Trying to get pregnant? Lifestyle tweaks can make a big difference

Claire Turnbull on what to eat, what to test and which supplements to take in order to maximise your chances of conceiving and keeping a pregnancy.

While you might know someone who fell pregnant without even trying, you probably know others who haven’t had such an easy ride. The journey of trying for a baby really can be all-consuming. It definitely was for me.

Ovulation tracking, mucus inspections, daily temperature checks, followed by utter heartbreak every time your period arrives – that sense of deep sadness and... why isn’t this working? It can feel like the whole process is taking over your life.

It can also put a strain on your relationship as bedroom encounters go from being fun and spontaneous, to scheduled and calculated, with guys often left feeling like machines on call, no longer wanted outside of their partner's ovulation window.

So much of this experience feels out of your control and, of course, some fertility issues can't be addressed through diet and lifestyle. But for many people, there things you can control, lifestyle tweaks that will considerably improve your chances of conception. And – no surprises – nutrition is a big one.

I interviewed two dietitians I work with, Hannah Eriksen and Ellie Connor, both specialists in the area of fertility, and got the lowdown on how best to improve your chances if you're trying to get pregnant. Plus, how to set yourself up for a healthy pregnancy before you even conceive.

It's normal for it to take a while. Under the age of 35, 90% of couples will get pregnant within a year and over the age of 35, it can take longer.

If you're under 35 and have tried for more than a year, or you're over 35 and have tried for more than six months, without success, this is the point where it's worth seeing your GP. (Those age/time-frames might sound counter-intuitive, but the reasoning is that those in the older group have a smaller fertility window, so should address any potential issues swiftly.)

But getting pregnant isn’t the only thing to consider. Keeping the pregnancy is the other part. One in three women will experience a miscarriage, and the rates rise with age. In the past, many early pregnancy losses would have gone unnoticed because the highly sensitive early testing we have now – able to detect a pregnancy just days after conception – wasn't available. We’re now more aware of early pregnancies, and early miscarriages – a double-edged sword. You can get excited very early on if the two lines on the stick go blue, but then you may have to deal with the devastation of an early loss. I know this so well; it happened to me multiple times.

One third of the time, the inability to fall pregnant or maintain a pregnancy comes down to an issue to do with the female. This could be due to your egg quality, environmental or lifestyle factors such as smoking, or a wide range of conditions including PCOS, endometriosis, inflammatory bowel disease (IBD), weight/body fat, uterine microbiome imbalance, fallopian tube blockages, nutrient deficiencies... the list goes on. It’s surprisingly common for women to only discover underlying health issues after struggling to conceive or experiencing repeated pregnancy losses.

One third of the time, fertility issues are to do with the other half of the equation – the male. Most commonly it's an issue with sperm quality, quantity, and motility (how well sperm swims). A male's sperm can also be impacted by many things including poor nutrition, nutrient deficiencies, genetic traits, smoking, alcohol, heat and even undiagnosed coeliac disease.

The last third of fertility issues can be a combination of factors affecting both the male and female, or sometimes there will be the diagnosis of unexplained infertility, when medical specialists just can’t find a clear answer. This can be frustrating. It doesn't mean you can't or won't get pregnant just that there's no clear reason why it hasn't happened yet.

In an ideal world you and your partner would give yourselves three months to focus on a few nutrition and lifestyle changes ahead of even trying to conceive, to optimise your chances.

A full check-up from your GP is recommended. (Note: some GPs are better than others, when it comes to understanding fertility, so if you hear of a good one, it's worth seeking them out.)

Women, ask your GP about the following blood tests:

And men, ask your GP to test:

What you eat can have a significant impact on the quality of the egg that matures each month as well as the quality of the sperm that you're hoping will meet it.

It takes about 100 days for an egg to mature and be ready for release to be fertilised, and the lifecycle of sperm is about 90 days – so you can see the value of the three-month prep window!

You might’ve heard of “the first 1000 days” describing the foundational importance of setting up a child with the best possibility of good lifelong health. What’s really interesting is that this doesn’t just begin at birth – it actually starts three months before conception.

Beyond conception and implantation, nutrition plays a major role in the health of the developing foetus and can help reduce the mother’s risk of gestational diabetes, pre-eclampsia, and pre-term birth.

While I rarely talk about weight in my work anymore, fertility is one area where the evidence is very clear; it can make a difference. If you have a BMI over 30, losing 5-10% of your body weight before trying to get pregnant can have a significant impact. The key thing here is approaching this in a healthy way, not going on a restrictive or extreme diet as that itself can cause issues.

Equally, if you do lot of exercise and/or have very low levels of body fat, this can stop ovulation because your body perceives that it is not safe to carry a pregnancy.

Weight aside, from a nutrition perspective, here are Ellie and Hannah's top six recommendations:

1. Adopt a Mediterranean-style approach. This way of eating is anti-inflammatory, centered around whole, minimally processed foods and a wide variety of colourful vegetables that are rich in antioxidants and fibre. Aim for five or more handfuls of veggies a day, with at least one green vegetable, as well as two servings of fruit.

2. Set aside carb phobia and focus on wholegrains. Quality carbs provide the fuel and nutrients needed by your body to make and grow a baby, as well as ensure a healthy uterine microbiome for implantation. Wholegrains like brown rice, oats, barley and quinoa are packed full of B vitamins and fibre and ideally are eaten every day.

3. Have protein at every meal and aim for variety. If you eat animal proteins, aim for red meat around twice a week, limit processed meat as much as possible and look to have fish at least twice a week, three times if possible. Chicken, seafood, and eggs are also great to enjoy. (Important note: according to the New Zealand food safety guidelines, raw seafood should not be eaten in pregnancy and some seafoods should only be eaten piping hot. Check out those guidelines here.)

A variety of protein will help you get the iron, zinc and Omega-3, all of which are important.

Include plenty of plant-based proteins too like legumes, tofu and tempeh. If you're vegetarian or vegan, you will need to find ways to get adequate amounts of iron, zinc and Omega-3, and sometimes supplements may be required.

4. Unless you have an allergy, it's best not to ditch dairy in pregnancy. The protein and calcium provided by dairy products is shown to have a positive impact on fertility outcomes, so 2-3 servings of dairy a day is recommended. A serving is a glass of milk (250mls), a pottle of yoghurt, or 2 slices of cheese (40g). If you can’t tolerate dairy, a calcium-enriched alternative like soy milk is recommended, plus additional calcium from canned salmon, nuts and chickpeas. Oat and almond milks aren’t typically high enough in calcium, so check what you buy when it comes to alternatives and make sure you choose the calcium-fortified varieties.

5. Eat healthy fats. Ideally that means including a small handful of a variety of nuts/seeds each day as well as oily fish such as salmon a couple of times a week. If you don’t eat oily fish, a quality Omega-3 supplement is recommended to support egg quality, a healthy microbiome and, if you succeed in falling pregnant, the brain development of your baby during pregnancy.

6. Moderate caffeine and alcohol. When you are trying to get pregnant, we recommend limiting caffeine to 200mg a day which is no more than a double shot espresso or 2-3 cups of tea. You may want less. Keeping alcohol to a minimum is also recommended.

In our opinion, folic acid, iodine, and Vitamin D are essential. You can get these from your GP or dietitian, and they are fully funded. It is recommended to take these three months before trying for a baby and throughout the whole pregnancy. And some others we'd recommend include:

Other supplements you want to include are ubiquinol for egg health, particularly in women over 35, magnesium and choline.

All of these supplements are recommended by dieticians Hannah Eriksen and Ellie Connor, but on a case-by-case basis. It's best to talk to a qualified fertility dietitian before piling supplements into your diet. Ask them about the ones above, and there are others that might be helpful to some people.

So much more than most people think! At the end of the day, the sperm is half of the party, so it's not really surprising that its quality matters.

For guys, the Mediterranean anti-inflammatory approach outlined above is also the way to go. Sperm is very sensitive to the oxidative process, so a diet high in antioxidants is a must to keep the tiny swimmers healthy.

Alcohol consumption also makes a massive difference as too much reduces sperm quality, quantity and ability to penetrate eggs. Likewise, smoking or vaping, being overweight, having high blood sugar levels, and micronutrient deficiencies.

A quality men's pre-natal multivitamin is recommended, and you might want to look into supplementation with zinc, folate, ubiquinol and Omega-3. Again, talk to a fertility dietitian for the best advice.

Yes, when it comes to the ability to fall and stay pregnant, what you eat can make a big difference. But adding more pressure to yourself by hyper-focusing on what you eat and feeling like you need to get everything "right" is not helpful either. It is OK to have some chocolate and the odd glass of wine even when you didn't plan to. You are human.

If you get too hung up on following all the guidelines and being "perfect", it just adds to the stress and can cause sleepless nights, neither of which are helpful on this journey, so be kind to yourself. Remember, what you do most often is what matters.

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Claire Turnbull is a registered nutritionist with an honours degree in dietetics, a wellbeing educator and author.

This article should not be read as personalised medical advice. If you have fertility concerns that endure, we advise you seek advice from a medical professional.