Optimize Fertility and Reproductive Health, According to an Expert

Globally, fertility rates are decreasing. While this partly reflects societal trends toward having fewer children by choice, infertility — which affects both men and women — is also on the rise. A natural, age-related decline in fertility typically starts in a woman’s early 30s, but the reasons for infertility are more than biological.

Carmen Messerlian, founder of The Vie Institute for Generational Health and CEO of Vie Science, spoke to WellnessPulse about foods and nutrients that support fertility.

With a background as a Research Scientist and Professor at Harvard T. H. Chan School of Public Health, and as an advisory member of the Environmental Protection Agency’s Science Advisory Committee on Chemicals, she explained which substances to avoid—and why overall health reflects reproductive and generational health—for both men and women.

What are the most important nutrients for fertility?

Fertility isn’t driven by a single nutrient, but by several that work together to create a system-level readiness.

Folate is associated with successful reproductive outcomes, and low folate consumption or low folate levels in a woman's body may not be conducive to fertility. Iron helps support ovulation, oxygen delivery, and placenta development.

Omega-3 fatty acids (EPA and DHA) play an important role in hormonal signaling and egg and sperm membrane quality. They also help regulate inflammation. Basically, they are involved in the reproductive cascade, from sperm and egg development to embryo formation.

Zinc and selenium are shown to influence sperm production, ovulation, immune function, and antioxidant defense.

Iodine is essential for proper thyroid function. If your thyroid gland isn’t functioning optimally, you're likely to have a really hard time getting pregnant, or if you do get pregnant, you may have a higher risk of miscarriage.

The last one is vitamin D, which is important for hormone development and may influence ovarian function, inflammation, and, importantly, embryo implantation into the uterus.

Is there a difference between consuming these nutrients as supplements versus food?

Supplementation allows for an opportunity to cover your nutritional bases, but don't rely on supplements as your primary nutrient source.

For example, taking a folic acid supplement gives you at least the minimum requirement, but you need to eat folate-rich foods because they also have fiber, antioxidants, and bioactive compounds that help enhance the utilization of folate in the human body.

Are there any specific fertility superfoods?

There are some foods that may positively affect fertility:

• Eggs are a great source of choline, an important nutrient for fertility, as well as protein and antioxidants.
• Fatty fish, including salmon and sardines, are rich in omega-3s, iodine, selenium, and zinc. Seafood and seafood-forward diets are generally pro-fertility. However, the guidance is to limit large fish (such as tuna and swordfish) because they tend to have high mercury levels.
• Dark leafy greens like kale, arugula, collard greens, and Swiss chard are rich in folate, magnesium, and antioxidants, nutrients that support fertility.
• Nuts and seeds contain zinc, selenium, healthy fats, and many micronutrients. Data shows that nuts and seeds may be a beneficial addition to your diet if you're planning to get pregnant, trying to get pregnant, or are pregnant.

What about specific foods that people should avoid or limit?

These food items are generally best to avoid or limit:

• Ultra-processed foods. During processing, these foods are usually exposed to a host of endocrine-disrupting chemicals and environmental toxicants, such as phthalates, phenols, BPA, flame retardants, and perfluoroalkyl and polyfluoroalkyl substances (PFAS). Not only are these foods depleted of nutrients, they can also contain these chemicals, which may cause inflammation and interfere with reproductive hormonal signaling.
• Excessive sugar. Insulin and glucose levels are important to balance when you're trying to get pregnant.
• Excessive alcohol. Binge drinking or daily drinking affects egg and sperm production.
• Excessive caffeine. The guidance is to consume no more than 200 milligrams per day, but I recommend less than 150 milligrams a day — roughly two espresso shots, maximum.
• Tobacco products and THC. Smoking marijuana or ingesting any type of marijuana product may result in risks to your fertility.

How concerned should people trying to conceive be about pesticides, plastics, and food packaging?

It's a high concern. Ample scientific evidence shows that higher concentrations [of endocrine-disrupting chemicals] in women’s and men’s bodies may result in a decline in every single parameter we measure. This includes sperm concentration, the number of eggs you produce in a cycle, the number of eggs that get harvested if you're going through in vitro fertilization (IVF), the chances of having an embryo develop during IVF, and the chances of implantation. The chances of miscarriage are also shown to be higher, and live birth rates — lower.

What can someone do to minimize their exposure risk?

I always advocate for baby steps. For example, you can avoid heating your food in plastic. Anything that goes into your mouth that is in contact with plastic or a plastic-like product, including plastic-lined paper cups or Styrofoam cups, should not go into the microwave if you're trying to get pregnant. You have to decrease the number of times you do it: if you're doing it every day, do it every other day.

Get rid of the products in your home that have fragrances added to them. Your dishwashing soap, laundry detergent, hand soap, body soap — always choose fragrance-free, period.

Personal-care products are also major sources of reproductive endocrine-disrupting chemicals: toothpaste, deodorant, body lotion, sunscreen, shampoo, conditioner, and makeup. Try to incrementally decrease the number you’re using, and I advise buying clean beauty products.

I'm an advocate of buying organic fruits and vegetables when possible, but you may also try washing conventional produce thoroughly with baking soda, which may eliminate some of the pesticides when done properly.

How long might someone need to follow a fertility-forward diet before seeing measurable benefits?

For men, sperm takes around 90 days to regenerate. A 3-month window will allow a man to have brand new sperm, so 3 months after starting a new diet. For women, the eggs ovulated in a given cycle started being recruited out of the ovary 3–6 months ago, so it would likely take around 3–6 months.

But there's lifetime accumulation, too. Starting earlier is always better, even if you don’t plan to get pregnant for a few years. Hormonal balance is health-enhancing for many different reasons, not just for getting pregnant. Even if you plan on never getting pregnant, following a pro-fertility, pro-reproductive-health diet may be important for your ovaries to function and age at a normal pace. We know that early reproductive decline is associated with a whole host of chronic age-related diseases, like heart disease, metabolic diseases, and cognitive decline.

Protecting your fertility and your reproductive health should be your number one goal because it actually aligns with all your other health goals.

Carmen Messerlian

Is there a too-late age where dietary factors no longer matter, or can nutrition make a difference at any age?

You can’t underestimate the impact of nutrition at any age, in terms of fertility health. For women over 40 who are trying to get pregnant, nutrition can be a critical strategy.

Diet can't reverse aging, but it can help improve egg and sperm quality, support implantation, and reduce inflammation and oxidative stress. It may also improve your outcomes, even if you're going through assisted reproduction. You can make your biology more receptive, and that's what couples should be aiming for.

What are the biggest misconceptions around fertility foods?

Supplements will not fix someone’s bad habits. Taking a big stack of supplements is not going to solve a bad lifestyle or diet, like eating ice cream and junk food all day long.

Another misconception is that fats are bad. Certain fats can be supportive of fertility, but it depends on what kind of fats we're talking about — for both men and women. We want to decrease saturated fats, and trans fats are big no-nos, but fats from fish and dairy have been associated with positive fertility outcomes. Low-fat, zero-fat milks are not pro-fertility, and despite the big push toward oat, almond, coconut, and cashew milks, dairy milks are much better.

There’s no magic diet. Exercise and a balanced diet are your two greatest tools to enhance your fertility and enhance your health.

How does today's food and environmental exposures affect fertility not just now, but across generations?

What a couple does before conception — their diet, lifestyle, and environmental exposures — can leave chemical signatures, called epigenetic marks, on eggs and sperm that may guide how the embryo develops. These marks might carry through the fetus and even influence the next generation, meaning your health today may affect your child’s and grandchild’s health tomorrow.