By: Milena Mastroianni

As a fertility nutritionist, one of the first questions I get asked by clients is “What is the best preconception diet? I searched the internet a lot and there seem to be so many different foods that are good for fertility…”

It’s no surprise that there is so much information out there when it comes to pre-conception foods, as well as many myths surrounding individual foods which are supposedly helpful…pineapple anyone?

When it comes to choosing the best diet for fertility while you are trying to conceive, personalized nutrition can be very powerful at maximizing general health and chances of conception for a couple. However, there is no doubt that one particular way of eating has been proven time and time again to be beneficial in relation to fertility. This way of eating is often referred to as the Mediterranean diet

A quick search in PubMed, the Google engine of scientific literature, will return many research studies associating the Mediterranean diet with positive fertility outcomes as well as improved sperm markers. Most studies are done in the context of Assisted Reproduction Techniques (ART) because that’s when it’s easier to look at the results objectively. In summary, their conclusions find a Mediterranean style of eating is associated with higher clinical pregnancy and live birth rate (1), better sperm concentration, total sperm count and sperm motility markers in men (2, 3).

The Mediterranean diet is also used as an example for its therapeutic role in studies on PCOS (Polycystic Ovarian Syndrome) showing that its anti-inflammatory and low glycaemic properties can support both weight management and ovulation. 

What is the Mediterranean Diet?

It can be difficult or even confusing to pinpoint what makes the Mediterranean diet so special when it comes to fertility. In fact, many of the research studies make use of adherence scores to the Mediterranean diet, which means there can be a wide variety of foods that can be considered “Mediterranean” but in fact are not as beneficial as we think.

Eating a Mediterranean diet can be confused with having the permission to eat lots of pasta, pizza and bread, which may have the opposite effect as these can still be highly processed foods. The reality is that the Mediterranean diet is not a diet per se - it’s more a pattern of eating followed in various Mediterranean countries. The diet focuses on eating the following:

  • High amounts of seasonal fruit and vegetables, providing an array of antioxidants and plant compounds called polyphenols which are fundamental to optimal gut health and immune balance for both men and women (4, 5), as well as combating oxidative stress for sperm health (6).
  • Plenty of whole grains and legumes, which, together with green leafy vegetables, are high sources of folate, known for being beneficial not only for fertility but also for the prevention of neural tube defects.
  • Plenty of different sources of low inflammatory and good quality sources proteins such as poultry, seafood, legumes, moderate amounts of dairy, and occasional red meat.
  • Plenty of oily fish and shellfish (7), which are high sources of omega 3 fatty acids known for their anti-inflammatory properties, also proven to help with ovulation, healthy progesterone production and embryo development (8).
  • Low consumption of processed foods, sugary beverages, alcohol and saturated fats or trans fats.
  • Plenty of Extra Virgin olive oil and a variety of nuts and seeds which again contain many anti-oxidants, promote good gut health and whose anti-inflammatory properties have been shown to improve sperm quality markers (9).

Last but not least, food is enjoyed in the context of family meals and community. Meals are considered a synergistic source of nutrients, vitamins and minerals, which are always of superior efficacy than individual nutrients consumed in supplemental form.

The Mediterranean Lifestyle

As a final note, another great example that the Mediterranean countries can provide, apart from their diet, is that they show us that lifestyle adjustments are important too. In fact, some of the research studies showed a lower impact of the Mediterranean pattern of eating when the age of the female partner was above 35 years of age and when other factors such as smoking, exercise, BMI, daily food intake were taken into account (10).

This goes to show that when it comes to health and fertility, a 365-degree approach which includes food but also lifestyle, community, movement, stress management and sleep is fundamental to optimal fertility, as well as general good health and longevity. 

The Author

Milena Mastroianni is a BANT UK Registered Nutritional Therapist working with women and couples on their fertility journey. As she also started her family way past the age of 35, her mission is to support her clients move away from worrying about the clock ticking and rediscover the healing, nurturing and regenerative power that real food has on fertility. Milena offers personalized diet and lifestyle advice using a Functional Medicine Approach through 1:1 online consultation packages. She is one of the practitioners of the Fertility Nutrition Centre founded by Sandra Greenbanks, and you can get in touch with Milena here to request a free 30 mins discovery call.




  1. Karayiannis, D., Kontogianni, M.D., Mendorou, C., Mastrominas, M. and Yiannakouris, N., 2018. Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility. Human Reproduction33(3), pp.494-502.
  2. Karayiannis, D., Kontogianni, M.D., Mendorou, C., Douka, L., Mastrominas, M. and Yiannakouris, N., 2017. Association between adherence to the Mediterranean diet and semen quality parameters in male partners of couples attempting fertility. Human reproduction32(1), pp.215-222.
  3. Ricci, E., Bravi, F., Noli, S., Ferrari, S., De Cosmi, V., La Vecchia, I., Cavadini, M., La Vecchia, C. and Parazzini, F., 2019. Mediterranean diet and the risk of poor semen quality: cross‐sectional analysis of men referring to an Italian Fertility Clinic. Andrology7(2), pp.156-162.
  4. Silva, M.S. and Giacobini, P., 2019. Don’t Trust Your Gut: When Gut Microbiota Disrupt Fertility. Cell metabolism30(4), pp.616-618.
  5. Qi, X., Yun, C., Sun, L., Xia, J., Wu, Q., Wang, Y., Wang, L., Zhang, Y., Liang, X., Wang, L. and Gonzalez, F.J., 2019. Gut microbiota–bile acid–interleukin-22 axis orchestrates polycystic ovary syndrome. Nature medicine25(8), pp.1225-1233.
  6. Majzoub, A. and Agarwal, A., 2018. Systematic review of antioxidant types and doses in male infertility: benefits on semen parameters, advanced sperm function, assisted reproduction and live-birth rate. Arab journal of urology16(1), pp.113-124.
  7. Majzoub, A. and Agarwal, A., 2018. Systematic review of antioxidant types and doses in male infertility: benefits on semen parameters, advanced sperm function, assisted reproduction and live-birth rate. Arab journal of urology16(1), pp.113-124.
  8. Kermack, A.J., Calder, P.C., Houghton, F.D., Godfrey, K.M. and Macklon, N.S., 2014. A randomised controlled trial of a preconceptional dietary intervention in women undergoing IVF treatment (PREPARE trial). BMC women's health14(1), p.130.
  9. Salas-Huetos, A., Moraleda, R., Giardina, S., Anton, E., Blanco, J., Salas-Salvadó, J. and Bulló, M., 2018. Effect of nut consumption on semen quality and functionality in healthy men consuming a Western-style diet: a randomized controlled trial. The American journal of clinical nutrition108(5), pp.953-962.
  10. Ricci, E., Bravi, F., Noli, S., Somigliana, E., Cipriani, S., Castiglioni, M., Chiaffarino, F., Vignali, M., Gallotti, B. and Parazzini, F., 2019. Mediterranean diet and outcomes of assisted reproduction: an Italian cohort study. American journal of obstetrics and gynecology221(6), pp.627-e1