When planning a pregnancy, couples are usually given the same advice: they’re told to stop smoking, cut back on alcohol and coffee, and eat well. Your doctor may have told you to include fresh fruit and vegetables, choose minimally processed foods, and perhaps add some protein alongside that. But generally speaking, the advice is pretty vague.
Most of the couples I work with have heard this already. They just don’t know what to do with it. There’s more to supporting your fertility than getting your five a day, and the research on the Mediterranean diet and fertility shows exactly where that general advice falls short.
Why “eating well” isn’t enough
When we think about fertility, we tend to focus on obvious things like hormones, egg quality and sperm quality. And rightly so. Because these are exactly what we want to support in the lead-up to a healthy pregnancy.
But what’s actually influencing the health of your eggs and sperm? What might be disrupting your hormone levels? This is where a whole-body approach is essential, because every system in your body has a part to play in your fertility health.
That’s why I encourage couples to think in terms of an anti-inflammatory way of eating rather than a vague “healthy diet.” The best example we have is the Mediterranean diet. It’s the most heavily researched way of eating in the world, for overall health and for fertility specifically, and when you look at it through a whole-body lens, it ticks a lot of the boxes that matter for conception.
So what is the Mediterranean diet?
Say “Mediterranean food” and most people picture pasta, pizza, and Greek salad. But there’s a bit more to it than this.
In this post, I’ll walk through what this way of eating actually involves, why it supports your fertility, and how to put it into practice in preconception.
The Mediterranean diet, in simple terms
The Mediterranean diet is a way of eating that draws on the traditional foods of the Mediterranean region. Plants are the hero of this diet, and it’s the variety of plant foods that gives this way of eating the edge on nutrient density. It’s not a vegan diet, and it’s not restrictive. Eggs, fish, meat, and dairy are all included. The emphasis is simply on the plant side of things.
The Mediterranean diet is built around:
- Vegetables, fruit and fresh herbs
- Whole grains
- Lentils, beans and other legumes
- Nuts and seeds
- Extra virgin olive oil and olives
- Oily fish and other fresh fish
- Eggs
- Good-quality dairy such as cheese, yogurt, butter and whole milk
- Small amounts of chicken, beef and lamb
- Herbs and spices for flavour
It includes whole foods, cooked from scratch and with lots of variety. That variety is a big part of its power, because eating such a broad range of foods gives you a broad spectrum of nutrients.
This is why it’s been researched so extensively, and not just for fertility. It’s linked to a lower risk of cancer, better cardiovascular health, and greater longevity. It’s widely considered the best way of eating for overall health and wellbeing.
More than just food
There’s more to this way of eating than what’s on the plate. Traditionally, Mediterranean families sit down and eat together. Meals are a social occasion. They involve taking time out of the day to prepare food and then enjoy it in company.
It’s also a seasonal way of eating. Foods are eaten when they’re naturally in season, which is when they’re at their freshest and most nutrient-dense. Produce picked at its peak and eaten soon after has more to offer than food that’s been grown out of season, stored for months, or shipped halfway around the world.
Connection and seasonality are both part of why this way of eating is so beneficial. Two things I think you would agree we pay little attention to in our standard busy routines.
How does the Mediterranean diet support fertility health?
Let’s come back to what we talked about earlier: optimising the quality of the cells that will go on to make your baby, your egg and your sperm.
Protecting egg and sperm quality
Egg and sperm cells are very vulnerable to oxidative stress. Oxidative stress happens when unstable molecules called free radicals outnumber the antioxidants available to neutralise them. It damages the DNA inside eggs and sperm, and it’s one of the main reasons cell quality declines with age, stress, smoking and a poor diet.
This matters enormously in the preconception window. The egg and sperm that will go on to make your embryo are maturing in the three to four months before conception, or before egg and sperm collection if you’re having IVF.
- Vitamin C from vegetables and fruit
- Vitamin E from olive oil, nuts and seeds
- Selenium from oily fish and Brazil nuts
- Beta-carotene from brightly coloured fruit and vegetables
- Lycopene from tomatoes, especially cooked ones
- Zinc from seeds, shellfish and legumes
- Polyphenols from fruit, vegetables, olive oil and herbs
The Mediterranean diet is packed with antioxidants at every meal:
It’s not only about antioxidants either. This way of eating also includes foods and nutrients that protect eggs and sperm more structurally. Omega-3 fatty acids and choline (found in eggs and fish) are building blocks of the cell membrane itself. Vitamin E sits within that membrane and shields it from damage. Together, they help keep the membrane strong and flexible; this makes the cell less susceptible to oxidative damage and allows nutrients to move in and out more easily.
Making sure you’re getting a broad spectrum of these nutrients every day is one of the best things you can do to support these cells in the lead-up to conception.
Essential nutrients for optimal fertility
Fertility is nutritionally expensive. Building healthy eggs and sperm, keeping your hormones in balance, and preparing the uterus for implantation all require a whole range of specific nutrients: folate, iron, B12, zinc, iodine, choline, magnesium, omega-3 and more.
A good prenatal multi absolutely has its place, but think of it as an insurance policy to make sure you’re hitting the right doses. What we really want is a food-first approach, with nutrients coming from what you eat.
What’s so great about the Mediterranean way of eating is that you cover a lot of these bases without having to think too hard about it. Green leafy vegetables, legumes and whole grains give you folate and iron. Fish, eggs and dairy give you B12, iodine and choline. Nuts and seeds top up your zinc, magnesium and vitamin E. Eat the variety this diet recommends and the nutrients largely take care of themselves.
The gut microbiome and preconception care
This is an area of health that, as a practitioner specialising in reproductive health, I see missed all the time. Your gut microbiome plays a huge part in regulating your hormones and, even more importantly, your overall inflammatory status. So we want to make sure you’re eating the foods that feed the healthy microbes in your gut. This is the foundation of a healthy microbiome, and it’s another place where the Mediterranean diet really comes into its own.
When you feed your gut bacteria well, they produce short-chain fatty acids. Short-chain fatty acids (SCFAs) calm inflammation, support your immune system, help maintain your gut lining, and play a part in how your body metabolises oestrogen. All of which matters a great deal for fertility.
The Mediterranean diet is set up to keep that production going. Fibre from vegetables, legumes and whole grains is the main fuel. Polyphenols, found in olive oil, berries, herbs, red and purple vegetables, and even good-quality coffee and dark chocolate, also feed the beneficial bacteria. Omega-3s from oily fish encourage the right kinds of microbes, and nutrients like beta-carotene, vitamin C and zinc help keep the gut lining strong.
My advice here is simple: aim for variety. Try for around thirty different plant foods a week, or roughly ten a day, with lots of colour and not the same few things on repeat. Do that, and you’ll be getting plenty of what your gut needs to support a healthier microbial ecosystem.
Blood glucose regulation and steady hormones
Blood sugar and fertility are closely linked. When your blood sugar spikes and crashes throughout the day, your body has to keep producing insulin to manage it. Over time, high insulin disrupts ovulation, affects egg quality, and pushes your sex hormones out of balance. This is especially relevant if you have PCOS, but it matters for everyone preparing to conceive, men included.
Because the Mediterranean diet is built on whole foods rather than refined ones, and puts such an emphasis on good-quality protein, fibre, and supporting the gut microbiome, it’s a really helpful way to keep your blood glucose steady. Steady blood sugar means steady insulin, and that creates a much calmer hormonal environment for conception.
Putting it all together: Mediterranean diet made simple
Where to start
You don’t need to overhaul everything overnight. Start with a few of these and build from there:
- Make extra virgin olive oil your main fat for cooking and dressing
- Eat oily fish like salmon, sardines or mackerel twice a week
- Build every plate around vegetables first, then add your protein
- Add legumes and lentils to a few meals a week
- Swap refined white carbohydrates for whole grains
- Snack on nuts, seeds and fruit instead of processed snacks
- Include eggs regularly
- Use fresh herbs and spices generously
- Aim for as much colour and variety as you can, ideally thirty different plant foods a week
- Cook from scratch where you can, and sit down to eat when you do
Do this consistently in the months before you try to conceive or start IVF, and you’re supporting your eggs, sperm, gut, hormones and womb lining all at once. That’s the real strength of the Mediterranean diet for fertility: one way of eating, working on every part of the picture.
To help you along the way, I’ve put together a fertility-friendly Mediterranean diet shopping list you can download and take with you.
References
- Gaskins AJ, Chavarro JE. Diet and fertility: a review. Am J Obstet Gynecol 2018;218:379–389.
- Dinu M et al. Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses. Eur J Clin Nutr 2018;72:30–43.
- Morze J et al. An updated systematic review and meta-analysis on adherence to Mediterranean diet and risk of cancer. Eur J Nutr 2021;60:1561–1586.
- Estruch R et al. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med 2018;378:e34.
- Karayiannis D et al. Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility. Hum Reprod 2018;33:494–502.
- Ghosh TS et al. Mediterranean diet intervention alters the gut microbiome in older people, reducing frailty and improving health status. Gut 2020;69:1218–1228.
- Chavarro JE et al. A prospective study of dietary carbohydrate quantity and quality in relation to risk of ovulatory infertility. Eur J Clin Nutr 2009;63:78–86.
- Salas-Huetos A et al. Mediterranean diet, semen quality, and medically assisted reproductive outcomes in the male population: a systematic review and meta-analysis. 2025.
