Everything You Need to Know About Optimizing Your Fertility

fertility hormone balance pathway to pregnancy Apr 09, 2024

Whether you’re looking to get pregnant now -or- are interested in prepping your body and being aware of what your potential is for a future pregnancy, I highly suggest no matter where you're at remembering to consider the state of your fertility if at some point you know that you want kids or might want kids!

This is because, and I'm sure that you've heard at this point, that 1 in 6 couples globally struggle with infertility (defined as the "inability to get pregnant after 1+ years of unprotected sex") which can be due to male AND female fertility factors.

If you're currently struggling to get pregnant, I want you to know that I SEE you, and admire your strength. I have been on my own emotional rollercoaster filled with highs and lows and frustrations with your body, but know that you’re not alone and the word "infertility" is not always accurate OR final. I've spoken with so many friends and clients who have had discouraging conversations about a their chances of getting pregnant BEFORE getting a clear picture of what’s going on with her hormonally and BEFORE diving into her lifestyle or nutritional habits. I also know plenty of couples who have been told that pregnancy will never happen for them, only to be able to conceive and bring a healthy baby into the world shortly thereafter.

In my opinion, when it comes to getting pregnant and bringing a healthy baby into the world, the process should always start with hormone testing, a plan to optimize fertility with balanced nutrition, self care/stress management, mindful movement and supportive supplements. So today, I am going to talk to you about my approach to holistic fertility and natural ways to begin on the journey towards improvement for more successful outcomes.

1. Start with TESTING - If you've been suffering from consistent PMS symptoms including having a hard time getting pregnant or miscarriage, testing your hormone levels is an critical action step that will be incredibly eye opening to identify root causes and support your personalized next steps. In my practice that means testing a few different things that are not often covered by insurance and that a lot of doctors wont necessarily say yes to.

Those would be:

  • FSH and AMH - Follicle-stimulating hormone (FSH) is released by the pituitary gland and is responsible for recruiting and developing follicles in the ovary which usually contain an egg that’s released during ovulation. Traditionally, testing a woman’s FSH levels is one of the most common infertility tests performed. As you age, the number of eggs you have remaining decrease, your pituitary gland needs to work harder to recruit a follicle. As a result, the pituitary gland produces a higher level of FSH, which must be done on a certain day of your cycle. This high level of FSH is correlated with infertility. AMH is produced by the cells that line the tiny follicles within the ovaries. As the number of available eggs in a your ovarian reserve begins to decline so does the corresponding AMH level. AMH has been found to reflect the QUANTITY of remaining eggs. A low level of AMH reflects a lower ovarian reserve where as a high level of AMH would indicate a higher ovarian reserve.
  • Estrogen to Progesterone Ratio - Knowing your estrogen levels relative to progesterone is crucial for assessing whether or not you have adequate amounts of progesterone to balance estrogen. Healthy levels of estrogen and progesterone are important for regular ovulation (you MUST ovulate in order to produce progesterone AND to get pregnant) as well as maintaining a healthy pregnancy! When progesterone levels are insufficient to support the pregnancy (due to disruption of ovulation, stress, extreme exercise, diets, nutrient deficiencies etc.), potential risks for miscarriage increase.⁠
  • Thyroid Panel - Research shows that when there are higher or lower levels of thyroid hormones, it can alter reproductive hormones and disrupt the menstrual cycle — which makes conception more difficult. The thyroid gland regulates important functions like metabolism, energy production, and hormone levels. Therefore, thyroid dysfunction can affect your menstrual cycle, ovulation, and the potential outcomes of fertility.
  • Androgen Levels - Testing androgen levels is critical in evaluating risks for PCOS and insulin resistance which is a leading cause of infertility. Elevated levels of DHEA and testosterone are often caused by a diet high in sugar and processed carbohydrates which raise blood sugar and thereby increase insulin. If insulin levels remains high this triggers higher levels of testosterone and/or DHEA which can result in insulin resistance and disorders like PCOS which can be a direct cause of infertility.
  • Cortisol - In my practice I measure cortisol over the course of the day to see if chronic stress is potentially disrupting ovulation and/or contributing to inadequate progesterone production, impacting your ability to conceive. Normal levels of cortisol are essential for daily functioning, but problematic symptoms start to arise when the adrenal glands have to work extra hard to meet demands for energy during periods of prolonged stress. Cortisol levels above or below the optimal range (along with the symptoms that accompany it like fatigue, low energy, cravings, belly fat, frequent illness, and trouble sleeping) are usually an indication of chronic stress which can disrupt ovulation and/or contribute to low progesterone in the second phase of the cycle which can make pregnancy nearly impossible.

Once you know what you're dealing with when it comes to your hormones and overall health, its so much easier to implement strategies that will actually work FOR YOU. For example if you're someone who is struggling with PCOS your diet is going to look different than someone who is struggling with hypothalamic amenorrhea caused by stress. With that said, here are a few tips that I would offer anyone on their fertility journey:

  • Get in touch with your ovulation - while it is not always necessary to track your ovulation in order to get pregnant, it certainly helps to make sure your timing is right which can increase your odds of conceiving. It will also help you determine if you are ovulating each month, which is imperative for conception. Tracking your cycle month-to-month is helpful as it is easy to forget what past cycles looked like, and history is good to have for any future analysis you may want to do. Find an app on your phone ( Flo or Clue are great options). Track the following:
  • Days of bleeding and heaviness each day
  • Days of cervical mucus and what it looked like
  • Basal Body Temperature (BBT) - this can help to determine when the shift in hormones happens from the follicular phase into the luteal phase. Body temperature will increase ½ - 1℉ after ovulation.
  • Days of intercourse
  • Anything significant going on in your life - a stressful day, a day of sickness, a very emotional day, etc. Any type of change to regular activity for your body, either mentally or physically, can affect the timing of your cycle and everything that goes on during the cycle
  • As with anything, it is best to have several months of data to look back on before determining if your cycle is regular or irregular. In order to determine an irregular cycle, it must be irregular for at least 3 months in a row. It is normal to have an irregular cycle every once in a while, as emotional or physical stressors can throw the body off balance and cause it to shorten or lengthen your cycle that month. It can also change the number of days menstruating, the day of ovulation (e.g. you always ovulate on day 14, however, you were very stressed this month and it ended up occurring on day 17), or the length of either the follicular or luteal phases.

2. Reduce stress - the body does not want to reproduce when in a fight-or-flight state. Stress hormones such as cortisol are increased when the body is stressed, which can lead to infertility. Although it is virtually impossible to eliminate all stress from our lives, it is important to do what we can to cope with and minimize the impacts of negative stress. Sit down and identify the stressors in all areas of your life, and then try to come up with a way to eliminate or reduce the stress in most areas. To help decrease stress overall, try to take time for yourself each day to do something you enjoy: practice deep breathing, start a journaling practice, meditate in the morning and/or at night, do yoga or stretching, go for walks, etc.

3. Eat hormone supportive foods - Eating clean is a way that you can take the stress off your body daily. Follow the 80/20 rule when eating clean, as you don’t have to be so strict that you can’t enjoy a treat (or two!), but be mindful of what you put in your body daily. Look to eat plenty of whole foods including leafy greens, organic meats and dairy, a variety of beans and legumes, and a lot of water. Make sure meals are filled with plenty of carbohydrates, protein, and fat in balance to allow meals to be filling and satisfying to your body. This should not feel like a diet! If you really love treats, look up some recipes to recreate your treats in a healthier way. Ideally look for recipes that are gluten-free, dairy-free and are low in sugar. Remember to drink plenty of water daily, and to limit the amount of dehydrating liquids consumed (i.e. coffee, black teas, pops).

If this blog post resonates with you and you want more support on your journey to conceive you watch my course, Pathway to Pregnancy.