I’m interested in information about and advice for patients with low AMH levels. I’m 33 with no other fertility issue (after extensive testing). My husband’s tests were normal too. 

• It’s important to check you are comparing your AMH results with your age range and percentile
• What cycle day was tested? Ideally it would be on cycle day 2 or 3 (you would have your period)
• Nutrition, stress and environmental factors can all reduce AMH, so if concerned I would touch base with us for a full assessment of what contributing factor may apply for you. 
• An AMH less than 4 is significantly less likely to conceive both naturally and ART BUT it just takes one quality egg for a baby. There is always hope. 
• Your doctor can use your AMH result as a guide to dose IVF protocol 

Gluten and dairy intolerance. How best to still achieve nutrient goals?

• There are plenty of dairy and gluten free options. Keep in mind that calcium (usually found in dairy) is a really important mineral for successful conception and wholegrains are important for maintaining a healthy uterine lining for a successful implantation. These are the gluten and dairy free options you may want to consider:
  • Calcium rich foods include blackstrap molasses, soymilk (calcium fortified), tofu, tempeh, turnip or collard greens, cooked kale, dried figs, tahini and sesame seeds, nuts and seeds 
  • Wholegrains - quinoa, buckwheat, brown rice, basmati, as well as starchy vegetables such as pumpkin, beetroot, sweet potato etc  

Do you have Trimester specific nutrition info?

 
• We’ve dedicated an entire course to this – Nutrition for Pregnancy -  if you’d like to follow on from our Preconception Fertility course!  

What if I am vegan? Do the recommendations change?

• We'd run lab tests with you first to establish nutritional status then supplement with this info - most common nutrient gaps in vegan diet include:
  • Vitamin D
  • Iodine
  • Vitamin B12 
  • Iron

Do you have an option for 1:1 with either Jacq or Brit?

• Absolutely - sign up for the Nutrition Preconception and Fertility VIP package and you’ll receive 1:1 sessions with both with options for add ons

I am 26 and considering cryopreservation - should I be following a fertility specific diet?

• You can be following the same dietary guidelines we provide for you in Nutrition for Preconception and Fertility  - whilst you’re not ready to fall pregnant our guidelines will provide optimal food and nutrients for supporting both healthy ovulation and boosting egg quality ready for when you decide to do an egg retrieval and cryopreservation
• We generally say to our clients that if you’re even just starting to “think” about it all then it’s worth making changes to improve your health TODAY

• ​​Depending on age and egg quality, a frozen egg has ~5-8 % chance of becoming a baby
• Number of frozen eggs required for a 75% chance of single live birth:
• 34yo needs 10 eggs
• 37yo needs 20 eggs
• 42yo needs 61 eggs

I have the MTHFR gene, can I still take folic acid? 

• It’s important we work 1:1 with you if you have the MTHFR gene, then we can tailor dose based on your needs because it’s definitely not a one size fits all approach. 
• We test serum folate to ensure adequate and homocysteine to see how you are “methylating” and converting your folates
• Our VIP package for Nutrition for Preconception and Fertility will give us the opportunity to work with you like this
• The Short answer is yes - take 400 mcg daily

When do I need to give up alcohol? 

• The best drink you can have for fertility is water - even though this sounds so boring! Remember that water also supports production of cervical fluid 
• Consider that whilst you don’t have to give it up completely whilst #ttc - you can have a drink to toast etc every now and then - you don’t want to risk early stages of pregnancy and alcohol 

I’ve had two miscarriages, do you have any advice? 

• We're so sorry to hear this... there is a lot you can do once you investigate further.
• Consider preconception genetic carrier screening. It now widely available and has a medicare rebate. 
• Check your thyroid function
• Look at Pink Elephant for some support resources 
• 3 piece of fruit daily - fruit lowers a hormone called androstenedione which has been linked to higher rates of miscarriage

I have an under active thyroid, can this impact fertility 

• Yes, low thyroid function impairs ovulation
• Low thyroid in pregnancy can contribute to miscarriage, intellectual impairment in baby and preterm labour. 

We are thinking of trying IVF, are there any steps we should take first? 

• Egg and sperm quality matter and improving the quality can increase your odds 
• Preconception care and good nutrition will set you up for the best success - which is why we've poured all the knowledge and resources we have into Nutrition for Preconception and Fertility

How many coffees a day is ok?

• 1 is ok during preconception and up to 200mg during pregnancy. 
• Excess caffeine can delay time to conception
• Remember that caffeine / polyphenols can block absorption of iron and deplete important micronutrients required for conception and pregnancy so limiting or eliminating caffeine intake during preconception is optimal

I am in the UK so any broader tips on things to buy would be amazing and I also have a high prolactin level and low amh so anything we can do to bolster those would be amazing

• Prolactin suppresses oestrogen and LH (luteinizing hormone), which is essential to trigger ovulation. 
• Elevated prolactin levels definitely need further investigation, we can work with you on this in Nutrition for Preconception and Fertility in our VIP course package. 
• All our supplements are available to shipped worldwide and we often liaise with international Drs so there is no issue with you being based overseas. 

I’ve been told I have clomid resistance, is there anything I can do to help? 

• Resistance means failure for clomid to stimulate ovulation
• Success is dependant on on endogenous (what you make) oestrogen levels 
• CoQ10 in women with PCOS has been shown to improve ovulation and clinical pregnancy rates and may help to overcome clomid resistance 

Do you have any advice for someone who has struggled massively with getting good gut bacteria and their microbiome to be half decent levels. Due to stress levels and way too many antibiotics as a kid for middle ear infections.

• We'd be curious to know what your gut symptoms are and if you have had any microbiome testing done. 
• The best thing you can do to feed your microbiome and let the good bugs thrive is to eat 30 different plant foods every week. Think legumes, beans, nuts, seeds, wholegrains, fruit and vegetables. 
• The vaginal microbiome plays a critical role in fertility, so I’d be making sure it's also in balance along with the gut microbiome.  

Do you have any tips for people with MANY allergies to food and non food?

• We'd be keen to see if your food allergies are “true” food allergies, meaning they at IgE mediated or if they are more food intolerances. 
• Allergies to non food items - assuming hayfever type or environmental allergies? 
• Immune support may help but Nutrition for Preconception and Fertility has many options for people with dietary requirements. 

Are ‘tinned’ legumes ok?

• Tinned legumes are ok but always buy BPA free tins which are labelled 
• If using dried, ensure you rinse and soak overnight to reduce anti-nutrients (phytates) which can block absorption of other nutrients important for fertility - e.g. iron, zinc

Specific nutrition requirements during the TWW? (two week wait)

• Oats - higher success with implantation in IVF and endometrial thickening 
• Vitamin c rich foods such as kiwi and strawberries 
• Salmon for omega 3 and anti inflammatory benefits 
• Dark leafy greens - folate 
• Beetroot - nitrates 
• Garlic and Ginger to help with blood flow to the uterus.  

Which brands of shampoos/conditioners do you recommend? Ones that still keep your hair nice!

• Andalou naturals 
• Mukti 
• Check out Nourished Life online store for a great range of products - skin, hair and body all natural and nasty free (not affiliated, just a great store with plenty of natural products to choose from)

How about oestrogen and testosterone levels in females? How does that impact fertility

• It is all about balance. 
• Too little oestrogen, ovulation is disrupted, eggs are immature and the uterine lining can be quite thin
• Too much oestrogen, implantation can be impaired 
• Too high androgens (including testosterone), can affect egg quality and is usually associated with conditions like PCOS. 
• Too little androgens can affect fertility and reduce libido. 
• It is normal to see a decline in oestrogen and androgen levels with age. 

Any dietary recommendations for incorporating healthy fats post gall bladder removal. I have difficulty tolerating fat post surgery.

• You should have been recommended a digestive enzyme or bile salt replacement after surgery. This will help you digest fat better. 

What nutritional tips do you have if you've experienced an early miscarriage (less than 8 weeks). Eg, specific foods you should eat to prepare your body for the next cycle

• We are so sorry that you experienced this.
• Early miscarriage before 8 weeks are usually due to chromosomal abnormalities. 
• BUT we would recommend having some more investigative bloods done- preconception genetic carrier screening and thyroid function to start. You may also want to screen for blood clotting disorders if this is your first pregnancy. 
• Keep taking your prenatal, and ensure all your nutrient levels are good. 
• 3 pieces of fruit daily - fruit lowers a hormone called androstenedione which has been linked to higher rates of miscarriage. 

Do you know if diet or other lifestyle factors could be the cause of bleeding during pregnancy? No visible cause of bleeding found under ultrasound, and baby is tracking along ok (18 weeks), but experiencing bleeding on average every 4 weeks.  IVF pregnancy.

• Recommend a vaginal swab or a pH test to check for bacterial vaginosis. 
• But there could be lots of causes, best speak to your doctor. 

I have been vegetarian for a decade and my husband is now asking for me to start eating meat while we are trying to conceive, which I am struggling to adjust to. what is an acceptable balance between meat and plant based foods.

• I would only start eating meat if you are struggling to meet your protein, iron and B12 requirements through plant based foods alone. You'll need blood tests to confirm some of these.
• In terms of research on animal protein and female fertility, you are much better off having plant proteins (like legumes and beans) and low mercury seafood. Animal proteins are higher in saturated fat and when cooked at high temperatures produce oxidative compounds known as AGEs (advanced glycation end products) which can impact egg quality and sperm quality. 

I’m in my mid thirties and considering having a baby on my own. Are there anything extra tips I need to know to help with my fertility knowing that I will be using a sperm donor?

• We supported lots of women in 2022 in becoming mothers via sperm donation. 
• Focus on your overall health and egg quality. 
• We recommend preconception care 3 months prior and would also consider some of the advanced fertility supplements we briefly discussed in the masterclass. With IVF and donor sperm, you want to make sure those eggs fertilise and go on to make good quality embryos. Your egg quality is the one thing you can work on prior to help with this.