As practitioners, our jobs seem simple enough on paper. We help our clients and patients optimize their health. But when you consider the scope of our impact, the stakes become much higher. Our overall health is the one thing that affects us all daily, directly, and profoundly. Each of us approaches the enormous task of making people healthy from different vantage points, informed by our backgrounds and specialties. But what if I told you - specialties aside - that one of the most effective tools for understanding overall health is fertility?
Human beings are evolutionarily engineered to reproduce. Think back to any of your early biology classes and remember that fundamentally, we are driven by two things: food and sex. We nourish our bodies in order to be as fit as we can possibly be for mating and reproduction. Now, in civilized society, human life has developed into something much more sophisticated and nuanced. While so many people can’t imagine a life without children, others actively decide to forgo having them altogether, and what’s more, many begin to ignore their own fertility as they age.
But whatever stage of life our clients and patients are in, and whether they are eager to start families or do not wish to have children, the fact remains that we are all designed to reproduce. This means that fertility is an extremely helpful marker of overall health. Taking great care to ensure that you are providing research-backed, data-driven reproductive, hormonal, and nutritional care will set those you treat up for success, regardless of whether or not they have had a baby (or if they want to at all).
Here are the top three things I think about when approaching fertility for optimal health in my private practice:
Both male and female reproductive systems offer insight into our clients’ and patients’ lives, so much so that we can often easily identify their healthiest habits. We know how everything should be working from a reproductive standpoint, so when something runs amiss, it can sound the alarm on a larger issue.
For example, analyzing a woman’s menstrual cycle will provide ample qualitative information about her stress levels, sleep patterns, dietary habits, movement capabilities, and other external factors affecting her life. Based on that, we can go deeper and uncover data that can help us move forward. Are there vitamin or mineral deficiencies playing a role? Is there a hormonal factor that needs to be taken into consideration? Similarly, in men, healthy sperm and semen are critical to proper sexual function, so looking into the causes for shifting numbers can lead to helpful diagnoses for other issues. Low sperm counts can be an indicator of oxidative stress factors for which you can provide guidance (e.g. smoking, excessive drinking, environmental exposures, etc.) and could also serve as a red flag for a hidden long-term illness. It could even point to a more serious hormonal imbalance that needs to be addressed not just for the sake of reproduction, but for your patient’s overall health and wellness.
Hormonal issues can affect both men and women and take a toll on fertility in addition to playing a key role in overall physical health and mental status.
Many women discover undiagnosed thyroid disorders after unsuccessful attempts at conception or repeated pregnancy loss. An embryo’s inability to properly implant into the uterine wall is a common reproductive symptom of thyroid disorder. For men, dysregulated thyroid function can damage sperm quality and motility, which can also result in a low chance of implantation as it makes it extremely difficult for the sperm to fertilize the egg.
Evaluate TSH, T4, T3 and thyroid antibodies for both men and women when you feel it is necessary. Running a DUTCH hormone test can also provide further insight when thyroid labs don’t deliver an immediate conclusion or when you want a broader look at hormone metabolism. In so many cases, taking care of fertility has led to the discovery and correction of hormonal issues that, once identified, drastically improve the daily lives of those who experience them.
Nutrition and supplements
I am a food-first dietitian, and I’m not kidding when I say the number one goal of eating is to be fit and fertile. Our bodies naturally crave nutrient-dense foods that provide us with the vitamins and minerals we need to create new life. Fertility-friendly foods are all found in a healthy colorful, well-varied diet. I’m talking about antioxidant-rich fruits and vegetables, vessels of omega 3 fatty acids like nuts, seeds, and fish, and full fat dairy that is packed full of saturated fat and important fat-soluble vitamins like A, E, D, and K. Eating for fertility is identical to eating for optimal health, because the goals are the exact same: consume everything you need to be as fit as possible.
In a perfect world, we all get everything we need through food alone. But in reality, our diets are dependent on many uncontrollable factors. Culture, lifestyle preferences, socio-economics, and physical geography all play a role in what ends up on our plates. That’s where supplementation comes in. We practitioners need to be aware of what nutrients are sufficiently supplied for each individual through food and then use our available lab resources to confirm what deficiencies we are dealing with. Just like with hormones, when one is out of line, it blurs the rest of the picture with regards to nutrient consumption as a whole.
Eating and supplementing for fertility is a simple way to make sure your clients and patients are getting everything they need to be on the right track health-wise, regardless of the final destination. I created Full Circle Prenatal vitamins for my clients who were trying to conceive, pregnant, and breastfeeding, but you might be surprised to find that it is a fairly comprehensive multivitamin for anyone (yes, there are plenty of men who take it, too!). If your patients are interested in learning more, feel free to direct them to our site. We discuss fertility diets, supplement quality, men’s fertility, and host more in-depth articles on individual vitamins and minerals like A, B, D, E, iron and omega 3s.
If you are a practitioner who is interested in learning more about how to fully assess fertility in your female clients, I collaborated with The Better Nutrition Program’s founder, Ashley Koff, RD for a masterclass on Personalizing Fertility Recommendations for women. All BNP members can access this masterclass to learn more about how fertility can truly be a lens through which we can evaluate and optimize the health of any woman, at every life stage, regardless of her desire or intention to physically have children. Interested in attending one of Ashley's upcoming masterclasses? See what is coming up next here.
About the Author: Ayla Barmmer, MS, RD, LDN
For over 15years, Ayla Barmmer, MS, RDN, LDN, has been advancing the health and empowerment of thousands of clients, patients, peers, and mentees, at the intersection of nutritional science, functional medicine, and evidence-based holistic solutions. Ayla owns and operates Boston Functional Nutrition, an integrative and functional nutrition multi-clinician practice, that specializes in women's health and infertility. She is also the founder of Full Circle Prenatal, a fertility wellness brand, widely endorsed by a diversity of health practitioners for its quality and education. Ayla founded the Women's Health Nutrition Practice Group in 2017 where she serves as a preceptor, mentor, and educator, and co-founded the Women's Health Nutrition Academy in 2018, a leader in its field.