Fertility and Nutritional Wellbeing

Dr Navdeep Singh Pannu and Dr Arifah Binti Mohd Amin share their professional medical insights.

Couples who undergo fertility treatments face physical and psychological demands that can be disconcerting and unsettling. Worse still, societal prejudices can make infertility, as prevalent as it is, the loneliest club to belong to.  In this casual conversation, Dr Navdeep Singh Pannu, Medical Director of TMC Fertility and Womens Specialist Centre and Dr Arifah Binti Mohd Amin, Obstetrician and Gynaecologist (with special interest in Nutritional and Integrative Medicine)  share their extensive experience and lend their professional insights into how good nutrition forms the building blocks that positively impacts ones journey towards building a family.

 Q: Having a baby is a celebrated experience for a couple. Do share an indelible moment or experience close to your heart.

Dr Navdeep:

In February this year, I handed a 52-year old patient her first child. It was hard to tell at that very moment, who was more excited.  After having journeyed with a couple through fertility treatments, it is a defining moment of joy when we see a ‘+’ sign, and when I am able to hand the baby over to its parents.  It is important to note that prior to the joy of holding your baby, the journey towards having a baby can sometimes be tumultuous. To me, it is important that I am with my patients every step of the way, and this is what keeps me coming back day after day.

Dr Arifah:

I have lost count of the number of patients I have had who experienced emotional instability caused by the process of having a baby. Some come in for postnatal check-ups feeling depressed, dispirited and dejected. I was desperate to help them, and this was a key reason why I furthered my knowledge in nutrition. I am convinced, now more than ever, that proper nutrition is essential to fertility and a healthy motherhood.  This is a great motivation to me.  Being able to help my patients be healthy gives me a sense of joy and purpose.

Q: We know that there is a rise in the cases of infertility. Is infertility a growing concern?

Dr Navdeep:

Yes, there is concern that infertility is becoming prevalent. Whilst the causes for infertility is unexplained, my personal experience indicates that our state of health plays a big part in the bigger picture. We have to pay more attention to inculcating a healthy lifestyle in our children from the time they are babies. Poor nutritional choices and unhealthy habits may compromise fertility and our chances of building a family.

Dr Arifah:

As a working woman, I know the demands and stresses of a career.  I am also aware that infertility can be caused by both or either partner. However, I want women to know that the choice we make to focus solely on our careers can chip away at our fertility window. The fixation on getting the house in order can give rise to overwhelming financial demands and upstage plans to start and raise a family. These are very real and present issues and many households face them.

Q: In your opinion, what are some of the misconceptions that surround infertility?

Dr Navdeep:

I have come across many but the one that stands out the most is ‘it is always the woman’s fault’.  To me, this is very concerning. Sometimes the husband is so confident that it is so, he does not even come in for an evaluation. I have treated cases that would beg to differ. Whilst the causes of infertility can sometimes be unexplained, in most cases both parties share the odds that the problem is due to either one of them.  There are also instances when the source of the problem could be attributed to both partners.

Dr Arifah:

In my opinion, our belief structures and customs can be a proponent of myths. Amongst those that I have come across are that some fruits are ‘hot’ and some are ‘cold’. Watermelons, for instance must be avoided as they are deemed to make the womb cold. Others are inspired by astronomy, such as whether it is a half or full moon. As the term itself suggests, the efficacy of myths is difficult to prove scientifically.

Q: In your experience, what are the primary causes of infertility?

Dr Navdeep:

For men, it is normally a low sperm count. Unhealthy lifestyle choices such as smoking, vaping and alcohol consumption as well as excessive body weight can also have negative effects on fertility. Infertility in a woman can be caused by Polycystic Ovarian Syndrome (PCOS), irregular period cycles, endometriosis and pre-existing medical issues amongst others. These conditions are treatable either with medication or lifestyle tweaks.

Dr Arifah:

Predisposing medical conditions such as obesity, diabetes and hypertension are some of the known causes. Oxidative stress is another concern where there is an imbalance between free radicals and antioxidants in the body. Similar to those mentioned by Dr Navdeep, these conditions too can be relieved by a conscious decision to observe a healthier diet and lifestyle.

Q: What is the one thing that couples take for granted when trying to get pregnant?

Dr Navdeep:

Couples sometimes think that getting pregnant is a ‘given thing’ in a marriage. I would like to encourage couples to consider undergoing Pre-Conception Consultation even before you decide to have a baby. This consultation can be done with and by their family doctor and it ascertains your state of health. Anomalies if any, can be duly detected and measures to deal with the condition put on track. Don’t wait until you decide to have a baby to get checked as lifestyle alterations could take some time before any effect is noticed.

Dr Arifah:

Every individual should make it a habit to attend annual health check-ups. I wish this fact could be emphasised right from school, in fact, better still, integrated into the education curriculum. Also, we should be open to visiting a dietician or a nutritionist to obtain the necessary health information and advice. Simple supplements such as folic acid and iron pills can go a long way.

Q: What role does nutrition play in affecting fertility?

Dr Navdeep:

A big one! Couples should prepare for pregnancy at least three months before getting pregnant. Some actions, such as quitting smoking, reaching a healthy weight or adjusting medicines you are using, should start even earlier. Women should also take daily doses of folic acid as prescribed by your doctor and any pre-existing conditions such as asthma, diabetes, oral health and obesity must be controlled.

Dr Arifah:

In my opinion, the mind can empower and fuel a change of mindset. Individuals need to understand the importance of observing a healthy lifestyle, and this must continue through their married life. Simple things like enough and proper sleep, adequate exercise and vitamin D are important for fertility.

Q: Fertility treatments can be daunting. Can nutrition play a role in helping couples tackle this process?

Dr Navdeep:

The most common fertility drug side effects are bloating, headache, breast tenderness, upset stomach, hot flashes and mood swings. This, in addition to the demands of when the drug and procedures should be administered, weigh heavily on one’s physical and psychological state. It is important that couples support each other through this period alongside observing a healthy lifestyle and diet, in addition to taking vitamins such as A, C and E as well as Zinc and Selenium.

Dr Arifah:

It is important to observe a well-balanced diet that include foods rich in antioxidants alongside reducing excessive carbohydrates and sugar. Feel free to discuss with your doctor about working out options that are suitable to your preferred dietary needs. It is also important that you manage your stress levels during this period, and that too can be discussed with your doctor who may have remedy options that you can consider. You will receive all sorts of well-intended advice but at the end of the day, this is your moment, so do something that you enjoy and feel comfortable with.

Q: What can couples do to have a healthy pregnancy?

Dr Navdeep:

I cannot emphasise this enough, but a healthy pregnancy begins with a healthy lifestyle, and this lifestyle must begin way before any thought of childbearing could be considered. Pregnancy can also be a time of confusing and conflicting emotions. For couples who conceive with the help of fertility treatments, you may also experience worry and insecurity. It is important that you share these feelings with each other, and to be reassured that you can discuss any issues with your doctor if you feel the need to do so.

Dr Arifah:

In achieving a healthy pregnancy, discipline is key. As a couple, arrange for a health check-up to ascertain your state of health. In doing so, medical ailments such as diabetes, prediabetes, hypertension, thyroid disorders or autoimmune disease can be detected and a plan to manage it put on track. Stay away from processed and refined foods and ensure that you consume a wholesome diet. You could seek assistance from a dietician or a nutritionist to help you through this process. Adequate sleep is important. Equally important is the time at which you go to bed so that you can get into a state of ‘deep sleep’. Deep sleep facilitates, amongst others, the secretion of hormones that are critical to your body functions. As this occurs typically between 10 pm – 4 am, you should be in a deep sleep by 10.30 pm.  It is also important for couples to take care of your emotional health. Activities such as prayers, meditation and yoga are beneficial in helping individuals balance the needs of the mind, body and soul. Building a family should be an exciting and enriching experience. Stay positive and surround yourself with company that can help you stay upbeat and optimistic.

You are sure to have many questions. In addressing infertility, the sooner you have them answered, the better. Do list them down and call 03-8076 7111 (TMC Fertility & Women’s Specialist Centre, Puchong) or 03-62871209 (Thomson Hospital, Kota Damansara) or email ask@drnavdeepfertility.com to make an appointment to consult with Dr Navdeep.