What is Functional Fertility? 

My personal definition of Functional Fertility goes something like this: a systems-based approach to optimize both female and male fertility by addressing nutritional, lifestyle, and psychological components that correct root-cause imbalances in order to prevent or drastically reduce infertility. Functional fertility has long-lasting benefits for the entire family unit beginning in the prenatal period and extending through to adulthood in the offspring impacting the health of generations to come. 

If you are not familiar with the idea of practicing in a “functional” way, I encourage you to read my blog here. In brief, Functional Medicine is a medical approach that treats health problems or prevents them by addressing the body as an interconnected unit. This is a very different model than the standard model of care, especially in the U.S., where medical care is a “pill for an ill” approach that addressed one part of the body at a time. You go to the gynecologist to help with your period problems, the dermatologist for acne, and a therapist for anxiety, yet none of these experts talk to one another. If they did, they might see how they could work together to accomplish relief of all of these symptoms for you, but this doesn’t happen.

Here in the United States we have amazing emergency care, and believe me, if I am ever in an emergency situation (a car accident, a broken bone, GI bleed, etc.), I would be incredibly thankful to be under this type of medical care! However, this focus on emergency care and the “pill for an ill” model, which is known as allopathic medicine, does not offer much in terms of preventive or wellness care especially for women. This leaves otherwise healthy individuals with a lack of answers to common underlying symptoms that are impacting their overall quality of life such as:

• Fatigue
• Infertility
• Anxiety
• Sleep issues
• Hormone imbalances like thyroid disorder or PCOS
• Skin irritations like eczema or psoriasis or acne
• GI issues like bloating, constipation, diarrhea
• Metabolic disorders like high blood sugars, diabetes, hypertension 

Why Is This Approach So Needed?

How many of you can relate to this picture?

This picture shows how the allopathic model of care is woefully lacking in the ability to see beyond the standard model of treatment and connect with the person in front of them. You may be familiar with this model: the doctor has limited time to talk with you in a rushed (and usually late) visit, the decision is made to run a standard lab panel, and then tell you that everything looks “normal” even though you are feeling terrible! This poor woman (albeit a cartoon, I still feel for her!) is clearly not living her best life and needs answers, but, everything came back “normal.” So she is sent home. How disconcerting and frustrating! 

Clearly there are a lot of pieces missing here:

• Is this women were real, I imagine she would not agree that she is “the picture of health”
• Her labs may be “normal” but are they “optimal?”
• What other labs could be done to dive deeper?
• Why are topics like gut health, stress, trauma, and hormones not discussed at all?

The root of the problem here is that the allopathic model of care simply is not built to be able to provide the kind of care this woman, and many other (real people), need. When these doctors need to see over 20 patients per day this dictates the median visit length of 15.7 minutes per patient with an average 1-5 minutes spent on 6 topics  (1). It’s not their fault! I am not putting these highly trained, brilliant medical doctors down in any way. The current system just can’t support a more comprehensive model of care that people need to dive deeper into their health.

Infertility When Everything is “Normal”

This is exactly the kind of system failure I am seeing surrounding the ever growing rates of infertility. One in eight couples in the US has trouble getting pregnant or sustaining a pregnancy. Globally, infertility affects an estimated 15% of couples (2). The Mayo Clinic defines infertility as “not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples.”

Doesn’t this sound an awful lot like the portrayed story in the cartoon image above? 

 Medical Professional: “Nothing seems wrong. Your labs are normal! Go home, have sex for a year, then come back and we will look into fertility treatments then.”

 Let me poke some holes in this scenario:

Your labs are “Normal”

“Normal” lab ranges are VERY different from “optimal” lab ranges. In fact, the values that define what puts you in the “normal” range are based on the average of the entire population: sick, old, chain smokers, couch potatoes, morbidly obese, and chronically ill. So your “normal” blood glucose is based off of what is normal for all of these people… talk about skewing the numbers here! A 1999 study in Denmark showed that women with a high but still “normal” A1C (a blood glucose marker) were half as likely to get pregnant over a six month period as women in a low normal A1C (3). In addition, many testing, especially hormone testing is done at the wrong time of the month not even giving an accurate portrayal of what’s going on with the reproductive system. I believe you deserve more than that.

Sending Mixed Signals

The nervous system can be in one of two modes: the sympathetic mode or the parasympathetic mode. Many couples who are starting off of the journey to parenthood are also busy in their careers and might still be burning the candle at both ends. This contributes to something called sympathetic dominance which means your body is stuck in a chronic stress response nicknamed “fight-flight-of freeze” mode. When the body perceives this stress it sends hormonal messages to both female and male reproductive organs via the hypothalamic-pituitary-gonadal axis (4) that it’s not a good time to think about growing, birthing, and keeping a tiny human alive! So as much as you may WANT to get pregnant, your body may be sending the exact opposite signal to your reproductive system! Yet, did anyone mention that you might want to consider making a few manageable lifestyle changes to optimize this hormonal communication during this year of trying to conceive (TTC)?

Suboptimal Terrain

 Did you know the prenatal microbiome may play a role not only in fetal development but also in the predisposition to diseases that may develop in adulthood (5)? Basically, the terrain of parent’s gut health may impact the chances of their child developing or not developing disease when they are an adult! Stress, birth control, alcohol, NSAIDs, and environmental toxins all damage the gut microbiome and deplete the very vitamins and minerals needed to support conception. A year is a long time to do some incredible improvements on your gut health… were you ever made aware of this impact you could have on the health of your future family?  

Timing is Everything

One of the most classic examples of misunderstood infertility is the concept that each woman may ovulate at a different point in her cycle. The textbook day of ovulation is on day 14 therefore a woman will be the most fertile at this time. However, some women ovulate on day 10, or day 18, or day 21 and this can change from one cycle to another! A simple issue of poor timing can lead couples to struggle with “infertility” thinking they are trying at the right time of the month when in fact they are missing the mark. Would one really be infertile just because they aren’t timing intercourse properly?

A Year is A Long Time

For many couples, a year of TTC can bring about a lot of unnecessary stress, frustration, and unanswered questions. So much so that when they return to the doctor a year later drastic interventions are often recommended and couples feel they are warranted. There are incredible changes that both you and your partner can be making during year of TTC to set the foundation for a healthy and effortless conception. As Lauren Manaker put in her book, Fueling Male Fertility, “you have to eat anyway, so why not eat and live in a way that has been shown to support your fertility goals?” 

A Better Solution 

For years, I have been helping people who want more than the standard model of care. By spending an average of 40 minutes per visit (not the standard 15.7 minutes) and utilizing functional nutrition I help families have the healthiest journey to parenthood possible by considering every aspect of their health, diet, and overall lifestyle when giving them recommendations to optimize fertility.

Instead of basing recommendations off of standard labs that compare you to “normal” ranges, I use data from specialty tests to get you into “optimal” ranges for superior results. Functional Fertility is more than what is on the end of your fork, it’s a deep dive into the therapeutic, root-cause answers you’ve been searching for. Functional Fertility is for those who want more out of their healthcare.

What is Functional Fertility?

I’ve always had a love for women’s and family health which I believe stemmed from my own upbringing. My mother prioritized fueling her five kids with nourishing foods which instilled in me a healthy relationship with nutrition. Fast forward a few years, after training with some of the best functional medicine doctors in the country, I realized that changing lives with functional nutrition was what I was called to do. It was clear from early on in my career that when a functional model of care was paired with those who wanted more than “the pill for an ill” solution, there weren’t many people that I couldn’t help!

However, it wasn’t until I was working with a very special client at my previous place of employment, The Moday Center for Functional and Integrative Health, that it all clicked for me! By practicing in a “functional” way I could directly improve a woman’s hormones, fertility, and health of her future family! Mind blown! Just like that, functional fertility was born! In fact, watch Heather’s amazing story here to see how functional fertility helped her have a natural conception at age 45 after 5 miscarriages, 2 failed IVF cycles, and a failed IUI!

Functional Fertility vs. A Standard Approach 

A “functional” approach means more than looking at what’s on the end of your fork. To practice functionally means to view your body as an interconnected system and take into account your unique history, genetic predispositions, and current lifestyle factors when developing a plan for you. 

Functional fertility is based on a belief that the body has an innate ability to heal itself when provided the proper nutrition, lifestyle, and psychological components which is why that full year of TTC is so important for couples to take advantage of! Why wait a year and only change one thing about your story, the fact that you aren’t using contraception, when there are a whole host of proven strategies to not only prevent infertility but improve the life-long health of your baby?!

Unfortunately, in a standard approach to fertility there is no cohesive treatment plan until an infertility diagnosis is found (after that long first year) and then it’s straight to medical intervention. Here there is a hyper focus on the women’s reproductive system without much attention on male fertility even though one third of infertility cases are caused my male reproductive issues (2) many of which can be improved with dietary and lifestyle practices.

The Standard Approach to Fertility

With so much technology in the fertility world now available like Clomid, IUI’s, and IVF, it’s easy for many to jump right to these as solutions. And while these are indeed incredible options and have proven to be wonderful for so many couples in order to begin or sustain a family, not everyone couple wants to jump into these first. The purpose of underlining the major differences between the standard approach to fertility and a functional approach in the following paragraphs is to show couples they do have options.

If a standard approach all sounds good to you and you wanted a baby yesterday, then by all means, the technology is there for you! For those people who can afford $10,000 for a single cycle of IVF or who are not willing to make adjustments in their diet and lifestyle this is one way to go and has helped countless families in their struggles with infertility. However, there is rarely one “right” way for all. 

For many doctors in the standard (allopathic) model of care it doesn’t make sense to dive deep into areas like hormone balance, gut health, thyroid support, and stress management. Why address issues such as a short luteal phase, low progesterone, PCOS, hypothyroid, autoimmune disease, sleep hygiene, and gut dysbiosis when Clomid can be prescribed easily or IUI’s can be done? This approach hyper focuses on a woman’s reproductive organs only with no regard to other inputs from connected systems of the body.

Picture laying under a blanket with an open hole right where your pelvis and vaginal region is. THAT is where a standard approach to fertility will look. That’s it. A functional approach to fertility will remove the blanket all together and look at YOU as an individual, the multiple and complex systems that all contribute to fertility, and even your partner’s health too. Remember, one third of infertility issues are caused by male reproductive issues (2). This isn’t a one woman show! 

A Functional Approach to Fertility

None of the solutions above address the underlying root-causes of impaired fertility, which can be many and take a little bit of digging. The implications of this could include recurrent infertility struggles for multiple pregnancy attempts, ignoring symptoms that could contribute to other serious health problems down the road like diabetes, heart disease, or PCOS, and couples miss out on a huge opportunity to improve the overall health of mom, dad, and baby.

So Why Haven’t You Heard About Functional Fertility?

It’s not where the big money is (unlike IVF). Addressing first line factors that could be inhibiting fertility like low progesterone leading to a luteal phase defect, high prolactin levels shutting down ovulation, hypothyroidism, or high stress that locks you in “fight-flight-or freeze” mode, increase chances of fertility exponentially, but it doesn’t make anyone money.

Instead, women are convinced to hand their fertility reins over to the medical system so they don’t have to “worry their pretty little heads” about it. Last time I checked women were more than capable of taking charge of their health and fertility should be no exception. Armed with the proper information, the right attitude, and a major dose of empowerment, women can lead themselves and their families right into fertile grounds. I highly recommend reading Taking Charge of Your Fertility by Toni Weshcler if this lights a little fire in your belly.

The body is a complex, multi-system organism which must be addressed in its entirety. We can’t simply isolate the ovaries or uterus when talking about fertility. Every system, literally, from the top of the body down has an impact on the fertility of both men and women! Yup- although this article won’t cover the topic of male infertility, which is ⅓ of the contributing factor in a couple’s infertility, functional fertility looks at that too! Almost unheard of in a standard approach.

Of course, there are never any guarantees in any approach to fertility. Multiple rounds of failed IVF can be exhausting emotionally and physically, extremely expensive, and if pregnancy is achieved mom can end up back in the same spot she started in after her delivery because the underlying issues were never addressed. Functional Fertility on the other hand avoids unnecessary medical intervention and costs, improves the health for both partners, and if fertility is achieved mom is set up for a great pregnancy and improved postpartum health.

In addition, the best part about taking a functional approach to fertility is you don’t have to only choose this direction. Functional Fertility can be used along-side of standard fertility treatments to improve results of IVF treatments. The science is continuing to come out with incredible data to back this up. In 2018, two controlled studies were published confirming that taking CoQ10 (a powerful antioxidant) for one or two months before IVF significantly boosts egg quality (6). Just one example of how the right testing and food and supplement recommendations can drastically improve outcomes. 

“I Wish I Knew About You Sooner.”

If you knew me you would know that I connect with people everywhere I go. I always leave the room having made another friend and I am so grateful that my career and passions open up these possibilities to me. My response to the inevitable, conversationally polite question of “so, what do you do?” has connected me to some incredible people but has really opened my eyes to the value of Functional Fertility! When I answer something like, “I am a functional health dietitian who helps families have the healthiest journey to parenthood possible,” I was surprised how many times I was met with responses that include:

“What?! That’s incredible! I had no idea that was an option or I would have absolutely pursued that!”

“I feel like everything you are saying is 1000% accurate and sadly the complete opposite of what my practitioners had convinced me of…”

“I wish so badly I had found you sooner”

“My doctor told me that my gut health doesn’t matter in my fertility”

“After taking out a second mortgage to pay for IVF, quitting my job to do fertility treatments, a getting a divorce from my husband, I still don’t have a baby. If I could do it all over again I would have no doubt gone this direction”

 These connections both inspire me to keep doing this work, but also break my heart that so many women don’t know there is a better way that could have saved them money, heartache, and precious time.

My Three Pillar Approach to Fertility

Many women don’t give their fertility a second thought until it is a problem for them. But what if I told you that you had the power to prevent or limit infertility problems with Functional Fertility. Much like preventative care in medicine, I help every woman prepare for the healthiest outcome possible no matter their starting point or current lifestyle obstacles. 

An Ounce Of Prevention Is Worth A Pound Of Cure

It’s recommended that the process begin six to twelve months before even starting to conceive in order to create the optimal environment for success as a full cycle of egg development takes four months. This is especially true if you have been on birth control or have existing hormone issues as these can limit the very nutrients that are essential for a healthy conception. During this time, my Functional Fertility programs focus on my proven Three-Pillar Approach: The Non-Negotiables, Depleted to Repleted, and Fertile Grounds.

Pillar #1: The Non-Negotiables

In the first pillar, The Non-Negotiables, we explore how to rebuild YOUR foundation. A very common mistake that people make when pursuing better health in any capacity is to skip this step. However, if your digestive fire is smoldering, sleep is impaired, stress is unmanaged, and natural detox pathways are clogged then no amount of expensive fertility treatments of prenatal supplements will help. Hence, why it’s called the Non-Negotiables. This critical step sets the stage for the next two pillars.

Pillar #2: Depleted to Repleted

After we’ve established a solid foundation to build from, the second pillar, Depleted to Repleted, dives into the best foods, nutrients, and movement to balance your hormones, directly support egg and sperm quality, and egg maturation. If you’re someone who is doing everything by the book and still not where you want to be, you may be reading the wrong book. Commit to learning how to fill your tank with the right inputs needed to support conception.

Pillar #3: Fertile Grounds

Lastly, we arrive at Fertile Grounds, the third pillar, is where we put your new foundation to the test. Your body is capable of incredible healing, do you believe in that possibility? Finally understand what it takes to give your body permission to thrive. 

Who Do I Work With?

 My Functional Fertility programs are like nothing you’ve ever experienced in healthcare before. I use an all-virtual platform for the most convenient yet comprehensive care, because let’s get real, don’t you have enough appointments to run around to? These appointments should compliment your busy life, not add to the stress of it!

 I work with women and couples who want more from their healthcare and aren’t afraid to commit time and energy to make that happen. No matter where you are on your fertility journey there is a program option for you. Whether you are just starting to plan for a family or on your fifth child, Functional Fertility can benefit you. My desire as a functional health dietitian is to educate, guide, and support you on a superior path toward total vitality and optimized fertility. 

Improving egg quality is helpful even without any fertility concerns because even young, healthy women have a significant proportion of abnormal eggs. If by chance these eggs are ovulated for a few months in a row this could decrease the chances of conceiving. So, if you are just starting out and don’t expect any fertility challenges but want to rebuild your foundation, go from “normal” to “optimal,” directly impact egg and embryo development, reduce some of the worst offenders when it comes to hormone-disrupting toxins, and shift your diet slightly you may be able to get pregnant faster and reduce the risk of miscarriage.

If you are having difficulty TTC it’s time to see what’s going on. PCOS is the number one reason for female infertility, however, standard lab tests are not always helpful in detecting this imbalance and it is only one possible root-cause imbalance that could be going on. With help from appropriate hormone testing, increasing antioxidant rich foods, and supplementation, together we can rewrite your fertility story.

If you are trying to conceive through IVF or IUI the above strategies taken in Functional Fertility like minimizing toxin exposure, dietary changes, and targeted supplements will help you on this journey. Research shows that only good quality eggs are likely to become embryos that can survive the critical first week and implant for a successful pregnancy. Maximizing the number of good-quality eggs that have the potential to become a healthy baby is number one priority here. This is the power of Functional Fertility.

Those experiencing recurrent miscarriage may benefit from improving egg and sperm quality, assessing thyroid health and immune function, and assessing progesterone levels through appropriately timed testing. In fact, studies have shown that women who have Hashimoto’s Thyroiditis (an autoimmune thyroid disorder which is severely under-diagnosed in women) may be able to reduce miscarriage rates by 50% when thyroid antibodies are lowered through dietary changes and an added treatment of Levothyroxine which stops the antibody attack on the thyroid (7).

“Once we know better, we do better” – Mary Angelou

Affiliate Disclaimer: This post may contain affiliate links which means, to no extra cost to you, I would make a small fee if you use them.  

Citations

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2254573/

(2) Manaker, L. (n.d.). Introduction. In Fueling Male Fertility (p. 2)

(3) Fett, R. (n.d.). The Egg Quality Diet. In It Starts With The Egg (p. 207)

(4) https://www.ncbi.nlm.nih.gov/pubmed/15723162

(5) https://www.ncbi.nlm.nih.gov/pubmed/30544936

(6) Fett, R. (n.d.). The Egg Quality Diet. In It Starts With The Egg (p. 112)

(7) Fett, R. (n.d.). The Egg Quality Diet. In It Starts With The Egg (p. 22)