My practice has ebbed and flowed in how I approach fertility support. From what I’ve learned, from what I feel patients needs, and from growing myself in practice and life! There are a few key places I like working with fertility patients to support them in their journey.
Nurturing foods:
This has been an interesting area of growth and what I suggest to be most beneficial for patients having issues wanting to conceive. I used to look at this area through quite a strict lens of restriction (or in hindsight, how it must’ve felt!). Eliminating inflammatory foods can only welcome a healthy area of growth and development, right? Well, yes, yet only partly. The MORE important piece to food is how do we nurture our body, hormones, uterus. Although simple, I will often write out a list of ‘good’ fats that I want patients to be intentional about getting into their diet.
Good fats —> omega 3 —> anti-inflammatory/make up hormones.
An example of a list for a patient can look like the following:
- 1/2 avocado
- 1 teaspoon MCT oil or 1 tablespoon coconut oil
- 2 tablespoons hemp hearts
- 1 tablespoon ground flaxseed
- 1 tablespoon pumpkin seeds
- Salmon (not daily)
All of this can be in one days worth of food! In oatmeal, on toast, in a smoothie, in salads, on protein, or for a snack. Protein – gotta love them DNA ladder rungs. Eat those up – they help us step up into health.
A word on ‘anti-inflammatory’ eating. Reducing or eliminating foods like our standard North American gluten products or cow dairy are not a bad idea in certain health conditions that may impede fertilization. Yet even research in this area is interesting as a lot of it is focused on how much these diets cause deficiencies and ‘malnutrition’. Although I’m certain these research rats are not seeing a Naturopathic Doctor and getting advice on their diet (just kidding, not really kidding!) I do then emphasize the importance of what we add in to our diet, not just what we take out.
Bloodwork:
My gosh I love looking at labs. I’m going to digress here. I had a fertility patient in the last 6 months come in where we discovered through bloodwork that she was Celiac and had Hashimotos. At our follow up I was so elated that we had answers (answers can be so helpful) and went on to tell her about the lab work findings, forgetting I had a human sitting in front of me that would actually be quite upset by the news. I just felt horrible as I sat there acting like this was ‘good news’. I quickly changed my tune FTR, and went on to apologize for my behaviour and was dead honest and said that I got caught up in getting answers.
Okay so here is a list (not a one size fits all by ANY means) that I love running:
- Thyroid panel – research shows that thyroid issues can cause infertility yet so can thyroid antibodies
- Fasting insulin, fasting glucose – we can plug this info into a calculation that looks at insulin resistance (IR). IR can affect egg quality
- Ferritin – low levels have been associated with increase pregnancy loss
- Anti mullerian hormone (AMH) – assessing egg quality (diverse opinions on this one across fertility centres in North America) I like to see the overall number alongside the rest of this list (depending on case)
- DHEA – serum levels correlate with AMH AND we also know supplementation can improve
- Sex hormone binding globulin and testosterone to calculate free androgen index (FAI): The is higher in patients with polycystic ovarian syndrome (PCOS) and one way to diagnose and therefore treat anovulation and fertility.
- Vitamin D levels: I love how well this is explored in research as an issue (if low) for people with fertility issues. Often GPs don’t run this as it costs a lot and we could all assume that we have some sort of deficiency here in Canada. I don’t always run it (I like monitoring it) yet always supplement (especially if not diligent in the past) Looking at actual numbers and treating accordingly is the best
- Estradiol (day 3 – 5): this gives great insight into certain health conditions if this is too high
- Progesterone levels in second part of cycle: I love sufficient levels. In the last five years some fertility clinics (not all) stop testing and treating for this as new research shows it might not move the needle on the outcome. Intuitively I think it makes sense to support progesterone if deficient as it helps to maintain lining.
- Cortisol AM: this is an interesting one that I look at as it gives insight into what ‘stress’ levels are at in your body (I often times don’t test as you can go off symptoms most definitely) There is no direct research indicating high or low levels (within normal limits) are an issue yet when stress is high —> cortisol is off —> lack of ovulation can occur
- FSH – follicle stimulating hormone: Wee and mighty little number – looking at levels here can suggest egg status
- FSH/LH ratio: can help to look at PCOS issues
Gosh I could go on yet I won’t. Oh but but. Okay one more thing. If we have any hint of a gluten intolerance (and this is a lot of symptoms!) I like to check for a celiac marker, ttg-IgA. AND lastly I also refer out to get immunology testing in case we wonder about body fending off embryos at all. This is a whole other can of worms that fertility centres down in the states specialize in.
Emotionally Where are you Jigging and Jagging at?
As fertility becomes a more communicated issue amongst friends, the public and most importantly the medical community, we have more and more resources for patients to reach out to (especially others going/having gone through it). This support doesn’t take away the severity of how heavy ones heart feels.
I talked to patients a lot about this part. I often ask what feelings come up for them about themselves, about the message they tell themselves, and what feelings does the fertility journey trigger in them?
Life hands up certain roads we walk down to teach, open us up to, understand ourselves on a deeper level. If you’re rolling your eyes at this while going through a struggle of your own, thinking ‘I don’t need a life lesson, I want a baby’ that makes sense. A lot of sense. Yet I feel like, if we can allow it to, the fertility journey can uncover/allow us to understand/lead us to a whole new level of understanding who we are/self love if we allow it to.
The last thing I’ll say about this topic is that if its appropriate, once in a while I’ll refer a patient to a healthcare practitioner that can help them with any energetic blockages. This is way to ‘out there’ for some patients (often those who need it the most lol!), yet it’s quite profound once you start digging around it. Is there any part of your energy is blocking you from progressing into next steps in your life, into welcoming a soul? These are big factors to explore and and very powerful to clear if need be.
Reach out with questions as always! Let’s connect.
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