Functional Medicine Approach to Fertility

Unexplained infertility is a frustrating diagnosis for many women and the Functional Medicine Approach to Fertility is really where it is at, in terms of preconception care. What does it really mean and what can cause it? Well, the list is long and it may be a combination of many factors including:

• • Nutritional insufficiencies 
  • Luteal Phase Dysfunction
  • Suboptimal thyroid function
  • HPA axis / adrenal dysfunction
  • Oxidative stress
  • Inflammation 
  • Toxin exposure
  • Poor gut health
  • Immune system dysfunction

Supporting Mitochondrial Health for Fertility

When thinking about fertility what we need to  think about is mitochondrial health (yep, the powerhouse of the cell if you remember back to middle school biology class) which is going to contribute to producing a healthy egg. The mitochondria also play a role in many processes of conception: egg health, ovulation function, ovarian aging, fertilization, and implantation. So, what can we do to support the mitochondria? The answer is, lots!

• • Regular, moderate intensity exercise
  • Food first approach – whole foods diet including adequate protein and healthy fats
  • Supplements:
    • CoQ10
    • Riboflavin (vitamin B2)
    • Antioxidants: resveratrol, alpha-lipoic acid, melatonin, curcumin
    • L-carnitine
    • Magnesium
    • Green Tea
    • Glutathione or N-acetyl cysteine 

Luteal Phase Support

We also need to focus on healthy progesterone levels to support the luteal phase (more Luteal Phase Dysfunction HERE). This can be done by 

• Adding healthy dietary fat and ensuring adequate caloric intake
• Taking vitamins C, E, B6
• Working on stress reduction
• Exercising but not over exercising
• Utilizing progesterone 

Thyroid Health and Fertility

I discussed this in a blog during the thyroid series but it bears repeating here. The thyroid is involved in MANY aspects of fertility and low thyroid function can lead to both fertility and pregnancy related complications so make sure you are getting a full thyroid panel to ensure optimal thyroid function. (more on thyroid and fertility HERE and thyroid labs HERE).

Vitamin D and Fertility

Vitamin D deficiency has been linked to many issues surrounding pregnancy including endometriosis, gestational diabetes, PCOS, premature labor and preeclampsia. Further, a study demonstrated that women with sufficient levels of vitamin (at least 30ng/ml) are more likely to get pregnant and carry a healthy pregnancy with IVF.

Cervical Fluid Health

Cervical fluid plays many roles in conception including protecting sperm from the acidic vaginal environment, filters abnormal sperm, acts as sperm food, stores the sperm for later release and maintains opening of the cervical canal. We can increase cervical fluid production by:

• • Maintaining good hydration
  • Acucupuncture
  • N-acetyl cysteine
  • Omega 3 fatty acids
  • Evening primrose oil 

The Microbiome and Fertility

The uterus has its own microbiome and it has been noted that women being treated for infertility have different microbes in their vagina, cervix and uterus compared to women without infertility. Increased intestinal permeability in the gut can allow inflammatory particles to get into systemic circulation causing downstream inflammation such as in the ovaries and endometrium which can lead to decreased progesterone production, impacting fertility. 

Environmental toxin exposure and Fertility 

We are swimming in a sea of toxins thanks to our industrialized society, some we can’t really do anything about but others we can. We know that certain environmental toxins interfere with fertility including: organophosphate pesticides, PCBs, cadmium, mercury, benzene and phthalates. Toxins impact reproductive health in many ways:

• • Contributing to PCOS and blood glucose/insulin dysregulation
  • Reducing Luteinizing hormone secretion
  • Altering semen
  • Increasing the rate of miscarriage 

Read more on Detoxification and how we can support detoxification in the body. It is important to note, you do not want to be doing any active detoxification while you are trying to conceive, when you are pregnant or when breastfeeding. 

Back to the Basics

With so much new knowledge and technology we sometimes forget that going back to the basics can truly make a big different. The true Functional Medicine approach to fertility, focuses on all of the lifestyle foundations that are crucial to health. Focus on getting adequate, good quality sleep. Utilize stress reduction techniques so that your adrenals are functioning at a high level. Utilize food as medicine, opting for an anti-inflammatory, whole foods diet such as the Mediterranean diet. Utilize supplements when needed. Ideally we want to be thinking about conception 6-12 months before planning to conceive to make sure everything is in place and the body is optimal in many aspects to make for an easier fertility journey as well as pregnancy and postpartum period. 

Foundational prenatal supplements:

• High quality prenatal vitamin 
• Omega 3 (EPA/DHA)
• Probiotic
• CoQ10

Preconception labs:

Day 3

• LH/FSH
• Estradiol
• Testosterone
• DHEA-S
• Prolactin
• AMH
• Full thyroid panel
• CBC and CMP
• Iron panel + ferritin
• Hemoglobin A1c and fasting insulin
• HsCRP
• Homocysetine
• Serum progesterone (day 21)

If you are looking to conceive and want to dive into a Functional Approach to Fertility to make sure that you are healthy and ready for conception and beyond book a FREE 15 minute consultation now!