Pregnancy and Newborn Health

Tackling Infertility with Nutrition Focused Modifications

India’s exploding population is popularized everywhere but ironically its current declining fertility rate is not known to everyone. According to many studies, India has reported a 50% drop in the fertility rate from 4.97 (1975-80) to 2.3 (2015-2020). By 2025-30, a further nosedive to 2.1 is projected, followed by a drop to 1.86 in 2045-50 and to 1.78 in 2095-2100. A steady hold on the population is achieved at a fertility rate of 2.2 but below this, a population decline occurs. Many reports suggest that the Urban Indian Fertility is among the lowest in the world. According to the Indian Society of Assisted Reproduction, 10-14% of the Indian population is affected by infertility.

Higher rates are seen in urban areas where 1 out of 6 couples are impacted. In India, nearly 27.5 million couples suffer from infertility which greatly hinders conception. Approximately, 35% of infertility cases is due to female infertility, 30% due to male infertility, 20% due to both, and 15% due to unexplained reasons.

The impact of Infertility

Fertility is viewed as an essential part of one’s identity. Infertility is always addressed as a social stigma, socially unacceptable, and culturally taboo. High levels of distress, guilt, and frustrations are experienced by the couples. They also experience low self-esteem, devastating hopelessness, social withdrawal, and loneliness. More stress is added thanks to the high cost of the infertility treatments. Studies report an an increased incidence of depression and anxiety in couples undergoing treatment. They often question self-identity and purpose in life. Due to these reasons, infertility experts face complexities while dealing with and managing such cases.

Causes of Infertility

Beyond age, fertility is negatively affected by lifestyle choices like smoking, nicotine, caffeine, and alcohol intake. Other factors like stressful work routine associated with anxiety & depression, excessive electronic gadget usage, chronic exposure to environmental pollutants, irregular meal timing, and, imbalanced nutritional habits also impact fertility. High consumption of carbohydrates and saturated fat-loaded food further deteriorates fertility parameters. Modern metabolic disorders like diabetes, obesity, and hyperlipidemia are commonly associated with hypercaloric diets, also interfere with normal reproductive functioning.

Improper Nutrition and Infertility

Healthy nutrition support is required for normal reproductive performance. Major infertile cases are reported in malnourished people. Altered fertility may occur due to deficient food intake, inadequate dietary regimes, strong dietary restrictions, and lack of nutrients leading to loss of both body weight and physical performance. Malnutrition also delays puberty, lengthens the postpartum interval to conception, lowers gonadotropin secretion levels altering the physiological ovarian cycles. Improper energy balance is directly correlated to reduced ovulatory maturation in women.

Poor intake of proteins, micro and macro-minerals, and vitamins reduce reproductive performance. Thus, inadequate nutrition is closely linked to worsening reproductive pathophysiology. Amenorrhea, infertility, and miscarriages are undisputably caused by two pathological conditions, bulimia nervosa, and anorexia. Almost 5% of women of childbearing age are affected by these conditions. Fertility complications such as extended conception, decreased infertility treatment outcomes, increased rates of gestational diabetes, and hypertension is further exacerbated by obesity.

Healthy Nutrition for normal Infertility

Adequate nutrition plays a major role in strengthening reproductive efficiency in both men and women. As demonstrated by several studies, fertility and perinatal conditions are influenced by preconceptional nutritional status. Refined and simple carbohydrate-containing foods in the diet should be replaced by a good amount of low glycemic index complex carbohydrate sources such as fresh seasonal fruits, vegetables, whole wheat, oats, and ragi. More plant-based and low-fat protein sources (nuts, legumes, soy, fish, chicken) should be added and high high-fat sources (Red meat, processed meat) should be avoided.

Consuming adequate amounts healthy fats can help promote positive IVF outcomes. These fats include

  1. unsaturated fatty acids such as PUFA (Polyunsaturated fatty acid) from walnuts, sunflower seeds, flax seeds, fish,
  2. MUFA (Monounsaturated fatty acid) from Avocado, nuts, olive oil
  3. DHA (Docosahexaenoic acid) and fish, seaweed, chia seeds, flax seeds) needs to be incorporated into daily diet

Oxidative stress-induced infertility can be lowered by the adding antioxidants like Vit C, A & E from nuts, plant-based oils, fruits, vegetables, eggs. Conception chances can be improved by regular consuming foods containing Folic acid (green leafy vegetables, chickpea, kidney pea) and Zinc (Shellfish, legumes, nuts, eggs). Pregnancy chances further are increased by including vitamin-like Coenzyme Q 10 (Spinach, orange, strawberry, nuts, whole grains) and Vit D-rich sources (Sunlight, Vit D fortified foods) in the diet. The right amount of healthy fluids consumed throughout the day. Infertility is affected by a lack of physical activity and sedentary lifestyle. Hence physical activity and mobility should be recommended along with other infertility treatments.

Conclusion

Infertility should not be seen through the lens of social shame and disgrace but should be addressed as a serious health risk. A great amount of awareness and sensitivity should be shown by the family, society, and healthcare professionals towards infertile couples. Infertility can also be tackled by doing focused health-promoting lifestyle interventions such as

  1. daily physical activity routine,
  2. appropriate nutritional intake,
  3. adapting positive habit,
  4. establishing secured trustworthy interpersonal relationships,

The specialist should offer motivation and guidance so as to achieve normal healthy well-being, satisfaction, confidence, and abolishing the feeling of being inferior or lacking from anyone.

References
  1. The World Population Prospects: The 2017 Revision report
  2. Frontiers in Endocrinology | www.frontiersin.org, 2019
  3. International Journal of Health Sciences, 6(S1), 310-323
  4. Journal of Nutrition and Health Sciences, 2018; Volume 5 | Issue 2 SSN: 2393-9060

Author

Aparna Das Parmar

Aparna Das Parmar has over 8.5 years of rich experience in the field of nutrition and healthcare and is currently a corporate nutritionist.

 

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