TTC? Your Pre-Pregnancy Nutrition Checklist: Preparing for a Healthy Pregnancy

Female infertility is unfortunately on the rise and the research is clear that it’s not solely because women are having babies later in life.

We can’t keep blaming age and have to look at the other variables.

As a registered dietitian and a mom myself, I am passionate about the following variables as it relates to a healthy pregnancy: nutrition, lifestyle and environment.

Nutritional status and the woman’s lifestyle has an impact on the ability to conceive and carry a healthy baby to term. I want to acknowledge that medical management of medical conditions also can influence this too. When any of these are sub optimal, it can lead to difficulty with conception or maintaining pregnancy.

Reproductive technologies are WONDERFUL interventions that assist with conception and have become available in recent decades; the fact that we can offer these to women shows how advanced medicine has become. They are one impressive intervention and have led to many bundles of joy!

Research also shows that when couples with a history of miscarriages or infertility implement preconception and nutrition related care, this drastically increases the odds of delivering a full term, healthy baby.

This shows that laying a good lifestyle foundation in which the body feels “safe to conceive” is an important step if the goal is pregnancy. Many advocate that it is also wise to explore this well prior to assisted reproductive technologies.

If a woman does choose to undergo IVF (or other assisted reproductive technologies), multiple studies show that preconception and nutrition related care prior to IVF has also been shown to significantly increase success rates in conception (versus IVF alone).

So there is something to be said about good old fashioned, sound nutrition and lifestyle interventions when TTC.

Assisted reproductive technologies sadly don’t always result in pregnancy, especially when there is a “root issue” that isn’t well addressed (or potentially not yet found!) When culprits like insulin resistance, nutrient deficiencies, former toxin exposures, living in a moldy home, drinking tap water, or other nutrition related problems are found and addressed prior to pursuing IVF, odds are IVF will more likely result in pregnancy. There are multiple factors influencing the success of reproductive technologies; nutrition/nutrition related care is one important stone to overturn.

What do I mean when I say the body feels “safe to conceive?”

Ultimately, that the body’s resources aren’t distracted with a higher priority or survival mode issue – like the body dealing with a poorly managed medical condition, hormone dysfunction, high blood sugars, poor nutrition, excess stress, trying to detox from a mold exposure and other scenarios.

“Eating clean” doesn’t automatically translate to increased conception rates.

“Eating clean” has good intentions, but it’s a vague definition and doesn’t automatically mean the nuances of nutrition and lifestyle have been well targeted and corrected (if applicable). Of course eating fruits and veggies is a good thing but individualized preconception nutrition related care is more specific.

The following are nutrition related stones to overturn (that are modifiable to some extent) that help support the female body to be “ready” to enter into pregnancy and maintain pregnancy:

• Adequate nutrition (energy, fat, protein)
• Nutrient deficiences have been 1) screened for 2) found 3) corrected 4) rechecked to gauge progress
• Optimal thyroid function -many experts agree TSH should be < 2.5 mIU/L and working towards reducing thyroid antibodies
• Sex hormones are within optimal ranges, such as an adequate progesterone surge in the luteal phase of the menstrual cycle (which occurs only after ovulation). I recommend checking a day 21 progesterone.
• Not too lean or too large body size, which are both associated with difficulty in conception. Controversial but research shows a BMI between 20-30 is associated with increased success in conceiving and maintaining pregnancy. But I understand there is a lot of nuance to the BMI topic
• Avoiding excess caffeine intake
• Addressing gut dysbiosis and other potential gut pathogens if present like H. Pylori (which increases risk of miscarriage)
• Avoiding toxin exposures like endocrine disruptors
• Checking the house for clinically significant levels of toxic indoor. The medically recognized way is via an ERMI at home dust collection kit. Buy ERMI kit 1, collect dust per instructions and send back to lab. Results are emailed to you and if above a 5, you must hire a certified mold inspector and pursue remediation. Indoor mold in a home is one of the biggest things I see missed that leads to infertility and miscarriages sadly
• Seeing your Doctor for assessing, diagnosing, and adequately managing medical conditions that can be a barrier to conceiving or maintaing pregnancy (celiac disease, diabetes, many others)

Individualized preconception planning that includes targeted nutrition is a commonly under utilized strategy before turning to assisted reproductive technologies. It is something to consider looking into.

When should a couple start focusing on preconception care for a planned pregnancy?

Ideally, nutrition & lifestyle should be assessed and addressed 3-4 months before planned conception. Why? This results in increased odds of pregnancy. Sound nutrition also influences the quality of the egg and the sperm, which are correlated to the health of the baby.

Main message here: targeted nutrition and lifestyle are impactful and positively influence success with conception for all of the following:

• Naturally conceiving without medicines or procedures
• IUI
• IVF

Taking prenatal vitamins are important, take them for sure, but there are multiple layers of health and nutrition to explore in the preconception phase, especially if difficulty with conceiving. Consider exploring the topics on the checklist above.

You don’t have to “try for a year and come back if not pregnant” which is common verbiage many women sadly hear. Take matters into your own hands and start intentionally addressing nutritional status.

Not sure where to begin? Take my FREE TTC Crash Course here!

As always, find an OB/GYN you jive with, and also schedule a telehealth preconception nutrition consult package today! I am a functional nutrition registered dietitian who specializes in Women’s Health. I am in network with many PPO insurance plans!

Warmly,

Katie Driessens, RD, LDN, CDCES, CGN

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