FERTILITY ENHANCEMENT
Fertility Support from the Toronto
Functional Medicine Centre
Fertility Support
A brief guide to a functional medicine-based Enhanced Fertility Protocol program
When it comes to conceiving, unexpected obstacles may arise – however, functional medicine may assist with your fertility health journey.
Family planning can take a physical, mental and emotional toll on patients, so it may be difficult to grasp how to enhance fertility. The functional medicine-based Enhanced Fertility Protocol program takes into consideration and understands your struggles and can address your concerns with compassionate, integrative care.
How Functional Medicine Address Fertility Concerns
Functional medicine is a practice that considers each patient’s root causes for triggering imbalances. This means that one patient’s fertility concerns are not the same as another patient’s concerns. At a functional medicine clinic, fertility health is treated as a distinct concern within a single individual.
According to the functional medicine model, all systems in the human body are interrelated. This means that unrelated factors could possibly contribute to your conception concerns. These factors may include inflammatory foods, insulin resistance, nutritional deficiencies, Celiac disease or other autoimmune conditions that could hinder your chances of getting pregnant (i.e. autoimmune thyroiditis).
A naturopathic doctor and nurse practitioner will work alongside patients to understand the scope of their current health issues. They may consider the following to establish infertility causes:
- Hormonal imbalances: Thyroid hormones and adrenal fatigue can impact fertility. It can measure various aspects of hormonal health, which includes thyroid and adrenal levels, insulin resistance and sex hormones. Your care team can discuss which hormone tests may be needed and review the results with you.
- Lifestyle factors:Â An important aspect of a fertility protocol is lifestyle/diet modifications to our daily lives. For some patients, infertility can be improved with day-to-day alterations, like reducing excessive exercising, lowering stress-related conditions, and improving sleep quality. For some patients, under-eating can cause fertility challenges, so dietary modifications may be suggested. Diet and lifestyle modifications can also be geared towards adrenal and hormonal health.
- Cellular health: Another component of infertility is toxicity and mitochondrial dysfunction in the body’s cells. A clinic can implement cellular optimization and detoxification processes in a functional medicine fertility protocol. This is crucial for removing excess hormones and toxins (i.e. pesticides, parabens, phthalates, etc.), which can contribute to infertility
About Functional Medicine-based Enhanced Fertility Protocol
Did you know that it takes around three months for sperm and egg cells to mature? This process is necessary before ovulation and ejaculation happens; in fact, wide ranges of micronutrients are needed just for the egg or sperm maturation process to occur.
Lifestyle changes, such as quitting both smoking and drinking alcohol and engaging in fertility-targeted supplementation, medications and diets, are parts of the groundwork for getting pregnant. Fertility-specific functional medicine treatments though could further assist with relieving nutritional deficiencies that cannot be treated through diet.
A customized Enhanced Fertility Protocol is designed to assist you in any phase of your fertility journey for optimizing sperm and egg cell health. Integrative and functional medicine treatments may include fertility-supporting herbs and supplements, acupuncture, functional nutrition support, and medications to help with oocyte quality and implantation.
Laboratory tests are vital for pinpointing your current nutritional status (i.e. deficiencies), toxins, biochemical abnormalities and hormonal imbalances that are not commonly detected by routine lab assessments. Lab results can then be used to create your personalized fertility-enhancing protocol.
Take note: integrative functional medicine tests are offered privately. Select fertility tests can be covered by OHIP.
Please read below about OHIP-covered fertility tests:
List of Fertility Blood Tests Covered by OHIP
1. TSH, Free T3, Free T4, anti-TPO and anti-TG antibodies, Iodine
2. Estradiol, Progesterone, Androstenedione, DHEA-S, Free Testosterone, Total Testosterone, Prolactin, FSH, LH
3. Vitamin B12, Ferritin, Zinc, Selenium, Vitamin A, Magnesium
4. CRP
5. Seminal fluid analysis
6. Sperm count
7. LFTs, Cr/eGFR
8. A1C, FPG, Fasting Insulin
9. Fasting 8am cortisol, 4pm cortisol
Functional Medicine Lab Tests Privately Offered
Sex and Adrenal Hormones Test – The DUTCH Cycle Mapping™ PLUS
What it is: This test is for women who experience troublesome menstrual symptoms (i.e. migraines, PCOS or infertility). Estrogen and progesterone levels are measured during your menstrual cycle. This test also measures hormone metabolites and the cortisol awakening response (CAR). Measuring CAR is a comprehensive measurement of fluctuating hormones and your stress response, which can help health care practitioners understand how your body copes with chronic stress and if stress is affecting your fertility.
How it’s done: This specific DUTCH test utilizes dried urine samples only, which have an elevated chance of providing accurate results. The overall testing procedure consists of multiple first-morning urine samples according to the duration of your cycle. It also involves four urine and five saliva samples from a full-day period to provide insights for CAR and hormone metabolite test results.
Heavy Metal Toxicity Test – Comprehensive Urine Element Profile
What it is: Acute and chronic exposures to metals (i.e. lead and mercury) can influence fertility health. If you think you’ve been exposed to toxic metals or suffer from mineral imbalances, this test may be suitable for you. This is a toxic exposure panel that can analyze 20 metals and 15 nutrients. Results can help your health care practitioner determine the next courses of action in removing toxicities and reaching fertility health goals.
How it’s done: Patients have the option to test either urine or blood. But it should be noted that a comprehensive urine test might provide further accuracy and insight into toxicities. Timing is imperative to getting accurate results: urine should be measured within a couple of hours to a few days after exposure. Blood samples can be collected from a few hours to a couple of months after exposure.
DNA Methylation Pathway Profile
What it is:Â This test may be appropriate for determining the functioning of vitamin D, methionine metabolism, hormones and detoxification in the body, which are all impacted when genes undergo changes (i.e. single nucleotide polymorphisms/SNPs). This test measures for SNPs, which can assist a health care practitioner in determining disease risks that would influence fertility outcomes and disease prevention.
How it’s done: The DNA methylation pathway profile requires four buccal swabs from the patient, which consists of swabbing the insides of the cheek for DNA cells.
Gastrointestinal Health – GI360™ Microbiome Profile
What it is:Â Chronic disease can affect your chances of conceiving. This particular test can analyze over 45 analytes (i.e. pathogenic viruses, parasites, bacteria) that could contribute to dysbiosis and chronic conditions. The results can aid healthcare professionals in determining the possible causes behind infertility, abdominal pain, nutritional deficiencies, gastrointestinal concerns, and others.
How it’s done: Stool samples are required. The samples must be gathered on three separate days or preferably three consecutive days. The final sample must be collected by the seventh day after the first day of stool collection.
What Does a Personalized Enhanced Fertility Protocol Program Look like?
Fertility-enhancing treatment plans are based on the patient’s biology, wellness goal and lab test results. Below are examples* of topics to discuss with your care team:
*This is a sample program only. Personalized medicine plans for fertility are based on individual needs and test results. The following program may not apply to every patient’s health status. Treatments and modalities may be combined with other forms of medicine, depending on the patient’s current health status.
Sample Enhanced Fertility Protocol program
Medication review: Bring a list of your medicines and supplements to your fertility consultation. Your care team can review this alongside your health history and treatment plan. They can help you prepare questions for your fertility care provider about possible interactions and any instructions to follow before or after a procedure. Before stopping or changing a prescribed medicine, speak with the practitioner who prescribed it.
Before an IVF cycle:Â Tell your care team when your IVF cycle is planned. Your visit can include a review of your hormone test results and any medicines or supplements you use.
Customized supplementation and herbal protocols: Fertility-supporting nutraceuticals may be recommended, such as include fish oil, coQ10, vitamin D, folic acid and prenatal vitamins. Male patients are encouraged to consume antioxidant supplements prior to conception for improving sperm quality.Â
Progesterone test results: Progesterone is included in the fertility blood test list above. Your care team can discuss if a test is needed and what the results mean. Bring any past test results to your visit.
Past IVF Results: Reviewing your past IVF records may provide valuable insights into your fertility journey. Your healthcare team can examine your previous treatment history, discuss any concerns or unanswered questions, and consider whether additional assessments may be appropriate. Bringing your IVF records to your appointment can help guide a more informed, individualized discussion about your reproductive health and possible next steps.
NAD IV therapy: NAD (nicotinamide adenine dinucleotide) is administered via IV therapy. NAD is a coenzyme that helps promote optimal cell health. In turn, NAD IV therapy may assist with improving egg quality, suggests research. In fact, one study has shown that augmenting NAD levels could help with infertility caused by reproductive aging.
Hormone Health Assessment: Hormonal changes and imbalances may be associated with menstrual irregularities and reproductive health concerns. Conditions such as polycystic ovary syndrome (PCOS) and endometriosis, as well as life stages such as perimenopause, may also involve symptoms that warrant further investigation. During your visit, your healthcare team can review your menstrual cycle, symptoms, medical history, and previous test results to better understand your hormonal health. Depending on your individual circumstances, additional hormone testing may be discussed to help identify potential concerns and guide conversations about appropriate next steps.
Acupuncture:Â This Traditional Chinese Medicine-based treatment is available for men and women with fertility concerns. Acupuncture may contribute to re-establishing fertility, improving both sperm quality and ovarian function, while helping to balance the endocrine system.
PCOS and fertility: Polycystic ovary syndrome (PCOS) can affect how often the ovaries release an egg. Some people with PCOS also have insulin resistance, which means the body does not respond to insulin as well as it should. At your visit, your care team can review your cycle, symptoms, medical history and previous test results. This can help guide a discussion about further assessment and your next steps in fertility care.
Contacting Us for Fertility Supplementation and Functional Medicine Support in Toronto
We understand the physical and emotional wellness behind fertility health goals. If you’re attempting to conceive, be assured that you can ask any TFMC Team Member about our Enhanced Fertility Protocol program.
Our Toronto functional medicine clinic is currently accepting new patients who require assistance in improving conception. Our approaches in treatment are based on integrative and functional medicine, while emphasizing naturopathy, acupuncture, clinical nutrition, allopathic medicine (western medicine), and Traditional Chinese Medicine.
Our integrative and functional medicine doctor can also address your other health concerns, including skin disorders, digestive disorders, gluten sensitivity, chronic fatigue and disease prevention.
FYI:Â We take your comfort into consideration! Our services are conveniently available in-person or through virtual telemedicine* appointments.
*Note: some exceptions may apply. For example, IV therapy and acupuncture therapies must be conducted in-person. Please call us for further details about telemedicine appointments.
Are you seeking evidence-based treatments for your fertility health goals? Our compassionate and integrated patient care is available to support your chances for conception. Call (416) 968-6961 to learn how functional medicine in Toronto could help your fertility journey.
References:
Magon N, Agrawal S, Malik S, Babu KM. Growth hormone in the management of female infertility. Indian J Endocrinol Metab. 2011;15 Suppl 3(Suppl3):S246-S247. doi:10.4103/2230-8210.84876
Michael J. Bertoldo, Dave R. Listijono, Wing-Hong Jonathan Ho, Angelique H. Riepsamen, Dale M. Goss, Dulama Richani, Xing L. Jin, Saabah Mahbub, Jared M. Campbell, Abbas Habibalahi, Wei-Guo Nicholas Loh, Neil A. Youngson, Jayanthi Maniam, Ashley S.A. Wong, Kaisa Selesniemi, Sonia Bustamante, Catherine Li, Yiqing Zhao, Maria B. Marinova, Lynn-Jee Kim, Laurin Lau, Rachael M. Wu, A. Stefanie Mikolaizak, Toshiyuki Araki, David G. Le Couteur, Nigel Turner, Margaret J. Morris, Kirsty A. Walters, Ewa Goldys, Christopher O’Neill, Robert B. Gilchrist, David A. Sinclair, Hayden A. Homer, Lindsay E. Wu, NAD+ Repletion Rescues Female Fertility during Reproductive Aging, Cell Reports, Volume 30, Issue 6, 2020, Pages 1670-1681.e7, ISSN 2211-1247, https://doi.org/10.1016/j.celrep.2020.01.058.
Morley, LC, Tang, TMH, Balen, AH on behalf of the Royal College of Obstetricians and Gynaecologists. Metformin Therapy for the Management of Infertility in Women with Polycystic Ovary Syndrome. Scientific Impact Paper No. 13. BJOG 2017; 124: e306– e313.
