Improving Fertility With Nutrition And Diet - Dr Lora Shahine

I'm Dr. Laura Sheehan. Welcome to my YouTube channel. And today we're going to talk about nutrition and IVF, improving your fertility diet. I'm Dr. Laura Sheehan. I'm a reproductive endocrinologist helping people build their families for over 15 years. And one of the most common things that I talk about is diet and fertility. Anybody who is planning to conceive, having trouble conceiving, planning IVF, always wants to know what can I do to improve my overall fertility, my overall success with treatment and diet and nutrition are a hot topic, very important to discuss. I love covering common questions, busting fertility myths. So put in the comments here, things that you have questions about and what topics you want to hear about. So nutrition is key. It is really important. You know, you are what you eat. We all know that what we put into our bodies can be really helpful for our overall health and wellbeing. And so it makes sense that the healthier we are, the more fertile we're going to be. But there's a lot of questions out there as far as what diets or what we should eat in order to improve our fertility. And this is a really sensitive topic. And I always want to be very mindful about how I talk about food. It can be very triggering for people to think about their diet. You already can feel so out of control when you are not starting your family when you want to. You know, we are taught since middle school health class that it's all about not getting pregnant when we aren't ready. And the rest of the equation without real education is, oh, so when I'm stop using birth control, it's going to be really easy to get pregnant. And for 15 percent of the population or one in eight couples, it is not that simple and not that easy. And so you can feel so out of control, you know, trying to conceive ovulation predicates, treatments that aren't working, that it feels like, OK, what can I control? And so you find people really focusing in on their diet, focusing on exercise, focusing in on supplements, reading a lot. It can really kind of permeate every aspect of life. Can you tell that I've struggled with fertility? I have been there as a type A person, you know, goal oriented and work hard, study for that exam, have that goal of getting into medical school and fellowship. You work hard enough, you reach your goals. Well, kind of felt like fertility was going to be like that. And it and it wasn't for me. For people that want to find control, they often will look for it and diet. And honestly, there is so much information out there on Dr. Google and social media. There's so many people that are honestly trying to sell diets, cleanses, optimize fertility that patients get stuck in the middle and they, you know, they're searching for certainty. So they're like, OK, this, you know, diet is going to make it so I'm more fertile. I'm going to follow it to the T. I'm going to go over the evidence in this video. But I just think that this part is really important to talk about because I know we already a lot of you are like, OK, fast forward, fast forward. Just tell me what to eat. I'm here, Dr. Shaheen, to get a diet and get off and go to the next video. But there's a tendency in this search for control to want to kind of manage and it can spiral and it can actually become very punitive. People can associate eating right as being good and eating bad or being bad, and they start to equate it to, oh, I didn't get pregnant again this month. I guess I didn't follow the diet close enough. I'm a bad person. This is my fault. I'm not getting pregnant. Therefore, I'm going to be even more strict next cycle with my diet and what I'm eating. I've seen patients fall back into disordered eating, you know, history of anorexia, bulimia, finding control through eating. And in the fertility process, here we are, another part of life where you're feeling out of control. So if you have a history of disordered eating and you're feeling triggers in your fertility journey, I just really want you to seek help and reach out to loved ones and make sure they're aware and find the help and support that you need. But I am going to get to the evidence because I know that people want to know what diet is right. I'm going to jump to the punch line and basically say everything in moderation. We know how to eat well. We want to eat more fruits and vegetables. We want to avoid highly processed foods. But also just be aware every once in a while it is OK to have something that is delicious. So let me get to the evidence because I know you want to know. So when I talk about diets, I think it's important for you to understand exactly what I'm talking about. So let me define some diets. When I talk about a Western diet, a typical Western diet, it's really meat heavy, a lot of red meat, heavy processed foods, refined grains, you know, white rice, white bread and lots of refined sugars, lots of soda, again, processed foods. When I'm talking about a Mediterranean diet, I'm talking about one that is fruit and vegetable heavy with some lean meats like fish and poultry, like chicken, less processed food, lots of olive oil. And think about that's what I'm talking about with a Mediterranean diet. There is actually a diet that's called the fertility diet, and this diet was discussed and sort of labeled after researchers really watched and observed a large group of people kind of going through their own fertility journey. It's a part of the Nurses' Health Study, one of the largest kind of observational studies in the United States. And these authors watched and found a diet that seemed to be associated with more regular menstrual cycles and decreased time to pregnancy. And this is called the fertility diet. This diet has more protein coming from vegetable sources than meat sources, has carbohydrates with low glycemic index, whole fat dairy products, and it includes multivitamins and some supplements like iron when they're watching impact of this diet. Another diet that's been studied really closely in our fertility community is called the pro fertility diet. And this diet was designed by a group of physicians and nutritionists in Boston as a part of their overall Earth study. This is the Environmental and Reproductive Health Study, and it's a group from Mass General and Harvard, multidisciplinary group of people coming together. And this diet really focuses on low pesticide exposure to fruits and vegetables, whole grains, seafood, dairy, and soy products. They also followed very closely vitamin D supplements, vitamin B supplements, and folic acid. I'm also going to talk about the ketogenic diet. Now, you might hear of this as like keto diet or Atkins, very popular about 10-ish years ago with no carbohydrates and lots and lots of fats and meats and proteins. There are so many different variations of keto or Atkins diet that's out there, but basically loading up on, you know, eggs and bacon and meat and protein and really trying to get as few carbs in the diet as possible. Another diet you hear a lot about is called the paleo diet, and this is a diet that's really focused on trying to get back to food that humans were eating in the paleo days. So again, lots of different variations on how to define this diet, but less processed foods, really whole foods, absolutely meat heavy, but less dairy, less grain, and certainly less processed foods. Other diets, of course, include a vegetarian diet, which in general does not include meat or animal products, but again, definitions vary, and sometimes people do include some dairy. And then, of course, a vegan diet in which it's no animal products or byproducts or dairy, et cetera, and any animal derived ingredients. All right, that's enough with going through all the different diets. I'm sure I didn't hit on all of them. Let's talk about what has been studied. Let's go through the evidence. Which diet is best for fertility? If you're getting ready to do IVF, what nutrition routine should you follow? Let's talk about it. Honestly, the Mediterranean diet has been studied the most and has been shown to time and time again be one of the best diets and nutrition routines for fertility. And it's been shown in multiple ways. One study out of Spain published in 2011, first author is Toledo, compared a group of women who are struggling with infertility to women who had not had infertility and had their family and really compared their diets over several months. And the people who did not have a history of infertility had a strong tendency towards a Mediterranean like diet, high in fruits and vegetables, some lean meats for protein. But not heavy in processed foods and following that Mediterranean like diet. An interesting study out of the Netherlands in 2010 showed that women who are getting ready to go through IVF as they were preparing for their IVF cycle and went through the IVF cycle. If they were more adherent to a Mediterranean diet, they had a 40 percent higher chance of success with their IVF cycle. What about miscarriage? There's a study out of the Netherlands published in 2012 showing a Mediterranean diet on the whole was associated with a lower miscarriage rate. And what about men? Again, there are studies showing the Mediterranean like diet is helpful for sperm parameters and improved sperm parameters over time. So time and time again, the Mediterranean diet has been associated with a positive impact on fertility. Whatever aspect you look at, time to getting pregnant, success with IVF, lower miscarriage rate, male factor fertility. Really, that seems to show some strong promise. So what about the nurses health study? I mentioned that a little bit earlier. It's a fascinating study. Over 17,000 women followed for years and years and years, looking at multiple different aspects of health. And they answered different questions, looking prospectively and different interactions. And one thing that they did study is diet and types of food that people eat and how it's associated with regular menstrual cycles, ovulation and time to conceiving or fertility for the people they were studying. meaning they conceived faster than women who did not have a diet high in these other things. And these food choices were called the fertility diet. So they didn't ask these women to follow the certain diet routine. They were just looking at people's ovulation, menstrual cycles, fertility over time and looked backward to see what different people were eating. And it's pretty interesting. They also had the women that were in the study group take vitamin D and the women who had the pro fertility diet with lower pesticides and more vitamin D had a higher success rate with their IVF cycles and lower miscarriage rate. In researching for this video, I did not find specific studies that compared a paleo Atkins or keto diet as far as fertility is concerned. I do think that in general, extremes are not something to follow. I think our body needs a little bit more balance. And I think following a strict diet that's putting your body into a ketogenic state. The reason that people often lose weight pretty quickly is sort of a temporary change in metabolism. And I don't feel that that is positive for fertility. So I am not a nutritionist. I do not have a degree in diets and nutrition. It just makes sense to me physiologically that one of the reasons that you're losing weight with these strict limited keto focused diets is putting your body into more of a metabolic stressful state to burn those calories and burn that weight. But I feel like a more balanced approach is better for fertility in your reproductive health. So what about vegetarian diets? What about vegan diets? Well, there aren't great studies really comparing them head to head as far as fertility is concerned. There are specific studies that have shown diets high in animal proteins are associated with difficulty with ovulation or anovulation, lower fertility rates for couples and poor sperm parameters. On the flip side, I think anybody that's vegetarian or vegan needs to be very careful, maybe work with a nutritionist or a dietitian or really research a lot on their own to make sure that they are getting adequate protein and a well balanced diet. I think an important thing to remember is if you are plant based or vegetarian or vegan, I think we automatically assume that that's a healthier diet. And there is some argument for that, but it's got to be balanced and we have to still find protein resources, be careful about nutrient balance and really think through what you're eating. An Oreo cookie is technically vegan and a diet full of Oreo cookies and a lot of Oreo cookies is not going to be that healthy. So finding that balance, maybe speaking with a nutritionist or a dietitian who can really walk through what you're eating and thinking about making sure you're sourcing well and getting all the protein, nutrients and supplements that you need. There is data that processed food is not good for reproduction. Diets high in fast food and a lot of highly processed food have been associated with lower fertility rates. So let's recap. Nutrition is important for your fertility. IVF success rates can be higher with a healthier diet. Miscarriage rates can be lower, but everything in moderation. The most well studied diet associated with highest fertility rates is a Mediterranean diet in which it's fruit and vegetable heavy, some animal protein in the form of fish and chicken. Other diets that have been looked at help remind us that vitamin D is important. Folic acid is important. Iron is important. If you're choosing dairy, the nurse's study showed us that whole dairy products were associated with a higher fertility. I see so many extremes when patients are trying to optimize their diet or their nutrition for their fertility. And I have had patients say, I completely cut out gluten because I heard that it's harmful for my fertility. I've completely cut out dairy because it's inflammatory. And I know I have to bring it out of my diet. Absolutely. People who have celiac disease and a true sensitivity to gluten will see improved inflammation and improved fertility with change in their diet. Does that mean every single person has to eat absolutely zero gluten? No. And as far as dairy is concerned, there are people that actually do feel a lot better if they decrease or eliminate dairy in their diet. But I don't think everybody that's trying to conceive needs to completely limit everything in their diet. I think that there can be extremes. There can be negative associations with food. And I just believe in balance. One of my favorite Chinese proverbs is perfection is 80 percent. If 80 percent of the time you can be eating fresh fruits and vegetables, you know, leaner meats, if that's right for you. Focused on less processed food. You are doing great. And every once in a while that ice cream might be really great. Every once in a while that dinner out with friends and family and your loved ones might be wonderful to enjoy that incredible food. Try to find the balance. Try to find what's right for you. Talk to a nutritionist. Talk to a registered dietitian. Learn about how to find these supplements and nutrients in your diet. Make sure it's balanced, but no extremes. I hope this video was helpful for you. Please like this video. Comment with questions that you have. Subscribe to this channel and stick around for more learning.