I’ve been talking to some of my friends who are still trying to get pregnant, and for many of them, the road is bumpier than they would ever expect. The road to pregnancy can go both ways, it is usually pretty and straightforward, you get off your pills have unprotected sex, and bam! You are pregnant. However, for many of us, including myself, the path isn’t that clear and we face a lot of challenges along the way. 

So why is it so easy for some of us and so freaking complicated for others? This is what I will try to answer in this article. I hope by the end of it you will find some help and comfort. 

What I will cover: 

• Hormonal imbalances

• Which hormones affect fertility

• Causes of hormonal imbalances

• Hormone testing types: blood testing vs home testing

• The effects of birth control in your cycle

• Fertility windows

• Foods to improve fertility

• Stress and your cycle

Hormonal Imbalances

Hormonal imbalances can happen to anyone and it isn’t your fault for following or not a specif lifestyle. There is however a link between weight and hormonal production as fat deposits in our bodies can impact hormonal production. People that are underweight or too lean (in the case of high-performance athletes) and people that are overweight and obese are at higher risk to develop hormonal imbalance due to the effect of too little or too much fat in their bodies. That is because hormonal production works best in the normal weight range. I have to point out, that although this must be true for the majority of people, I’ve seen super lean and obese women getting pregnant just fine and this rule may not apply to you. 

Hormonal imbalances can be caused for a number of reasons, but most of the time doctors link them to two medical conditions: thyroid dysfunction and polycystic ovary syndrome (PCOS). As a nutritional coach, I also believe that some foods that we eat can influence hormone production and makes things better or worst if you already have any underlining hormonal issue - more on that later in this article. 

Which hormones affect fertility

Some of the hormones that have a more direct impact on fertility are: 

• Thyroid hormones: the thyroid produces several hormones that impact many different functions in your body, but the most known are triiodothyronine (T3) and thyroxine (T4) hormones. They are primarily related to digestion and metabolic rate, but they have a great influence in fertility as well. If you are concern about hormonal imbalance, it may be a great idea to start with a thyroid function test. 

• Prolactin: this is the hormone that regulates breastmilk production. In new moms when they are breastfeeding, prolactin levels are high and inhibits ovulation. This is normal while the new baby is still breastfeeding, but the baby transitions to solid foods, prolactin levels should start to go back to pre-pregnancy levels and your menstrual cycle should restart. If prolactin levels are abnormal it may impact your ovulation, thus your fertility. 

• Anti-Mullerian Hormone (AMH): this hormone is produced by the ovarian follicles and its function is to support the immature eggs. This hormone is the best predictor of how many eggs you have remaining in your ovaries. 

• Follicle-stimulating hormone (FSH): this is directly linked to fertility, as its main function is to regulate the menstrual cycle and induce the production of eggs in the ovaries. Women with loss of ovarian function often have higher levels of FSH, as their bodies are trying to compensate for the dysfunction. 

• Luteinizing Hormone (LH): its function is to signal the body to release the mature egg. If there is a disfunction here it can inhibit the release of the egg, directly impacting fertility. It is a great predictor of ovulation, as its levels are higher right before ovulation occurs. 

• Progesterone: This is the most known female hormone. It is linked to the maintenance of pregnancy. These are the hormones responsible for thickening the uterine linen to receive the fertilized egg. If there is a dysfunction in progesterone production the egg may not be able to attach to the uterine walls which can lead to miscarriages. 

Signs of hormonal Imbalances

As I always tell my friends and clients, paying close attention to our bodies’ clues is the best way to tell if anything is wrong. If you notice any of the following symptoms, these could be signs that your hormones are out of balance. 

• Menstrual cycle irregularities

• Spotting or irregular bleeding

• New or worsening acne

• Facial hair

• Male-pattern body hair

• Unexplained hair loss

• Extreme mood changes

While everyone is different, and some people will develop imbalances without any apparent symptoms, most women will show at least one of these signs. If you notice any of these connect with your health care provider and suggest a hormonal panel checkup. If it is confirmed that your hormones are not right, let’s talk about it. 

Causes of hormone imbalances

Most science points the cause of hormonal imbalances to either polycystic ovary syndrome (PCOS) or thyroid dysfunction. I also agree with other nutritionists and health care professionals that what we eat can also greatly impact the development of either or both conditions, which would also lead to fertility issues.

Hormone testing

You can get tested for hormonal imbalances at a lab with a healthcare provider requisition or at home using a home test. There are many tests available, you can get most of them ordered online. Most of them will provide reliable results, but you should be aware of the companies you are trusting, as not all of them are certified or regulated. Make sure you do your research before purchasing your test pack. 

Also, although home-testing is easy, convenient, and mostly reliable, you should not try to interpret the results by yourself or self-medicate. When you get your results, if anything looks abnormal, you should share it with your healthcare provider. 

The effects of birth control in your cycle

Just like me, you may also have been told that birth control pills will not affect your fertility. But if you are out of the pill (or any other birth control medication) for a while now and still did not regain your period, you are not alone. For many of us getting rid of the synthetic hormones left in our system can be very hard. The absence of menstrual periods is a great indicator that something isn’t right yet, and you may need to get your hormones checked up. For me, it took over nine months so I could ovulate and get pregnant. I knew I was ovulating because I got pregnant, however, I never got my menstrual cycle back. So, if you are going through something similar, let’s talk, I will love to hear! 

Most of us don’t know exactly how birth control pills can affect our fertility, it is not told to us straight away. We are recommended to go on the pill at a very young age for reasons beyond preventing pregnancy. The pill is prescribed to us to regulate our cycles, minimize period pain, control PMS, treat acne, and many other conditions. Taking medication for so long can leave lasting effects in our bodies, that are hard to revert. It is hard, but in most cases, it is possible. 

Our livers work as a filter for toxins in our bodies. It helps cleaning the blood from anything that should be waste. That goes for excess hormones and the synthetics residuals from the birth control. When we stop taking them, sometimes, there is too much of it in our systems and our bodies only need extra time to cleanse. The residual hormones present in our bodies can be enough to cause imbalances and prevent fertility. Many women in this situation may need help supporting their liver functions, so they can successfully remove the excess hormones from the bloodstream so their normal cycle could restart and ovulation can occur. This can be done through food and lifestyle changes, in some cases, extra supplementation may be necessary. 

This process of detoxification can last a few months or years, as each body process the toxins differently, and for each one of us, this is a different journey.  Happily, today we have access to knowledge and tools from both traditional and non-traditional medicine to guide and help us reestablish fertility. So if pregnancy still did not happen for you, don’t get discouraged, let’s talk. 

Fertility windows

Once you were able to regain your cycle and you are finally ovulating again, you may want to know when your ovulation occurs so you can concentrate your efforts around that time of the month - that includes been extra sexy :) 

We generally ovulate around day 14th of our cycle. Our menstrual cycle has 28 days and starts from the first day of your period. Our fertility window occurs from a few days before ovulation to a few days after ovulation - from days 11 to 16th of your menstrual cycle. That window is when the sperm has the most chance to find the egg. The sperm can survive for a few days in the uterus, so it can stick around until ovulation occurs. The egg will also take some time to leave the uterus, so a late sperm can still meet the egg a few days after ovulation. But the further along the cycle, the hardest it gets for fertilization to occur, as conditions in the womb are not optimal for pregnancy after the 16th day of our cycles. The best time to try to conceive, however, is around 2 days before you ovulate (day 12). 

Foods to improve fertility

As a nutrition coach, a question that I get a lot is if there are foods that will help improve fertility. While I can’t guarantee any particular ingredient or dish will do that, there are some nutrients that can impact fertility. 

There is no magic diet or recipe that will make you pregnant, but there are some things you can do to improve your chances. Avoid inflammatory and oxidative foods like deep-fried, grassy foods. Reduce the amount of animal protein in your plate - the fat present in the meat tissues is linked to increased body inflammation and oxidation, two things that can impact the health of both female eggs and male sperm. As mention previously, too much fat in the diet can deregulate hormonal function. Add more whole and fresh vegetables and fruits to your meals as they are rich in vitamins and minerals with important antioxidant properties.  

To list a few, Vitamins E and C are two vitamins with antioxidants properties. This is especially important since the fluid surrounding the egg follicle (located in the ovary) is rich in vitamin E, this fluid acts as a protective barrier around the egg. Vitamin C is thought to influence progesterone production and has been measured in significant quantities after an egg is released from its follicle during ovulation. Likewise, new research suggests that a high intake of vitamins E and C may be especially helpful in decreasing the inflammation associated with the development and progression of endometriosis. Endometriosis is a common cause of infertility and a medical condition that affects 2 to 10 percent of American women.

We can’t talk about fertility and nutrition, without mention Folic acid (vitamin B9).  Adequate folic acid intake has been linked to improvements in female fertility. Research conducted at Harvard University concluded that women who consumed at least 400 micrograms of folic acid per day (in either food or supplemental form) were 40 percent less likely to be diagnosed with ovulatory infertility over a period of eight years.

Sufficient amounts of folic acid are also essential to prevent neural tube defects or serious abnormalities of the fetal brain and spinal cord. A fetus’ neural tube develops in the first month of pregnancy, so defects often occur before a woman even realizes she is pregnant.

These important nutrients can be found mainly in plants, thus the importance of adding a variety of vegetables, seeds, and nuts to your diet. And, although, these vitamins can be supplemented, their best versions are still the naturally occurring ones found in food. 

Good dietary sources of folic acid include:

• Asparagus

• Avocados

• Corn

• Whole grains

• Fortified cereals (Oatmeal Squares, Life, Special K, Wheat Chex, All-Bran, Mueslix, Product 19, Total)

• Oranges

• Grapefruit

• Papaya

• Berries

• Green leafy vegetables (spinach, mustard greens, turnip greens)

• Broccoli

• Winter squash

• Cauliflower

• Brussels sprouts

• Lentils

• Beans (pinto, black, kidney, navy, chickpeas)

• Peanuts

• Almonds

• Sunflower seeds

While there is much more that can be discussed surround food and fertility, the big takeaway is to minimize the amount of meat, processed foods, saturated fats, and added sugars in the foods you eat. A diet rich in fresh foods like vegetables, fruits, raw seeds, and nuts is a great way to increase the intake of important vitamins and minerals. 

Stress and your cycle

Studies point to stress as a risk factor when it comes to fertility. A study published in the Fertility and Sterility journal concluded that stress levels (represented by abnormal amounts of alpha-amylase in the saliva) are directed linked to a reduction in fertility rates by day during the fertility window. In other words, as stress builds up in our systems, our chances of getting pregnant reduce. Another study shows a strong link between mindfulness practices to reduced stress and an increase in successful pregnancies. This effect can be explained by how our bodies respond to stress. When stress is chronic, our body starts to shut some functions, reproduction is not a priority if we are in fight or flight mode. Stress hormones can suppress fertility hormone production and, therefore, cause hormonal imbalances that may lead to infertility. Women who exercise regularly and practice mindfulness show a better pregnancy rate, possibly because their bodies are not fighting stress, their hormones are produced and released at normal levels. 

Conclusion

Infertility can be caused by many factors, mostly related to hormonal dysfunction. The most common causes of imbalances are PCOS and thyroid issues. The amount of body fat we carry can also impact hormonal production. Women with more fat tend to produce and retain more hormones, while the underweight carries fewer hormones. Both situations can lead to imbalances and impact fertility. 

Stress is also related to impacts on the reproductive system. Hormones responsible for the regulation of the menstrual cycle can be disrupted if stress becomes chronic, shutting down reproductive functions. 

The best way to support the reproductive system is to reduce stress, exercise frequently, and eat foods that are rich in vitamins such as folate and minerals like zinc. Fiber is also important in balancing hormonal function. Avoiding highly processed foods is also recommended. 

We are all different in how our bodies will respond to change. For some, it happens right away, while for others it will take longer. Genetics, lifestyle, nutrition, age, and environmental factors can all influence how fast or slow we can regain fertility. If it feels harder for you, know that you are not alone, and I will love to help you on this journey! 

Sources

https://www.webmd.com/baby/features/infertility-stress#1 

https://www.shadygrovefertility.com/blog/diagnosing-infertility/9-must-read-faqs-about-hormonal-imbalances-and-trying-to-get-pregnant/ 

Beyond the Pill: A 30-Day Program to Balance Your Hormones, Reclaim Your Body, and Reverse the Dangerous Side Effects of the Birth Control Pill, Book by Jolene Brighten

Your Body in Balance: The New Science of Food, Hormones, and Health, by Neal Barnard