Hannah Aylward (00:00.192)
Just don’t believe there’s anything like unexplained infertility. Like, I don’t believe it exists. I think the term exists, we’ve used it, but I don’t think it’s real. So for me, unexplained means we just really haven’t looked hard enough, we haven’t analyzed the data appropriately, we haven’t asked the right questions to understand what’s really going on.

Hello, hello, my dears, and welcome back to another episode of the Nutrient Dense podcast. I am really truly so excited for today’s episode because we’re gonna be diving into the topic of fertility and really taking a root cause approach to optimizing fertility and looking at unexplained fertility, which I think is just kind of getting more and more prominent today. So we have Dr. Mark Sklar on the podcast with us today. Welcome to the podcast. Thanks for having me.

Yes, and Dr. Mark Sklar is known as the fertility expert. he is a natural fertility specialist helping couples get pregnant for 22 years. His mission is to help you feel hopeful and confident about your fertility journey again. In addition to his doctor of acupuncture and oriental medicine, Dr. Sklar trained at the Harvard Medical School, Mind Body Medical Institute.

He’s the creator of Fertility TV, Marksclar.com, and Reproductive Wellness.com, and a fellow of the American Board of Oriental Reproductive Medicine and a medical advisor for Symphony Natural Health. We’re that’s a mouthful, quite quite a bunch of many accomplishments. So we’re excited to have you today. Yeah, thanks for having me. I’m excited to be here. This is a topic that I love to chat about. So anytime I’m given the opportunity, I’m gonna jump at it. Yes, beautiful. So first and foremost, what kind of

made you specialize or kind of pushed you towards specializing in fertility? Cause I’m a huge fan of oriental medicine and I love acupuncture. and when in doubt, I go to my Chinese medicine doctor in town. I think it’s such a beautiful practice, but there’s so many avenues that you can kind of take it and so many areas you can choose to specialize in. So what kind of pushed you towards specializing in fertility? Yeah, so it kind of somewhat happened by accident. While I was in my training, I had an interest in women’s health

Hannah Aylward (02:15.422)
And I was interning with s with some providers who who specialized in women’s health and fertility, but I really still wasn’t sure what I was gonna do. And when I started working in the clinic and started to see my first patients, the patients that would come to see me were all patients coming to see me for women’s health and hormone related issues. And everybody else was getting pain. So but my my first fertility patient was a woman with PCOS.

And she had irregular well now called PMOS and she had irregular cycles and so we started working with her in about four and a half months, less than four four and a half months, we were able to regulate her cycle, but she comes in for her appointment at the four and a half month mark and she says, Mark, I think we messed up again. She’s like, My my cycle is gone. We were on a good track and it’s just not here, and she was upset.

And frustrated. And I said, hold on, hold on. Before we get upset, let’s know what we’re actually dealing with. So here’s a pregnancy test. Go to the bathroom. Let’s just confirm that you’re not pregnant and come back. While she’s walked in the bathroom, I was like, I turned to my assistant. I’m like, I think she’s pregnant. So she comes, she comes back and she’s got this huge smile on her face with the pregnancy test positive in her hand. And even now, when I tell the story, I get chills, but like just that moment was life-changing for me.

Obviously it was life changing for her. I helped her with her next child as well. She was able to have, you know, two healthy, great, successful pregnancies. But I always say that the amount that she impacted me is much more than I impacted her. Like it was wonderful that I can help her create her her family. But in reality, she put me on a trajectory because that was it. Like once I had that feeling, I’m like, I want this again.

And what do I need to do to make this happen more? And so that’s really what pushed me down this road. And as a result, I’ve been able to help thousands of couples. And I would never you know, maybe I would have, I don’t know, but like I would never have been in this situation if it really wasn’t for that experience. So that’s what did it. So beautiful. We have had the honor of playing a role in some people’s journeys as well. And it really is something. Like it feels really special to be able to

Hannah Aylward (04:33.272)
To have any like point in that, like it’s bringing tears to my eyes even as I think of it. Like getting the pictures of women in from the hospital and they’re like, here’s my baby. I’m like, you know what? If this is all I do in this life, like I’ve done something good. I agree. It really like tugs on my heartstrings to to play a role. So I can totally understand in that. And it’s so beautiful. We need more people doing doing the good work like this. Yeah. So I would love for you to speak to the topic of

Unexplained infertility. And I feel like these numbers are growing. Maybe I’m maybe I’m off, but I feel like the numbers are growing. It impacts like when I did a quick Google search, it was like 10 to 30 percent of couples that are trying to conceive are are dealing with this unexplained infertility. I have my own thoughts about that. I don’t know if it’s quite always unexplained, but I would love for you to

First off, like let the let the listeners know what does that even mean? My understanding is it’s a diagnosis of exclusion. So there’s something there. And then do you feel like you’re seeing like people getting that diagnosis more and more and just kind of speaking to that topic overall? Yeah. So I think f just a a simple piece of it is for those people who don’t understand what it means, is you’ve gone to your OB.

Maybe you’ve also gone to your REI, your reproductive endocrinologist and infertility specialist. So that’s the IVF doctor for all intents and purposes. You’ve gone to both of them. They’ve done some minimal, being purposeful in my wording here, they’ve done some minimal testing. And they said, you know what? You don’t fit into any of the boxes that would make sense for us. You’re unexplained. Let’s just move to IVF. I’m I’m simplifying the process, you know, for this conversation, but that’s essentially what happens. That might take

Three months, that might take a year, that might take two years to get to that point. But in essence, that’s basically what’s happened. They’ve they’ve exhausted their form of testing. They’ve exhausted what they can look at and what they feel like would categorize some diagnoses that would allow them to say, you have endometriosis or PMOS or whatever it might be. You don’t fall into those categories. And they’re like, Hey, you know what? You’ve been trying for X amount of time. We don’t know why this is happening, but we’ve got IVF. Here you go.

Hannah Aylward (06:46.348)
Let’s do that. So that’s basically what unexplained is. I feel like for me in my world, I feel like it’s about the same in terms of percentages that I see. So I don’t feel like it’s changed too much. I think maybe if it has increased a little bit, it’s because there’s a bigger acceptance of IVF and the the steps to get to that point in time for treatment are much faster now than they used to be. And so that might kind of increase

that unexplained diagnosis, sort of speak. But you know, for anyone who’s heard me talk before, if you’ve listened to any of my YouTube videos or anything like that, you will know that I just don’t believe there’s anything like un unexplained infertility. Like I don’t believe it exists. I think the term exists, we’ve used it, but I don’t think it’s real. So for me, unexplained means we just really haven’t looked hard enough. We haven’t analyzed the data

appropriately, we haven’t asked the right questions to understand what’s really going on. And we could probably do this about all health related issues, but we’re talking about fertility. So if we put fertility in a box and said these are the definitions of what describes infertility, and we don’t look anywhere outside of those walls, then you’re going to have a lot of people with the term unexplained.

Because if all you’re looking at is some structural issue that’s abnormal in the pelvic region, the reproductive organs, male or female, or if all you’re looking at is these minimal hormone tests, you know, just a handful of hormone tests, and all you have is these like again, minimal diagnoses that you’re trying to rule somebody into, then that’s not gonna fit for most people who are struggling. Because most people today

Who have fertility issues don’t have fertility issues because it’s not always about egg quality or endometriosis or whatever it might be. We live in a very different world today than we did when IVF was created many years ago. And for those listening, IVF was really created for very minimal use. It was created because there was a structural issue, the tubes were blocked. Male factor, maybe there was a sperm issue and they couldn’t fertilize the egg, or it just, you know,

Hannah Aylward (09:09.976)
Would it mature into a healthy embryo? And so, like, okay, these are real reasons why we need in vitro fertilization. Now, in vitro is basically used as I don’t want to say the first line, but almost the first line. If not, it’s the second line of intervention for all fertility-related issues or infertility-related issues. And so couples have become so used to it. The marketing has gotten much stronger. And so, like, I’ve been trying for three months. I’m 30. There must be something wrong. I’ll just go to IVF. So

If if if all we’re looking at is these sh you know small parameters, we’re gonna have a high number of unexplained. But in the world that I live in, I think in the world that you live in, our systems are not compartmentalized. They’re not separated from one another. You know, they don’t have walls and doors intervening. They’re all one. Our body is one whole entity, one unit. And just like as we thought when we were younger,

And what we were told, like all these symptoms systems communicate and interact with one another. They they are integrated and they need one another to function properly. So if you’re high, you know, there’s a lot of high stress, you’re not sleeping very well, your lifestyle is compromised. Like these might seem like basic foundational things to some people, but the reality is over time, that’s going to impact your reproductive health. If you’ve got inflammation,

Thyroid issues, metabolic disorder, you know, we could go down the list. All of these things are absolutely going to impact your fertility and reproductive health and hormones. And so if we’re not looking at those areas, which is typically what’s happened in the type of medical model we have, we don’t we don’t look at those because all of our medical systems are specialized, right? And and that’s I’m not saying there’s a a problem with specialization. I specialize, but

But we have to have a broader approach and a broader understanding of the body. And so if you’re just going to see the OB and they don’t even understand or want to even contemplate or think about, whether that’s because they don’t want to, or insurance, or whatever’s dictating it, that they’re not thinking outside of those walls and that structure, then of course you’re going to get this unexplained infertility diagnosis because the majority of us have all sorts of stuff going on in our lives that are impacting

Hannah Aylward (11:33.322)
all of the other systems and in this case your reproductive function. So the big one for me, which is really, really huge that I see and I have always this conversation with couples is digestive health and digestive function. Like one of the first things that we do when someone starts to work with us is we evaluate their digestive health. We prioritize evaluating it and then improving it.

And then move from there. And sometimes that can take months before I ever do anything truly having to do with fertility or hormones. And I often get the question back, well, you know, I started working with you because I wanted to get pregnant, but we haven’t even, you know, we’re four months down the road and we haven’t even done anything with fertility. I’m like, I’m aware, but just so you know, this is all supporting your fertility. Right. Right. And so I have to re-educate them as to why and what the importance is.

But those but if you’re never looking at those things, then you know, unexplained is gonna be a much bigger diagnosis, but I don’t truly find them to be unexplained. Yeah. I agree. I it’s you know, it’s a delicate topic. I I think fertility is a delicate topic. It’s obviously like it’s charged, it’s it feels like fragile, it feels very important, it can be devastating, it’s like there’s so much emotion kind of wrapped into it. So I always try to just talk about it with tender tenderness. You know, I don’t I don’t want

anyone to feel like I I don’t know, wrong for whatever they’ve done. But I but I do agree with you that it just seems like the like IVF pipeline is really expedited now. And yeah, once again, I don’t know if it’s if it’s insurance, if it’s money, if it’s lack of exploration or whatever it is, it’s probably kind of a all of it. but it does feel like it’s very fast. We had a client, gosh, and this was like earlier on in my career as well, and she had three failed IUIs. She was getting ready to start IVF.

And then I was like, girl, please, like before you do before you invest like, I don’t know, twenty thousand dollars or whatever it is for IVF, like just let us run a just work with us for a couple months and let’s see what we can do. And I kid you not, I mean, it was like two months since she I got the picture with the positive pregnancy test. And what was really what it was really stemming from for her, we couldn’t even get into like our more detailed work with her. A lot of it was like lack of nourishment, fight or flight. Like her, she just didn’t have enough of the

Hannah Aylward (13:53.282)
She wasn’t well nourished enough. I mean, that’s the simplest way to put it, you know? So when we are looking at these and of course that’s one example, right? There’s so many different underlying causes of quote unquote unexplained infertility. So can you break those down for us? Like what do you see most commonly and and what should people be looking at here if they’ve been told like you’re struggling with or you’re dealing with unexplained infertility? Yeah, excellent question. And and I wanna highlight the story you just mentioned about that woman early on in your career.

I have tons of those as well. Right. Someone’s like, we’re just gonna let’s just clean some of these things up first. And then all of a sudden they’re like, hey, look, I’m pregnant. Like, look at that. Imagine imagine that. They’re not always that easy, but it’s a good example to like, you know, prove the point. So as I mentioned, my my number one is digestive issues. most of us in Western society have, whether we acknowledge it or aware of it, we have digestive issues in some capacity that need to be addressed and supported.

Inflammation and blood sugar. My holy trinity, by the way, is thyroid, blood sugar, and adrenal function or stress. And so those three to me are essential, need to be evaluated and looked at. I will often say sleep on its own, although it impacts so many things, but I’ve had several stories of women who weren’t getting enough rest and sleep because they were prioritizing all all sorts of other things. One of my favorites is.

I I had someone who I was working with. Everything looked perfect on paper. We had worked with her for three months. I’m like, everything looks wonderful, but like something just seems off. And you should really be able to just get pregnant. There’s nothing interfering. So I said, Will you do just run me through your day? Just give me a sample of what your day looks like. She did that. She said, Well, I wake up at 5 a.m. to go to the gym before I’ve got to go to before I got to go to work. And

You know, that was like red flag, and but I let her go through the whole day because I was like, Well, if she wakes up at five, like what time is she going to sleep? My God, my what is that? You know, maybe that’s eight or nine, and I I’m the one who’s putting a flag on something that I shouldn’t. But lo and behold, she’s going to sleep around, you know, eleven or twelve most nights. So I said, Look, listen, I understand like you’re using the gym to de-stress, but really you’re causing more stress by not getting enough sleep. So this is gonna be my only requirement. You need to get seven hours of sleep.

Hannah Aylward (16:13.76)
If you want to do the gym in the morning, it’s fine, but you have to get seven hours of sleep. If not, and then other than that, you you find another time to do the gym. That was literally the only other change I made after working with her for three months. That next month she was pregnant once she did that. So, you know, these things are are real because they cause a lot of stress on the body, and we need to have those foundational things in place. So those are probably my big ones. There is

I don’t know that I would call it unexplained, like part of the unexplained category, because it will get into that does get into a more real infertility diagnosis, endometriosis, but but there’s a lot of silent endometriosis and there’s a lot of low-grade endometriosis that women just don’t think are there, or by the time you realize it’s there, it’s years down the road. And so they were diagnosed with unexplained, but in the end, that’s what it was. But I so we could add that in, but that is something that

That I see quite a bit. And the reality is, is with much of this, is when you go to your OB and RE, they are really running a very limited view of your body of your hormones. You know, they’re they’re if we’re lucky, they’re running estradyl, FSH, but often they’re skipping FSH now. They’re just doing estradyle and AMH, maybe TSH and maybe a thyroid antibody, maybe if we’re lucky. And then

They run vitamin D in most cases. And then, you know, your STDs and they’re like, okay, let’s do a semen analysis. Look, everything looks fine. I don’t know what’s going on here. Let’s just do IVF. So if all you’re running is that really limited view, then what I do as a standard for me is we just need a lot more information to get started. And so often I find couples are diagnosed with unexplained when they really just haven’t had a real workup done.

And so that’s a that’s also a big one that needs to be to needs to be highlighted. And I say that on both sides because it’s not just the female in the relationship. I can’t tell you how many times, even to this day, that someone walks into my office. Yes, I’ve gone to see so and so. We’ve done our workups. Okay, where’s the semen analysis? we didn’t we didn’t do that. 50% of all fertility issues are male factor related. We need to run at minimum a semen analysis and

Hannah Aylward (18:35.146)
And typically we like to run a lot more than that. So we really just need a lot more information to have a solid understanding for where a couple is at when we’re starting to have this conversation because then we really know how to move forward when we’re supporting them. Yeah. Yeah. And for the for the men, I think it’s a really important like note to make because I don’t think that’s always done, right? Like there’s there’s almost so much pressure on the woman and it’s like how can we optimize

her health and her health and her health, which is of course important, you know. But what about this other person? It takes it takes two to tango, you know? It’s like, okay. Absolutely. And I’d say more typically, but not always, maybe this will get me into a little trouble. But more typically, women are like going to the doctor more. They’re they’re doing the stuff more. They’re researching the supplements more, you know, and men some men, I feel very grateful. My boyfriend is like more into health than I am, truly. So there’s there are definitely men like that, but a lot of men are like whatever.

They’re like, you know? And so it’s just so important, I think, to make that point. And it’s like he is he is fifty part of or fifty percent of the equation. And when you are looking, say you’re you’re optimizing her health and then you’re looking at him, are you also checking like thyroid and adrenal function and things like that? So well we always start with men because for me, because I I feel the same way that you do about men. So I have to take a tender baby step approach when I’m when I’m dealing with men.

And with the exception of few, like most are the way you described, you know, I’m fine, nothing hurts, it’s okay. When was the last time you went for your annual? What annual? I never go to an annual. Right. So so we take a baby step approach, I say, because it’s it’s actually it might seem silly, but it’s really difficult in most cases for us to get men to give a semen analysis. So I always start with a semen analysis. For me, a semen analysis gives me is a reflection of a man’s overall health.

So if everything looks awesome, yes, we can run additional labs, but I’m much less concerned if I have like, you know, supersperm and everything looks great. But if parameters are off, that’s where I use like, okay, so these things are not where they need to be. And this is a reflection of your overall health. And as a result of this, I would like to do more testing. I want to check your hormones. I want to check your thyroid.

Hannah Aylward (20:59.724)
Maybe we might do advanced, a more advanced semen analysis. So like there’s other things that we would look at. And I so I use that as my ammunition to request more. We’re starting there. Now, if someone, if there’s a a man who’s like, look, just tell me what I need and I’ll do all of it. Well, great. We can do that from the beginning, especially if they have a history where things are off. but typically that’s where I start because it’s really it it sounds funny, but it’s really challenging for me.

All sorts of excuses that I hear for men to not want to do a semen analysis. I had a kid 10 years ago. Okay, well, that was 10 years ago. I had a semen analysis done a year ago, it’s fine. Sperm regenerate every 24 hours, and you really have like new genetically normal sperm every roughly 90 days. And so what you had a year ago is not the same today. If everything was great a year ago, but today

You’re under a lot of stress, you’re not sleeping, you’re not eating well, like 100% we’re gonna see that in the sperm. So we need to have that information. So I’m really just trying to get them to start there and then we add on. Yeah. We’ll see it too. I mean, when it comes to gut issues, you know, I I will ask oftentimes like, how’s the partner? Because you do share, I mean, you can share your microbiome and your bacteria and things like that. And especially things like Helicobacter pylori or H. pylori, like you’ll swap it back and forth. So

If we see a woman who’s had chronic digestive issues for so long and then we find the H Py Lori, I’m like, I like to I like to say like we the best practice is to check him too. I mean it’s very likely, right? So but we’ll get pushback from that too. Whether it’s it could be cost, which I understand, but it can also, you know, usually they’re like, I just feel well, I’m he’s fine. I feel fine. So it’s like we have to convince Like we we’ve had to provide huge like data sheets, like here’s how this is the percentage

Like chance that it gets transmitted that you have it. Like I’m just like, my goodness. The the Yeah, we we do the same thing. I’ve actually had less pushback recently, by the way, when I request that because they’re like, Well, I don’t want to get it again. I don’t want this to come right. So then they’re they’re really pushing their partner to have that to so we do a lot of that as well. And we used to get more pushback. The biggest pushback is really cost. It’s just it’s an added expense and which I understand. And so we just try to solve that solution as best as we can.

Hannah Aylward (23:22.572)
Yeah. Okay. So when I’m what I’ve kind of heard you say is like thyroid, adrenal, digestive health. You mentioned one sleep. Like these are some of the main things that you’re blood sugar, inflammation. Blood sugar. Yes, exactly. So these are the things that you’re really focusing on when expl optimizing fertility or doing deeper exploration with a case that’s been deemed like dealing with unexplained infertility. Correct. Yeah.

And then is it after that that you would go, if someone wasn’t responding, you would go, hey, you may want to get checked for endometriosis? Or what does that kind of look like? Because I feel like the endo piece is really interesting. And in our line of work with the digestive issues, endo can be playing a role in that too. And I mean, if if they haven’t been diagnosed with it, like there’s no way for us to know really. We’re kind of looking at how they’re presenting, how they’re responding. And the endo thing is tricky too, because you can go for the ultrasound, they’ll see nothing, you’ll go.

You know, it’s like you kind of have to go for the laparoscopy or whatever. So so what does that look like in your practice? Yeah, it’s great. So we have seen a lot more endometriosis recently. And and I don’t know if that’s just because we’re really hypersensitive to it now. We’re really looking for it much more than we used to, or if it’s really there more. It’s probably a combination of both. But it’s much easier for me to go one direction than the other. So if someone comes in and says,

Have a history of endo, it’s much easier for me to then take that information and say, okay, well, you’ve never had a stool test done. We’ve never looked deeper at your immune system. We’ve never looked deeper at inflammation. Okay, we need to look at all of these things because these are root cause issues for endo. And we need to make sure your immune system is solid, inflammation is handled, gut is strong. So all of that is easy for me to do going that way. But

Not necessarily the other way, because we often start with all of these things. We don’t know about the endo. So we’ll start here, we’ll see some things here. If in our workup we start to they say some key things that flag endo, pain, the way their menstrual cycle is, their menstruation is, the timing of it, if they get spotting with bleeding, when they get that spotting, there are just some clues that we hear that we’re like, okay, we need to start to look deeper at endo.

Hannah Aylward (25:45.42)
But that doesn’t cover everybody. So then if we’ve ruled out all of these things, and then we’ve given somebody, let’s just say, and this will vary because we see couples of of wide ranges, and depending on their age, we might give them shorter or longer time to try before we look deeper. But if we feel like, hey, look, everything just is penciling out, you’ve done all the things, you’re doing really well, you’re ovulating well.

You’re still not pregnant after X amount of time. Again, that might be six months. For someone who’s older, it might be three months and maybe longer. Then they think we’re having a conversation. Look, we might need to look for silent endo. We might need to dive a little bit deeper on this because we have no other real reason. Everything else we’ve found, we’ve addressed, you’re doing really well. Now we’ve got to go to another layer. And so that’s where we’re having these conversations. Now

Fortunately, today, so a year ago, I would have said, even six months ago, I would have said, if we’ve got to rule out endo, we have to do a lap in the end. Like that’s really you need to do exploratory surgery. And if they find something, they’re also going to address it or remove it. There are some new companies that just came out that are doing blood tests. Yeah. Which is fantastic. It will it will make diagnosis much easier.

And help us get to a place where we know how to move forward much faster. And so that blood test is now something that we’re playing with and exploring with with women. prior to that, there was an endometrial biopsy test that women could do, but really they had to do that at an IVF clinic. So it’s not convenient for everybody. And then some just didn’t want to deal with that. So so it becomes a little bit tricky, but with I think with this new test will make things a lot.

easier to try to rope that into some of the initial testing so we can just say, hey, you know, I think this is something we should just put in there and let’s rule and let’s rule this thing out. And I think the only thing that would preclude anyone from doing it is just again, it’s gonna be a cost thing. Yeah. Yeah. So you have used some of these blood tests yourself. Just starting to. Yeah. Yeah. Yeah. That’s very exciting. Yeah, it’s great. Yeah, it makes a big difference. And I mean who wouldn’t want, you know, it’s the same thing when

Hannah Aylward (28:09.282)
They started doing all these this blood test for when women were pregnant. Instead of doing an amnio, they can do a blood test now to check for downs and some other abnormalities. And so, you know, 15 years ago or 20 years ago, when that came out, this was heaven sent, right? Because now we don’t have to do an invasive procedure. It’s the same thing. I feel the same way about this blood test, if it can turn out to be that. I feel the same way because now we don’t have to do this invasive procedure, at least not from the get-go. We can do this testing first and then determine who needs that.

Yeah, ’cause it’s hard. It’s I it’s exciting to look at the new or the newer stool test coming out too for like colon cancer ’cause it’s like yeah. You know, it’s like the colonoscopy and it’s like it’s a s it’s a s more serious thing. I mean it’s not. I know they do so many of them and it’s quick and all of that. But you know, you gotta go under and it’s a whole thing and you gotta prep for it and it’s like when I have to tell someone, Hey, you really should go for colonoscopy, it’s like

I just don’t love it. No one wants to do that. No one wants to do it. And it’s really intensive. So it’s like other these other stool tests or whatever they are, I think are can be so game changing, which is really, really exciting. Because it is hard. It’s hard to know. And women will get told, I don’t know what the timeline is specifically. Maybe you do. It’s like ten years or something before a woman like diagnosed with endo and she can be struggling with it for so long. And that is the timing. It’s it’s about ten years, which is crazy.

Yeah. It’s just kind of brutal, you know, so without knowing. But I I think, you know, what how I kind of see it is it’s like if we have those lesions and that more severe inflammation, it can be hard, especially if lesions like get really bad and then it’s like, you know, attaching to the colon or the rectum or whatever is happening. I mean, it’s like it’s a lot and the work that we do will struggle to work fully if that’s there. More of a structural issue. But I I think

doing the work, the gut work and the adrenal work and all of that and optimizing thyroid function is still massively beneficial because it’s more of like a systemic inflammation issue, right? So can you speak to that a little bit? Cause I think sometimes it’s like you go in, you get the surgery, you get the lesions removed, which is fantastic, incision surgery, and then it comes back, right? So what what is endometriosis? I know like we don’t have all the answers yet, but

Hannah Aylward (30:23.64)
Do you see it being more of a systemic inflammatory condition than it is like a hormone issue? I do. I see it being more of a inflammatory issue and an immune issue more than a hormone issue. Now hormones will impact it for sure, but I don’t feel like that’s the root of it. And I agree, like the work I try to do that you as well is I want to correct what’s going on underlying, even if they haven’t had the surgery yet, because that will set them up to recover better.

bounce back faster and to hopefully not have a return of the endo in the future. So for me it’s twofold. We’re gonna bookend the surgery. We’re gonna do this prep work in advance, really try to dramatically reduce inflammation, improve immune function, restore proper gut health. Then if they do this procedure, if they need it, and then we’re gonna go back to that foundational work afterwards to maintain the results and hopefully make sure they don’t

They don’t come back. And we’ve seen really good results with that. You know, I I will say that it is challenging to see some of the more long-term results when they still have some of that really deep stage three or four endo and it hasn’t been removed. And so the work initially might seem slow or challenging, but it’s still making a difference, is what I’ve seen. And then once that’s removed, hopefully all of it, but if not most of it, then

that work makes a much significant, much more significant difference later on. And so the women say to me, like they just feel like different, like a different person after after the surgery. I do want to highlight here for everyone listening, it’s really, really important that you see the right surgeon for this procedure if you’re going to do it. Someone, you know, I I always say there’s I have a very small number of people that I refer to for endosurgery.

And you know, I have women who have said, well, my OB just said she can do it. I’m like, no, no, no, no, no. This is not like that’s not okay. If she’s not on our list or this is not what she does all day long, this is not who you want doing this procedure. You really want someone for two reasons to this to do to someone who has a lot of experience doing this. One is just want it done right. You don’t want anyone to mess up while they’re in there.

Hannah Aylward (32:44.578)
You want to make sure they know where to look, that they know how to clean this up properly. And then two, from a fertility perspective, that you’re preserving your fertility. It’s really easy to go in there and just like hack away at stuff and just get, we took care of it all, but you can’t get pregnant now. Right. Like that’s not the result we want. And unfortunately, I have seen that, you know, too many times, which is devastating. And so you’d rather they take less out and preserve your fertility.

than do more because their job was just solely focused on this endo piece. And so I think that’s a really important piece to understand. I’ve seen recently with stage three or four endo that some women have needed multiple surgeries because when they go in the first time, they didn’t expect to find it wrapped around the colon or the intestines. And so they actually have to go in again with a colorectal surgeon to be able to do it.

in tandem to make sure they got some out the first time, but then now they’re gonna clean everything up the second time. And, you know, two of these women that I’m thinking of had silent endo. They didn’t even know they had any problems. So, you know, these things are it’s really important to just make sure that you have the right surgeon doing this. It it really can make the world of difference for you moving forward with your fertility. Yeah, I think it’s very important. Yeah, just 100% agree with all of that. You hear some interesting

kind of horror stories. You know? Yeah. So get the get the right person. It’s a it’s a more serious thing. Have a good surgeon, like you said, that that has done does a a bunch a day, like tons every single day. That’s all they do. Yeah. That’s all they do. Exactly. Yeah. Yeah.

Hannah Aylward (34:28.024)
We are big fans of eating enough protein over here on Team Han. Protein is essential for muscle repair, a strong gut lining, balanced blood sugar levels, and so much more. For most of our clients, we like recommending around 100 grams of protein per day to start, and adding in a good quality protein powder can be super helpful for hitting those numbers. It’s an easy add-in, you can throw it into a smoothie or even add it to oatmeal. Choosing the right protein powder can feel so overwhelming.

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We also see that it’s typically much better tolerated in our clients with chronic gut and digestive issues over something like a plant-based protein powder. In addition, some of their flavors do contain natural flavors, but they’re distilled vapors from natural and organic compounds or fruits like vanilla, coconut, and strawberry, and are processed without any chemicals, fillers, binders, or artificial ingredients, which once again is incredibly hard to find. Personally, I buy both the chocolate and the vanilla.

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Hannah Aylward (36:44.652)
When we’re thinking of like labs that you’re running, what are you what what are kind of the standard labs that you’re running that are digging deeper into like optimizing fertility for people? Like a full thyroid panel, a stool test. Can you expand on some of that? Yeah, sure. So my foundational labs is going to be full hormone panels. So estradyl, progesterone, FSH, LH, AMH, testosterone free in total.

Sex hormone binding globulin, DHEAS, like from a hormone perspective, that’s the bare minimum. I prefer to do those, not that all of them need a prolactin, I should throw in there as well. I prefer to do all of those at the beginning of a cycle, so cycle day two, three, or four of a woman’s cycle. They don’t all have to be done at that time, but if you’re already going in to have hormones, I like to have all the hormones kind of done together. it gives me a good picture.

Someone listening might say, Well, I thought progesterone needs to be done at a different time of the cycle. It does. I’m gonna get that as well. We’re gonna do that again later on. And then just full, full thyropon panel. I want all TSH, T four, T three, antibodies. I want it all. And most of you who’ll say, I ha I’ve had it all. No, you’ve had you know TSH and maybe T three or T four, depending on who you saw, and that’s about it.

You know, and then a lot of the basic ones that hopefully people have had on an annual. So CBC, CMP, you know, metabolic panel, blood sugar, iron. I like to look at inflammatory markers like CRP and homocysteine. Vitamin D is really important for me. It has a strong correlation with AMH levels. So I’m always looking at that, amongst other things. So I’m always looking at that. And so that’s like that and a semen analysis are bare minimum for me. That’s where everybody has to start.

And then from there, if a woman hasn’t had an HSG done, which to check your fallopian tubes to make sure they’re open, I can’t tell you how many people have been trying for years and have never checked to see if their fallopian tubes are open, by the way. So we need to have that checked. And then from there, from a more functional perspective, I start to layer things in. So I love using the Dutch test or some form, it doesn’t always have to be specifically that Dutch test could be similar to another in another company, but I want to do that.

Hannah Aylward (39:03.052)
That gives me a lot of information. I, if allowed, I always say, I would also throw in a stool test as a foundational piece. And then I also do everybody in my program, I don’t want to say everyone, I would prefer that everybody does, an environmental toxin panel as well. So I have found that that’s been huge. And for the last three-ish years, that’s a that’s a foundational piece that we do for for couples as well.

And then it’s really much about each individual couple, what their history is, what’s going on. I try to I I do it in this way because I really try to be mindful of cost where they’re spending a lot of money on tests. Yeah. And I’m just trying to be aware of what’s going on. And so that’s like the bare minimum. That’s like the foundational thing that I ask everyone to do. And then from there, it’s about what’s going on individually. And then we’ll start to add on from that foundational piece.

Yeah, that’s great. I and kind of leads me exactly where I wanted to go, which was the environmental toxin conversation. So we see a good bit of mold impacting our clients more than I would ever like to see. I dealt with it myself, totally tanked my health. I know people have varying opinions on the topic overall, but I I was curious, yeah, if you see like this environmental toxin exposure component impacting fertility and and how big of a role do you think that’s playing?

I think it’s playing a huge role. by the way, I I think it’s playing a huge role in both men and women, but I think it’s playing a slightly larger role in men than in women just because of how volatile sperm are, how sensitive they are. Like the eggs are somewhat protected very deep in the ovaries, in the follicles in the ovaries. So I’m not saying they’re not impacted. They are, they can be, but that’s more like longer term exposure. Sperm are highly sensitive.

And highly volatile and are impacted much easier, I find, from toxins. And so if we look, by the way, at the last fifty years and we see that male sperm counts have decreased dramatically over the last fifty years. What used to be considered normal for people listening w in terms of counts specifically was like a hundred million sperm count. Then it would drop down to fifty million. Today what’s considered normal in terms of sperm counter concentration is fifteen million. Wow.

Hannah Aylward (41:25.74)
Okay, so we used to be a hundred million, now we’re at fifteen million. Yeah. So as we’ve seen those numbers decline consistently, and the reason for that change in what’s considered normal is because if you can’t get men to consistently produce a hundred million, you can’t consider it normal anymore. So they have to change the parameters. Yeah. We’ve seen an increase in environmental toxin use in the world. Yeah. And so that’s why I’m saying I do think it’s affecting men more than it’s affecting women, especially on the short term and day to day. But

We’re exposed every day. I mean, now it’s just it’s just everywhere. You know, I constantly am telling as I’m out with my kids, I’m like, don’t touch that receipt paper, just tell them to email it to you. You know, you know, all the things. And it’s real. We’re just we’re exposed to microplastics, we’re exposed to glysofate, you know, Roundup. Like when I’m testing, I see it in I see it everywhere.

things that I’m actually always surprised when I get someone’s report back and it’s like, they only have two things that are slightly elevated. I’m like, wow, where do they live? You know, because I just don’t I just don’t see that. So all of these things, including mold, like these are highly impactful for our overall health. They cause more inflammation. They make it difficult for our immune system to function properly. So for all of us, I find it’s going to impact us all a little bit differently. It’s where is our weakness genetically, what are we

predisposed to, you know, so we can all have high, let’s just say BPA, but it’s gonna it’s gonna impact me a little bit differently than it would impact you or somebody else. And so, you know, for those listening, we can’t really compare ourselves like, but like so and so didn’t have this. I’m like, well, we’re all unique individuals and we all have our stuff. And as a result, our stuff is going to look a little different than somebody else’s stuff, even if we’re impacted by the same thing. But

I do see it being a a huge issue, which is why it’s a standard that we’re testing for it now. And it’s a part of our initial, not just our workup, but our foundation foundational work in terms of supporting couples. Like we have to address this now. So we do like a little initial boost and kick, like, okay, let’s hit this hard. But then it’s got to be ongoing because we’re, you know, we’re constantly exposed to things. But I’m also asking them to reduce exposure wherever possible. So once we know what’s going on, okay, we need to

Hannah Aylward (43:43.448)
We need to then start to clean that up as best as we can in our environment. You know, we can’t not recognize and we can’t control everything. Like if my neighbor sprays, I can’t do anything about it. Try to have a conversation and be like, hey, you know, it’s not good for us. I don’t care. Like, okay, well, thanks. that worked out really well. I I’ve had those conversations. So we just try to do as best as we can and try to manage it on for ourselves on a daily basis.

Yeah. So you’re looking at like mycotoxins, BPA, glyphosate you mentioned, heavy metals. Parabens, phthalates, yes, all the things. Are you doing that tot total talks burden panel? Yes. When I can, ’cause again, it’s a cost thing. So I it’s expensive. Yeah. It’s expensive. So sometimes I’ll just do just a pared down version. Like we start everybody with a pared down version and then we’ll kind of bump up from there if we if we can. Okay. Yeah.

I’ve been thinking about running that on myself and I’m like, I talked to my team about it. I’m like, to be honest, you guys, I don’t want to see it. I’m like, I’m I ran it on myself and I cannot believe how shocked I was because I’m super hyper vigilant and aware of like all the things. And I was like, I cannot believe all these things that are elevated. And and some of it were again were things like I can’t stop the 80 year old behind me from spraying pesticides. Like, you know, there’s not much I can do about that. He doesn’t want to listen to me.

So so it’s it’s just then saying, Okay, what am I gonna do? How am I gonna take ownership of this and what can I do to to try to try to manage that? Yeah. I honestly am like a big fan of just gentle Liberty Talk support, like ongoing and not necessarily like supplementing with a binder all the time, but like using fiber as binders, you know, like that those kinds of things to upkeep. So exactly what you said for for anyone that’s like, you know, what’s the strategy for this if my levels are looking high or whatever?

You know, minimize exposure as much as you can and then gently support detox. That when people are like, you have a liver and kidneys and it detoxes all the time for you and you don’t I’m We need some help. I know I’m like, you guys haven’t worked with chronically sick people then it’s showing. So so I agree. So I always build in something into their plan to like, this is gonna I’m just gonna put this in. It’s gonna help ongoingly, just a little bit, you know, just like you’re mentioning. So they might not even be aware of it that I’m doing it.

Hannah Aylward (46:04.29)
But then I asked them to do sauna. I asked them to drink a lot of water, just stay hydrated, be urinating. We’ve just got to excrete. So we’ve got to through sweat, through urine. So we’ve just got to be flushing on a regular basis. So hydration is huge. Sweating, going out exercising, sweating in a sauna, those sorts of things. So those are all ways to naturally and safely detox and they don’t cost any money theoretically. So or very little.

Yeah. And is it true that this regular sauna use can decrease sperm count? So I am careful with that. So yeah, so it just depends. So one for sure I don’t want you in the in the hot tub. So that that for sure I don’t want. But in a sauna, I feel like I can control things a little bit easier. So the the testes aren’t wrapped around hot boiling water, right? In a sauna. So it so I feel better about it. I’ll reduce the frequency that they do it.

If there’s a male factor issue. And then I it sounds funny, but I ask men to ice their testicles afterwards. No, I was gonna I was gonna say just cold towel. Cold towel on it. Yep. Cold towel on it while you’re in it if you want. And then and then when you get out, ice for about 15, 20 minutes. Every man says it feels great, by the way. And that’s my kind of balance to manage it.

Yeah. And what about alcohol? Because I think you I read I’ve read as well that alcohol, I mean, really impacts sperm qual quality or count or both. Can you t touch on that briefly? All of it. So we should we haven’t talked about it, so I should highlight the three main parameters that we look at in sperm counts for or sperm semen analysis for for men. So you’re looking at sperm count and concentration. Sometimes they’re separated, sometimes it’s the same number.

Motility, the way they swim, how well do they swim and how strong do they swim in a forward progression? Because it sounds funny, but me sperm are stupid and they get stuck. Like they’re not thinking that it’s just a beacon from them to the egg, and they’re like, I can’t, I can’t go that way. And you know, the so how well do they swim in that forward progression? And then morphology, the shape one head, one body, one tail, all proper sizes. The majority of sperm that men produce are abnormal.

Hannah Aylward (48:18.038)
And that is normal. So if what we’re looking for is let’s just say for easy numbers, a hundred million sperm count, four percent, at least four percent normal morphology of that count, right? Of that of that concentration. So that means ninety-six percent are abnormal and that is normal for men. So I just want to say that so that like we understand what we’re dealing with.

the majority of sperm that we produce are abnormal, meaning they have two heads, no head, three tails, no tails, like whatever variations of those things. So the the higher those numbers can be, the more the better chances we have. And I I forgot your question as I was talking about that. Yeah, you were talking about the three different kind of things that you’re looking at, like that. And then what I asked really was like alcohol and these other that’s right. Alcohol. Thank you. Yeah. So

All of those things absolutely impact. I will I’m gonna group, I’m gonna say alcohol, I’m gonna say marijuana use, because marijuana use has skyrocketed in the United States, I’m sure worldwide, always been high. But there’s tons of research studies that will show you that smoking marijuana and having high marijuana use or THC use is detrimental to your sperm health. There’s no question, it’s not like an if or I.

but I can. I’ve been doing it for so long. It’s okay. Nope. None of it. It’s not okay. And most of the marijuana, because it’s so valuable now, is highly sprayed with pesticides. So now you have that as an added piece of it. And I’ll say the same thing about alcohol. So alcohol is not ideal. There is some small benefit to some alcohol consumption here and there, but that’s like one to two glasses a week. It’s not.

three to four a night. And so if you’re going to drink alcohol, one, it should be minimal, should not be a regular thing. And then two, I’m really concerned about the type of alcohol we drink. So coming back to toxins and pesticides, all wine that is produced in the United States, you should expect to be highly sprayed and highly toxic. Yeah. I never choose US wine. All wine, I’m just like for everyone listening,

Hannah Aylward (50:36.704)
If you are out do n and you want a glass of wine, I mean, I can’t speak for like, you know, all the big wineries in Europe, but like you’re much better, that’s a better chance, you have a better chance of success going that route. And the same thing is true for beer, because all of that wheat comes from sprayed fields. So when and I’ve seen research studies on this. So it’s they’ve tested all sorts of wine and beer from the United States. It’s through the roof. Even the ones that say they’re organic from the United States, both wine and beer.

They have less, but they still have a lot because they’re still from the same, they’re still being the water source is still the same. So and it all gets into the soil. So if you’re going to have alcohol, it should be or be wine outside of the US. And then I like to just stick with like single liquor and the clearer, the cleaner. So the darker it is, they’ve probably added sugar or

flavoring or whatever it is, the more clear that it is, the cleaner that it is. And then just be, you know, moderation. Keep it simple. Don’t overdo it. Yeah. Beautiful. Have them ditch the beer habit. The the evening beer that maybe turns into like two beers or three beers. Three beers. Right. I feel like it’s such a of course I I do think things are changing and like people are more aware now and things like that. But you’ll still see the habit a lot in a lot of men. It’s like the postwork, the postwork drink, the the beer or whatever that

Yeah. Well, like, look, I I love beer and I love wine, but you know, we have to draw the line someplace, right? So we can’t overdo it. And if you’re reaching for that drink, even if it’s, you know, a clean tequila or something like that, if you’re reaching for that drink when you come home from work because like, I’ve had a hard day and I just need a drink, same thing with marijuana. I had a hard day, I’m gonna smoke a joint. Like, if that’s the case, that tells me you need you need to find a d different avenue.

to manage your stress levels, go for a great walk outside in the fresh air. Go take a swim someplace, put your feet in the sand, go to the beach, go to the gym, meditate, read a book, paint, do something else because that’s just telling you that you’re reaching for a vice to soothe your nervous system. And long term that’s just not a healthy outcome. Yeah. Yes. Totally agree. If I ever am feeling like I really need a drink, I’m like, I’m I’m like past my point.

Hannah Aylward (53:02.806)
of like fatigue. You know, I’m like, I’ve overdone it so much. If I’m really craving it, sometimes I usually it’s just celebratory, which I you know, and it’s sparse. But if I’m ever really like, it’s like a Friday and I’m like, my gosh, I could really use drink. I’m like, I am too tired. Like I’m too fatigued. I’m too burnt out and that’s why I’m feeling that way. And it always kind of signals to me like, okay Hannah, time to restructure some things or like decrease the workload or shift some things around because it doesn’t feel good to feel that way, you know.

No, and and and I think for everyone who does do that, just think about it this way. When you wake up in the morning, you’re gonna feel fatigued, you’re gonna feel groggy, you’re not gonna have energy. It it’s all a trickle effect. So having that drink tonight is not just that drink tonight. It’s gonna impact your next day, your work day, maybe the relationship, all sorts of other things. So let’s find other ways to to manage. Yeah. Beautiful.

Okay, so there are a few other questions that I want I want to ask you. Sure. I feel like women are having children later now. Well that’s what we’ll see. I think the stats support that, right? It’s like more women are having them thirties, forties, whatever, more so than in their twenties, or maybe it like teens. I’m not exactly sure, so I don’t wanna butcher it. But women are ha trying to have kids later, you know, they’re building careers, they’re doing other things and I think now they have we we don’t need to get on that soapbox, but they have choice. They have they have there’s other things going on. So

To the to women, like I’m thirty two years old and I don’t have any children yet and I would like to have children. And I know that I’m still quote unquote young, you know, but I feel like once you’re like, I don’t know, thirty five, it’s like, my gosh, it’s the end of the world. So

What for the woman that’s 30 to 40 years old, like what would you say she should be looking at? She should be prioritizing right now? Are there supplements? And of course, you know, the work that we do is like it’s so personalized, so I understand that. But is there are there a couple core things that you would recommend for like all almost everyone? Yeah, absolutely. So look, the if you are in your somewhere between 30 and 40 and you know at some point that you wanna have children.

Hannah Aylward (55:05.73)
But you’re either not in a long-term relationship or you just got married and you want to enjoy life for a little bit before you, you know, make that decision, which I appreciate. Start to just take care of yourself now. So the way I think of it is take inventory, take stock of your overall health. Say what are the areas that really need attention? Not the areas that you already give attention to that are easy to do. You you love to cook. So you spend a lot of time in the kitchen and you cook really good food. Okay. So

Don’t keep like I’m not saying not to do that, but don’t put your attention there, put your attention someplace else. Like, I always get headaches, or I don’t exercise enough, or I don’t sleep well, and I really need to work on that. Start to focus on those areas. Like we all know what that is. And if you don’t, just spend a little bit of time taking inventory and recognize those things. Put your, you know, prioritize the top one, two or three things that you want to improve and make a plan to do that. And if you don’t know how to do that, then get some the support that you need to make that happen.

Those I think are important for all of us because that’s going to play dividends down the road. You don’t want to say, hey, I want to be, I want to get pregnant and I want to have a child and then like just turn to your partner like, okay, let’s just start trying when you know that there’s all these things that really could be better. So let’s be proactive. And if you’re doing that now recognizing that, hey, it’s a year or two or three down the road, it’s so much less stressful for you because you can set up a plan and you don’t have the pressure of trying to also at the same time conceive.

So that th those are some things that I would just say from the beginning. Outside of that, if there’s some daily routines that you need to put into your habits, is make sure you’re hydrated, make sure you’re sleeping well. And then when it comes to supplements, there are some key things that you can be taking and should be taking. Obviously, as you mentioned, there’s personalization, but CoQ10 is wonderful. It’s a strong antioxidant, it has been it’s one of the most researched nutrients.

for fertility, both men and women. So you can both be taking that regularly. Vitamin D, I mentioned it earlier, but vitamin D is extremely important for fertility and overall health. And just making sure where your levels are at and make sure making sure you’re getting proper supplementation for that. Not just in the winter months, like you’d be surprised how many people I test in the summer months who, you know, their vitamin D is in the tank. So let’s make sure that our vitamin D level is where it needs to be.

Hannah Aylward (57:30.442)
And essential fatty acids are fish oils are just super, super key. And the other piece that I find is really important is just making sure you’re getting enough protein and fat in your diet. So those two things are hugely important. making sure you’re eating enough, like getting enough proper calories in a day. Too many people are fasting and trying to deprive themselves. I want to lose some weight, so I’m gonna skip some meals. I’m only gonna have one meal a day or whatever that might be. And that’s not a a healthy way to go about it. So

Just doing those key foundational things, I think, will play pay huge dividends, you know, in the long term when you’re ready to turn on that switch and say, like, hey, I’m ready to get pregnant. And that’s typically when I see the best results is when somebody’s like, I’ve done all these things and now I’m wanting to get pregnant. Just flip the switch and all of a sudden, you know, they’re able to get pregnant more easily. I will say if you already know that you have an issue in a certain system or chronic health issues in a certain place or whatever that is for you for yourself, don’t wait to take care of that.

when you want to get pregnant. Start to do that work now again so that it’s easier and less stressful. And then you don’t have to feel the pressure of conceiving. You can do that work now. And then that will be easier for you later on because you’ve already put in that work. Yes. That’s a question that I honestly get all the time. When women are like, because they feel pressure, right? So it’s like, I have a little bit of time. I want to try to conceive, we want to get pregnant. Should I do the gut work with you before or after? And I’m like, before I’m like, of course before.

But I understand and of course you know, it’s it’s a sensitive topic and there’s a lot that goes into trying and like timing and life, your life and like are you moving and the jobs and everything. So I understand it’s it’s complex and and unique for people. But I’m like, if you can control it at all, like please do the deeper gut work, the full thyroid panel, the full hormone panel, the toxin panel, all of this before it’s only gonna set you up for a better chances down down the line, you know. So I’m glad you’re

I’m glad you said that because we get that I get that question all the time, you know, or should I do it after? And I’m like, your whole preg pregnancy experience is gonna be better if we do it if we do it before. And not to freak you out, but you’re gonna give that microbiome to your baby. I was just about to say that. Yeah. Yeah. So like don’t think of it as this is just so much work. You are creating a child, you’re creating generations of children. The work you put in today to get yourself healthier.

Hannah Aylward (59:56.466)
is gonna play pay dividends tenfold down the road. You’re creating healthier children with h healthier microbiome. That gives them the foundation to create healthier children. It’ll be easier for you to take care of them, all the things. So yeah, hugely important. Yeah. one other like last question that I wanna ask you is HRT. Are you ever are you ever working with that, recommending it, working in conjunction with a medical doctor on that to kind of optimize hormones, especially as women

get like late thirties, early forties? So I don’t really see it so much in late thirties or early forties unless they need progesterone specifically. Yep. Yeah. But I have a fair amount of women who are in their forties who, you know, might be anobulatory or, you know, may maybe perimenopausal, haven’t had a cycle, they’re trying to get it back, and they still want to have children. And so in that situation, absolutely HRT comes into play and and can.

we might try to do it first without depending on the circumstance, we might try to do it without HRT first, but I won’t do that for too long because I just don’t want to waste time. Yeah. And so then we’ll have them get on some HRT and then we’ll interject and support simultaneously. And the all of those things can be done simultaneously. By the way, if anyone’s going through IVF and 50% of the couples we support are going through IVF. amazing. Yeah. So we could support couples, we meet them where they’re at.

So whatever they’re going through, and they are often on some sort some form of hormones when they’re going through IVF. It might not be like a full HRT protocol, but yes, they’re often given estrogen. At some point, will be also given progesterone and so forth. So we’re very familiar with supporting that and managing. Yeah. Do you ever do what I’ve heard before is kind of if you if you can

Check where your progesterone levels are and and see if they’re lower, know they’re on their lower end, then in the lute specifically at luteal phase, supplementing a little bit with like topical or or oral. I’m not I don’t honestly like don’t know, but can actually help support the chances of getting pregnant and carrying the pregnancy. Yes. So that’s a big one, and which is why we’ll check progesterone in the luteal phase. Yeah. And we’ll do a deeper dive.

Hannah Aylward (01:02:17.478)
with just being closer at managing that. And then if they do need some progesterone, we’ll start we’ll we’ll start with like lower dose and then we’ll creep our way up if they need more. Absolutely, it’s it’s it’s important, especially for women who have had miscarriages, rear current pregnancy loss. Like we didn’t talk about that in in our conversation today, but that’s a a huge variable and something that we see very, very often, unfortunately. And progesterone plays a huge role in that. So it often needs additional support.

Yes, okay. That’s kind of the context through which I’ve I’ve heard about that too, and the miscarriage piece and really checking that and seeing where you can optimize to try to prevent that from happening in the future. So a great strategy to know because I don’t hear a lot of I don’t hear a lot of traditional medical doctors talking about it, but maybe maybe I’m I’m mistaken, but I feel like they’re not checking that, you know. So they’re not often and yeah, it’s frustrating. I’ve just been on the phone with someone earlier today.

Having that same same conversation. And they need to do a better job of it, but they they just don’t feel like it makes a difference, which is why they don’t bother to check. Right. Which is just fascinating to me. So just to recap for everyone listening, the things that I heard were we have a lot of additional kind of deeper dive labs that we can explore here. CoQ10, generally speaking, supportive for both male male and female, omegas, which

Is I I had mine tested and I was like, wow, this is bad. This is way worse than I was expecting. Because we get so many, so we get so much exposure to omega-6s, right? So I was like, goodness, this looks quite bad. so there’s optimization for me there. Omegas, vitamin D, checking those levels, potentially supplementing there. of course, blood sugar regulation, good nutrition, hydration, sleep, you mentioned, stress management, decreasing alcohol. These are some of the main takeaways that I’m pulling, pulling from the episode. Did I miss anything there?

We talked about a lot, so maybe, but but those are some big good highlights that I think everyone should should should focus on. I will add for everyone listening, please don’t make medical decisions or fertility decisions out of fear. Please sit with it. Don’t be scared into doing IVF or scared into or out of IVF or into whatever it might be. Make a decision because it feels right for you.

Hannah Aylward (01:04:34.986)
Not because you’re scared it might not happen if you don’t do X, Y, and Z. And they told me this was the only path forward and I need to do that. So I really want you to decisions for all healthcare needs really shouldn’t be made out of fear. So really just focus on listening to your body and try to make decisions that feel right. and make them because you want to, not because someone forced you to do it. Beautiful. What a gr what a fabulous way to end it.

If people want to connect with you further, learn from you more. I know we have a YouTube channel. Where can people kind of connect with you? and and learn more of this great information from you. Yeah, I’m I’m on all the socials. So you can always find me there or my website, marksclar.com. But my favorite place is my YouTube channel, Fertility TV. We put out a new video every week. there’s tons of information on almost every topic that you could think of. So you can head on there and pick

Pick the topic that suits your needs and and check it out. Amazing. Thank you so much. We’ll make sure to link your your resources in the show notes below for everyone. And thanks so much for taking the time to come on today. Thanks for having me, Hannah.