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Is Nutrition & Female Fertility Connected?

There is a great deal of complexity involved when considering the effects of nutrition on female reproductive health. However, a multitude of studies suggests that diet quality, particularly the ingestion of processed foods, is a key modifiable risk factor that may be responsible for contributing to lower pregnancy and increased miscarriage rates.


Infertility is a significant issue in contemporary society and affects up to 20–30% of viable females. Infertility is defined as the inability to conceive despite one or more years of attempts at natural fertilisation.

In addition to a multitude of gynaecological and systemic disorders that impair a woman's fertility, environmental variables and lifestyle choices including stressful work, improper nutrition, and unhealthy diets can affect women's ability to reproduce. As a result, aberrant body weight, excessive or insufficient energy intake, and a diet rich in processed foods all have a negative effect on ovulatory function.

Pathophysiology of female reproduction and poor nutrition are tightly related. The undeniable causes of amenorrhea, infertility, and miscarriages are bulimia nervosa and anorexia, two pathological diseases that affect 5% of women of childbearing age. Unhealthy diet results in severe under- or overweight which alters ovarian function and increases infertility.


When a woman is of reproductive age, being overweight or obese is a common medical condition with a prevalence of up to 20–25% among patients seeking infertility treatment. According to the WHO, 9% to 25% of women in industrialised nations are obese. These women might give birth to obese children, especially if they have gestational diabetes. Adipose tissue is responsible for ovulatory abnormalities in predisposed people through insulin resistance (IR), high levels of insulin and androgens, and the anovulation linked with obesity is responsible for a higher incidence of miscarriages and infertility.


Since the altered energy balance is directly related to the decreased ovulatory maturation in women, poor protein, micro, macromineral, and vitamin consumption is associated with reproductive failure. Smoking decreases ovarian reserves quickly in females, delays conception, increases the chance of spontaneous miscarriage, and lowers the success rate of Assisted Reproductive Technology (ART).


High BMI is also linked to adverse pregnancy outcomes like gestational diabetes, hypertension, and premature births. Additionally, dietary variables may affect the quality of embryos as well as oocyte maturation.


Diets high in unsaturated fats, whole grains, vegetables, and fish have been associated with improved fertility in both women and men. While current evidence on the role of dairy, alcohol, and caffeine is inconsistent, saturated fats and sugar have been associated with poorer fertility outcomes in women and men. (Neelima panth, 2018)



Gestational diabetes:

Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance that begins or is first detected during pregnancy. Insulin resistance usually begins in the second trimester and progresses throughout the remainder of the pregnancy. Placental secretion of hormones, such as progesterone, cortisol, placental lactogen, prolactin, and growth hormones are major contributors to insulin-resistant states seen in pregnancy. Insulin resistance likely plays a role in ensuring that the fetus has an adequate supply of glucose by changing the maternal energy metabolism from carbohydrates to lipids. Symptoms include excessive thirst, hunger and urination.


Risk Factors:

  • Overweight during pregnancy

  • Ethnicity (Asian, African-American, Hispanic, native American)

  • Family history of diabetes

  • Had gestational diabetes in a previous pregnancy

  • Have insulin-related health conditions like PCOS/PCOD

  • Have high blood pressure, cholesterol or heart disease

  • Have given birth to the large baby

  • Had miscarriage


Complications:

If untreated during the first few weeks gestations are associated with spontaneous abortion & birth defects. If untreated during the second or third trimester, it is associated with foetal macrosomia, birth injury, late-term foetal death, maternal hypertension, maternal preeclampsia, neonatal hypoglycemia, future diabetes and/or obesity in children. Therefore, In GDM/Type 2 Diabetes with gestation, insulin is started if Medical Nutritional Therapy does not maintain normoglycemia. gestation. GDM is diagnosed most often during the second or third trimester of pregnancy


Screening:

The usual recommendation for screening is between 24 and 28 weeks of because of an increase in insulin-antagonist hormone levels and insulin resistance that normally occurs at this time. However, the number of pregnant women with undiagnosed diabetes has increased and therefore it has now been recommended that women with risk factors for diabetes should be screened for undiagnosed T2DM at the first prenatal visit. The recent concept is to screen for glucose intolerance in the first trimester itself as the fetal beta cell recognizes and responds to maternal glycemic levels as early as the 16th week of gestation.


Gestational Diabetes Mellitus-Diagnostic criteria:

  • OGTT (Oral Glucose Tolerance Test)-50 or 75 g glucose

  • Fasting blood glucose:- > 95 mg/dl

  • 2 hours postprandial:- 140-199 mg/dl


Treatment mostly includes changing lifestyle modifications. Eating a healthy diet rich in fibre, vitamins, minerals and protein, and low in fat, simple carbohydrates and processed or canned foods.


Preeclampsia and eclampsia are pregnancy-related high blood pressure disorders. Preeclampsia is a sudden spike in blood pressure. Eclampsia is more severe and can include seizures or coma.

The exact cause of eclampsia is not known. Factors that may play a role include Blood vessel problems Brain and nervous system (neurological) factors Diet and Gene. Most women with preeclampsia do not go on to have seizures. You might experience signs of both preeclampsia and eclampsia since they can develop into one another. However, some of your symptoms can be brought on by undiagnosed illnesses like diabetes or kidney disease. It's crucial to disclose all medical conditions to your doctor so they can rule out any other potential causes.


The following signs and symptoms of preeclampsia are typical:

  • Increased blood pressure headaches swollen hands or face

  • Unwarranted weight gain

  • Nauseous and Dizzy

  • Visual issues, such as periods of blindness or hazy vision

  • Having trouble urinating

  • Discomfort in the belly, particularly in the right upper abdomen

Eclampsia patients may exhibit the same symptoms as those listed above, or they may even show up with no symptoms at all.

  • seizures coma

  • agitation

  • loss of consciousness

Risk factors:

  • 35 years of age or older.

  • You identify as black.

  • Your first pregnancy is now.

  • You suffer from kidney disease, diabetes, or high blood pressure.

  • You are carrying more than one child (such as twins or triplets).

  • Teenager, you are.

  • You are fat.

  • You have a history of preeclampsia in your family.

  • You suffer from autoimmune diseases.

  • In vitro fertilisation has been done on you

Both preeclampsia and eclampsia have an impact on the placenta, which is responsible for transferring nutrients and oxygen from the mother's blood to the foetus. The placenta may not be able to function correctly when high blood pressure restricts blood flow via the veins. This could cause your kid to have a low birth weight or other health issues. Preterm delivery is frequently necessary for the baby's health and safety when there are placental problems. These ailments occasionally result in stillbirth.


Anaemia is another complication of pregnancy. Haemoglobin is a vital protein found in red blood cells (RBCs). This protein helps your red blood cells transport oxygen from your lungs to your body by storing oxygen. Additionally, it aids in transporting carbon dioxide from your body to your lungs so you may exhale it. Your body needs a regular supply of iron and vitamins to make RBCs and haemoglobin. Your body won't manufacture enough haemoglobin to effectively transport oxygen to your organs without that source. Many women don't get enough iron to last through the second and third trimesters of pregnancy. Due to an increase in blood volume during pregnancy, mild anaemia is common. However, your infant may be more susceptible to anaemia later if the anaemia is more severe. Additionally, if you are considerably anaemic throughout your first two trimesters, you run the risk of giving birth prematurely or to a child who is underweight at birth. The mother is further burdened by being anaemic because it makes it harder for her to fight infections and increases the danger of blood loss during birth.

During your pregnancy, you are more likely to become anaemic if you:

  • Have two pregnancies that are close to one another or carrying more than one child

  • Frequent vomiting from morning sickness?

  • Lack of iron consumption

  • Possess a big period prior to becoming pregnant


Even if you are not anaemic, you may still experience many of the symptoms of anaemia during pregnancy, such as:

  • being worn out or fragile

  • progressively fading skin colour

  • a quick heartbeat

  • breathing difficulty

  • difficulty concentrating

The greatest approach to avoiding anaemia while pregnant or attempting to get pregnant is with a healthy diet. Eating a diet rich in iron-containing foods, such as dark green leafy vegetables, red meat, fortified cereals, eggs, and peanuts, can help you maintain the level of iron your body requires to function effectively. Additionally, your obstetrician will recommend supplements to make sure you get enough folic acid and iron. Make sure you consume 27 mg of iron daily or more. Iron supplements can usually be used to treat anaemia if it does occur during pregnancy.


Conclusion

In current society, obesity, excessive and unhealthy energy intake, and a diet rich in processed foods all have a negative effect on ovulatory function. In addition to a multitude of gynaecological and systemic disorders that impair a woman's fertility, environmental variables and lifestyle choices including stressful work, improper nutrition, and unhealthy diets can affect women's ability to reproduce, thus increasing their risk of becoming infertile.


References


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