains) in the diet. Supplementation with these nutrients is not necessary unless prescribed by your doctor or dietitian.
• Avoid excessive amounts of vitamin A as it may cause birth defects. It is advised to avoid it during the periconceptional period as well as during pregnancy. Vitamin A is found in organ meats and crustacean, but be especially vigilant for supplements containing vitamin A.
• Anti-oxidants such as zinc, selenium, Vitamin E, Vitamin C and folic acid can have a beneficial effect on specifically male infertility. It can increase sperm count and have a positive effect on the morphology and motility of sperm. Your doctor / registered dietitian might recommend supplementation with these nutrients, but you can also increase your dietary intake thereof by increasing the intake of zinc found in wholegrain products, red meat (without fat), seafood, legumes, pulses, nuts and seeds and folic acid found green leafy vegetables and fruit.
Our registered dietitian can provide an individualised meal plan to help you reach your ideal body weight or simply provide more information on eating habits when you are trying to conceive and micronutrient requirements. Get in touch today.