Why Nutrition Improves Ivf Cycles
M E G A N D E L C O R R A L , B S N , M S N , C F N P , C P N P - A C
Hearing the word “infertility” can be really scary.
We can feel at the whim of medical treatment options without ever having a thorough discussion on the significant impact our diet and lifestyle can make on our fertility and in-vitro fertilization (IVF) outcomes.
If you’ve already started the IVF process, you’ll know the costs are steep. The National Average of one cycle costs ~$20,000 and depending on how many rounds are required, the cost can be much greater. According to one study, the “average” couple will need 2.7 IVF cycles (with a median of 2) to achieve a successful outcome, which means the cost is around $40,000-$50,000 [1,2].
The question then becomes, how can I be successful with just one cycle instead of ~2-3? How can I potentially save $2030,000?! We know that BMI, hormonal profiles, sperm health, and genetic factors are predictive factors of IVF success, all of which are modifiable factors that can be influenced by nutrition, diet, and lifestyle. Not only can nutrition influence a successful IVF round, but they influence maternal and fetal outcomes during pregnancy, postpartum, and beyond.
The Mediterranean Diet, rich in antioxidants, fresh fruit, vegetables, fatty fish, and organic, minimally processed foods, has been shown to improve clinical outcomes of IVF cycles in infertile women One study found that among 590 infertile women in IVF treatment, those with a higher adherence to this way of eating were associated with more embryos available. It’s also been associated with a shorter time to conceive in patients with unexplained infertility, as well as improved embryo yield.
If you change your dietary patterns today, your egg and sperm quality can look drastically different in 3 months. For females, a follicle takes ~100 days to mature, and for males, sperm an average of 74 days to regenerate This is why I recommend to all of my patients who may be considering IVF to give at least 3 months of making changes in their diet before the next egg retrieval process
The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
Here’s why I want you to take a stand and get serious about you and your partner's health
1.Enhanced Egg Quality
Proper nutrition can improve the quality of eggs produced during an IVF cycle, increasing the chances of successful fertilization and implantation.
Nutrients + Foods for Egg Quality
Omega 3 Fatty Acid
Increasing omega 3 fatty acid levels may delay ovarian aging, improve egg quality, and improve overall fertility and pregnancy rates [3].
Based on data from 900 women, findings show the odds of conceiving are 1.5x greater among women who supplement their diet with Omega 3 Fatty Acids [4].
Omega-3 Rich Foods
Recommend 2-3 servings of wild caught fish/week. Cod liver oil, salmon, herring, oysters, sardines, and anchovies are excellent sources! If you do not consume fish you will want to ensure you are supplementing with a good quality fish oil or fish oil alternative (there are algae options for vegans/vegetarians but may not offer the same high potency)
*limit consumption of low-mercury fish
Vitamin D
42% of the US population is Vitamin D deficient. Vitamin D deficiency has been shown to impair female fertility and (IVF) success while sufficient preconception maternal vitamin D has been associated with a successful pregnancy outcome following IVF [5]
Folic Acid, Methyl Folate, and B12
A preconception Mediterranean Diet was found to raise folate and B6 blood levels and follicular fluid levels which are both shown to help improve ovarian response and egg quality. This may also help to upregulate maturation promoting factors and improve DNA methylation of the egg cell or oocyte and embryo
CoQ10
One study showed that women who received pre-treatment of CoQ10 supplements for 60 days or longer resulted in improved egg health and higher fertilization rates [6].
The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
Foods To Avoid For Successful Embryo Transfer That Negatively Impact Egg Health
Processed food, fried food, excess sugar, and processed vegetable oils are associated with a higher risk of infertility
Caffeine
Caffeine doesn’t just mess up your fertility; it also makes it more likely that you’ll have a miscarriage and makes it harder for your body to absorb iron and calcium. Impacts adrenal, thyroid, gut, and… fertility.
Alcohol
Negatively impacts sperm and eggs. Impacts blood sugar, sleep/especially restorative deep sleep, and adrenal health
Smoking
it’s not a food but it is a major carcinogen and worth adding to this list! This includes vaping too!
Marijuana
Female eggs exposed to THC, the psychoactive ingredient in marijuana, have an impaired ability to produce viable embryos and are significantly less likely to result in a viable pregnancy [7]
Nutrition Has The Ability To “Clean Our Genes”
(ALSO KNOWN AS NUTRIGENOMICS)
There are multiple genetic SNP’s (single nucleotide polymorphisms) affecting the success of in vitro fertilization (ex MTHFR, SLC, COMT) Genes may “load the gun” but the environment “pulls the trigger”. Meaning that if we know what genetic SNP’s we have, we can therapeutically target those pathways to improve its phenotypic expression Concentrated food, a healthy lifestyle, and supplementation can drastically improve these pathways Adding in the most bioavailable forms of B vitamins such as methylated forms of folate and methyl or adenosyl/hydroxylB12 and additional cofactors like Magnesium, SamE, Choline, B6 can help improve the methylation cycle for those dealing with COMT or MTHFR genetic SNP’s
The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
2.
3.
Improved Sperm Quality
Good nutrition can improve sperm quality, leading to better fertilization rates and higher chances of successful embryo development. Several nutrients have been shown to improve sperm quality Nutrients like Zinc, Vitamin C, Vitamin E, Selenium, CoQ10, L Carnitine, Folate, B Vitamins, Vitamin D, and Omega-3 Fatty Acids (particularly DHA) are well documented in the research to improve sperm health and fertility outcomes.
Nutrients to Improve Sperm Quality
Zinc
Zinc is essential for sperm production and motility It helps maintain healthy testosterone levels and protects sperm from oxidative damage
Vitamin C
Vitamin C is a powerful antioxidant that helps reduce oxidative stress and improve sperm quality.
Vitamin E
Vitamin E is another antioxidant that protects sperm from oxidative damage and improves sperm motility
Selenium
Selenium is a trace mineral that plays a crucial role in sperm formation and function It helps protect sperm from oxidative damage and supports healthy sperm production
Coenzyme Q10
Coenzyme Q10 is an antioxidant that helps improve sperm motility and overall sperm quality
Omega-3 fatty acids
Omega-3 fatty acids, particularly docosahexaenoic acid (DHA), are important for sperm health They help improve sperm motility and reduce inflammation
L-carnitine
L-carnitine is an amino acid that plays a role in energy production in sperm cells It has been shown to improve sperm motility and function
Folate
Folate is important for DNA synthesis and repair It helps maintain the integrity of sperm DNA and improves sperm quality
Vitamin D
Vitamin D deficiency has been associated with poor sperm quality
B vitamins
B vitamins, such as B12 and folate, are essential for sperm production and DNA synthesis They help support healthy sperm development and improve sperm quality
Zinc rich foods: Oysters, Beef, Legumes, Pumpkin seeds
Vitamin C rich foods: Kiwi, Bell pepper, citrus, lemon, orange
Vitamin E rich foods: Sunflower seeds, almonds, peanuts, pumpkin/squash
Selenium rich foods: Organ meats, seafood, brazil nuts
CoQ10 rich foods: Organ meats, fatty fish like sardines, salmon and trout Chicken, beef
Look for wild caught salmon, cod liver oil, sardines, flaxseeds, chia seeds
L Carnitine rich foods: Meat, fish, and dairy products
Foods rich in folate are: dark leafy greens, beans, peanuts, sunflower seeds, fresh fruit
We get Vitamin D from the sunaim to get outdoors at least 20 min/day of direct sunlight
B vitamin rich foods: Organ meats, beef, seafood, dairy such as milk and yogurt
The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
4.
Improved Uterine Lining
Nutrient-rich foods, a balanced diet, and hydration, can promote a healthy uterine lining, which is essential for successful embryo implantation. Having healthy circulation and blood flow to the uterine cavity depends on good nutrition Signs of poor uterine blood flow could include painful periods, scanty periods, or clots in menstrual blood. Nutritional considerations would be to include iron-rich foods, digestive enzymes (potentially needed to break down iron), fish oil, L-arginine, Vitamin E, and turmeric Types of exercise to improve blood flow to your uterine lining would be walking, dancing, hip circles, yoga, and tai chi
The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
Improved Mitochondrial Function
Mitochondria is a critical part of our cells, the “powerhouse” making ATP or energy Research has found these organelles to be involved in optimal oocyte quality, proper fertilization, and subsequent embryo development.
Factors that increase mitochondrial damage are:
Alcohol
Organic pollutants
Toxic metals
Oxidative damage
Certain drugs (such as statins, NSAIDs, and antibiotics)
Strategies to improve mitochondrial function are:
Decreasing toxin exposure
Building muscle mass
Addressing stress by walking and being in nature
Specifically optimizing nutrient status through antioxidants like CoQ10, Alpha Lipoic Acid, Acetyl L, Carnitine, Resveratrol, NAC, and Vitamin E [8,9].
The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
6.
Reduce Inflammation & Oxidative Stress
A diet rich in anti-inflammatory foods can help reduce inflammation in the body, which can improve fertility and IVF success rates. A diet rich in antioxidants can help reduce oxidative stress, which can negatively impact fertility and IVF success rates.
Consume these antioxidant-rich foods:
Wild blueberries
Red grapes
Pomegranate
Walnuts
Spinach
Broccoli
Cranberries
Artichokes
Cherries
Plums
Strawberries
Blackberries
Oxidative stress is increased by things like sugar/processed foods, smoking, antioxidant intake, alcohol, hormone imbalance, and heavy metals.
Weight Management
We know body mass index (BMI) is a predictive factor for IVF success. Overweight women have been shown to have significantly fewer eggs retrieved and a decreased fertilization rate. There is also an increased risk of miscarriage in overweight and obese women after spontaneous conception, IUI, and IVF We know a well-balanced diet and healthy lifestyle is the foundation for weight management. The 3 key areas you can focus on today are consuming adequate fiber, protein, and hydration when it comes to satiety and weight management. Aim for at least 25-30+ grams of fiber each day, at least 25-30g protein at all meals, and a gallon of filtered water each day.
The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
7.
Enhanced Embryo Development
Proper nutrition can provide the necessary nutrients for optimal embryo development, increasing the chances of a healthy pregnancy
The environment we live in prior to conception and during pregnancy has striking effects on egg cell and follicle development and on early embryos in the reproductive tract Making alterations in the quantity and quality of food prior to conception (or in the case of IVF cycle) has been shown to affect oocyte maturity, blastocyst yield, prenatal survival, and successful birth. Nutrition at this time also affects the quality of embryos with increasing evidence showing nutrition can alter behavior, cardiovascular function, and reproductive function throughout the postnatal life of the future offspring [10]
The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
8.
Balanced Blood Sugar Levels
Stable blood sugar levels are important for reproductive health A balanced diet can help regulate blood sugar levels, improving fertility and IVF outcomes
When blood sugar is poorly controlled and insulin levels increase, this creates a state of chronic inflammation and oxidative stress on the body, which is known to damage both egg and sperm cells and lead to poor reproductive outcomes In men, research shows that higher levels of simple sugars and carbohydrates are associated with reduced sperm concentration and motility. Insulin resistance is associated with decreased testosterone and negatively impacts sperm health. In women, insulin resistance is associated with impaired follicle and oocyte development, implantation failure, and poor embryo development Poor blood sugar regulation may also lead to excess stress hormone (cortisol) production, adrenal dysfunction, depleted sex hormone levels, and reduced thyroid function, all of which can reduce your chances of conceiving.
Symptoms that you may have poor blood sugar are:
Sugar cravings
Difficulty losing weight (especially around the midsection)
Relying on coffee or sweets to get through your day
Excessive appetite or binge eating
Afternoon sleepiness
Fatigue that is relieved by eating
Frequent thirst
Frequent urination
If you are curious about assessing your blood sugar, I recommend to pickup a glucometer or a CGM (Continuous Glucose Monitor) to assess HERE Alongside foundational food, movement, and sleep guidelines, my favorite product for addressing elevated blood sugars is GDA max, which helps to restore insulin sensitivity, improve satiety and fullness, and reduce elevated blood sugars [11,12,13].
The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
Improved Overall Health and Reversing Deficiencies That Are Shown To Impact Fertility
A healthy body is more likely to respond positively to IVF treatment. Nutritional deficiencies and insufficient intakes that are implicated in infertility, miscarriage, and poor pregnancy outcomes are nutrients like iron, choline, b12, folate, DHA, and Vitamin D Addressing nutritional components in the pre-conception stage of protein, carbs, fats, and key antioxidants like resveratrol, luteolin, Lycopene has been shown to positively impact fertility outcomes [14].
An observational study performed on 161 women found a diet rich in fish, legumes, and vegetables and low in carbohydrates had a 40% increase in the chance of pregnancy by IVF. Additionally, a dietary intake of Omega-3 Fatty Acids and Docosahexaenoic Acid (DHA) was associated with positive outcomes when undergoing IVF [15,16].
Increased Energy Levels Adrenal Health And Mood
Proper nutrition can provide the energy needed for the body to undergo the physical and emotional demands of an IVF cycle, improving overall wellbeing and treatment outcomes. By addressing components like HPA function, cortisol levels, and mood through nutrition and lifestyle, we are able to support a healthy environment for successful fertility outcomes
The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
10. 9.
Your Successful Fertility Sample Day
Breakfast
1 cup blueberries
6 oz pomegranate juice
1 cup bitter greens
2 ribs celery
½ lemon (squeezed)
1 tsp cinnamon
1 serving Medipure Detox Medical Food
Snack
1 slice sprouted grain toast or Rice Cake
2 Tbsp almond butter
Sprinkle of Himalayan sea salt
2 Tbsp Goji Berries
Lunch
1-2 cups spinach/greens
3 eggs
1 cup tomatoes garlic
*Feta if consuming dairy
Morning antioxidant Berry Smoothie
Avocado Toast or Almond Butter Rice Cake with Green Juice
Egg Scramble (or frittata to make ahead of time for meal prep)
Snack Fruit + Nuts
Fresh Fruit or dried fruit like Figs with almonds/nuts/walnuts
Dinner
4-6 oz wild caught salmon
2 cups roasted broccoli, cauliflower, and brussels on a sheet pan
½-1 cup Farro, Quinoa, or roasted Sweet Potatoes
¼ cup chickpeas
2 Tbsp pumpkin seeds
Drizzle with dressing:
1/2 Tbsp tahini
½ squeezed lemon
1 Tbsp flaxseed oil
1-2 tsp maple syrup
Dessert
Nourishing Bowl
1 oz 85% Dark Chocolate
Walk outside in the sunshine for 30 minutes. Laugh out loud, chew your food well, and do something that brings joy to your day today! [17,18,19]
The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
Looking for more 1-1 support in your fertility journey? Visit www.nutritiondynamic.com to learn more about how we can help you achieve your fertility goals. The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
About the Authors
Megan del Corral, BSN, MSN, CFNP, CPNP-AC
Megan del Corral is Clinical Director of Vidal Medical, LLC & is the medical director of Nutrition Dynamic, the largest one-on-one health coaching company in the United States. Megan is a double boarded & certified nurse practitioner with over 15 years of medical experience Megan has an extensive background in critical care medical, congenital cardiothoracic disease & transplantation, women’s health, complex endocrine & metabolic disorders and is certified in hormone replacement therapy.
Megan graduated from The Ohio State University with a Bachelor of Science in Nursing and achieved a master’s degree of science in nursing as an acute care pediatric nurse practitioner as well as a post graduate degree in family medicine. Megan underwent extensive training in women’s health at The Cleveland Clinic Hospital and has completed in-depth training in bioidentical hormone replacement therapy certification through World Link Medical.
Kristen DeAngelis, RD,
IFNCP, RYT
Kristen DeAngelis is a Registered Dietitian Nutritionist, Board Certified Functional Practitioner, and Health Coach, and an expert in women’s health, hormones, and fertility. She is the Director of Health Coaching at Nutrition Dynamic, one of the top health coaching companies in the United States Driven by the mission to create lasting impact, Kristen is dedicated to the well-being of her clients, coaches, and the global community, by helping them achieve optimal health, vitality, and above all empowerment through holistic solutions Check out her comprehensive Trying to Conceive book and video course.
The contents of this article should not be taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
References
1
Katz, P , Showstack, J , Smith, J F , Nachtigall, R D , Millstein, S G , Wing, H , Eisenberg, M L , Pasch, L A , Croughan, M S , & Adler, N E (2011, March 1) Costs of infertility treatment: results from an 18-month prospective cohort study Fertility and Sterility; Elsevier BV https://doi org/10 1016/j fertnstert 2010 11 026
3
Kiltz, W (2023, March 14) IVF Cost: From $4,500 To Over $100,000 - But How? CNY Fertility https://www.cnyfertility.com/ivf-cost/
2 Nehra, D , Le, H D , Fallon, E M , Carlson, S , Woods, D C , White, Y A , Pan, A , Guo, L , Rodig, S J , Tilly, J L , Rueda, B R , & Puder, M (2012, October 19) Prolonging the female reproductive lifespan and improving egg quality with dietary omega-3 fatty acids Aging Cell; Wiley https://doi org/10 1111/acel 12006
4 Hasan, H , Barber, T M , Cheaib, S , & Coussa, A (2023, April 1) Preconception Vitamin D Level and In Vitro Fertilization: Pregnancy Outcome Endocrine Practice; Elsevier BV https://doi org/10 1016/j eprac 2023 01 005
Dietary supplementation with omega-3s found to improve female fertility (n d ) https://www focusonreproduction eu/article/News-in-Reproduction-Omega-3-supplementation
5 Xu, Y , Nisenblat, V , Lu, C , Li, R , Qiao, J , Zhang, X , & Wang, S (2018, March 27) Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial Reproductive Biology and Endocrinology; BioMed Central https://doi org/10 1186/s12958018-0343-0
6 Misner, & Favetta (n d ) MON-010: Effects of Delta-9-Tetrahydrocannabinol (THC) on Oocyte Competence and Early Embryonic Development www endocrine org Retrieved November 7, 2023, from https://www endocrine org/-/media/endocrine/files/endo2020/abstracts/misner-abstract pdf
7 Rodríguez-Varela, C , & Labarta, E (2022, June 8) Role of Mitochondria Transfer in Infertility: A Commentary Cells; Multidisciplinary Digital Publishing Institute https://doi org/10 3390/cells11121867
8 Pizzorno J Mitochondria-Fundamental to Life and Health Integr Med (Encinitas) 2014 Apr;13(2):8-15 PMID: 26770084; PMCID: PMC4684129.
10
9 Ashworth, C , Toma, L , & Hunter, M G (2009, November 27) Nutritional effects on oocyte and embryo development in mammals: implications for reproductive efficiency and environmental sustainability Philosophical Transactions of the Royal Society B; Royal Society https://doi org/10 1098/rstb 2009 0184
11
Liu, C Y , Chou, Y C , Chao, J C J , Hsu, C Y , Lung, T , & Tsao, C W (2015, July 28) The Association between Dietary Patterns and Semen Quality in a General Asian Population of 7282 Males PLOS ONE; Public Library of Science https://doi org/10 1371/journal pone 0134224
12
13.
Zitzmann, M (2009, October 27) Testosterone deficiency, insulin resistance and the metabolic syndrome Nature Reviews Endocrinology; Nature Portfolio https://doi org/10 1038/nrendo 2009 212
Dumesic, D. A., & Abbott, D. H. (2008, January 1). Implications of Polycystic Ovary Syndrome on Oocyte Development. Seminars in Reproductive Medicine; Thieme Medical Publishers (Germany) https://doi org/10 1055/s-2007-992925
14
15
Silvestris, E , Lovero, D , & Palmirotta, R (2019, June 7) Nutrition and Female Fertility: An Interdependent Correlation Frontiers in Endocrinology; Frontiers Media https://doi org/10 3389/fendo 2019 00346
Vujkovic, M , De Vries, J , Lindemans, J , Macklon, N S , Van Der Spek, P J , Steegers, E A , & Steegers-Theunissen, R P (2010, November 1) The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment increases the chance of pregnancy Fertility and Sterility; Elsevier BV https://doi org/10 1016/j fertnstert 2009 12 079
16
Hammiche, F , Vujkovic, M , Wijburg, W , De Vries, J , Macklon, N S , Laven, J , & Steegers‐Theunissen, R P (2011, April 1) Increased preconception omega-3 polyunsaturated fatty acid intake improves embryo morphology. Fertility and Sterility; Elsevier BV https://doi org/10 1016/j fertnstert 2010 11 021
17
Sun, H , Lin, Y , Lin, D , Chang-E, Z , Zou, X , Fu, L , Meng, F , & Qian, W (2019, September 2) Mediterranean diet improves embryo yield in IVF: a prospective cohort study Reproductive Biology and Endocrinology; BioMed Central https://doi org/10 1186/s12958-019-0520-9
18
Rezaeiyeh, R D , Mehrara, A , Pour, A M A , Fallahi, J , & Forouhari, S (2022, April 1) Impact of Various Parameters as Predictors of The Success Rate of In Vitro Fertilization DOAJ (DOAJ: Directory of Open Access Journals)
https://doi org/10 22074/ijfs 2021 531672 1134
19
Mudditt, J (2023, May 16) Does your diet affect your fertility? BBC Future https://www bbc com/future/article/20230510can-food-boostfertility#:~:text However%2C%20trans%20fatty%20acids%20%E2%80%93%20which,plants%20may%20also%20be%20bene ficial
of this article
contents
should
taken as medical advice It is not intended to diagnose, treat, cure, or prevent disease This is not intended to replace the advice of a physician Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes
The
not be