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Fertility, Pregnancy, and Lactation

Fertility

Nutrition and lifestyle factors may affect fertility directly, and they also influence the risk for several diseases that decrease fertility, including polycystic ovarian syndrome, endometriosis, and uterine fibroids.

Some studies suggest that supplements of high-dose (750 mg/day) vitamin C, combinations of antioxidants, iron, and the amino acid arginine may help women achieve pregnancy. In contrast, celiac disease, which is triggered by gluten in the diet, can decrease fertility and cause miscarriage. In affected women, fertility may be improved by a gluten-free diet.

In males, infertility may occur by smoking, infections of the reproductive tract, varicocele, and possibly poor diets, all of which may damage sperm. Controlled studies of high-dose combinations of antioxidants (vitamins C, >200 mg/day; vitamin E, 200-600 IU/day; selenium, 100-200 μg/day) appear to improve sperm function and may lead to increased pregnancy rates, particularly in former smokers.

Alcohol consumption is associated with decreased fertility in both women and men.

Pregnancy and Lactation

Pregnant and lactating women have increased requirements for calories overall and for specific nutrients. The failure to achieve required intakes may increase risk for certain chronic diseases in their children, sometimes occurring many years or decades later.

Protein requirements in pregnancy are slightly increased to allow for fetal growth and milk production. The source of protein may be as important as the amount, however. Some evidence suggests that protein requirements can be more safely met by plant foods, rather than animal products. Vegetable protein sources, aside from meeting protein needs, can help meet the increased needs for folic acid, potassium, and magnesium and provide fiber, which can help reduce the constipation that is a common complaint during pregnancy.

Pregnant women also should be careful to avoid certain types of fish, such as shark, swordfish, mackerel, and tilefish, which often contain high levels of mercury. Other mercury-contaminated fish, including tuna and fish taken from polluted waters (pike, walleye, and bass), should be especially avoided.   

Pregnant and/or lactating women also require increased amounts of vitamins A, C, E, and the B vitamins, including folic acid. Folic acid intakes were noted to be poorest in women eating a typical Western diet and highest in women eating vegetarian diets. Pregnant women also require increased amounts of calcium, phosphorus, magnesium, iron, zinc, potassium, selenium, and other minerals. Prenatal vitamin-mineral formulas are strongly suggested for all women to increase the likelihood that these nutrient needs will be met.

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