Feb 12, 2018

Part 4 of our 4-Part Series on Preconception


Jane, a 35-year-old woman, with no prior pregnancies, comes into the clinic hoping to get pregnant. She knows that she is approaching the age where there are increased risks of trisomies and other genetic abnormalities; thus, she would like to increase her chances of a healthy pregnancy and baby. Jane is a kindergarten teacher, modestly overweight (BMI=28), and eats a standard American diet. She describes her stress as moderate and doesn’t have any formal exercise, although she notes that she spends her day chasing 6-year-olds. She and her husband, Nick, have been trying to conceive for 2 months. Neither partner has been evaluated for infertility, as there has been no need to-date.

Recommendations for Jane (and her husband)

Mediterranean Diet: Jane and Nick were provided a handout and 20 minutes of dietary counseling on the Mediterranean diet, including a 1-week, plant-strong meal plan. This meal plan provided meals focused around plant-based proteins (beans, lentils, legumes, quinoa) plus healthy fish, and limited intake of sugars, meats, and animal proteins. The discussion also included the importance of organic food, clean water, and avoidance of xenoestrogens and, specifically, bisphenol-A (BPA).

Exercise: Each partner was instructed to get a minimum of 2 hours per week of exercise, plus a minimum of 20 minutes of walking daily. They loved this instruction and discussed that they would do after-dinner walks together.

Supplementation (Jane): Jane was prescribed a prenatal multivitamin (containing 800 µg methylfolate, 25 mg zinc, 15 mg iron, and 400 IU vitamin D) and fish oil (2000 mg of EPA + DHA daily; fish oil also contained 2000 IU of vitamin D). Due to her “advanced age,” she was also encouraged to include an extra boost of colorful fruits and veggies daily. She chose to do this through a reds/greens functional food powder that also contained turmeric root.

Supplementation (Nick): Nick was prescribed a high-quality multivitamin containing 1000 IU vitamin D, 25 mg zinc, 200 µg selenium, and 50 mg CoQ10, as well as fish oil (2000 mg EPA + DHA).

The couple was counseled on cycle-charting and fertility signs, and optimal time to attempt conception, and were encouraged to stay on this plan for 3-4 months prior to returning to the office.


After 3 cycles, Jane scheduled a follow-up visit to share the news that they were pregnant, also to discuss her changing nutritional needs… and address nausea.

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