Pre-conceptual Care

We are all older than we like to think. From a health perspective, the nine months spent in the womb and the months before conception are the most critical periods of our lives.

Maximising Fertility
One in every four couples suffers from some degree of infertility. For some, this means having fewer children than they want; for most, it means no children at all. And even for couples who are fertile, getting pregnant is not the easy matter that it is commonly thought to be. The average length of time taken to get pregnant is six months, although eighteen months is not uncommon. But unless fertility tests show otherwise, failure to conceive within eighteen months does not necessarily mean that you are completely infertile.

While it’s well known that a woman’s fertility decreases with age, did you know that a man’s does too? A couple’s chances of conceiving within six months of trying decrease by 2 per cent for every year the man is over twenty-four, regardless of how young his partner is. And if she’s in her thirties, then she’ll take twice as long to conceive as a woman in her twenties.

Yet, despite these statistics, research has shown that if both partners are in good health and receiving optimum levels of all the right nutrients, the effect of their age on their chances of conceiving and having a successful pregnancy can be reduced. Fertility and the speed of conception depend on many factors, some psychological, some physical and some nutritional. Conception rate is very high during holiday periods, for example, since stress – a major factor in infertility – is reduced. Knowing how to time intercourse to coincide with ovulation (the release of the female egg to be fertilised by the sperm) greatly increases the chances of conception. Also, your nutrition and especially your vitamin status play a crucial role.

Vitamins for Fertility
The male partner is responsible in about a third of infertility cases. (It should be stressed that infertility has nothing to do with sexual virility, which is usually not affected.) The usual test for infertility in a man involves a sperm count – the higher the sperm count, the greater the fertility. One study has shown that extra vitamin C increased sperm count as well as sperm mobility.(1) Likewise, vitamin E or essential fat deficiency has been found to induce sterility in both sexes by causing damage to the reproductive tissues. Unfortunately, however, simply taking vitamin E will not reverse the condition if you are sterile.

Pre-Conceptual Care
The best odds for a healthy offspring are achieved when both partners prepare for pregnancy. It takes three months for sperm to mature, while the egg or ovum takes a month. If, during these pre-conceptual months, each partner pursues optimum nutrition, minimises his or her intake of anti¬nutrients, especially alcohol, and stays healthy, the chances of a healthy conception are high, especially if the couple abstains from sex during the non-fertile phases of the month.

One in three conceptions are spontaneously aborted during the first three months of pregnancy. This risk is reduced when both partners are optimally nourished and healthy. A common cause of miscarriage is a lack of progesterone, which is needed to maintain the pregnancy in the early weeks. This can be a result of oestrogen dominance. Homocysteine is a new health marker that’s been making headlines for its association with more than100 different health conditions including infertility and pregnancy complications.

One study, which looked at nearly 6,000 women, found that those with high homocysteine levels were up to 100 per cent more likely to have suffered problems with their pregnancies or had babies with birth defects. It’s now easy to have your homocysteine tested and if a high level is found, this can be reduced to a healthy level in around three months with the right nutritional supplements. It’s well worth checking your homocysteine level before trying to conceive, and lowering your score, if above 6, by supplementing folic acid, B12, B6 and TMG.

Anyone considering IVF (where a women’s egg and her partner’s sperm are fertilised outside her body and then impregnated in the womb) should cover all these ‘optimum nutrition’ bases first. While IVF has an average success rate of 21.8 per cent (and that’s among the ‘cream of the crop’ who are selected for this expensive treatment), the holistic approach – where both partners are given an optimum nutrition ‘MOT’ and any underlying health problems resolved – has a success rate of more than 78 per cent, according to the pre-conceptual care organization, Foresight, who followed up 1,076 couples, 779 of which resulted in a live birth.

The high rate of infertility among diabetics may provide us with a clue. Diabetics are frequently low in vitamin A, which is essential for making the male sex hormones. Vitamin A is dependent on zinc being released from the liver. Of all the nutrients known to affect male fertility, zinc is perhaps the best researched. Signs of zinc deficiency include late sexual maturation, small sex organs and infertility. With adequate supplements of zinc these problems can be corrected. Dr Carl Pfeiffer, Director of the Princeton Biocenter, one of the first research groups to identify the importance of zinc, also found a high degree of impotence and infertility in male patients who suffer from zinc deficiency. ‘With adequate dosage of vitamin B6 and zinc,’ he wrote, ‘the sexual ability of the male should return in one or two months’ time.’ In view of the fact that the average dietary intake of zinc is half the RDA, the effects of zinc on fertility may be quite substantial and widespread. Zinc is found in high concentrations in male sex glands and in the sperm itself, where it is needed to make the outer layer and the tail.

Vitamins for a Healthy Pregnancy
Optimum nutrition can greatly improve your chances of having a healthy pregnancy. Even the slightest deficiencies during pregnancy can have serious effects on the health of the offspring, and the idea that birth defects are often cased by nutritional imbalances in the mother is rapidly gaining wider acceptance. So far, slight deficiencies of vitamins B1, B2 and B6, folic acid, zinc, iron, calcium and magnesium have all been linked to birth abnormalities. So too have excesses of toxic metals, especially lead, cadmium and copper. Severe deficiencies of any vitamin will cause birth abnormalities, since a vitamin is by definition necessary for maintaining normal growth. A healthy pregnancy will of course depend on a greater supply than normal of all these nutrients, since accommodating the needs of a growing foetus as well as her own put extra demands on the expectant mother.

Spina Bifida
As many as 5 per cent of births show some developmental defect, many of which affect the central nervous system. Spina bifida, a condition in which the spinal chord does not develop properly, has been strongly linked to a lack of folic acid and probably of other nutrients too in the mother’s diet. A survey of 23,000 women found that those who supplemented their diet during the first six weeks of pregnancy had a 75 per cent lower incidence of neural tube defects than those who did not.(2) The incidence of this condition is far higher when mothers have had a nutritionally poor diet for the first three months of pregnancy. One study found that dietary counselling alone lowered the rate of spina bifida in mothers at risk, but that the administration of extra folic acid, on its own or in a multi¬vitamin, resulted in a much lower number of babies with neural tube defects. Since the optimum daily allowance (ODA) for folic acid intake is 800mcg per day, with a good diet providing 400mcg per day, a supplement of at least 400mcg per day is recommended for women intending to become pregnant.


1. Hargreave, T.B. et al., ‘Randomised trial of mesterolone versus vitamin C for male infertility’, British Journal of Urology, vol 56:6, pp. 740–4, (1984); Abel, B.J. et al., ‘Randomised trial of clomiphene citrate treatment and vitamin C for male infertility’, British Journal of Urology, vol 54:6, pp. 780–4 (1982).

2. Milunsky, A. et al., ‘Multivitamin/folic acid supplementation in early pregnancy reduces the prevalence of neural tube defects’, Journal of the American Medical Association, 262:20, pp. 2847–52 (24 Nov 1989).