Many women undergoing fertility treatments would have at some stage come across theory of eating pineapple to aid in implantation.  But there seems to be some confusion as to why pineapple and can eating canned pineapple or drinking pineapple juice be of any benefit also?

Why Pineapple?

There are many forum posts and blogs written by ladies TTC who report that pineapple, or Ananas comosus, to use the scientific name, is said to aid in implantation as it contains bromelain.  Bromelain is an enzyme is found in the core, juice and skin of pineapple but is most plentifully found in pineapple stem (2).   Therefore bromelain is likely to be found in low levels in pineapple juice, however, if you are buying canned or carton pineapple juice the pasteurisation and sterilisation processes it needs to go through to preserve the pineapple juice in a can or carton most likely reduces the effectiveness of any naturally occurring bromelain.  That is not to say though that firstly, there is any scientific evidence supporting the theory that bromelain is beneficial in aiding implantation and secondly, even if it was that there are sufficient levels found naturally in pineapple stem for it to be of therapeutic value.

Extracted bromelain is also available as a tablet form, though the dose varies considerably according to the reason for use and it would not be advisable to self medicate.

Uses of bromelain

Bromelain is believed to have properties that can assist the human body in many ways including the prevention of blood clots, swelling and inflammation. Due to these properties it has been indicated as being useful in preventing transient ischaemic attacks or mini-strokes and angina (1). It is also beneficial for those with osteo and rheumatoid arthritis due to its anti-inflammatory and pain relieving properties and is also suggested for people with chronic, inflammatory immune conditions and also as a method of assisting in the debridement of burns, in the relief of diarrhoea and with future research may also become an adjunct cancer therapy (1).  Finally, bromelain has also been administered to people who have had sports injuries in order to control the swelling and bruising (2)- is there anything it can not do?!

Bromelain and pregnancy

As this is a fertility blog though we will assume that we want to know how bromelain can assist in supporting a pregnancy.  I have been unable to find any control trial experiments or scientific research that indicates that bromelain is effective in the implantation of embryos.  This does not necessarily mean that bromelain has no benefit just that it has not been researched and hence its efficacy can not be determined.

Due to its anti-inflammatory and anticoagulant properties though there might be a couple of pathways in which bromelain may be effective.

1. Due to its anticoagulant (stops blood clots) properties it could possibly facilitate blood flow to the uterus.  With improved blood flow to the uterus the lining and health of the uterus may be improved which provides a better environment for which implantation can occur.  Possibly.
2. Due to its anti-inflammatory properties bromelain has been found to benefit those who have autoimmune conditions such as rheumatoid arthritis.  Further research may one day suggest that bromelain can assist women with autoimmune conditions and markers who’s condition is resulting in infertility.  There have been studies done that indicates that bromelain was able to   modulate how cells binded with T cells and natural killer cells (1), two types of cells also implicated in infertility.

Well, it can’t hurt anyway?

The mechanisms of bromelain are clearly under researched, particularly with reference to fertility.  Therefore any benefits and also any costs of using bromelain are unknown and hence taking bromelain tablets should be avoided without proper medical advice. Although bromelain found naturally in pineapple is likely to be in doses that are relatively low, some people advise against eating too much pineapple too early in your cycle.  This is as if it is eaten before ovulation some believe that the acidity of the pineapple may increase the acidity of cervical mucous making it a hostile environment for sperm and hence fertilisation (2).

However, due to the assumed relatively low levels of bromelain existing naturally in pineapple, as long as you eat it as recommended (no more then a couple of slices a day) and after confirmed ovulation, or embryo transfer, it is unlikely to do any harm.  If you are looking at taking bromelain tablets, I would definitely recommend you speaking to a health professional before doing so, particularly due to bromelains blood thinning properties and especially if your fertility specialist has put you on low dose aspirin.  It has also been found to increase the effectiveness of antibiotics so again seek medical advice before commencing bromelain but especially if you are on any other medications.

If you are thinking of, or doing, IVF don’t forget to get your free IVF guide with 18 other evidence based ways that will hopefully increase your egg quality, implantation rates and ultimately, IVF success.

References

1.Pavan, R., Jain, S. & Kumar, A. (2012) Properties and Therapeutic Application of Bromelain: A Review. Biotechnology Research International, published online 2012 Dec 10. doi: 10.1155/2012/976203

2. Meschino, J. Meschino Health Comprehensive Guide to Herbs.  Available from meschinohealth.com

3. Campbell, L http://natural-fertility-info.com/bromelain-pineapple-for-implantation.html