Comprehensive Fertility Testing

We get this question A LOT: why should I do fertility screening? Truthfully, the answer in our minds is usually, why not? Optimizing your health and wellbeing before trying to conceive is often an intuitive feeling most parents will experience when they decide to start planning for their family. Our experience as ND's has been that the timeline for testing within the conventional system can be less than ideal for some couples. Seeking naturopathic care can help to provide some insight and education around modifiable risk factors (see more below) and help you understand necessary testing and screening to determine if there are underlying issues that may impact your chances of conceiving. We discuss specific hormones, nutrition and supplementation for male fertility and female fertility in these posts as well!

Let's start by addressing timelines and guidelines within our current conventional system. An assessment for infertility will be addressed:

• When there is a failure to achieve pregnancy after 12 months of regular unprotected intercourse - After 6 months in women over age 35.
• Immediately in women over the age of 40.
• When there is a history of amenorrhea (no period)  or oligo-menorrhea (irregular periods)

We often see most women pushed into very long referral wait times to see OB/GYNS to assess these underlying issues. As ND's we can begin to explore these underlying issues and provide comprehensive testing to assess any hormonal imbalances and nutrient deficiencies.

Things we cannot evaluate would be structural issues (which would require imaging) and genetic testing which requires specialized testing and consultations with genetic specialists.

• Known or suspected structural issues (this requires a Fertility clinic or OBGYN referral)
• Stage III-IV endometriosis  (if diagnosed, but even then it can be challenging to get this diagnosis)
• Known or suspected male factor infertility

Male factor infertility is not often assessed in the beginning with females. Clinically, we have found we need to encourage patients to have sperm analysis done early in their journey to optimize treatment plans. Early on in the process is the perfect time to correct nutrient deficiencies, regulate cycles, learn how to confidently identify your fertile window, seek care for stress management and managing the impact that every month without conception can have on your emotional health.

Comprehensive Hormone Testing Options: 

Looks at: Progesterone, Estrogen, Testosterone, DHEA, Cortisol

1. DUTCH (dried urine) 

Our preferred method! It measures over a period of 24 hours and/or an entire cycle for more detailed analysis. It is also advantageous in that we see the hormone pathways (their metabolites and how they are broken down or used in the body), oxidative stress markers, liver burden, methylation pathways, and select vitamins. 

2.   Serum (blood) 

*More commonly run through family doctor or fertility clinic and covered via Medicare

Gives us an idea of what is going on but we feel that it offers limited information due to drastic fluctuation of hormones in a 24-hour period but gold standard of testing in the medical community.

3.     Fertility Profile Kit: Serum (blood) & saliva 

A ZRT blood spot tests for estradiol, progesterone, testosterone , cortisol, TSH, and is a reliable means of understanding hormone levels.

Our fertility profile kit combines blood and urine for a combination of in depth hormone testing. Although we prefer urine over saliva, this test kit also offers information over a 24 hour period AND includes the following: FSH, LH, and comprehensive

Comprehensive Thyroid Testing Options:

Looks at: TSH, fT3, fT4, TPOab, Tgbn, Iodine, Bromine, Selenium, Arsenic, Mercury, Cadmium

This is a test that can be done with your family doctor. Ideally we see levels between 1-2.5, as levels greater than 2.5 have been shown to increase risk for miscarriage. Autoimmune thyroid is important to look into, and can often go undiagnosed or untreated. If the thyroid is managed with synthroid (manufactured thyroid hormone thyroxine) but the anti-bodies are not being actively reduced, immune function and nutrient absorption can be hindered.

Screening for autoimmune thyroid is done in a thorough fertility screen and comprehensive private testing is done at our clinics!

• Essential Thyroid Profile 

Includes TSH, free T3 and T4, and one autoimmune marker.

• Comprehensive Thyroid Profile 

Includes essential thyroid profile + additional autoimmune marker, minerals essential to thyroid function, and heavy metals potentially affecting thyroid function.

Heavy Metal and Nutrient Testing

We look for: Arsenic, Cadmium, Lead, Mercury, Bromine, Copper, Iodine, Lithium, Magnesium, Selenium, Zinc

• Heavy Metal Hair, Urine, or Saliva Analysis

If DUTCH testing reveals elevated levels of oxidative stress heavy metal testing is a worthwhile next step. Heavy metals in the body can prevent a healthy pregnancy, lead to recurrent loss, and poor embryo development by preventing essential nutrients and vitamins from functioning properly on a cellular level. 

As always, reach out to us if you have any questions! We love discussing these options and finding what will work for you as an individual!