One of the most challenging aspects of PCOS is dealing with infertility. According to a study, anywhere from 70-80% of women with PCOS suffer from it.
The treatment of infertility caused by PCOS typically involves inducing ovulation—through medications or medical procedures, as needed—and correcting metabolic issues that impair fertility. It also involves proper blood sugar management and improving insulin sensitivity.
Dietary improvement and lifestyle modifications are some of the widely encouraged treatment options for women struggling with infertility. A well-balanced diet can reverse several PCOS symptoms and improve egg quality, insulin sensitivity and energy levels, manage weight, and facilitate ovulation.
- Infertility affects a major percentage of the PCOS population,
- Consumption of whole grains, poultry, seafood, fruits and vegetables leads to improved fertility outcomes. On the other hand, consuming foods that are high in saturated fats, sodium, and sugar has a detrimental effect on one’s fertility,
- Before opting for conventional fertility treatments, dietary improvement can be used to restore ovulation and improve PCOS symptoms significantly.
What does science say?
Evidence shows that a diet that incorporates whole grains, poultry, seafood, fruits and vegetables leads to improved fertility outcomes in individuals. Such a diet can also improve semen quality in men. On the other hand, a diet high in saturated fats and sugar has been linked with poorer fertility outcomes in individuals.
Another study suggests high fast food and low fruit consumption are associated with infertility. Published in the journal Human Reproduction, the study was conducted on a total of 5598 participants and found that women who consumed low amounts of fruits and had a higher fast food intake in their preconception diets took longer to get pregnant than those who followed healthier diets.
Fast food contains high amounts of saturated fats, sodium and sugar. The findings indicate that increasing the consumption of fruits and minimizing fast food intake can lead to better fertility outcomes.
Another study published in Epidemiology found that consuming sugar-laden beverages (such as soft drinks, energy drinks or other sweet beverages) was associated with poorer fertility outcomes in men and women. However, consuming diet soda or fruit juice didn’t affect either.
You get the gist: processed foods with high amounts of sugar or trans fats are the culprits.
Similarly, high blood sugar levels (caused by food items such as doughnuts, candies, sugary beverages, french fries, etc.) lead to higher insulin levels, leading to insulin resistance. Insulin resistance inhibits ovulation and makes it difficult for women to get pregnant. Therefore, insulin reduction strategies are used to increase ovulation rates in women with PCOS who are struggling with infertility.
It goes to show that a healthy diet and blood sugar management are key to boosting fertility. On the other hand, an unhealthy diet that includes trans fat, processed food items, or fast food contributes to infertility.
A systematic review that explored the effects of improved insulin sensitivity on pregnancy outcomes found that improved insulin sensitivity led to increased clinical pregnancy rates in infertile women with PCOS, regardless of the various non-surgical therapeutic strategies.
With that said, let’s take a look at the food items that should be included in a fertility diet—and the sequence in which they should be eaten—to facilitate ovulation and increase your chances of getting pregnant.
The impact of food sequence on postprandial glucose and insulin levels
A recent clinical trial suggests that the order in which you consume your meals significantly impacts postprandial (after a meal) glucose and insulin levels in type 2 diabetes patients.
Women with PCOS who suffer from type 2 diabetes can make use of correct food sequences to lower post-meal glucose levels. This can be done by eating fibre and protein first, followed by carbs.
A study found that consuming vegetables and protein first resulted in a lower spike in insulin levels.
What Should Be Included In A Fertility Boosting Diet?
Fat was considered a villain for a long time: it gained a bad reputation around the 1950s when saturated fat was linked to high total cholesterol levels. As a result, low-fat, high-carb diets gained popularity. Researchers suggested that such diets would help people stay healthy. On the contrary, obesity and diabetes were on the rise.
Now that newer studies and evidence have come to light, experts think that healthy fats should be an essential part of one’s diet.
“Good” fats (monounsaturated and polyunsaturated fats) are healthy for the heart. They are vital for reducing blood clotting, improving cholesterol levels, reducing inflammation and lowering the risk of cardiovascular diseases.
Fats—specifically unsaturated fats from marine sources (think tuna, salmon and sardines) and plant sources (nuts and seeds)—play a significant role in a fertility diet by contributing to the production of estrogen and progesterone.
A study conducted on PCOS-induced rats showed that a low-carb diet in combination with omega-3 administration led to balanced follicle-stimulating hormone (which helps stimulate the growth of eggs in the ovaries) and testosterone levels, leading to better fertility outcomes.
Inflammation is the body’s natural immune response to an illness or injury. A majority of women with PCOS suffer from chronic inflammation, which triggers the production of androgens. However, it is still unclear why this chronic low-grade inflammation occurs in the first place.
Inflammation is typically measured through C-reactive protein (CRP) blood tests. PCOS has been associated with high white blood cells and CRP concentrations. These increased levels of CRP are linked with insulin resistance and diabetes. In addition to that, research suggests that elevated CRP levels might be an indicator of early cardiovascular risk.
Reducing inflammation through anti-inflammatory foods can be immensely helpful in inducing ovulation. These foods include tomatoes, nuts (such as almonds and walnuts), seeds (such as chia seeds and flax seeds), fatty fish (mackerel, tuna, salmon, sardines), and leafy green vegetables, olive oil, etc.
Whole grains are high in dietary fibre, B vitamins and folate (vitamin B9). These include barley, quinoa, buckwheat millets, pearl millets, proso millets, foxtail millets, etc. The fibre in whole grains helps lower cholesterol levels and gets rid of the excess estrogen in the body, protecting you against cancers caused by estrogen dominance.
Consuming whole-grain foods (as opposed to refined grain foods) can help manage weight and maintain ideal blood sugar and blood pressure levels over time, leading to a lower risk of ovulation inhibition.
Plus, whole grains take longer to digest than other carbs, which is why blood sugar and insulin spike are comparatively smaller. A smaller insulin spike means lesser testosterone levels, which aids in PCOS management.
Protein is present in all the cells of the human body. It is a critical macronutrient that is responsible for the growth, development and maintenance of tissues. Protein slows down the process of digestion and helps curb glucose spikes in the body.
The source, quantity and quality of the protein you consume affect insulin sensitivity. It is recommended to choose a lean protein to ensure that you stay full for longer periods. Fish, such as salmon, sardines and tuna can be a great source of protein.
Evidence has shown that choosing plant-based protein sources (such as tofu, peanut butter, spirulina, lentils, quinoa and so on) over animal sources can help lower the risk of ovulatory infertility. Additionally, a low intake of protein during pregnancy has been associated with slow or stunted embryo growth.
On the contrary, a controlled clinical trial conducted on PCOS women suggests that a high protein diet can lead to more weight loss, body fat loss and greater decreases in blood glucose levels than a standard protein diet.
Opt for counselling
Whatever ailment you might be going through, make sure that you consult a dietician/nutritionist before making changes to your dietary intake. Healthcare practitioners can be a prized resource in your fertility journey and help you with a personalised diet plan while considering deficiencies and allergies. They might also suggest prenatal vitamins according to your individual needs. Counselling should be sought before conception and during and after pregnancy.
Lifestyle changes play a significant role in the improvement of reproductive health in women with PCOS. For obese women, moderate weight loss might restore ovulation and improve insulin sensitivity. Before opting for conventional fertility treatments, a holistic treatment approach that focuses on lifestyle modifications to restore ovulation is encouraged.
Meal sequencing, or food order, can be a great way to manage glucose levels and reduce spikes. Likewise, incorporating healthy fats, protein, whole grains and anti-inflammatory foods can tremendously help improve fertility outcomes. This would also reduce the risks and complications associated with a pregnancy where the mother is obese.
Similarly, fad or crash diets and yo-yo dieting are not long-term, sustainable solutions. Instead, the focus should be on making changes and alterations that one can keep up with for a long duration.
Disclaimer:The contents of this article are for general information and educational purposes only. It neither provides any medical advice nor intends to substitute professional medical opinion on the treatment, diagnosis, prevention or alleviation of any disease, disorder or disability. Always consult with your doctor or qualified healthcare professional about your health condition and/or concerns and before undertaking a new health care regimen including making any dietary or lifestyle changes.
- Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice
- Diet and fertility: a review
- The Influence of Diet on Fertility and the Implications for Public Health Nutrition in the United States
- Pre-pregnancy fast food and fruit intake is associated with time to pregnancy
- Intake of Sugar-sweetened Beverages and Fecundability in a North American Preconception Cohort