Trying to conceive over 40 is not uncommon, but it's crucial to acknowledge the natural decline in fertility rates that occurs with age, particularly from the late 30s onwards. While many factors influence fertility, nutrition is a fundamental aspect that can often be overlooked. A fertility-focused diet can reduce the risk of complications, support fetal development, and improve long-term health outcomes for both parents and child.
Understanding Fertility in Your 40s
Age is the single biggest factor affecting female fertility. As women, we’re born with all the eggs we’ll ever have, and their quality declines over time. A girl may be born with 1-2 million eggs, but by the time she is 40, that number is thought to be around 5,000-10,000. While a couple aged 30 having unprotected sex tends to have around a 20% chance of conceiving each month, by the time a woman is 40 that figure has dropped to 5%. The fertility downward curve that begins in a woman’s thirties, sharpens after age 35 and becomes steeper still in her 40s.
Additionally, approximately 20% of all human eggs are aneuploid, meaning they have an incorrect number of chromosomes. As we get older, the number of aneuploid eggs rises, which sadly increases the risk of miscarriage. For women aged 35-39, the risk is around 35%, but it jumps to 51% between ages 40-44, and by 45, it’s as high as 93%.
Male fertility begins to decline in the 40s too (albeit more slowly). Advancing paternal age is associated with lower sperm quality and testicular function, in addition to chromosomal abnormalities and genetic diseases.
Despite these challenges, many couples in their 40s will conceive naturally and go on to have successful pregnancies and healthy babies.
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Foundational Steps for Trying to Conceive Over 40
Before diving into specific dietary recommendations, it's essential to consider these foundational steps:
- Pre-conception Lab Work: Even if this isn’t your first pregnancy, it’s still important to get pre-conception lab work done. This helps identify any potential barriers to conception and ensures you’re in the best possible health before trying to conceive.
- Seek Expert Help: If you’re experiencing issues like painful, irregular, or heavy periods, or if you have a medical history that could impact your fertility, it’s important to seek help from a fertility specialist sooner rather than later. This is also crucial if you’ve experienced a pregnancy loss or are dealing with recurrent pregnancy loss. For women over 35, it’s generally recommended to seek assistance after trying to conceive for 6 months. By the time you are 40, really you should seek fertility testing if you are not pregnant within 3 months of trying or ideally as soon as you decide you’re ready to try.
- Understand Your Menstrual Cycle: Take the time to get to know your menstrual cycle better. Understanding the different phases-the follicular phase, luteal phase, and the signs of ovulation-can help you pinpoint your fertile window. Charting your cycle is important. A study in Fertility and Sterility Journal determined that if women aged 35 to 40 had sex during the most fertile time in their cycles, the chances for pregnancy increased to 78 percent compared to 84 percent of women between 20 and 34.
Key Nutrients for Fertility
By influencing hormonal health, ovulation, sperm production, and more, nutrition plays an undeniable role in fertility. A well-balanced diet that includes key nutrients for fertility sets the foundation for becoming pregnant and maintaining a healthy pregnancy. Certain macronutrients - namely fats and proteins - are essential for creating the hormones necessary for reproduction.
- Folic Acid: Folic acid (a form of folate, which is a type of B vitamin), plays a vital role in male and female DNA synthesis and repair, and is considered essential for reproductive cell development. It is the only form of folate (a B vitamin) that's been shown to help prevent serious birth defects called neural tube defects (NTDs) like anencephaly and spina bifida.
- Vitamin D: Research has shown that vitamin D can play a role in regulating the menstrual cycle, and adequate vitamin D levels may help maintain normal ovulation and menstrual regularity. Additionally, vitamin D is involved in the healthy development of the egg, and some research shows a correlation between vitamin D levels and Anti-Müllerian Hormone (AMH), which is a key indicator of the number of eggs a woman has (also known as ovarian reserve). In men, vitamin D has been linked with healthy sperm motility.
- Iron: Iron is considered an important nutrient in female fertility due to the fact that women are more susceptible to iron deficiency due to blood loss during menstruation. Low levels of ferritin (a protein that stores iron in the body), are associated with unexplained infertility. In men, iron has an important role in maintaining normal sperm development.
- Omega-3 Fatty Acids: Because low-grade inflammation can interfere with ovulation, implantation, and sperm function, omega-3s-especially eicosapentaenoic acids or EPAs found in fish-can help create a healthier reproductive environment, which is especially important in people with conditions like polycystic ovary syndrome (PCOS) or endometriosis.
- Zinc: Zinc supports key reproductive processes and plays an important role in the growth of the neural tube and placenta. Research has shown that even very short-term zinc deficiency can significantly impair fertility and pregnancy outcomes.
- Selenium: Selenium is highly concentrated in the follicular fluid surrounding a woman's eggs and helps protect the developing egg from oxidative stress, which can negatively impact its quality and lead to DNA damage. Selenium is also critical for sperm production and motility.
- CoQ10: Coenzyme Q10 (CoQ10) helps protect the body from cell damage and is important for cellular energy production in men and women. Has been shown to both help improve egg quality and sperm motility. Co q10 is a vital nutrient because it is the primary antioxidant that protects and supports mitochondria. As co q10 levels decrease, so do the levels of energy mitochondria can produce.
Dietary Recommendations for Enhancing Fertility After 40
Rather than fixating on age, it’s more beneficial to focus on the modifiable factors that may make all the difference.
- Prenatal Multivitamin: Make sure your prenatal multivitamin contains the right amount of folate or folic acid, as this is crucial for your health and the health of a future pregnancy. Additionally, consider adding an omega-3 supplement to your routine.
- CoQ10 Supplementation: CoQ10 is an antioxidant linked to improved embryo quality, especially for those over 35.
- NAD+: NAD+ is a coenzyme vital for energy production, but its levels naturally decrease as we age. Restoring NAD+ through supplements might help slow or even reverse some of these effects.
- Antioxidant-Rich Diet: Eating a variety of colourful fruits and vegetables is crucial for maximising your antioxidant intake. This helps protect your precious eggs during their sprint to ovulation, which takes about 90-120 days before conception. Antioxidants play a key role in shielding your eggs from environmental damage, toxin exposure, alcohol, and other dietary factors.
- Seafood Consumption: Couples that consume more seafood boost their ability to conceive by about 61%.
- Limit Alcohol Intake: At the end of the day, our eggs don’t love alcohol.
- Reduce Exposure to Endocrine Disrupting Chemicals (EDCs): EDCs are found in a range of everyday items, from plastics and thermal receipts to food packaging, cleaning products, cosmetics, and hair care products. Chemicals like BPA, phthalates, and dioxins can mimic natural hormones, particularly estrogen, which can disrupt menstrual cycles and negatively affect egg health. Switch to plant-based cleaning sprays, never microwave plastic containers, throw out that plastic coffee cup and switch cling film wrapping for foil.
- Fertility-Friendly Diet Plans:
- Mediterranean Diet: The Mediterranean Diet is also rooted in a balance of macronutrients, all of which helps to foster reproductive health for men and women. The diet places a heavy emphasis on plant-based foods, including vegetables and whole grains, and healthy fats like extra virgin olive oil. The antioxidant-rich eating plan may help combat oxidative stress, which is a major factor in both male and female infertility.
- DASH Diet: Because of its focus on antioxidant-rich foods, healthy fats, and reduced processed foods, the DASH diet helps support many of the dietary components that have been shown to support fertility and reproduction.
- Whole-Food, Anti-Inflammatory Diets: The participants in the Nurses Health Study II who had a high intake of these components had a 66% lower risk of ovulatory infertility compared to women who did not.
- Foods to Incorporate:
- Leafy greens like spinach, kale, and romaine lettuce are rich sources of folate (vitamin B9), folic acid, antioxidants, and iron, which are important for both male and female fertility.
- Salmon and other oily fish like mackerel, sardines, anchovies, and more are excellent sources of vitamin D and selenium which are known to optimize fertility in men and women.
- Nuts and seeds like Brazil nuts, walnuts, pumpkin seeds, and more are excellent sources of nutrition that support fertility.
- Whole grains (including quinoa, oats, brown rice, barley, and more) can help support menstrual regularity and ovulatory function.
- Legumes like beans, lentils, chickpeas, and peas help support fertility and reproduction by serving as sources of plant-based protein that are rich in folate, iron, zinc, and fiber.
- Avocados are considered an excellent source of monounsaturated fats which contributes to overall hormonal health.
- Berries can help support hormone balance, and create a healthier reproductive environment in both men and women.
- Eggs provide a concentrated mix of high-quality protein, healthy fats, and key micronutrients that support reproductive health for both men and women.
- Foods to Limit or Avoid:
- Trans fats may contribute to insulin resistance, inflammation, and cellular dysfunction, all of which can disrupt the hormonal balance needed for ovulation.
- Excess sugar and refined carbohydrates cause rapid spikes in blood sugar and insulin levels which can disrupt the balance of reproductive hormones (particularly for women with PCOS), and increase inflammation.
- Processed meats are now in the same category of cancer risk as tobacco and asbestos.
Lifestyle Changes to Improve Egg Quality
When you are trying to improve your egg quality and chances of getting pregnant, it is important to focus on improving your overall health.
- Regular Exercise: Find a form of exercise that you genuinely enjoy and make it a regular part of your routine. The benefits of physical activity on both physical and mental health are well-established. For fertility, getting your blood flowing and managing stress through exercise can be very beneficial. Light exercises like walking, stretching, and yoga are great ways to reduce stress, increase blood flow to your reproductive organs and balance the immune system.
- Prioritize Sleep: Aim for 7-9 hours of sleep each night. This isn’t just important for overall health; it’s crucial for fertility as well. At night, the pineal gland in our brain produces the hormone melatonin to promote sleep. Melatonin is essential to maintain our body’s biological clock, and it also can improve egg quality. Research has shown that melatonin is beneficial for reproductive function and is believed to facilitate oocyte quality, ovulation, embryo development.
- Manage Stress: Emotionally eating, over-exercising, and using alcohol as coping strategies for stress can significantly affect your fertility. When we are stressed, our bodies produce increased levels of cortisol and prolactin, which can decrease ovulation, hindering egg production. Mind body techniques, acupuncture and yoga can emotionally and physically relieve stress and increase your chances of pregnancy.
- Avoid Smoking: Smoking causes a laundry list of health problems and research shows it impairs egg quality and quantity. Smoking increases egg loss in the ovaries and increases the number of abnormal eggs produced.
- Men: Don’t let your testes get too toastyIn addition to the other recommendations which apply to men as well, male partners can take extra steps to help their sperm health by trying to maintain optimum conditions for the testicles. For instance by opting for baggy boxer shorts and avoiding hot baths.
- Have plenty of sex!It may sound obvious but when you consider that a couple aged 30 has a 20% chance of conception each cycle compared to a 5% chance aged 40, getting plenty of sex when you’re not menstruating can’t hurt - especially since your menstrual cycle might be less predictable in your 40s.
Supplement Recommendations
Fertility supplements can be used to improve the egg quality of women over 40. Taking supplements is a great way to support a healthy diet and ensure overall and fertility health.
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- Fish Oil (Omega 3s): Omega 3 supplementation is a practical and effective way to delay ovarian aging and improve oocyte quality at advanced maternal age.
- Co-Enzyme Q10 (Coq10): Co q10 supplementation can help to combat and reverse the age-related decline in oocyte quality by improving the mitochondrial function.
- Vitamin A: Supplementing vitamin A can help women in their 40s to ensure they have appropriate levels to support healthy egg development.
- Other Vitamins and Nutrients:
- Vitamin E has strong antioxidant effects.
- Zinc and certain B vitamins have been shown to play a pivotal role in DNA synthesis.
- Folate levels are important for oocyte quality, maturation, fertilization, and implantation.
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