Fertility from Dr. Doni’s Perspective – with Dr. Doni

Hi, it's Dr. Donny. I wanted to talk today about.

Fertility and helping to improve your fertility and to be preventing pregnancy loss as much as possible. This is one of the areas that I find so rewarding with what I do over. For over 21 years, I've been trained as a naturopathic doctor, but also as a midwife. I helped a lot with also women getting pregnant and staying pregnant and having a successful pregnancy. I've done a lot of speaking on this topic over the years to professional audiences, training other practitioners, as well as to more public audiences, because I feel so passionate about making sure women have this information because I know how it can feel so isolating and stressful to be trying to get pregnant or preventing pregnancy losses. Sometimes these are things we don't talk about with other people. Sometimes you feel like you're in this process on your own or with your partner and feeling overwhelmed or stressed and sometimes embarrassed or ashamed about your experience. And so to be able to be present for you and to encourage you and help you to know that there's so much we can do to help your body, support your body, to first of all get pregnant, to have a healthy pregnancy and to prevent miscarriages, and to help you through the whole pregnancy feeling as best as you can, even to postpartum and beyond. So there's a lot of ways we can be supportive. This is even beyond the standard medical prenatal care, because the thing is that.

It'S important to know, of course, we need OB gyn. They're going to be doing your exams, they're going to be following along during the pregnancy and monitoring the baby in the pregnancy and helping with the delivery of the baby. Those are all really important parts of it. That's what I also learned as a midwife. It's just, I also noticed there's aspects of it that are not included, that are not standard care. And I feel like they are important aspects of care that I like to provide to patients. And women have really then been able to report back to me what a difference it made for them to have support along the way. Especially because, like in early pregnancy, this is not. This is before, really even before the OB GYN will meet with you.

You might be trying to get pregnant or just found out you're pregnant, but it's not time to see the doctor yet. And so you're kind of on your own. Or sometimes during pregnancy, the OBGYN might not be paying attention to nutrient levels, for example, as much as I would, or throughout the process, paying Attention to thyroid levels or blood sugar levels or methylation levels. Those are not usual aspects of pre, prenatal care unless they really get to be out of range. But I'm paying attention, even if it's slightly out of balance, because I want to be preventing it from being an issue. And so if that resonates with you, then just please know that that's available, that's possible. It's possible to have a practitioner to support you in those ways. And it could be a naturopathic doctor like me, it could be a functional medicine practitioner who specializes in this area.

Certainly I'm happy to be supportive for you.

If you wanted to work with me one on one or as part of one of my programs, we can then really help you to be in your optimal health. See, that's the thing about getting pregnant is of course getting pregnant is a normal thing our human women bodies do, or a body with a uterus can get pregnant. And that's, that's just a normal function. It's just that when we go, we almost, I think, get too far away from just doing normal human stuff. You know, as human bodies, we sleep, we eat, we, we have menstrual cycles, we have bowel movements, sometimes we vomit, we sweat. This is just stuff that a human body does. Yet our human bodies also are very responsive to our environment. So if we want our body to be naturally doing these things, we need to give it time in nature. We need to give it time to sleep, we need to feed it with healthy foods and drink water and, and so we start to really realize, hey, if I want my body to do what I need it to do, I got to give it what it needs to do. That sometimes it's like such a big aha moment or realization for something, you know, so simple because again, it, believe me, I've been there many times in my life where, you know, we're so caught up in the deadlines and the projects and the, you know, the school curriculum or the final exam or the whatever it is trying to get this next position. We can get ourselves so caught up in our lives that we lose track of just what do I need as a human? What do I need in terms of my mind, my spirit, my body in order to have, in order to be feeling, not only feeling good, but functioning well on the inside. And one of the ways that I start to even begin to think about if you start to go well, how is my body functioning on the inside? The first things I look at is I look for energy levels like Any part of the day, ask yourself, how's my energy? If I rate it from zero to five, do I feel tired? Do I feel pretty good? Do I feel like I have too much energy? Then do the same thing for your mood. How does your mood feel right now? How does your focus? How are you focusing? Can you complete a project or do you have brain fog? You can think of how you focusing. How foggy do you feel? Then also think about.

Your digestion. How's your digestion doing? How's your body feel? Do you have any joint or muscle issues? You can start to check in in these different ways and in a sense of, hey, what are the signals your body's sending to you? Because the signals are really your body trying to tell you that something needs attention or something's out of balance. Then, of course, we can look at different lab tests, even from a regular blood work. We can look at cbc, do you have anemia? We can look at a complete metabolic panel and see how's your kidney liver function, how's your electrolyte levels?

A lot of times they'll come back in normal range, but we want to make sure they're really optimal. And if they're out of range, let's ask the question why? And what do we need to do to resolve it? We also want to do other tests, like looking at CRP for inflammation levels, hemoglobin A1C for blood sugar and insulin function. We want to look at thyroid function, so important for fertility. With thyroid, we look at the TSH and I look at the free T3 and free T4 because we want to know the hormone levels. We might also do autoimmunity testing, like thyroid autoantibodies or autoantibodies in general.

And we can look at nutrient levels like vitamin D, which is so important for pregnancy and health in general. Ferritin, which is your iron storage, is so important. Thyroid function for pregnancy. We want to look at homocysteine, which is telling us about the B vitamins, especially B6, B9 and B12. Methylmalonic acid tells us about B12.

In a standard blood test, you can't really check all the different nutrients, but at least the ones I just named. You can get a good sense of it from the blood work. But if the doctor measures B12 in the blood, it's not helpful. B6 is not helpful. We need the homocysteine and the methylmalonic acid to really understand how is your body using these nutrients and do you need more or less of them? So now you can give your body what it needs based on actual information instead of just guessing. You know, sometimes it's like you want to just start with a prenatal, which I think is a good thing. Just look at your prenatal vitamin. Make sure it says methylfolate, not folic acid. That would be. Someone asked me earlier today, she's like, where can I start? And I said, look at your. If you're taking a prenatal or a multivitamin, look at the label. And if it says folic acid, we need to replace it right away because folic acid is an inactive synthetic nutrient that most people are not able to even use effectively. If you're going to swallow a multivitamin, let's at least get one with active nutrients. And if it has folic acid, it probably has other inactive nutrients too. So we need one that's Got methylfolate. Methyl B12. Methyl is the active form that our bodies can use. So, you know, it's helpful to take these, these multivitamins or prenatals. But you want to make sure it has the active nutrients you can use. And then, you know, if you need vitamin D, which now studies show for anyone trying to get pregnant, you should really be taking 2000ius of D A day. And if we want to make sure ferritin is at. Is at least 50, or if you know you have low iron, let's get some iron going because you're going to need it during pregnancy anyway. But if your ferritin is fine, you don't have to add in iron until you're further into pregnancy.

Let's see. So those are some of the top ones. If you have an MTHFR gene variation, then we're going to really want to look at your homocysteine and really make sure you have the right doses of folate as well as B6 and B12. Because the MTHFR gene variation can increase risk of miscarriages and, and birth defects. And so we want to make sure we're really on top of that. We're like, know exactly that you're getting enough but not too much. Some practitioners, it's easy with any of these nutrients to underdo it or overdo it. And underdoing it and overdoing it is, is not very helpful. We want to, we want to know what your body needs and get just the right dose. And so that's why these tests, like regular blood tests you can build through your insurance, can be very helpful. And then there's other tests that we might decide we want to do that are not billed through regular insur, but are really essential, especially if you're having a hard time getting pregnant or you've had pregnancy losses. It's worth it to invest in some specialty tests where we might be able to look at. For example, we can look for food sensitivities. Are there foods that are inflammatory? Do you have leaky gut? We know that food sensitivities and leaky gut contribute to pregnancy loss and fertility issues. So we got to figure that out, which foods are a problem. And let's shift your diet away from the foods that are inflammatory for you. We don't want inflammation in your ovaries. We want your ovaries nice and happy and not inflamed and no oxidative stress. We want them to do their best functioning. We need your ovaries to.

Ovulate. They need to.

Prepare the egg and ovulate. Then once ovulation happens, the ovaries make progesterone to maintain the environment in the uterus for pregnancy to implant and get started. So we really are counting on your ovaries to be able to do that. And sometimes, I don't know, some of you can tell when you ovulate. Like you, you might be able to. Maybe you feel a pinchy feeling on one side or the other. Maybe you notice some vaginal discharge. It would be. Usually the fertility discharge is more of like a. Where we say like egg whites, like clear and slimy discharge. Or you might, you could be tracking your body temperature each morning, your basal body temperature, and notice if it goes up, like by a degree, like from 96.5 to 97.5, for example. And you have to track it every day to notice that kind of a change. But then you can go, oh, my temperature went up. By then, you know you ovulated because it raises your body temperature a little bit. There's ways you can start to notice if you're ovulating, let alone you can always get ovulation test kits to get a sense of it too. And this way you start to learn your body. When is that? When is that ovulation happening? Classically, it would be about two weeks after the last period. If your period is day one of the cycle, ovulation is usually at about day 14 to 16. Then the next period would be at about day 28. If you don't get pregnant, it's in these two week patterns. You go, here's a period two weeks is ovulation. Two weeks later, we run, I'm Going to do a pregnancy test. I tend to like to do pregnancy tests before you expect your period to start because I'd rather catch the pregnancy a day or two early. Because then especially if you're, you know, worried about maintaining the pregnancy or losing the pregnancy, then we're going to want to do testing for progesterone right away as soon as we know you're pregnant. I like to do blood levels of progesterone because the progesterone, serum progesterone in early pregnancy should be at least 26. And if it's less than 26, we know you need help with progesterone. We can use. You can get it from your gynecologist, we can get progesterone cream, we can get progesterone, vaginal suppositories. But progesterone is necessary to maintain the pregnancy. It maintains the environment in the uterus until about 12 weeks of pregnancy when the placenta takes over. Making progesterone that first 12 weeks, that's why miscarriages are so common, is because that's when progesterone may not be high enough to get you all the way to 12 weeks. There's other reasons too, but that's one of the common ones I see is just not having enough progesterone. And of course, when we're under a lot of stress, our ovaries are. They might still be ovulating, but maybe they're not making as much progesterone. And so then it's not enough progesterone to make it to 12 weeks when the placenta takes over. So we need to help that out. We can help your ovaries make more progesterone and we can actually use out side progesterone to help you through that. We can also do testing to measure these things. Yes, you can test estrogen and progesterone in blood work, but it's not very helpful. It's like very broad ranges and it's easy to fall within the normal. So if we really want to get specific about your hormones, we need to do a urine estrogen, progesterone, estrogen metabolism. We can also check testosterone and melatonin and cortisol. You can learn so much more about your hormones by doing a urine. I usually use what's called the Dutch test or the precision analytical dried urine test, which you can do at home. It comes back in a couple of weeks. You collect the sample right after ovulation, about day 19 or 20 of your cycle. We get the Results back a couple of weeks later and we can get a much better sense. Is your progesterone too low? Is your estrogen too low? Sometimes that happens too.

Then we can actually be more supportive of those hormones. Of course, some of the things we were talking about earlier just help overall help your whole health and help your ovaries do better production of estrogen and progesterone. But there's also specific herbs and supplements we can use to promote estrogen or promote progesterone or both. The testing can be really helpful because it really helps guide us for your body instead of just in general. I'd rather know for you. We want to know which food sensitivities do you have leaky gut, how severe? How about the hormone levels? Then we want to know your.

Sometimes even we want to check on the gut bacteria. We can do a stool test because the gut bacteria and the vaginal bacteria and there's even bacteria that live in the ovaries. These all affect fertility. So the main one that's easy to test at this point is the stool because we can check the gut bacteria. And the more we if we see an imbalance and we address it using nutrients and herbal approaches and probiotics or helminth therapy, we can get those bacteria back on track.

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That'S the thing is helminthic therapy, which some of you probably heard me talk about is essentially along the lines of if you think about a probiotic, which by the way, there's studies that show that women who take probiotics improve their fertility. And so we know those gut bacteria are really important for fertility. But Even more specifically, the helminths, which are another microbe that lives in the human digestion and it helps decrease inflammation, heal leaky gut, balance the nervous system and the hormones and the blood sugar. It's like these guys that can live in our gut and have all this profound positive influence on our health, including for pregnancy, for fertility and pregnancy. And they're safe to use with fertility and pregnancy. It's very exciting to be able to have them help us. Especially if you have maybe more severe leaky gut or more severe if you have autoimmunity, for sure. So if you know you have say Hashimoto's or another kind of autoimmune condition.

Crohn's colitis, celiac disease, even rheumatoid arthritis, or different kinds of autoimmunity, there's also autoimmunity related to phospholipids that can, we know, affects fertility. A lot of women, when it comes down to it, if they're having issues with fertility, it's an autoimmune issue. And so we, the helminthic therapy can be such a big support for that. We can now we can. It's going to help manage the gut bacteria, heal leaky gut, drop the inflammation, drop the autoimmunity, and really allow your body to do ovulation and pregnancy in a much more optimal way. If you have questions, of course, about anything I'm mentioning, just reach out to me because I'm happy to talk more with you and explain more and really help see what would match best for your case. But I'm just trying to talk through today. What are these different possibilities? How do I look at it? How do I look at fertility? How do I look at the way we can improve our fertility and prevent miscarriages? And it's by doing this, by understanding your body, what your symptoms are, which are the signals from your body. Looking at different testing, some of it that can be covered by insurance, some of it that we do from out of pocket type testing, like we can check cortisol levels, which tells us about how stress is affecting you. Is your cortisol too high at certain times of day, too low at certain times of day? Because if it is that cortisol that's either too high or too low is going to be inhibiting your ovaries. We need to get the cortisol back to optimal again. Just like we want the insulin to be optimal and thyroid to be optimal, we want these hormones which are messengers around your body. We want them balanced and sending the right Signals to promote you being healthy. But the amazing thing is, the more you're healthy, the. The more fertile you are. And that I see all the time with patients that I help with HPV and Pap smears. So say if you had Pap smear that came back with abnormal cells, or maybe just with hpv and you're wondering, what am I going to do? Because maybe you're wanting to get pregnant, but you want to make sure that your cervix is healthy to begin with. Or maybe you've had a pregnancy and you're wanting to help your cervix and prevent this HPV before your next pregnancy. What I find is that, first of all, that's all possible. We can definitely help clear the HPV out of your system and help your cervix heal and the cervix cells come back to being healthy again. The amazing thing is, as we go through that process of healing your cervix, it actually ends up healing your whole body. And so you become more fertile in the process. Actually, I like to tell women who are working with me to help solve the hpv, you're going to become more fertile because otherwise they might get pregnant by accident.

But it's so true that as you improve your overall health, the fertility improves. And I see it over and over again. It just shows me that it's true. And some of the same things we do to help your body fend off a virus like hpv, by the time we help you with the stress reduction and the leaky gut healing and the hormone balancing and the nutrients. Right. It sounds very similar. It's a similar process that we follow for getting rid of HPV and abnormal Pap smears is improving your fertility. And so, of course, you can be doing two things at once. By the time you've gotten rid of the HPV and healed your cervix, you already took a couple months to get your fertility improved as well. And so I always love it when we can achieve multiple things at the same time. Right? Like you didn't have to put in, you know, more effort or more time or, you know, more stuff to take. It's actually we can do some of the same things, foundational things that have many different positive influences in our body. And to me, then you're, you know, it's kind of the ultimate multitasking, right? It's like that efficiency of what can we do as a common denominator, as a foundational activities and choices that end up having a ripple effect that improve Many different systems and symptoms in our bodies. That's one of my favorite ways to approach hpv, but is also one of my favorite ways to approach fertility. Then, as I was mentioning, when I work with people one on one, usually we go within my. What's called a women's wellness program, where we do the food sensitivity tests, we look at cortisol and adrenaline and neurotransmitters, we look at all the blood work we meant, I talked about sometimes we need to do additional tests. Like if we need to, we can do genetic tests or we can do stool tests, but we gather the information we need for your case and then we create a plan that really makes sense for your body from top to bottom. Which nutrients do we need at the right doses for your body to optimize your fertility? And that's what we do in the program. Over, we meet, we do the test, we review the test results, we create a program, we follow up on the program. And along the way, I'm also teaching you.

Tips and techniques and skills to know yourself better. Because that's the thing is as we just as humans, one of the things that happens is as we start to bring attention to ourselves and try shift our patterns and change different choices, it can trigger these limiting beliefs, I call them. Like sometimes there is an anxiety or a worry or something that you might be familiar with. What those messages you hear in your head that kind of hold you back, right? If you feel that, like, oh, there it is again, trying to block me from moving forward. You know, sometimes it's I'm not good enough or I might do it wrong or I have to be perfect, or some of these, do I really deserve this? Or these kind of messages that sometimes we have happening in our mind, not on purpose, they're just there and they pop up. Especially when we're trying to make changes and do something new because they're kind of like preventing us from getting where we're trying to go. So these are opportunities I look at, like to notice these beliefs and really then be able to connect with it and understand it and shift it. This is something that I do in my work, one on one with people, but also just so you have a taste of it. From here we look at what is that anxiety? Where did it start? What is it really? What are we really saying to ourselves? And did it start in childhood and why? And how can we shift that belief into a belief that's more compassionate and loving toward yourself and then shift that belief and bring it into your day to day activities, so it really becomes real where you can live it and you can shift it. And now you're going to be able to move beyond those little speed bumps, so to speak. You're going to be able to move beyond the blockages and be closer and closer to what you really want. Right. Like you, maybe you're. Whatever it is for you. You know, if I'm assuming, listening to this podcast, that you might be really wanting a pregnancy, and so you realize, hey, I. What do I need to do to show up in such a way that that possibility can happen, that I can get pregnant, that I can have a healthy pregnancy, a successful pregnancy? We want to phrase it in the positive, really find the words around what you really desire in the positive words. Because our brain listens that way. Whatever we say, our brain listens to. So we want to give our brain the signals of what we really want. I want a healthy pregnancy, for example. And then you can also really connect with yourself, because sometimes when people connect with themselves, you might even realize, hey, is this even really what I want? Maybe there's something else that is a priority for me at this point in my life. You want to really connect with yourself. You're really coming from a place of knowing yourself and knowing your priorities, because then you know your authentic and you're being loving towards yourself, and you're going to be showing up as your true self in the process. And this is a tricky thing with fertility, is we can lose track of ourselves. You know, we. We end up just paying attention to the next pregnancy test and, you know, how many months have gone by and how old you are and. Right. It's so easy to get caught up in all these numbers and in the clock. Right. The biological clock. And what I'm suggesting is you. Yes, we're going to have awareness for your age. We're going to have awareness for time and where you are in your menstrual cycle. So it's possible to have awareness for this, but also give yourself some space so it doesn't have to be so stressful. So you can be. Because actually, a lot of times pregnancy happens when people stop trying to get pregnant. Right. As soon as a person says, okay, I'm done trying, the next month, they get pregnant. Why is that? Well, it's because they let go. They let go of the expectation, they let go of the stress, they let go of watching every minute of the day, and they just let their bodies do their thing. And so there's something to learn from that. How can we, even when you are really wanting to get pregnant. How can you give yourself more time and space instead of thinking, oh, it has to be this month. Can we be like, okay, you know, let's give ourselves a few months. Let's, you know, let's observe where your menstrual cycle is and when your fertility window is, but at the same time not stress about it. You know, try to be in love with your body and in love with the process. And that's when actually you're going to be most likely to be able to get pregnant. By the way, it's, you know, you're most likely to get pregnant when you're ovulating. So day 14 to 16 is the classic, but may not be true for you. So you want to know for you, maybe you ovulate more like day 12. I would say it's more like a 10 day window. I would say between probably day 10 and 20 is the most likely that a person could get pregnant because the egg lives a couple days and the sperm can live a few days. There's time in there. It's not just one day you can relax because then your whole system works better and you feel better. Right.

Why should we stress ourselves out if it's not even going to help the process? So just a little check and be like, okay, how can I be more human with myself? How can I be more loving to myself? And by doing that, be more successful with achieving what you're going for. If that's a pregnancy or not a pregnancy, then you're just being more present with yourself along the way and more forgiving and more understanding and more trusting of the process. It doesn't mean when you're trusting the process, it doesn't mean you give up and you're not paying attention to anything. No, you can be both aware and relaxed at the same time. And that's what I encourage you to just practice. It's something that doesn't necessarily come, you know, instinctually. We have to kind of let go of these limiting beliefs and preconceived expectations and everybody else's. He should, he said, she said, they said they want all of that. Just let it go and just be with you and what you really want and what you really believe about yourself and then move forward from there. And so that's some of the mindset shifting and mindfulness work that I do with patients as well, because it really can make a difference. Because otherwise fertility and especially if you're working with a reproductive endocrinologist or doing IVF and Having to do different treatments, it can get very stressful. It's very important that we support you along the way. You know, we have to counterbalance the stress with some anti stress. And so we need to get really, if we're going to go through something stressful like that, we need to make sure we do. We are really good at our self care for you on your stress recovery.

Let's see. So let's see. I think I covered a lot of what I wanted to cover in this video. So let's see. You got it. So if you have, if you're working on fertility, if you have a history of miscarriages, if you're working on some other health issue and you're thinking of fertility or pregnancy at some point in the future, might as well start bringing it into your awareness sooner. The sooner you can start.

Thinking about preparing your body for pregnancy, the better. It can sometimes be months or even a couple years to really have you at your healthiest place, you know? Yes. Sometimes people get pregnant without realizing it like and you just pick up with wherever you are and you start supporting from there. But if you have time then I think you might as well start, you know, working on it and bringing your awareness to it because the healthier you are, it also means the healthier your baby's going to be. So just looking at it as a chance to improve your health, improve your potential future baby's health and then it all is a win win. Right? It doesn't have to feel stressful. It can feel like you're really nurturing yourself and it's going to benefit your future baby at the same time. So it's all good. And let's see if you guys have any questions. Please reach out to me. Please reach out to my office. You can find me@drdonnie.com d r d o n I.com or you can find me, you can contact my office by phone which is 855-316-2114. And my assistants are always happy to help. They've been working with me for a long time so they understand my approach and they'll be able to explain more about how I can help.

Let's see. And then we can always meet, we can always have a quick call or we can set up a whole comprehensive session and just really dig in and get your whole strategy set. Because I find that once you have a strategy that's really based on your body and you knowing yourself, then there's less room, there's less of this being distracted and Less of this stress because you have a plan and, you know, you're working with, you know, like, for me, I've been helping patients for over 21 years, so I've seen all different kinds of scenarios. I'm going to be able to show you, here's what helped the most people and then let's learn from your body if we need to make adjustments along the way. So just know that I'm here to help and, or reach out to us if. And we can always guide you to whatever you need. And I'm so glad you joined me in this. I'm really so excited for you. Again. It's, you know, when I, when working with patients, it's so rewarding to me and then I want to share with more of you. So it's, that's what, you know, you hear from me. It's just like excitement about the possibility of helping you learn about your body and what it needs to for you to experience what you're hoping to experience in your life, including potentially being a parent and having your own family. Of course, there's so many different ways to have families. Even if, you know, sometimes you may have a egg donor or surrogate parent or adopted parent or could be a foster parent. There's so many different. I mean, really, there's also parenting animals, which some of you know, I do a lot of, because I think that there's so much we can experience in life from those connections with others and that humans also have this ability to love and experience gratitude and connection with others. And so I think that's what really draws us to want to bring other people and pets and animals into our lives, is because we want to be able to connect with the world around us and connect with each other. And so just realizing that that may be part of what's pulling you forward is that oxytocin, our love and bonding hormone, and recognize it and love that about yourself and enjoy that and know there's many different ways to experience it. And actually, the more you experience love and oxytocin, even from day to day, that also is so healing to your body and your fertility. So again, you may even want to practice kind of acting as if leaning in, feeling the feeling of what you want to create. So thanks again for joining me and I hope this is helpful. Please be in touch if you have any questions and I look forward to connecting with you again soon.

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