Are you wanting to fall pregnant after recovering from an eating disorder? Know that it is possible!

In this blog, we’ll explore how nutrition can help to support fertility and maintain a healthy relationship with food after recovery and beyond. 

There is a lot of recent research about how nutrition can help to support fertility. Whilst it’s great to have up to date information, this can often mean there is a lot of noise and perfectionistic ideas online about the “best diet” for fertility (hint: there isn’t one). This can be so overwhelming when figuring out what is best for you when trying to conceive (or TTC), especially when recovering from an eating disorder, as it can lead to black and white thinking and following rigid rules that are characteristic of disordered eating. 

Nutrition for fertility doesn’t have to be complicated, and there is no right or wrong way to go about it.  Working with an experienced dietitian can ensure you feel supported throughout your fertility and recovery journey. 

Get Your Period Back On Track

Eating disorders can often lead to amenorrhoea, where the menstrual period is stopped as the body doesn’t have enough energy to support a regular cycle. This disrupts reproductive hormones that are necessary to support conception, and therefore affects fertility. Some strategies to support a regular period include:

• Regular eating

  • Nourishing our body adequately helps our body feel safe and supported and provides the necessary energy for our body systems to work at their best. When there’s enough fuel, our reproductive hormones can function well and signal that the body is ready to conceive. 

• Weight restoration

  • Achieving a healthy body weight for you throughout recovery can help to support reproductive hormones and regain a menstrual period. Fat tissue produces the hormone oestrogen which supports regular ovulation needed for conception. Research also shows that fertility in womxn with a history of anorexia nervosa was unlikely to be affected when weight restoration was achieved1,2. 

• Adequate nutrition

  • Certain nutrients, such as folate, iron, calcium and vitamin D, are required to support processes involved in conception. Deficiencies in these nutrients can impact fertility by halting these processes and delaying conception. Eating a variety of foods rich in these nutrients can ensure that we consume them in adequate amounts to support conception and lead to pregnancy. We’ll explore some of these foods a little later, so keep reading for some meal ideas and tips on how to support your fertility!

Nutrients for Fertility

Conception occurs when an egg (or oocyte) is released from the ovary and travels down the fallopian tube. When it meets with sperm, the egg is fertilised, and cells rapidly divide into a blastocyst. The blastocyst continues to travel down into the uterus, then implants into the uterine lining, where it continues to grow and develop into an embryo and pregnancy occurs. Here’s how certain nutrients are involved in the process, and where you can find them:

Folate

Necessary for early conception and cell growth, supports foetal development and prevents the development of neural tube defects. Found in green leafy vegetables like spinach, citrus fruits like oranges, legumes and beans, and fortified breads and cereals. 

Iron

Helps support ovulation and implantation of the embryo. Iron rich foods include red meats like beef, eggs, fish like tuna and salmon, beans and legumes, dark green vegetables like spinach and broccoli, wholegrains like oats and dried fruit. 

Calcium

Involved in fertilisation and implantation of the egg, leading to pregnancy. Including dairy foods including milk, cheese and yoghurt, almonds with the skin, salmon with bones and tofu. 

Vitamin D

Associated with improved egg quality and has anti-inflammatory properties that can support conception. We can get small amounts of vitamin D from our food; however, the best source is from the sun! Mushrooms, milk, eggs and oily fish like salmon can provide some vitamin D. 

Meal and Snack Ideas to Support Fertility when TTC in Recovery

As we discussed, regular eating and adequate nutrition are key to supporting your fertility journey in ED recovery. Here are some quick and easy meal and snack ideas to help take the guess work out of maintaining regular nutrition!

Breakfast

• Overnight oats with banana and almond butter

• Packed with fibre, micronutrients, antioxidants and unsaturated fats to support hormone regulation and minimise inflammation to promote conception.

• Spinach and cheese omelette with avocado and wholegrain bread

• Spinach is rich in folate and cheese is a great source of calcium; both of which are essential for conception. Eggs contain choline which is also an important nutrient that supports hormone regulation and neural tube closure in early pregnancy. 

• Greek yoghurt parfait with berries, granola and honey

• Full fat dairy provides extra energy necessary for bodily functions and has been shown to support a regular menstrual cycle and fertility outcomes. Berries are also rich in fibre and antioxidants to support fertility. 

Lunch

• Salmon poke bowl with rice, edamame and nori

• Salmon is rich in omega-3 fatty acids that have anti-inflammatory benefits and has also been shown to be protective of brain and mental health. Edamame is a great source of protein, and soy has also been linked to improved fertility outcomes. Nori is rich in iodine to support thyroid function. 

• Chicken and avocado wholegrain wraps

• Wholegrains are rich sources of folate and other B-vitamin essential for energy production, DNA synthesis and conception. Avocado is a source of fibre and unsaturated fat to support optimal hormone functioning. 

• Chickpea and couscous salad with roasted vegetables, pomegranate and olive oil dressing

• Chickpeas are a plant-based protein that also contain essential B-vitamins and iron, whilst the vitamin C in pomegranate helps to increase the amount of iron absorbed from plant sources. 

Dinner

• Prawn pasta with cherry tomatoes, spinach and olive oil

• Prawns and seafood are rich in iodine to support thyroid function. Olive oil has anti-inflammatory properties to support the processes of conception. Spinach is a rich source of folate needed for formation of the neural tube in early pregnancy. 

• Tofu stir-fry with rice, capsicum and mixed greens

• The phytoestrogens in soy can support regular ovulation, menstrual cycle and hormone function. Rice is a source of B-vitamins and essential energy for our body and brain to function at their best. Mixed greens can also provide folate and other antioxidants to support conception. 

• Stuffed capsicum with beef mince and rice

• Beef is a rich source of iron and capsicum is high in vitamin C, which helps to maximise the absorption of iron in the gut. 

Snacks

• Crackers with cottage cheese and berries

• Full fat fairy foods have been shown to be linked to improved ovulatory function and fertility outcomes. 

• Mixed nuts and seeds 

• Sources of fatty acids like Omega-3, protein, and fibre, nuts make a great fertility friendly snack. Seeds are also rich in these nutrients and contain lignans (which are also phytoestrogens) that have been shown to reduce time to pregnancy3. 

• Roasted chickpeas with cumin and paprika

• Chickpeas are a rich source of protein and B-vitamins. Cumin and paprika provide antioxidants and extra flavour!

• Veggie sticks and hummus

• Packed with protein, fibre, fats and micronutrients to support proper functioning of body systems and support fertility. 

Aiming for 3 main meals and 3 snacks spaced about 3 hours apart can help to ensure regular energy, support appetite and hormone regulation and ensure we have plenty of opportunities to meet our nutritional needs when TTC throughout the day!

Cutting Through the Noise - A Personalised Approach to Fertility in Recovery

With so much information at our fingertips, it can be tricky to navigate your TTC journey and know what will work best for you. Social media can be a helpful tool in accessing tips and ideas, however, sometimes this information excess can feel overwhelming and ends up doing more harm than good. Certain messaging may promote an “ideal” way of approaching fertility nutrition or encourage restriction of certain foods and food groups, not to mention the endless marketing of diets and nutritional supplements that aren’t evidenced based and just. don’t. work. 

The saying “comparison is the thief of joy” also applies here, as we can often fall victim to comparing our lives with others we see online. It’s important to remember that social media is usually a highlight reel, and we don’t see what happens behind the scenes. Be kind to yourself, as we all have unique lifestyles, responsibilities and capacities – and we’re all just doing our best! Your TTC journey is unique to you!

Feeling the pressures of “doing it right” can also be unhelpful in recovery, as eating disorder thoughts can latch onto these ideals as a way to maintain control in working towards conception. The added stressors of accessing fertility treatments in your TTC journey can heighten these feelings of perfectionism in trying to do everything in your power to “make it work.”

Working 1:1 with an accredited dietitian can support and guide you through your fertility journey and provide education on what will be best for you. Dietitians will tailor nutrition strategies based on your unique needs, helping you feel confident in nourishing your body whilst maintaining a positive relationship with food and calming food-related anxieties. 

Final Thoughts

If you’re navigating TTC after recovery, remember, you don’t need to aim for perfection – there is no such thing. Consistency, balance and flexibility in food choices can support adequate nutrition for fertility and maintain positive mental health and attitudes towards food. You’re not alone on this journey – we’re here to provide support and guidance, helping you work toward a healthy and fulfilling path to pregnancy!

References:

1. S.H. Shomento, R.E. Kreipe, Menstruation and fertility following anorexia nervosa, Adolescent and Pediatric Gynecology, Volume 7, Issue 3,1994, Pages 142-146, ISSN 0932-8610, https://doi.org/10.1016/S0932-8610(19)80117-2.

2. Chaer R, Nakouzi N, Itani L, Tannir H, Kreidieh D, El Masri D, El Ghoch M. Fertility and Reproduction after Recovery from Anorexia Nervosa: A Systematic Review and Meta-Analysis of Long-Term Follow-Up Studies. Diseases. 2020 Dec 16;8(4):46. doi: 10.3390/diseases8040046. PMID: 33339411; PMCID: PMC7768504.

3. Mumford SL, Sundaram R, Schisterman EF, Sweeney AM, Barr DB, Rybak ME, Maisog JM, Parker DL, Pfeiffer CM, Louis GM. Higher urinary lignan concentrations in women but not men are positively associated with shorter time to pregnancy. J Nutr. 2014 Mar;144(3):352-8. doi: 10.3945/jn.113.184820. Epub 2014 Jan 8. PMID: 24401816; PMCID: PMC3927547.