The Naturopathic View: The Impact of Fish Oils on Fertility - by Judith Fiore (Spring 2010)

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THE IMPACT OF FISH OIL ON FERTILITY
by Judith Fiore, ND
Spring 2010

Whether you love it or hate it, fish is a food that cannot be ignored when it comes to living a healthy lifestyle. It seems that more and more reports from the scientific community are showing how good fish is for us, and medical experts are urging us all to consume more of the omega 3 essential fatty acids found in fish. But what about fertility? Should those of us who are trying to conceive be taking fish oil supplements?    

In my opinion, the answer is a definitive yes. There are a number of health benefits attributed to taking fish oil supplements and increasing the amount of omega-3 fatty acid foods in the daily diet. The main reason that fish oil is touted as being so important for good health is that it has an anti-inflammatory effect. This is because omega-3 fish oils favour metabolic pathways in the body that improve circulation. Better circulation means our cells are better nourished and function better, which helps to prevent inflammatory states in the body that can be linked to chronic illness.1   

The two main types of omega-3 fatty acids in fish oil are Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA). Both are considered essential for the health of all cells as they are required in cell membrane function. Cell membranes are necessary to a number of functions such as the action of cell receptors and therefore hormone binding, cell fluidity, and membrane-bound enzyme activity.2

Another important benefit of EPA and DHA is that they are precursors to eicosanoids. Eicosanoids are hormone-like molecules that act as messengers and mediators for the body’s immune response. When the immune system is activated by infection, injury, or exposure to allergens, the type of eicosanoids produced by the body depends on the ratio of omega-3 to omega-6 fatty acids consumed. If a healthy amount of omega-3 fatty acids are in the diet and subsequently incorporated into cell membranes, then converted into their corresponding eicosanoids, these eicosanoids direct an anti-inflammatory response.3 Omega-6 fatty acids eventually convert to prostaglandins, the type of eicosanoids that result in an inflammatory response.4

While omega-3 fatty acids are also converted to prostaglandins, the prostaglandins formed from omega-3 fatty acids are generally two to fifty times less active than those formed from the omega-6 fatty acids.5 When a prostaglandin is less active, there is less inflammation. Prostaglandins are synthesized in the cell from both omega-3 and omega-6 fatty acids and they act upon many cells in the body.

It must be pointed out that an inflammatory response is not necessarily a bad thing. We need a balance of pro- and anti-inflammatory responses for good health and fertility. An example of an inflammatory action in the body is when a woman ovulates. Pro-inflammatory prostaglandins are necessary to allow the egg to rupture from an ovarian follicle during ovulation. If prostaglandins are inhibited, as they can be when a woman is using aspirin and other NSAIDs (non-steroidal anti-inflammatory drugs), then ovulation of a mature egg may be delayed or not occur at all.6, 7, 8

Research into the effect of fish oil on human fertility has been scant. We know that fish consumption is championed by organizations such as the American Heart Association and the World Health Organization, among many others, but in recent years there has been some interest from the scientific community in the relationship between omega-3 fatty acids and improved fertility for both women and men. One study on fish oil and other omega-3 fatty acid food sources (pumpkin seeds, walnuts, chia seeds, flaxseeds) showed improved circulation to the uterus and appeared to increase pregnancy rates for women dealing with infertility.9  

Another possible use of fish oil supplementation is for male factor problems. A study of 150 men found that infertile males had lower levels of omega-3 fatty acids in their sperm, and it was also found that the ratio of omega-6 to omega-3 was higher. It is being suggested that more research should be done to see if omega-3 fatty acid supplementation would help improve male fertility.10

There have been many published studies on the benefits of fish oil supplementation during pregnancy. Fish oil has been shown to reduce the incidence of pre-eclampsia, improve fetal growth, provide EPA and DHA needed for proper fetal brain and spinal cord development during pregnancy, and lengthen pregnancy duration in high-risk patients.11, 12, 13, 14 If fish oil has such benefits during pregnancy, then it seems reasonable to investigate whether it would help in the earlier stage of reproduction – whether it could improve fertility.

There is a strong interest in fish oil supplementation for animal fertility. Currently there is a two-year study under way, funded by the U.S. Department of Agriculture, to see if fish oil improves fertility in cattle. It is believed that this study may have implications for human fertility treatment if the results are favourable.  

In the meantime, while we wait for more studies to be conducted, it is probably a good idea to supplement with fish oil. The results of research into omega-3 fatty acids’ improving cardiovascular health, digestive health, skin health, diabetes, and many other conditions have been overwhelmingly positive. One study found that Canadian women were not taking in enough omega-3 fatty acids during pregnancy,15 and if pregnant women are not getting the recommended amount of omega-3s, it is likely that their diets are not high enough in omega-3 fatty acids before pregnancy.  

However, with the knowledge that fish can also contain mercury and other contaminants, many of us are afraid to tuck into that plate of grilled salmon more than once per week. Most of us are aware of Health Canada’s recommendation that pregnant women avoid fish species known to be higher in mercury. Understandably, couples that are trying to conceive are especially wary of eating fish more frequently, in case there could be a deleterious effect on their fertility. Yet the indication from health experts is that fish is very healthy for us, and the best source of the much-needed DHA and EPA omega-3 fatty acids. It seems to be a case of “damned if you do, and damned if you don’t.”

The best option? Take a daily fish oil supplement that has been molecularly distilled. Molecular distillation is a process whereby PCB’s and heavy metals such as mercury are removed, as well as other potentially harmful chemicals that may have leached into the fish, and therefore the oil. When you go to your health food store, ask for fish oil supplements that have undergone this process. Ideally you will be shown fish oils that have also been third party tested to ensure quality and safety. One thing you will notice is that the fish oils that have been molecularly distilled cost more than fish oils that have only undergone filtration. Filtering fish oil is a cheap shortcut that does nothing to remove mercury and PCBs, and therefore you should not buy it. Spend the extra money to get a good quality fish oil product. It is worth it. You are worth it.

As far as the amount of fish oil to take, it is best to consult with a naturopathic doctor or nutritionist. While side effects from taking fish oil are unusual, you must still exercise caution, especially if you have a health condition that affects your circulation. For example, if you are currently taking a blood thinning medication, then you may be advised to not take a fish oil supplement. If you are scheduled for surgery, then you should avoid taking fish oil before your procedure. It is always a good idea to consult with a health practitioner who is knowledgeable about fish oil supplements and how to use them safely.

The Final Word

It is a good idea for both men and women to take fish oil supplements as part of a healthy lifestyle and, hopefully to improve fertility. We live in a fast-paced, stressful world that shows no sign of slowing down. Chronic exposure to stress can have profound physiological effects, including reduced blood flow to reproductive organs. While it won’t reduce the causes of stress you face in your daily life, fish oil supplementation appears to increase circulation to the uterus. I suspect it would also increase circulation to the male reproductive system. With better circulation comes the possibility of better fertility. And that, dear readers, is a very good thing.


Judith Fiore, ND, a registered naturopathic doctor in the province of Ontario, owns and operates the Naturopathic Fertility Centre, located in downtown Toronto. Her practice is entirely dedicated to providing naturopathic treatments including nutritional consults and acupuncture to individuals and couples with fertility concerns. She can be reached at 416-231-4477, or through her website at www.naturalfertility.ca


References

1.    Simopoulos, A. P.  Omega-3 Fatty Acids in Inflammation and Autoimmune Diseases. Journal of the American College of Nutrition, Vol. 21, No. 6, 495-505 (2002)
2.    Lerman, R. Essential Fatty Acids. Integrative Medicine. 2006;5:34-44
3.    Simopoulos, A.P. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomedicine & Pharmacotherapy Volume 56, Issue 8, October 2002
4.    James, M. J., Gibson, R.A., Cleland, L. G. Dietary polyunsaturated fatty acids and inflammatory mediator production. American Journal of Clinical Nutrition. 2000;71 (1 Suppl): 343S-348S
5.    Smith, W. L.  Anti-Inflammatory Effects of Omega-3 Fatty Acids in Fish Oil Linked to Lowering of Prostaglandin. Presentation of findings at Experimental Biology 2006, April 4th.
6.    Bata, M.S., Al-Ramahi, M., Salhab, A.S., Gharaibeh, M.N., Schwartz, J. Delay of ovulation by meloxicam in healthy cycling volunteers: A placebo-controlled, double-blind, crossover study.  ournal of Clinical Pharmacology. 2006 Aug;46(8):925-32.
7.    Gaytan, M., Morales, C., Bellido, C., Sanchez-Criado, J. E., Gaytan, F. Non-steroidal anti-inflammatory drugs (NSAIDs) and ovulation: lessons from morphology. History and Histopathology. Volume 21, no. 5 (2006 May): 541-56.
8.    Smith, G., Roberts, R., Hall, C., Nuki, G. Reversible ovulatory failure associated with the development of luteinized unruptured follicles in women with inflammatory arthritis taking non-steroidal anti-inflammatory drugs. British Journal of Rheumatology. 35:5, 458-62, May, 1996.
9.    Saldeen, P., Saldeen, T.  Women and omega-3 fatty acids. Omega-3 fatty acids can facilitate pregnancy in women with infertility problems by increasing uterine blood flow. Obstetrical & Gynecological Survey. 2004, Volume 59, no. 10.
10.    Safarinejad, M. R., Hosseini, S. Y., Dadkhah, F., Asgari, M. A.  Relationship of omega-3 and omega-6 fatty acids with semen characteristics, and anti-oxidant status of seminal plasma: A comparison between fertile and infertile men. Clinical Nutrition. 2009; Volume 10; 1016.
11.    Williams, M. A., Zingheim, R. W., King, I. B., Zebelman, A. M. Omega-3 fatty acids in maternal erythrocytes and risk of pre-eclampsia. Epidemiology. 1995;6(3);232-237.
12.    Haggarty, P. Placental regulation of fatty acid delivery and its effect on fetal growth – review.  Placenta. 2002;23(Suppl A):S28.
13.    Lauritzen, L., Hansen, H.S., Jorgensen, M. H., Michaelsen, K. F. The essentiality of long chain n-3 fatty acids in relation to development and function of brain and retina.  Progr Lipid Res. 2001;40:1.
14.    Olsen, S. F., Sorensen, J. D., Secher, N. J. et al. Randomised controlled trial of effect of fish oil supplementation on pregnancy duration. Lancet. 1992;339:1003-1007.
15.    Denomme, J., Stark, K. D., Holub, B. J. Directly quantitated dietary (n-3) fatty acid intakes of pregnant Canadian women are lower than current dietary recommendations. Journal of Nutrition. 2005;135:206-211.