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How Can I Support Fertility?

Updated: Jan 15, 2023




You’ve made the very significant and exciting life decision to have a baby but you want to know how to best support yourself and your future child’s health. It seems like everyone and their mother has an opinion on this topic and the information can be overwhelming. There’s a lot of “do’s and don'ts” but like everybody, you probably just want a highlighted list of things you can do to have a successful pregnancy. Look no further, mama, this blog is for you.


If you’re in the preparation stage of conception, there are 7 main areas that I encourage you to focus on now. Factors like diet, supplements, stress management, hormones, thyroid function, gut health, and detoxification are imperative in creating a safe, nurturing environment for your little one, while ensuring your own personal nutrient status. Stick with me because there’s actually a lot you can do to help support your fertility, a successful pregnancy, and the health of your future baby.


Diet

Have you ever tried to correct a pregnant woman’s eating habits? Doubtful or you wouldn’t have made it out alive to even read this blog. It won’t work. Instead, I suggest putting forth effort to support the body before you decide to create a life (male partners, I’m talking to you too).


Assessing nutrient and caloric intake before conceiving are important as they alter the environment where the egg and sperm develop, and can modify hormones involved in the reproductive process. Following the 80/20 rule is critical for your sanity. This rule provides a more manageable guideline to eating structure, encouraging 80% of your focus to be on whole, nutrient dense foods, while limiting sugar and refined foods, and the other 20% for you to enjoy your life. Contrary to popular opinion, a piece of pizza will not kill you. The stress about it is usually much worse than the food itself.


Beyond generalized diet clean ups, at Gut Honest Truth our patients have had a lot of success utilizing a few different therapeutic approaches, whether in combination or by themselves. Below is an outline of the 3 approaches we most commonly recommend.


The Elimination Diet

Food sensitivities can initiate a handful of inflammatory processes in the body in hopes to correct the problem aka the food you just ate. Long term exposure to a food you’re sensitive to could be causing continual inflammation, which may be impacting your fertility.

An elimination diet can be helpful in the months leading to conception as it identifies food sensitivities and decreases inflammation, both of which make it easier to actually get pregnant. If your body isn’t spending time healing from chronic food triggers, it can allocate the space to support a safe pregnancy.


The gold standard and most recommended way to identify food sensitivities or how the food is affecting your body is to do a proper elimination and reintroduction program which I highly recommend you work with a functional nutritionist on. This can be as minor as removing gluten or as major as removing the top 9 food sensitivities at once; gluten, dairy, corn, soy, eggs, shellfish, beef, pork and peanuts.


The Ketogenic Diet

A ketogenic diet can be a nutrient-focused therapeutic approach to aligning your body appropriately for pregnancy. The ketogenic diet is a strategically designed protocol that emphasizes the utilization of dietary fats, while limiting carbohydrate intake. A properly followed ketogenic diet can help reduce levels of insulin, regulating reproductive hormones including testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH). A ketogenic diet can be used therapeutically to mitigate inflammation, and improve ovulation to improve pregnancy rate. However, ketogenic diets are not generally recommended for during pregnancy, so please work with a provider if this is something you need, medically.


The Detox Diet

A properly structured detoxification protocol and diet can be invaluable before actively trying to conceive. This needs to be done preferably about 6 months prior to conception, and women who are pregnant or nursing should not attempt detoxification under any circumstances, as a growing fetus is uniquely vulnerable to toxic exposure due to placental transfer. Toxins accumulate in your fat, muscles, and organs, so you want to allow for plenty of time for those toxins to be eliminated prior to conception. I highly recommend that you work under the care of a functional medicine practitioner to help you navigate an effective detox program in your preparation journey but more on this towards the end of the blog.


Supplementing for Fertility

Focusing on specific nutrients, such as folate, choline, iron, zinc, iodine, and B vitamins is critical to your baby’s development.

Some GHT favorite supplements:

  • Prenatals

    • Metagenics Plus One Daily Packets

    • Pure Encapsulations PreNatal Nutrients

    • Seeking Health Optimal Prenatal

  • DHA

    • Nordic Naturals Prenatal DHA

  • Phosphatidylcholine

    • Designs for Health Phosphatidylcholine Powder


You can find some of our favorite quality prenatal supportive supplements here.

Additionally, testing for genetic mutations can provide insight as to how well you’re naturally able to use your nutrients. Some genetic mutations will place a different demand on the forms of nutrients necessary to fulfill the requirements for you and the baby. For example, MTHFR is a gene that impacts your ability to utilize B vitamins properly, so it would behoove you to know that you need a specific form to meet adequate requirements which are imperative to the baby’s neural development.


Stress

Infertility is much more common than many of us realize and seemingly the blame is often offloaded on the woman who is then forced to take responsibility for the infertility and jump through hoops to reattempt for a successful result. This often results in fertility treatment methods like intrauterine insemination (IUI) or in vitro fertilization (IVF). But did you know that at least 30% of infertility issues are actually due to issues with the male partner. Male infertility can be due to low sperm production or function and/or inadequate sperm delivery, and can be the result of illness, injury, chronic health problems, lifestyle factors, and nutrient deficiencies. Therefore, males may need dietary protocols, lifestyle changes, stress reduction, and testing done to ensure their contribution to the fertility journey is as optimal as possible. Addressing nutrient status, gut health, and hormonal status should be a therapeutic approach directed at the male partner in the relationship as well. I often have couples in my practice get treated simultaneously to best support conception success, and generally have success accordingly.


Hormones

Follicle Stimulating Hormone (FSH)- produced by the pituitary gland to stimulate ovarian follicle growth and maturation, estrogen secretion, and endometrial preparedness. Stimulants sperm production in males.

Luteinizing Hormone (LH)- produced by the pituitary gland to stimulate ovulation, development of corpus luteum (which secretes progesterone) and the production of testosterone in males.

GnRH- produced by the hypothalamus to stimulate the release of FSH and LH. Estrogen- produced from ovaries, testes, fat cells, corpus luteum, and placenta during pregnancy. Stimulates release of GnRH in follicular phase and inhibits it in the luteal phase; stimulates thickening of the uterine wall during menstrual cycle. Progesterone- produced in the ovaries and placenta; prepares the uterus for fertilized ovum and pregnancy maintenance; stimulates uterine lining buildup during the menstrual cycle; helps stimulate cell division of the fertilized ova; inhibits action of testosterone. Testosterone- produced by the testes and ovaries; stimulates maturation of male sex organs and sperm, formation of muscle tissue.

Hormones are undeniably the biggest aspect of conception. Ensuring adequate hormonal status during preconception is one of the best ways to support a successful pregnancy. For women, tracking estrogen levels, ensuring adequate progesterone (and thus, ovulation), moderating cortisol output, and having a big picture understanding of metabolites are critical to creating a safe space to harbor a life. At Gut Honest Truth we utilize DUTCH testing by Precision Analytical to get deeper insight on hormonal levels prior to actively trying to conceive, so that we can support the body as necessary. Hormonal testing can be done on your male partner as well.


Thyroid

We often have more control over how well our thyroid functions than we think. This butterfly-shaped gland has a significant impact on a variety of bodily functions including metabolism, motility, digestion, sleep, cholesterol, ovulation, and menstruation. Given its role in ovulation and menstruation, a suboptimal thyroid can influence progesterone production, estrogen metabolism, sex-hormone binding globulin, and egg maturation. Meaning, small dips in your thyroid health can greatly impact your fertility, pregnancy, and eventually, postpartum journey.

The problem is, women don’t get regularly screened for thyroid discrepancies, and if they get lucky with some blood work, it’s often only measuring their thyroid stimulating hormone (TSH). That’s not enough to truly see the whole thyroid picture. At Gut Honest Truth we recommend running a full panel in order to get the whole story, not just the spark notes version. A full panel includes the following markers:

  • TSH- thyroid-stimulating hormone produced by the pituitary

  • T4- metabolically inactive and converted to T3 to be useable

  • T3- metabolically active thyroid hormone

  • Free T3- the most usable form of your thyroid hormone

  • Free T4- level of free or active form of T4

  • Reverse T3 (rT3)- the inactive form of T3 produced from T4 when the body is experiencing stress, infection, cortisol dysregulation, or nutrient deficiencies; competes with T3

  • TPO- an enzyme that is involved in the production of T3 and T4.

  • TgAB- proteins that transport thyroid hormone to the tissues throughout your body

    • TPO & TgAB can be useful when investigating thyroid autoimmunity


Thyroid issues can take time to correct, so testing well before trying to conceive is always ideal. If you’ve already been diagnosed with thyroid issues, I highly recommend you check out my thyroid ebook and become your own best health advocate.


Gut health

How well your gut is functioning has a broader bodily impact than on just your digestion. It impacts immunity, chemical nerve signaling, and hormone balancing just to name a few. Before conception, it’s highly encouraged to identify and treat possible gut infections. At Gut Honest Truth, we recommend starting with a stool test and a SIBO (small intestine bacterial overgrowth) test to look at the health of the large intestine and small intestine, respectively. Having both of these test results gives us the whole picture of total gut function, not just a sectional understanding.


Gut infections can change your immune response (Th1 vs Th2), making it hard to conceive as your body is allocating resources to defend you against the pathogen instead of creating an environment to host a baby. The Th1 response is more preferred when handling an active infection/invader. When pregnant, the immunological state biases toward the Th2 response to help protect the fetus, and a disruption can have an impact on a healthy pregnancy. Therefore, it’s in your best interest to support the clearance of a bacterial, parasitic, or pathogenic infection of the gut before actively trying to conceive.


It should be noted that a well trained practitioner will not attempt to clear infections while you’re pregnant or while you are actively trying to conceive, but instead will prioritize the health of the baby. Most herbal and therapeutic supplements are contraindicated during pregnancy and lactation, so treating the gut must wait until after breast-feeding (in most cases).


Detox

Let me preface this section by reminding you that a 3 day juice cleanse does not, will not, cannot qualify as a detoxification protocol. In fact, it may make things worse for your healing. Detoxification and biotransformation are natural processes of the body, carried out by a number of organs, including the liver, gastrointestinal tract, kidneys and skin. Your body’s natural ability to discard toxins is relied upon every day. The common misconception is that the liver is supposed to do it all for you, and though that may have been true thousands of years ago, it can’t possibly do all 500+ jobs it has and rid you of the chemicals we’re surrounded by in our modern lives. By the time a woman leaves the house, she’s already embraced over 168 chemicals from things like skin care, house cleaning supplies, makeup, etc.


Supporting your body with a proper detoxification protocol can be a huge shift in healthy fertility and conception. Common contributors are:

  • Heavy- lead, cadmium, molybdenum, manganese, boron;

  • BPA- plastics

  • Phthalates- synthetic fragrance, catering, clothing, cosmetics, food packaging, chemical cleaning supplies, air fresheners, etc.

  • Parabens- skin care, medicine, cleaning products, laundry products, and hand sanitizer

  • Pesticides- conventional meat and dairy, weed killer, air pollution

  • Mold and mycotoxins- carpets, attects, water damage, HVACs

Detoxification protocols should be done under professional supervision and preferably completed at least 6 months prior to pregnancy. We absolutely don’t want to mobilize anything harmful that can pass through the bloodstream to the baby, so if you’re already pregnant please wait until after the lactation period to engage in such programs. If you’re interested in further reading, this is a great article highlighting the toxic burden we’re seeing in newborns. If you’re unfamiliar with detoxification, I have a free webinar that goes much deeper into details.


Preconception and pregnancy require a lot of biological systems to function well simultaneously. In order to sustain a healthy pregnancy, for both you and the baby, the above areas should be taken into consideration. Deciding to create life is incredible, your experience should be too! Sending you all the love and support, soon-to-be mama.



Katie Morra MS, RD, LDN, IFMCP is an Institute for Functional Medicine Certified Practitioner and Registered Dietitian Nutritionist specializing in gut and hormone optimization. Katie runs a fully virtual functional medicine practice, Gut Honest Truth, based out of Maryland. Katie focuses on the root causes of inflammation, autoimmune disease, irritable bowel syndrome, food sensitivities, hypothyroidism, hormone imbalance, adrenal dysfunction as well as other chronic disease states.​



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