Infertility, most of the time, is defined by a woman who unable to get pregnant after a year. Even if a woman is unable to get pregnant, in about 35% of couples struggling with infertility, males may be the cause as well. Because the ketogenic diet has helped with weight loss and controlling insulin levels, many couples have also decided to try the diet to enhance their fertility chances. The ketogenic diet is a high-fat, low carb diet that not only helps people lose weight but improves a person’s energy and reduces body inflammation, to name a few of its countless benefits. Research continues to show that a low carb, high-fat diet can help people combat being overweight. It can also help women who have PCOS, which may also include healing hormones. Keep reading to learn more about the ketogenic diet and how it may help with fertility related issues.

Perfect we dive into how the keto diet may help with infertility, let’s learn a little bit more about how obesity and fertility relate to one another from Perfect Keto.

Obesity is another common cause of infertility in women. Research shows that women who are overweight or obese tend to struggle with menstruation and ovulation issues, conception rates, miscarriages and other pregnancy complications.

Several studies found that the risk of infertility is 3x higher in obese women than in non-obese women and one study found that a larger portion of women who are seeking medical help to get pregnant are obese.

Because the ketogenic diet is very beneficial for weight loss and controlling insulin levels, it has become extremely popular as an effective tool to enhance fertility outcomes.

Research is continuing to emerge that a low-carbohydrate, ketogenic diet can help combat issues associated with PCOS and obesity, including healing reproductive hormones.

Before we dive into the results of these studies, it’s necessary to understand what the various reproductive hormones are and how they relate to fertility.

Healthline discusses how the ketogenic diet can help regulate hormones such as the luteinizing hormone, testosterone, and the stimulating follicle hormone.

A ketogenic diet — which is high in fat, moderate in protein, and low in carbohydrates — puts your body into a natural metabolic state called ketosis. By dramatically reducing your intake of carbohydrates (its primary source of energy), your body is forced to become super efficient at burning fat for energy instead. Preliminary research suggests this shift can enhance weight loss temporarily, as well as help reduce systemic inflammation, which is important because “inflammation can reduce overall fertility,” says Kristin Kirkpatrick, RDN, a wellness nutrition services consultant at the Cleveland Clinic Wellness Institute in Ohio. What’s more, a properly followed ketogenic diet can help reduce levels of insulin and possibly better regulate levels of other reproductive hormones, including testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH).

You may or may not have heard about the keto diet’s benefits for women with PCOS. Healthline reveals that women who battle with PCOS can lose weight on the keto diet which in turn can help balance out their hormones.

Some research suggests that besides helping women with PCOS lose weight, the ketogenic diet may help rebalance their hormones — and in some cases help women who had previous infertility problems become pregnant on their own. In a small study published in the September–October 2018 issue of the journal AACE Clinical Case Reports, researchers followed four overweight women with PCOS who were trying to conceive follow a ketogenic diet, monitoring their progress monthly. Within six months, all four women lost weight, ranging from 19 to 36 pounds, and resumed regular menstruation (they’d all had irregular periods before they started the diet). The kicker: Two of the women conceived spontaneously without requiring ovulation induction.

A study discussed in AACE Journals examines the results of what happened when women with PCOS went on the keto diet for six months. They found that the women lost anywhere from 19 to 36 pounds and resumed regular menstruation (they all had irregular periods before the diet). In addition to that, two of the women spontaneously conceived without assistance!

Objective: Polycystic ovary syndrome (PCOS) is the most common cause of infertility in women. We report the clinical course of 4 women with PCOS trying to conceive while following a ketogenic diet and assess their fecundity after a period of 6 months.

Methods: The patients were followed once monthly in a shared medical appointment setting for total of 6 months. During each visit, the patients were assessed for weight loss progression, menstrual regularity, and ovulation.

Results: The patients' ages ranged from 24 to 29 years old, their body mass indexes from 30.75 to 42.46 kg/m2, and their duration of infertility from 1 to 4.5 years. All patients were interested in pregnancy. The diagnosis of PCOS was confirmed by an endocrinology consultation, and the patients initiated a protein-sparing modified fast (PSMF) diet. The PSMF diet entails a maximum daily total carbohydrate intake of 20 g, fat intake up to 50 g, and an approximate protein intake of about 1.5 g for each 1 kg of ideal body weight. Metformin was continued if they were already taking it, otherwise it was initiated with the PSMF diet and titrated up to 500 mg twice daily. All 4 patients adhered to the PSMF diet and were able to lose weight (ranging from 19 to 36 lbs). All 4 also had irregular periods prior to the PSMF diet, and resumed regular menstruation shortly after starting the PSMF diet (ranging from 4 to 8 weeks). Two women were able to conceive spontaneously with no ovulation induction needed.

Another study published in March 2017 by the Nutrients journal discovered that a low carb diet improved several women’s hormones and helped them ovulate more regularly.

Background: Medical interventions including assisted reproductive technologies have improved fertility outcomes for many sub-fertile couples. Increasing research interest has investigated the effect of low carbohydrate diets, with or without energy restriction. We aimed to systematically review the published literature to determine the extent to which low carbohydrate diets can affect fertility outcomes;

Methods: The review protocol was registered prospectively with Prospective Register for Systematic Reviews (registration number CRD42016042669) and followed Preferred Reporting Items For Systematic Reviews and Meta-Analyses guidelines. Infertile women were the population of interest, the intervention was low carbohydrate diets (less than 45% total energy from carbohydrates), compared to usual diet (with or without co-treatments). Four databases were searched from date of commencement until April 2016; a supplementary Google scholar search was also undertaken. Title and abstract, then full text review, were undertaken independently and in duplicate. Reference lists of included studies and relevant systematic reviews were checked to ensure that all relevant studies were identified for inclusion. Quality assessment was undertaken independently by both authors using the Quality Criteria Checklist for Primary Research. Outcome measures were improved fertility outcomes defined by an improvement in reproductive hormones, ovulation rates and/or pregnancy rates;

Results: Seven studies fulfilled the inclusion criteria and were included in the evidence synthesis. Interventions were diverse and included a combination of low carbohydrate diets with energy deficit or other co-treatments. Study quality was rated as positive for six studies, suggesting a low risk of bias, with one study rated as neutral. Of the six studies which reported changes in reproductive hormones, five reported significant improvements post intervention;

Conclusion: The findings of these studies suggest that low carbohydrate diets warrant further research to determine their effect. These randomised controlled trials should consider the effect of carbohydrates (with or without energy deficit) on hormonal and fertility outcomes.

Perfect Keto discusses the Clin Obes. 2014 study below and the study unveiled yet again that there was an improvement in women's’ hormones and some of them even became pregnant after being on the diet.

12% decrease in body weight

22% decrease in percent free testosterone

36% decrease in LH/FSH ratio

54% decrease in fasting insulin

As discussed above, the decreases in these levels are positively associated with increased fertility outcomes.

Additionally, two of the women in this study became pregnant despite previous infertility issues.

A 2014 study including obese women undergoing fertility treatment found that compared to the control group, women following a structured, low-carbohydrate diet for 12-weeks had significant improvements in pregnancy outcomes.

Compared to the control group, the women in the low-carb diet group:

Lost an average of 20 pounds in just 12-weeks.

Achieved a pregnancy rate of 48% compared to 14% in the control group.

Took an average of two fertility treatment cycles to achieve each pregnancy compared with four treatments in the control group.

Had a 44% increase in the number of live births compared to only 14% in the control group.

It’s incredible knowing that the keto diet has the potential to help women get pregnant. Whether you want to increase your chances of having a child, lose weight, or learn how to make healthier choices, the keto diet can help with that. Learn all about the keto diet in the Body Reboot book. To get your free copy help us cover the cost of shipping. Visit this page today to get your copy!

Sources: Everyday Health, AACE Health Journals, NCBI: Nutrients. 2017, Perfect Keto, NCBI: Clin Obes. 2014