As a naturopathic doctor, I’ve been writing on health and breaking down research studies for the past decade. Within that time, I’ve treated women’s health conditions such as endometriosis, polycystic ovarian syndrome (PCOS), infertility and pregnancy care, as well as men’s reproductive health—including sperm quality and the impact of stress, sleep and cardiovascular health. All this experience has culminated in my newly released book, It Takes Two… And a Uterus.
I wrote this fertility guidebook with two questions in mind: what can prospective parents do to support fertility and what could be affecting someone's ability to become and remain pregnant? I cover a range of topics within fertility and share the research shedding light on different elements affecting the ability to conceive and carry a pregnancy to term.
Here are few top takeaways with excerpts from It Takes Two... And a Uterus:
Sperm health is a major fertility factor and will affect offspring health.
Fifty percent of the embryo’s DNA comes from the sperm, and the health of the sperm provider before conception can affect that future baby’s health outcomes. The good news is that new sperm are generated every two-to-three months, so sperm health can be improved with dietary and lifestyle changes (and supplements if indicated).
“Although sperm and egg DNA will merge, the genetic material that gets passed specifically from sperm to offspring has a greater risk of undergoing spontaneous mutations which can be passed down for generations.”
Unless you give it the right information, your cycle tracking app doesn’t know when or if you’re ovulating.
Understanding your body and your cycles is a major component of fertility—if you don’t know how to recognize your fertile window (ovulation, and the three to five days prior to), you will miss the opportunity for sperm to meet up with the egg. Tracking apps typically estimate ovulation by counting back 14 days from your next expected period. But this isn’t accurate for a lot of people. One of the most important signs of the fertile window is cervical mucus, which is released as your estrogen levels rise in the follicular phase.
“This particular discharge will be slippery, stretchy, clear and more abundant than ‘dry’ discharge. It has a consistency like raw egg whites and is extremely lubricating… When you feel this type of fluid, either with your finger or when wiping with tissue, it’ll be jellylike and slippery. This is the magic fluid that signifies your fertile window. Apart from telling you you’ll be ovulating soon (within one to five days), it has several key functions. First, it’s alkaline in nature, meaning it has a higher pH to protect sperm from the otherwise acidic vagina. Second, it serves as a medium for sperm movement and helps keep them alive longer.”
The best thing about cervical-mucus tracking? It’s free! Just pay attention when you’re wiping in the bathroom. Other signs and information you can track include urine LH testing—the at-home ovulation test—as well as basal body temperature (BBT). Neither will tell you if you did in fact ovulate but they can help you further understand your cycles and your hormones. For example, a positive LH test indicates you are likely to ovulate within 24 to 36 hours, whereas progesterone is thermogenic (heat generating) meaning it causes BBT to rise—a sign that you may have ovulated.
The uterus and its health affect the ability of an embryo to implant and grow.
Uterine health includes the collection of bacteria living in there, called the endometrial microbiome, as well as the presence of any physical abnormalities such as fibroids, polyps and disorders like adenomyosis (abnormal uterine muscle tissue). Abnormal cells and structures can get in the way of implantation and healthy embryonic and fetal growth, not just physically, but also because of the micro factors they affect. They can cause inflammation as well as interfere with cell signalling, making it more challenging for an embryo to stick, implant and grow.
“Similarly to a healthy vagina, a healthy uterus is dominated (more than 90%) by Lactobacillus bacteria. These bacteria hang around the uterus so when an embryo arrives, they help set up a landing pad for it. Without these bacteria, the embryo may not be able to attach."
These are major factors to consider in failed implantation (the inability to get pregnant) and early pregnancy loss. Having a healthy uterine environment and the right bacteria present is necessary to facilitate the interaction between the embryo and the uterine lining, and this starts with the bacteria living in our gut and vaginal environments.
My top three basic recommendations for improving the reproductive odds:
1. Get a daily dose of physical exercise.
Exercise is so important for our physical, mental and emotional well-being. It enhances blood flow, endorphin release and causes your cells to make more mitochondria (the energy producers). Aim for 30 minutes of moderate to vigorous activity on most days of the week.
2. Adjust your diet to prioritize vegetables and minimally processed grains.
Consuming simple sugars and low-fiber baked goods can lead to insulin spikes and high insulin levels (not good for reproductive function). Ditch the sugar and processed carbohydrates and up your intake of low-pesticide vegetables (pesticides can interfere with your hormones and can increase your susceptibility to obesity) to optimize your nutrition.
3. If you or your reproductive partner smokes, stop.
Smoking and nicotine have numerous negative effects on fertility, including tanking sperm and egg quality, our microbiomes and the ability of the uterus and fallopian tubes to function properly.