Episode 2: Things You Think Are Working…but May Actually Be Hurting You

If you want to listen to the full episode, head over to: www.wellspringnutrition.co/healing-in-fertility

Transcript:

Hey, everyone. I’m Anabelle Clebenar, registered dietitian, functional nutritionist and your new fertility bestie. In this episode, I’m going to cover why some of the things you’ve tried in the past haven’t been working for you, what a conventional approach to fertility looks like, and why you need to start thinking about a different approach to your reproductive health. All right, let’s dive in. So if you’re like many of my clients, you’ve probably tried a whole bunch of different things on your fertility journey. I’m guessing you probably started tracking your cycles. Maybe you’ve used ovulation predictor kits. Maybe you cut out some of your favorite foods.

Maybe you cut out sugar, alcohol, gluten, dairy, grains. Maybe you’ve tried a whole bunch of different supplements because you saw an influencer talk about them. Or maybe you got an Instagram ad and you thought, hey, why not try it out? And maybe you even went to your doctor and you were met with some really terrible advice like lose some weight, or just wait another six to twelve months and then come back. So let’s break down why some of these things are not working for you, and also why this approach to fertility doesn’t make that much sense. Okay, first let’s talk about period tracking apps and ovulation predictor kits. The issue with period tracking apps is that they use an algorithm to determine when you’re ovulating. So if you’re simply entering data into an app and it’s going to tell you when you ovulate again, that’s based off of a typical 28 day cycle with ovulation happening on day 14. And if you veer away from that, which many women do, then you’re missing your timing, right? So if you’re relying solely on a period tracker algorithm, you may be missing out on the cues that your body is giving you.

So every cycle, our body has certain hormonal cues and signs that it gives you to let you know when ovulation is coming. And you can also confirm ovulation by tracking your temperatures. If you’ve gone up one step and you’re using ovulation predictor kits, this can be helpful for many women, but for others, it’s not. So, for example, if you have PCOS, ovulation predictor kits are not a good use of your money because ovulation predictor kits measure luteinizing hormone or LH. And in women with PCOS, they have higher levels of LH throughout their entire cycle. So if you have PCOS and you’re using an OPK or ovulation predictor kit, you’re likely getting a positive test. But that doesn’t necessarily mean that it’s a positive LH surge that’s associated with ovulation. And if you don’t have PCOS and you’re using ovulation predictor kits and you’re timing things accordingly and you’re still not getting pregnant, there’s likely something else going on that needs further investigation.

The Balancing Act of Elimination Diets: Navigating Health, Social Life, and Fertility

Now, if you’re like many of my clients, you’ve probably tried a bunch of different elimination diets. Maybe you tried going gluten free or dairy free, sugar free, grain free, or maybe you tried all of those all at once. You may have felt a little bit better, you may have even lost some weight. But the issue with cutting out all of these different foods is that you’re depriving yourself of enjoyment, of experiences with your friends and your family. You’re depriving yourself of entire food groups, and you may actually be putting more stress on your body than actually necessary. So, for example, dairy products have a lot of nutrients that are needed and beneficial for fertility. So things like vitamin D, vitamin A, magnesium, and calcium, these are all necessary for fertility to occur. And often these nutrients are depleted in women who are struggling with infertility.

I had one client who had to eliminate fruit because she was told that fruit has too much sugar in it and she had PCOS. And when I told her that she could actually eat fruit, the smile and the joy that came to her was so amazing, because I have seen so many women depriving themselves of healthy foods, things like fruit or oatmeal or dairy products, that it’s just not necessary. So if you’ve been doing that to yourself, I want to give you the permission right now to scale back and start to incorporate some of those foods that you love and enjoy and are actually healthy and beneficial for you. All right, now let’s shift gears and talk a little bit about what a conventional approach to fertility looks like, especially if you’ve already gone to your doctor or to your OB. And you were told to just keep trying for another six to twelve months before any lab work could be done, and you felt like it was either dismissive or just not good enough. I totally get it. Let’s talk about what this approach is and the reasoning behind it. So first, if you go to your OB and you’re over the age of 35, they’re going to tell you to keep trying for another six months.

And if you’re under the age of 35, they’re going to tell you to keep trying for another twelve months. Now, if you are trying to get pregnant ASAP, which I feel like for many people, once they decide they want a baby, they’re like, it’s go time, and you don’t want to wait that full twelve months. Wait till the end of the episode, because I’m going to share a little bit more about what you can do to be proactive during this time. So in a typical conventional fertility setting, they’ll first do an initial evaluation with a thorough medical exam, physical exam, and look at the health of both partners. They’ll ask you about ovulation, about your cycle history, any previous pregnancies or miscarriages, and hopefully they’ll also talk about lifestyle factors like smoking, alcohol, and exercise. Then a semen analysis will typically be done to assess sperm count, motility, and morphology. So this is to help determine male fertility potential, which about one third of all infertility cases are male factor, and then they’ll do an ovulation assessment. So for the female partner, ovulation is assessed through blood tests to measure hormone levels like progesterone and ultrasound monitoring.

Fertility Tracking and Treatment Options

To track follicle development, you may do an HSG, which is an X ray procedure to check for blockages or abnormalities in the fallopian tubes and uterus. There may be testing to check ovarian reserve. So this is a blood test to evaluate the quantity and quality of a woman’s remaining egg supply or ovarian reserve. They may look into some underlying causes. So any additional tests that are needed for hormonal imbalances like PCOS, endometriosis or structural issues, and then typically what is recommended is to start on ovulation induction medicine. So typically clomid or letrozole are prescribed and those are used to induce ovulation. If that doesn’t work on its own, the next step is to do an IUI or intrauterine insemination, which involves placing a specially prepared sperm directly into the uterus around the time of ovulation to increase the chances of fertilization. And then IUI is typically done anywhere between three to six times or three to six rounds.

And then if that’s unsuccessful, typically the next step is IVF or in vitro fertilization. So this involves retrieving in eggs from the woman’s ovaries, fertilizing them with sperm in a laboratory, and then transferring the resulting embryos into the uterus. It’s important to note that infertility treatments can be complex and not always successful. So the approach taken between different fertility clinics, between different couples is going to be different depending on unique circumstances and decisions made by the doctors and by you as a couple. So to recap, you would go from doing initial tests to being prescribed ovulation induction meds to trying IUI, and then if that didn’t work, to try IVF. So let’s look at some stats on IVF for a moment. One round of IVF typically costs anywhere between $10,000 to $25,000, depending on the state you live in. This is for the United States, and IVF success rates really vary from clinic to clinic.

But the most recent stats that I pulled up was that the overall success rate was between 25% to 30%. So this changes depending on the age of the woman. So if we’re looking at women under the age of 35, for the first embryo transfer, the success rate is 41.4%. And for women between the ages of 35 to 37, the first embryo transfer success rate is 31.6%. I don’t know about you, but if I was spending upward of $25,000, I would want something that had a higher success rate than 41%. In the best case scenario, that’s less than a 50 50 shot if you think about it. And I know for many couples, IVF is truly their only option. Whether you have a blocked fallopian tube, if your partner has a history of testicular cancer, or any of the other hundreds of situations that would lead a couple to doing IVF.

The Power of Functional Medicine and Addressing Root Causes

But it’s certainly not the answer for all couples, which what the current conventional medical model directs couples to. So for many people, addressing underlying factors like hormone imbalances, blood sugar imbalances, nutrient deficiencies, gut health all of that has a profound effect on their fertility. And I know this because this is the work that I do and I see it firsthand every single day. So if you’re thinking, okay, if it’s not IVF, what other way is there? Well, Functional Nutrition or Functional Medicine is the approach that I’m going to talk about because it’s what I use with my one on one clients as well as inside my group program, the Holistic Fertility Method. So, Functional Medicine is a holistic approach to healthcare that aims to identify and address the root causes of health issues rather than just treating symptoms. So it focuses on understanding the underlying imbalances and dysfunctions within a body that could be contributing to disease or a health condition. And while specific root causes can vary depending on each person, there are some common root causes that are typically addressed in functional medicine. So, the first is poor diet.

Nutrient poor diets that are high in processed foods, sugar, unhealthy fats, and artificial additives can lead to nutritional deficiencies and imbalances. And this contributes to various different health problems, including infertility. The second is chronic inflammation. So, prolonged inflammation caused by things like poor diet, stress, lack of exercise, environmental toxins, gut health this can all disrupt the body’s natural balance and lead to chronic disease and impair reproductive function. Third is gut health imbalances. So an unhealthy gut with an imbalance of beneficial and harmful bacteria can lead to digestive issues, immune system dysfunction, and systemic inflammation, which also leads to fertility struggles. Fourth is stress and adrenal dysfunction. So chronic stress can impact the adrenal glands, which leads to imbalances in stress hormones like cortisol, adrenaline, epinephrine, norepinephrine.

And these directly affect sex hormones like lowering progesterone, which is needed in adequate amounts to sustain a pregnancy. Fifth is hormonal imbalances. So think about disruptions in hormone levels like your thyroid hormone or sex hormones. Estrogen, progesterone, testosterone, insulin and others can lead to a range of health issues. So it’s estimated that one in eight women will develop thyroid problems during her lifetime. And having poor thyroid function can interfere with the release of an egg from your ovary, which is ovulation, and it impairs fertility. In many fertility cases, subclinical hypothyroid has been found to be a root cause. The 6th root cause is toxin exposure.

Unraveling Fertility Challenges: Toxins, Infections, and Immune System Factors

So exposure to environmental toxins, heavy metals and pollutants can accumulate in the body and cause harm to organs and tissues, including reproductive organs and tissues. The 7th root cause is chronic infections. So, hidden or recurring infections can trigger chronic inflammation and disrupt the immune system function, which makes the body feel unsafe for pregnancy. We have a few more to cover. So the next one is immune system dysregulation, an overactive or underactive immune system can contribute to autoimmune conditions and increase susceptibility to infections, which then leads to fertility problems. Mitochondrial Dysfunction so, mitochondria are the energy producing organelles inside of your cells. Think of it as like the battery or the powerhouse of the cell. This is what creates energy.

Dysfunction here can lead to decreased cellular energy and impact overall health, including fertility. Sleep disturbances, so, poor sleep quality inefficient sleep, not being able to fall asleep, having a wired but tired brain at night, these can all negatively impact your overall health and contribute to a range of health issues that will impact fertility as well. And then there’s also psychological and emotional factors. So mental and emotional well being can influence your physical health. So any unresolved trauma or chronic stress can actually contribute to fertility struggles. So, functional medicine practitioners use all of this comprehensive data, patient history, in depth functional lab testing, and a personalized treatment plan to help you address these root causes and promote optimal health and well being. And the focus is often on lifestyle changes like nutrition supplements, stress reduction, and other therapeutic interventions to support your body’s natural healing mechanisms, restore balance, and make your body feel safe for pregnancy. So, as you can see, a functional approach to fertility is very different from the conventional approach.

In a conventional approach, it’s basically taking some pills to try to induce ovulation, and then if that doesn’t work, IUI or IVF. And in a functional approach, we’re looking at underlying factors to help get your body into a healthy pregnancy state. And while making these changes to your diet and tracking your cycle are all important first steps to take, if you’re currently struggling to get pregnant, it’s probably time you look into some of these deeper root causes and work with a practitioner who can help guide you through this. So, that’s all for this episode. In the next episode, we’re going to dive deeper into some of these root causes, and specifically which tests you can take so that you know what is contributing to your fertility problems. If you enjoyed this episode, tag me on Instagram at TTC dietitian or send me an email. Let me know what you thought of this episode. If you found this helpful, please share it with a friend.

And thank you so much for listening. I’ll see you soon.