Start with basic tests - Ask your OBGYN to have AMH levels tested (for women) and your sperm tested (for men). Most insurance companies usually partially cover these tests.
Find a Functional Medicine Doctor. Don’t get me wrong, I am all for Western medicine when needed. However, the remainder of the things I’m sharing in this list require a functional medicine doctor. I doubt we’d have had the success we did in IVF and have a shot of conceiving naturally again without my having a more holistic approach that was developed by my It was my functional medicine doctor who discovered the reason we lost MaryKate. I’ll share this test below in item 7. When I asked my OBGYN why she hadn’t tested for it, she said insurance/hospitals won’t test for this until you’ve had multiple recurring losses. Furthermore, the original bloodwork we did together showed that my hormones and thyroid were “normal.” Turns out the hormone and thyroid panels you take in your doctor’s office only show you a 30-day snapshot at best, and they’re comparing your levels on a very BROAD scale: from 25-year-olds to 55-year-olds in most cases. If you want to find the root cause of your issue(s), you must go the functional medicine route.
Take the NutrEval Test—This is the most valuable test I took, regardless of whether I was trying to get pregnant. I would also recommend adding the Hair Tissue Mineral Analysis (HTMA) if you can find an office/lab that offers them together or with your functional medicine doctor. The HTMA wasn’t available to me when I started my healing journey after losing our daughter and going through TTC. However, the Nutreval test was super effective for me.
For some additional context, the NutrEval FMV Test analyzes over 125 biomarkers and evaluates over 40 antioxidants, minerals, vitamins, amino acids, essential fatty acids, and other selected nutrients. I learned I was deficient in magnesium, vitamin D, DHA, and DHEA through this. These minerals are critical not only for day-to-day function but also for FERTILITY.
Similarly, the HTMA test is a noninvasive hair test that examines minerals and heavy metals in the body. It provides a blueprint of your biochemistry over the last 90 days, or at least when that hair sample grew. The results can be overwhelming because of the amount of information they provide, so make sure you meet with your doctor to review them. It is crucial to ensure they develop a comprehensive plan for you to follow based on your results to help you heal your body.
Ask for a Four-Point Hormone Panel or Dutch Test. The four-point hormone test is where you take four different samples, usually upon waking, lunchtime, dinner time, and before you go to bed, either by saliva or urine, and measures your cortisol levels at these four times. These results can provide valuable insights into the body's stress response and adrenal function. If you have high cortisol levels, this can make it very hard for your body to conceive and function appropriately in general. High cortisol levels mean your body is STRESSED TF OUT and is operating in fight or flight. The Dutch test is a more advanced hormone test, offering an extensive look into sex and adrenal hormones, melatonin, and their metabolites to identify symptoms of hormonal imbalances.
Take a Gut test (the stool kind) foul but SO eye-opening. Your Gut is your MOTHERBOARD. I am screaming this at you. You must start here to get the complete picture and overall health. I learned almost a year after MK that I had a severe leaking gut. The crazy thing is I didn’t have very many apparent symptoms. I didn’t bloat per se after eating any of the foods I was sensitive to, and I didn’t have any bowel issues either. However, I was such a mess after MK physically, and I realized this was where a lot of my problems started. I know had we not come up with a plan to heal it, I’m not sure my IVF round would have been successful.
Take the time for a Food Sensitivity Test - I know these get a bad reputation, but if anything comes back that you’re highly sensitive to, know that you do NOT have to cut it out for LIFE. You only have to cut out for 8-12 weeks to give your gut a chance to heal itself, and then you can slowly introduce things that you love again (obviously, you will need to come up with a plan with your doctor, but I just wanted to give you some encouragement). For me, I had to cut out gluten, dairy and eggs. After Losing MK, I started gaining more weight than I ever had in my life, and more than I had 20 weeks pregnant. I couldn’t figure out what was wrong to save my life. I kept going to see my family doctor and OBGYN, who ran hormone and thyroid panels, and they said I was completely normal and just to give it time. I wanted to scream at them YOU’RE NOT LISTENING. I DON’T FEEL GOOD AT ALL. I CAN’T STOP GAINING WEIGHT EVEN THOUGH I’M EATING A CALORIE-DEFICIT DIET AND DOING TWO A DAYS AT THE GYM. It took 12-14 days after we realized I had a leaking gut and was highly sensitive to these particular foods. I started taking the appropriate supplements and temporarily eliminated these things from my diet to start feeling SO much better, and the weight started shredding off. So, as I mentioned, your GUT is where most of your issues/answers lie, you just need to pay attention to it!
Ask for these tests and make sure you take them! The results can be causing infertility but your Family Doctor/OBGYN probably won’t test you for in a routine workup:
Ureaplasma: a bacteria that can cause infertility but is easily treated when both you and your partner are treated with antibiotics to clear it. A great at-home test you can take is the Evvy which specifically tests not just for ureaplasma but your entire vaginal microbiome. There are so many cases of women who didn’t know they had this and were experiencing infertility or secondary infertility, got tested and found out they were positive, and then got pregnant quickly after once they were clear.
Antiphospholipid and/or anticardiolipid syndrome(s): both blood clotting disorders that can/cause miscarriage/stillbirth. Most OBGYN’s will not test for this until you’ve had recurrent losses because it’s “rare” – this is why we lost MK. Luckily, when I saw her on my first visit, my functional medicine doctor thought to test me for this right away. Otherwise, all subsequent pregnancies would have probably ended up in loss. The great news is that if you carry/test positive for either or both of these, it is treated with daily Aspirin and/or a blood thinner shot while pregnant.
Get tested to rule out endometritis, a rare infection that causes inflammation in the uterus that can cause infertility, NOT to be confused with endometriosis. This requires a biopsy of the uterus (probably not fun) but should be highly considered if you’ve experienced physical trauma during delivery or had to have a DNC.
Speaking of a DNC, if you’ve had one (I had to have one for my placenta after delivering MK), you should schedule an ultrasound with OBGYN to see if there’s scar tissue that has formed on your uterus and could be preventing you from conceiving/carrying your baby to term.
Do a fallopian tube “dye” test to ensure your tubes are open/functioning correctly to conceive
Have doctors rule out endometriosis and PCOS
I’m writing up Part II of this. This will cover more recommendations from my functional medicine doctor, but there are more lifestyle change requirements that you can fulfill once you’ve had some or all of this testing done!
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