Bottom Line/Health: The fertility business has become a huge business, but before people go running to the fertility specialist, there really are things that they can be doing on their own beforehand to help them conceive. Is that correct?

Dr. Brooke Kalanick, ND: Yeah. One thing that I see a lot of times with women struggling to conceive is that they haven’t had any good blood work. I go back to this all the time with women. You haven’t had your thyroid checked. There are so many women with undiagnosed thyroid problems. Hashimoto’s is 1 in 8 women, so if you count your girlfriends and none of them have Hashimoto’s, it could be you. So I’d recommend getting screened for thyroid issues as you’re starting to conceive if you’re having trouble.

Also, many, many women are waiting longer to have children, and many of them have been on the pill for some amount of time. Sometimes women are on the pill just purely for contraception, but most women go on the pill to manage some sort of hormonal issue – they had painful, heavy periods, they had irregular periods, they had acne, they had some condition, something like polycystic ovarian syndrome.

All of those conditions that were there when they started the pill, and oftentimes are a reason that women take the pill, they’re going to be there when you come off. So the notion that those are gone now that you start coming off the pill, and even if you’re getting a cycle back, those hormonal issues will still be there. So if there were things that prompted you to take the pill, those still need to be sorted out for optimal fertility after women come off the pill.

When I work with women, I tell them this can take 6 months to a year. So those two things are important for women to do. By the time you’re already starting down the infertility path with the doctors, one thing I repeatedly see is that women are getting checked out and the men aren’t. And I see over and over and over again, we’ll find out that there was an issue with low sperm count or motility that we could’ve caught a lot earlier. So get your husband checked or your partner checked as well.

Bottom Line: Step 1 might be to get your husband checked, get the sperm count checked. As far as if they’ve got thyroid issues, once they treat the thyroid issue, should they have any problem conceiving?

Dr. Kalanick: If they’re just in deficit of thyroid hormone, getting that up is not only important for fertility, it’s very important for baby’s brain as a woman goes through her pregnancy. So definitely want to have medication on board if you need that.

But also, having a proper thyroid hormone level is one issue. If the problem of the thyroid is Hashimoto’s, if that’s why you’re low thyroid – that’s an autoimmune condition that’s one way you can be hypothyroid and the most common way – that has consequences for fertility as well. So getting on top of the immune system could be a really important thing to do if you’re struggling to conceive.

Bottom Line: And then you talked about some of the issues that somebody had that led them to be on birth control pills. In fact, for those people though, they really do need some kind of fertility specialist or some endocrinologist that can help them to manage their hormones?

Dr. Kalanick: Yeah. Like I said, if there’s an issue that brings the pill on as a band-aid solution – because it will minimize side effects of things like PCOS, it will make your cycle lighter if it was heavier – but working with someone like ideally a functional medicine practitioner such as myself, those oftentimes aren’t really overt conditions that are going to be addressed by our mainstream model. They’re more functional issues that respond really well to diet, exercise, and certain supplements.

Sometimes we do need medications on board as well, and often working with an endocrinologist can be a piece of that. Getting those things on board and getting help before you try to conceive will help your fertility, and it’s also going to help you have a much healthier pregnancy.

Bottom Line: And how about just the basic issue of stress? How many times have I ever met a woman that said, “Couldn’t conceive, couldn’t conceive, gave up – got pregnant”?

Dr. Kalanick: That’s something in functional medicine we call the progesterone steal. As soon as you’re under a lot of stress, your body’s going to choose its resources wisely. We care less that you get pregnant than we care if you survive, so you start robbing resources from progesterone – we call that progesterone steal – and using them towards cortisol. When cortisol and stress go down, you have a healthier progesterone level to hold onto that brand new pregnancy.

Bottom Line: All right. A little stress management, a little management of the hormones if you’ve been on birth control pills – men, get your sperm counts checked – and check your thyroid. Thank you, Dr. Brooke Kalanick.