When it comes to optimizing fertility, I am a big believer that small changes make big differences.
I often have couples seeing me when they are months or even years into their fertility journey. Some come to me just as they are considering Assisted Reproductive Technologies such as IUI or IVF, hoping for an alternative natural solution before going that route and others are already in the midst of that process. Unfortunately its rare for a couple to see me early on because most assume they won’t have any issues becoming pregnant until months or even after a year has gone by and they realize they need some help.
What most couples don’t understand is that it can take time to prepare the body for pregnancy, ideally 3-6 months which can be hard for a couple to accept. The burden typically falls on the woman, which is understandable since she is the one who “houses” the baby but male infertility plays a role in 20-30% of infertility cases. What is interesting is that it can take a man 12-18 months to finally recognize that it might be him who’s “the problem.”
It is common to see women with Polycystic Ovarian Syndrome (PCOS) or Endometriosis or women experiencing irregular periods and unaware of their optimal fertility window. Often times I see older age women trying to conceive or women with older partners. Other times I see women who are able to conceive but experience recurrent pregnancy loss and simply cannot maintain their pregnancy.
There are so many potential causes of infertility and in order to optimize a couple’s chances, a truly comprehensive and integrative approach is required. Below are my 5 favourite fertility strategies but please understand they are a few of many. If you are interested in booking a free consultation to learn how I can help you and your partner in your fertility journey, please reach out. I offer online and in-person visits both in Maple, out of my home office, and North York, out of Uptown Midwives and Family Wellness.
My Top 5 Favourite Fertility Strategies:
1. Test your hormones.
Don’t wait until you’re 6 or 12 months into your fertility journey to consider testing your hormones. As soon as you decide you want to grow your family is the time to start investigating the health of your hormones. Blood work only shows a snap shot in time so I often recommend DUTCH testing, Dried Urine Testing for Comprehensive Hormones. This test does not simply test estrogen and progesterone; it gathers extensive information on your hormones and how they are metabolized in the body. It measures both hormones and metabolites to give a better overall picture of hormone production and also looks at neurotransmitter metabolites and cortisol production and utilization. Unfortunately DUTCH testing is not covered by OHIP but the cost of testing is significantly less than investing in Assisted Reproductive Technologies.
The only thing that DUTCH testing does not explore is thyroid health. Most Medical Doctors only test for TSH and ignore other possible factors that impact thyroid health such as thyroid antibodies resulting in a Hashimoto Thyroiditis diagnosis. Many Medical Doctors who do test for autoimmune antibodies dismiss the antibodies and simply treat patients as hypothyroid. The implications of this can be grave! Comprehensive hormone testing is essential and should be done as soon as possible – it should not be an afterthought.
Other testing I recommend include: Ferritin, B12, Vitamin D, Zinc, fasting blood glucose, HbA1C and AMH. A quick note on AMH: It used to be the standard test to determine egg quality and how fertile a woman is; today it is used to determine if a woman is a good candidate for IVF. A low AMH does not necessarily equate to infertility.
2. Change your diet.
Food is truly the foundation of health. If you want to optimize your fertility outcomes you have to consider your diet and how it might impact your reproductive health. Ditch the processed, convenient foods and consume fresh, whole foods instead. Prioritize organic fruits, vegetables and herbs for their lower pesticide and higher nutrient content and replace meats with vegetarian options such as tofu, lentils and legumes. Remove hormone-filled dairy products and choose organic options or dairy-free options instead.
Be sure you consume enough protein! The goal should be to consume approximately 45-55g of protein per day and if you have a hard time doing this, incorporate a vegan protein powder into your daily routine. My personal favourites are Sunwarrior, Thorne or Iron Vegan brands.
Remember to eat the rainbow. The more colours on your plate, the more nutrients you’re consuming. Avoid white, bleached breads, pasta and rice and ensure every food you eat is somehow benefiting your body. Food is fuel. I cannot stress this enough when it comes to reproductive health and fertility optimization.
One thing to keep in mind: Fertility can be impaired in people who are overweight OR underweight. The goal is to be at a healthy weight and have balanced blood sugar levels. This is something I often focus on when it comes to my patients’ fertility optimization plan.
3. Monitor your cycle and know your fertility window
A fertility monitor tests for estrogen levels and the LH surge. This gives you insight into your optimal fertility window and increases your chances by identifying an additional 3 days when your chances are greatest.
If you don’t want to invest in ovulation sticks or a fertility monitor your other option is to monitor your basal body temperature or cervical mucus. Your basal body temperature is your temperature when you’re at rest. Your body temperature dips just before your ovary releases the egg and rises 24 hours after its release for several days thereafter. Before ovulation a woman’s basal body temperature ranges from 36.1 (97F) and 36.4 (97.5) and after ovulation it raises to a range of 36.4 (97.6) and 37 (98.6). If you want to measure your basal body temperature If you want to measure your basal body temperature check your temperature in the morning, before getting out of bed. Use a digital oral thermometer or one specifically designed to measure basal body temperature.
Your last option is to monitor your cervical mucus. Prior to ovulation, as your estrogen levels are rising, your cervical mucus may be more clear, stretchy, watery and slippery, comparable to the consistency of egg whites. The texture and pH of your mucus at this time are protective for sperm and will remain during ovulation. It is during these days when you are the most fertile. After ovulation cervical mucus becomes thicker, cloudy or “gluey” again.
As you see, there are a variety of ways to monitor your cycle and your fertile window. Ditch the free apps and start strategically monitoring your cycle to optimize your chances.
4. Take a high quality prenatal vitamin and consider other supplements to improve your fertility outcomes.
It is rare for me to meet a patient at a first appointment who is not taking a prenatal vitamin. Unfortunately, the most common prenatal vitamin taken by most women are Materna, Centrum or First Response. Medical Doctors and OB-GYNs emphasize the importance of folic acid but fail to acknowledge that different vitamins come in different forms with different bioavailabilities and therefore, absorption capacity. You get what you pay for.
There are many high quality prenatal supplements that are readily available. Be sure you’re investing in the right prenatal supplement for you and not some generic brand. What is the use of taking a supplement if it’s providing you little to no benefit?
A prenatal vitamin is not the only supplement worth investing in. Yes, folic acid is also important (some might call it essential), but you also want to be sure you’re taking supplements that improve egg quality, sperm quality and hormone levels. Some of my other go-to’s include N-Acetyl Cysteine, CoQ10, PQQ, Inositol and chaste tree – there are many others. Each product requires a very specific dose so do NOT self prescribe. Speak with a licensed Naturopathic Doctor who can provide you with a strategic supplement plan based on a comprehensive assessment. Different people benefit from different products at different doses and self-prescribing can either lead to ineffective therapeutic doses or dangerous doses.
5. Incorporate Fertility Acupuncture
Acupuncture. My absolute favourite! Acupuncture is a well-studied and effective treatment for optimizing fertility. It regulates hormones, improves blood flow to the uterus and testes and reduces stress. It can be used to on its own or in conjunction with IUI or IVF. I have personally used acupuncture on countless women prior to and after egg retrieval and transfers with great success. Acupuncture is one of those treatments that always amaze me (and my patients). If you have never tried acupuncture, it is definitely a modality worth considering. While some people feel apprehensive about it, most experience its positive effects almost immediately. Many fertility clinics recommend acupuncture to their patients as well so it truly is worth trying.
Optimizing fertility isn’t always so black and white; there can be many factors affecting a couples ability to conceive and it’s important to investigate all possible causes as early as possible. Small changes do make big differences but if you want to see a change, you have to make a change. Sometimes that means changing your diet or supplement regimen and other times it means considering treatment options you would have never otherwise considered. Comprehensive testing is crucial because it might provide some insight that can change the course your treatment and overall fertility journey.
These are only 5 of my favourite strategies but keep in mind, there are so many other factors to consider and strategic solutions that exist. Ideally you want to give your body 3-6 months to prepare itself for pregnancy rather than frantically feel like Naturopathic Care is your last resort. It really should be your first, especially if you have extended health insurance making visits extremely affordable if not 100% reimbursed.
If you live in Ontario and would like more information about how I can help you optimize your fertility, remember I offer both online and in person visits. I see patient’s in-person out of my home office in Maple or out of Uptown Midwives and Family Wellness in North York. I am happy to provide you with a complimentary consultation to discuss your goals and concerns by either completing a free consultation request form or booking an appointment directly through my website.