What to expect… when you’re expecting to expect?
Social media mamas-to-be are abuzz about “trimester zero,” a pre-pregnancy plan that some experts say is seriously misguided.
“Trimester zero is a ‘hot new topic’ in the world of OB and fertility that suggests there’s a critical three-month window before conception where you need to optimize everything — diet, supplements, lifestyle — to improve egg quality and fertility outcomes,” Dr. Jaime Knopman, Director of Fertility Preservation for CCRM Fertility New York and author of the newly published book, Own Your Fertility, told The Post.
But Knopman says that the science isn’t in their corner.
“There has been no definitive research linking actions taken three months before trying to conceive and fertility outcomes,” she stressed. “Unfortunately, for most of us, egg quality is rooted in genetics and underlying medical issues.”
Trimester zero is trending especially among older women struggling to conceive, as poor egg quality is the primary cause of IVF failure and miscarriage in this demographic.
But, Knopman says, these measures are unlikely to drive true results.
“There is no magic wand that can be waved to improve egg quality,” she said. “As much as I wish this weren’t the case, for the majority of women, you can’t simply go gluten-free, take some supplements, and cut out sugar and expect to see massive changes in your ovarian health.”
While she always encourages her patients to take care of their overall health when preparing for pregnancy, she sees trimester zero as reinforcing harmful beliefs.
“Touting trimester zero as the linchpin to success creates false hope and supports the incorrect notion that all a woman needs is a few good months to change her ovaries. It places blame and burden on women, promoting the ‘it’s your fault this happened’ culture,” she said.
She emphasized that there is no evidence linking habits adopted in trimester zero and improved egg quality, noting that freezing your eggs at a younger age and abstaining from smoking are the only factors proven to affect future fertility.
“We do not want women to believe that actions taken in the months before can override everything they have done for years or their genetics,” she went on. “If we’re going to prioritize health, it should be ‘Trimester Forever’ — not just a three-month sprint. Conception is a marathon, not a sprint.”
In addition to reinforcing the narrative that women are responsible — and thus ultimately to blame for their infertility — Knopman sees the trimester zero trend being taken to dangerous extremes.
“I am seeing women implementing restrictive diets, spending fortunes on unproven supplements, and adding stress and anxiety to an already stressful and anxiety-provoking situation!”
Knopman underscores that the stress created by the pressure to perfect oneself in trimester zero could be counterproductive to fertility.
“Stress impacts all aspects of our health and our bodies. Stress should not prevent pregnancy, but it can make the process untenable and have a negative impact on your ability to reach the end goal: achieving parenthood.”
Infertility is a disease, she noted, and should be treated as such.
“We cannot out-study, out-eat it, or out-supplement it. We can arm ourselves with knowledge and make educated choices, but white-knuckling it and trying to control it will only make the situation worse,” she said.
Knopman recommends that women trying to conceive have a support system in place and find a self-soothing activity, such as walking or knitting, to help mitigate stress.
In terms of effective fertility prep, she said, while there is no “magic bullet,” the following measures can support overall health prior to conception:
- Take a prenatal vitamin with folic acid
- Try to be the best version of you (healthy lifestyle choices)
- Don’t smoke!
- Get any chronic medical conditions under control and make sure the medications you take to treat these conditions are safe in pregnancy
- See your OB/GYN for a preconception visit (genetic carrier testing), talk about risk factors for infertility
- Learn about your menstrual cycle
In addition to a solid support system and following the simple measures listed above, Knopman said that education is key, and it’s never too early or too late to start learning about your body.
“Your reproductive organs and talking about them starting at a young age should not be taboo! Have a fertility plan! You plan for college, retirement, and even your Christmas break — plan for your fertility.”
As part of that education and plan, she encourages women to ask their female relatives about their own reproductive journeys.
In her book, Own Your Fertility, which she calls “a modern-day fertility guide,” Knopman encourages women to make informed, empowered decisions about their reproductive health.
“Science and society have advanced so much so that our ticking biological clock no longer needs to feel like a time bomb. Now more than ever, it doesn’t have to be, but only if we proactively take charge of our reproduction.”
