Why I talk about food with my patients
Patients often ask me what they can do on their own while they’re trying to conceive or getting ready for treatment. Food is one of the few things that feels completely in your control, and that makes it a powerful place to start. It can also become a source of anxiety and guilt if it turns into a long list of rules.
So here’s my promise: no shame, no fads, and no expensive powders. Just the pattern of eating with the strongest evidence behind it, explained in plain language.
What the research says
The diet with the most consistent support for fertility is a Mediterranean-style pattern. A few studies I come back to often:
- The “fertility diet” from the Nurses’ Health Study II. In a large group of women followed over time, those whose eating leaned toward plant protein, healthy fats, whole grains, and multivitamins, and away from trans fats and sugary foods, had a lower risk of infertility caused by ovulation problems.
- Mediterranean diet and IVF outcomes. A study of women going through IVF found that those under 35 who followed a Mediterranean-style diet more closely had higher pregnancy and live birth rates.
- Dietary patterns and assisted reproduction. Research from the same long-running study group suggests that eating patterns rich in folate, vitamin B12, vitamin D, low-pesticide produce, and seafood are linked to better treatment outcomes.
These studies show associations, not guarantees. Food will not override age or a blocked tube. But eating this way supports your overall health, your metabolism, and a future pregnancy, which makes it a smart bet either way.
Watch on Instagram: Dr. Rasouli on the Mediterranean diet and fertility
What it looks like on a plate
Mediterranean eating is less of a diet and more of a style. Think:
- Plenty of vegetables and fruit, in a variety of colors.
- Legumes like lentils, chickpeas, and beans, a few times a week.
- Whole grains such as oats, farro, quinoa, and whole-wheat bread.
- Olive oil as your main cooking fat.
- Nuts and seeds as snacks or toppings.
- Fish a couple of times a week, choosing lower-mercury options like salmon, sardines, trout, and shrimp.
- Less processed meat, fried food, refined sugar, and sugar-sweetened drinks.
Living in Orange County makes this easier than most places. Farmers markets, fresh seafood, and year-round produce are right here.
A few specifics that matter
Start a prenatal vitamin now
Folic acid helps prevent certain birth defects, and it works best when you start at least a month before conception. A standard prenatal vitamin with 400 to 800 micrograms of folic acid is a good baseline for most people. Some people need more, so check with your doctor.
Coffee is okay, in moderation
Keeping caffeine under about 200 milligrams a day, roughly one 12-ounce coffee, is a reasonable target while trying to conceive and in pregnancy.
Alcohol: less is better
No amount of alcohol is known to be safe in pregnancy. While you’re trying, and especially during treatment cycles, I encourage cutting way back or skipping it.
Avoid high-mercury fish
Skip shark, swordfish, king mackerel, tilefish, and bigeye tuna.
Partners: this applies to you too
Sperm take about three months to develop, so changes made now show up in a future semen analysis. I’ve published research on the connection between obesity, metabolic health, and male infertility. A Mediterranean-style diet, staying active, not smoking, and limiting alcohol all support sperm health. This is a team project.
What I don’t recommend
- Very restrictive diets unless you have a medical reason. Cutting out entire food groups can backfire.
- Under-eating. Not eating enough for your activity level can actually shut down ovulation. I’ve researched this closely in hypothalamic amenorrhea, and it’s far more common than people think. Read more on my exercise and fertility page.
- Pricey “fertility” supplement stacks marketed online. Most have little evidence behind them. Bring the bottle to your visit and we’ll look at it together.
If you have PMOS, food can help with insulin resistance and cycle regularity, and I talk about that on my PMOS and hypothalamic amenorrhea page.
Selected references
- Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstetrics & Gynecology. 2007.
- Karayiannis D, et al. Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility. Human Reproduction. 2018.
- Gaskins AJ, et al. Dietary patterns and outcomes of assisted reproduction. American Journal of Obstetrics & Gynecology. 2019.
- Rasouli M, Dumesic D, Singhal V. Male infertility and obesity. Current Opinion in Endocrinology, Diabetes and Obesity. 2024.
Questions Patients Ask Me
Do I need to go gluten-free or dairy-free to get pregnant?
Not unless you have celiac disease or a true intolerance. There isn’t good evidence that cutting gluten or dairy improves fertility for everyone else, and unnecessary restriction can make it harder to eat enough.
What supplements should I take while trying to conceive?
Start with a prenatal vitamin that includes 400 to 800 micrograms of folic acid. Some people also need vitamin D or iron depending on their bloodwork. For anything else, bring the label to your visit and we’ll decide together whether it’s worth taking.
Is coffee okay when I’m trying to get pregnant?
Yes, in moderation. Keeping caffeine under about 200 milligrams a day, roughly one 12-ounce coffee, is a reasonable goal while trying and during pregnancy.
Does my partner’s diet matter?
Yes. Sperm take about three months to develop, and diet, weight, smoking, and alcohol all affect sperm health. A Mediterranean-style diet is a good choice for both partners.
Can changing my diet fix my PMOS?
Diet can make a real difference in insulin resistance and cycle regularity for many people with PMOS, but it isn’t a cure, and it isn’t the only tool. Many people need medication to ovulate, and that is not a failure of willpower.
Do I need to lose weight before fertility treatment?
Not necessarily. For some people, modest weight change improves ovulation and pregnancy health, but delaying treatment can cost valuable time, especially with age. We’ll weigh those tradeoffs for your situation.