Knowledge is power.

—SIR FRANCIS BACON

A 2006 to 2010 national survey of family growth from the Centers for Disease Control and Prevention (CDC) established the average infertility rate of women ages fifteen to forty-four as 10.9 percent and the infertility of men at about 9 percent.¹ That means about 6.1 million women and couples struggle with infertility, or 1 out of 7 couples have trouble conceiving; and that number is projected to climb to 1 out of 3 in the next ten years. As a result, the number of infertility clinics has increased by elevenfold since the 1990s.

If you fall in this category, take a deep breath and try not to fret. Yes, really. There is so much that can be done, and done naturally. In a world with seriously declining fertility, high-quality diagnostic lab tests can wield near-magical powers—a few simple tests you can request at a doctor’s office can help shed light on why your body isn’t ready to conceive. In this chapter, we’ll not only share what tests you can ask for, but also provide suggestions on what to do based on the results of each test. In life—and in fertility—there are often simple solutions to complex problems. These simple tests can provide key health information that can make a vital difference in understanding your body and what it needs to naturally conceive. Your results can often provide missing pieces of information that will help you and your doctor figure out why you might be having a hard time conceiving so that you can address any issues head-on with safe and natural remedies.

If you haven’t started trying to conceive yet and are a bit anxious about whether you will be able to (since, you know, we spend so much of our lives trying not to get pregnant), the very first thing we want you to do is trust your body and relax. Stress alone can be your nemesis because it creates hormonal disruption—but more on that later. Let’s take an honest look at the realities and common fears women might have about conception and pregnancy in their thirties and early forties.

You will discover that your health, happiness, and the future of life on earth are rarely so much in your own hands as when you sit down to eat.

—JOHN ROBBINS, DIET FOR A NEW AMERICA

ADDRESSING COMMON FEARS

For many women, the biggest fear is that once you decide to try to get pregnant, you won’t be able to. Or that it will be exceedingly difficult to do so, and you might have to resort to invasive and expensive procedures to try to increase your odds of successful conception. So that’s a lot to worry about! And, of course, you know that stress makes it more difficult to get pregnant, so you find yourself trying really hard not to feel stressed. Which doesn’t work and makes the whole endeavor seem ridiculously frustrating and overwhelming. And you haven’t even gotten to the fun part of procreation yet!

First, take a deep breath. Let it out. Here’s what we know: Getting pregnant naturally in your thirties (and even your early forties) is not only possible, but all the doom-and-gloom statistics you’ve heard forever aren’t even that accurate. It is possible to have just as healthy a pregnancy during this time in your life as it was in your twenties.

The challenges associated with being over thirty-five and pregnant tend to be exaggerated. An infertility study in 2004 from the National Institutes of Health concluded that there was only a 4 percent increase in infertility between the ages of twenty-seven and thirty-four and the ages of thirty-five and thirty-nine, and zero increase in sterility.² In addition, the famed Mayo Clinic says that healthy women in this age group can generally expect to have a successful pregnancy.³ It goes on to list the small increase in various complications from conception to delivery in women older than thirty-five, but stresses that the incidences are minute, even for women in their late thirties, and that health care providers are well-equipped to guide you through the process safely. A healthy lifestyle really does increase the odds of a natural conception and healthy pregnancy.

While there is truth to the less-optimistic statistics, they tend to be more scary and blown out of proportion than helpful. So what are some of these statistics? According to the Centers for Disease Control and Prevention (CDC), 6 percent of married women ages fifteen to forty-four are infertile, and about one-third of couples where the woman is over the age of thirty-five will have infertility problems.⁴ The American Society for Reproductive Medicine (ASRM) states that “for every 100 fertile thirty-year-old women trying to get pregnant in one cycle, 20 will be successful and the other 80 will have to try again.”⁵ This last one makes it sound like the odds are against you. However, the time frame makes for an incomplete picture. The last statistic by the ASRM shows that in four months of trying, 60 out of the 100 fertile women will get pregnant, and after twelve months of trying, 93 out of the 100 fertile women will get pregnant. This sounds much more promising than 1 out of 20. As for the first set of statistics from the CDC, we must consider the fact that we don’t know the preconception state of health of these women. They might have pre-existing conditions that would affect fertility that were never tested or taken into account.

So what are realistic concerns to have? Here are some common concerns we hear in our practice:

“I won’t be able to conceive naturally.” If you try everything and still need intrauterine insemination (IUI) or in vitro fertilization (IVF) or the like, then go easy on yourself. You’ve done everything you can. We are lucky to have additional measures and tools we can use. If you haven’t tried everything, then it may take a little longer to get pregnant than when you were in your twenties, but in most cases we’re only talking about a few months longer—a year, tops. You’re in your thirties now, though, so hopefully you’ve developed patience in your maturity. Keep in mind, it’s not that it will never happen, but it just might take a little longer. Yes, there are some women for whom it can take longer than a year, and there are some women who will need to explore IVF or other treatments, but they, too, should nourish and prep their body before such treatments. That’s why we wrote this book—to give you a step-by-step guide to improving those odds for natural conception and even IVF, and paving the way for a vibrant pregnancy!

“I’m told my baby could have a higher chance of birth defects.” Statistically, this is true for chromosomal defects such as Down syndrome, but this statement is still misleading. According to the Mayo Clinic, women over thirty-five have a 0.285 percent chance of giving birth to a baby with Down syndrome; after forty, a 1 percent chance; and after forty-five, a 3.33 percent chance.⁶ This is in comparison to women at age twenty who have a 0.06 percent chance of giving birth to a baby with Down syndrome. These statistics are usually explained without percentages and with the following numbers, which are much more scary: 1 out of 350 if over age thirty, 1 out of 100 if over age thirty-five, and 1 out of 30 if over age forty-five. This is where the fear tactics get out of control, and, frankly, make us a little upset. The truth is that the chance of having a baby with a chromosomal abnormality does increase after the age of forty. However, a woman over forty has only a 3.33 percent chance of having a baby with abnormalities. On the positive side, that means the same woman has a 96.66 percent chance of giving birth to a perfectly healthy baby.

Birth defects are a very real possibility for any child, regardless of the mother’s age, but just because you’ve passed your thirtieth birthday does not make it inevitable. These are still low percentages, and these are just for chromosomal defects and do not address major congenital birth defects.

A 2014 study conducted by Dr. Katherine Goetzinger, a Washington University OB/GYN and the primary maternal-fetal medicine specialist for the Fetal Care Center, found that major congenital birth defects that affect a baby’s organs such as the heart, brain, lungs, etc., do not have any correlation to an age increase. Actually, the opposite is true.⁷ They found that women over thirty-five who got pregnant and made it to their second trimester actually had a 40 percent less chance of giving birth to a baby with a congenital malformation than a woman in her twenties. We think that these statistics are promising and we certainly know many women who delivered perfectly healthy babies in their early forties, so try not to let the fear win.

“I’ll have a harder pregnancy and more difficult delivery.” This is where your lifestyle choices can really make a big difference. Yes, “statistically” (can we agree to put that word in air quotes from now on?), women in their thirties and early forties may encounter complications in their pregnancy such as gestational diabetes (a condition that starts in pregnancy when the body stops producing and using insulin, which leaves the body with too much glucose [sugar] in the blood) and preeclampsia, a pregnancy condition from high blood pressure and often protein in the urine that affects both the mom and the baby. However, what is often overlooked in these statistics is that in many of these cases, the women’s pre-existing health conditions, like high blood pressure, cardiovascular disease, and diabetes, far more greatly increased their odds of developing these conditions than did their age. Yet another reason to really take care of your own health before you even try to conceive.

When it comes to delivery, there are a million reasons both known and unknown that factor in the length and intensity of labor and delivery. Sometimes women in their thirties and forties have longer labor because of lower uterine muscle tone, which can come with age, as opposed to some defect in their birth canal. So you might try prenatal yoga, a great form of exercise that strengthens your pelvic floor and tones your entire body. An even more important factor to keep in mind is your physical lifestyle. This consists of how you sit, how much you sit or stand, how much you walk, etc. All these things affect the pelvis, the ligaments and muscles around the pelvis, and the position of the baby—all of which have a lot to do with the ease of labor and birth. If you spend most of the day sitting in a non-ergonomic chair at work, that’s not a great way to prepare the body for labor and birth. In this book, we provide simple tips to make sedentary work easier on your body with things like using an exercise ball (see here). But again, these suggestions are for any woman, not just a woman over thirty-five.

The idea that it’s going to be harder for a woman over thirty-five might come from the interventions that are more likely offered to a mature mom. More frequent and detailed monitoring of the mother and baby is likely recommended and if interventions are necessary, having a labor doula (see here for more on doulas) can help you through such interventions to successfully have the birth experience you desire. The goal is the experience, because whether you have an “easier” or “harder” labor depends on your perception. Interventions like inductions often start a cycle of more interventions, and being supported along the way helps a woman get the desired experience, interventions or not.

Now that we have quickly addressed a couple of the primary concerns many women have, let’s dig a little deeper into some of these concerns, as well as look at the promising realities for becoming a mother in your thirties, particularly after age thirty-five.

CHALLENGES AND ENCOURAGEMENT

One of the primary challenges of conceiving past age thirty-five is decreased ovulation, both in frequency and in quantity. We have all been told that those millions of eggs you were born with start dying off every year—use it or lose it, if you will. And while we certainly see a real drop-off in viable egg production in our forties, we know that balanced hormones and solid overall health can keep our egg production in business well into our late thirties.

Stated differently, we could say that women older than thirty have a 20 percent chance of getting pregnant per cycle; and after forty they have a 5 percent chance. Or, as Dr. Jean M. Twenge, professor of psychology at San Diego State University, so wisely points out in her book, The Impatient Woman’s Guide to Getting Pregnant, we could take the glass-half-full approach and say that “women in their early thirties have a 75 to 80 percent chance of getting pregnant within one year, and women in their early forties have a 65 percent chance of getting pregnant within that year.”⁸ The odds really are in your favor.

We encourage you to feel empowered to evaluate your current health, study our recommendations for balancing hormones and bringing your body’s systems into alignment, and take the steps to reclaim your optimum reproductive health. Your ability to naturally conceive is largely in your hands.

Women in their early thirties have a 75 to 80 percent chance of getting pregnant within one year, and women in their early forties have a 65 percent chance of getting pregnant within that year. The odds really are in your favor.

Some women (and doctors) consider long-term birth control a factor that can make it harder to get pregnant. They say that once you go off birth control, it can take awhile or can be more difficult to resume a normal ovulation cycle. But we have found that the biggest reasons it takes longer to resume a healthy cycle are lifestyle habits and overall hormonal health—both areas in which you have control. The nutrition plan in this book will help.

Other reasons conceiving after thirty-five may be more difficult include endometriosis and fibroids or uterine disorders. The good news is that these are conditions that can be well cared for with supplements and the right foods.

Another concern is an age-related decrease in cervical fluid, but we know that a diet full of quality animal fats, avocado, vitamin E–rich foods, and an adaptogenic herb called maca, which helps to balance the pituitary gland, the hormone-secreting gland that is often referred to as the master gland (more on this here), can all but eliminate this concern.

If you have chronic health problems, such as high blood pressure or type 2 diabetes, these conditions will certainly make natural conception and a healthy pregnancy more difficult, but these are conditions that are dramatically improved with diet and lifestyle changes. When you improve the health of the gut microbiome, you improve the health and function of the entire body and many health issues and symptoms resolve on their own. Our preconception cleanse not only strengthens your entire body to better conceive and carry a healthy baby to term, it also activates your body’s natural healing properties. If you are on medication(s), we suggest you visit with your physician as your diet and lifestyle improves to run lab work and evaluate your dosage and continued need for some of them. As seen in both of our private practices, as the body gets healthier and more nourished, it often takes away the need for certain medications or allows the dose to be lowered. This process should always be guided and approved by your physician.

It’s important to state that we are not in any way against Western, allopathic medicine. We are for the marriage of both Western and natural medicine and aim to build a bridge between the two.

Another thing women in their thirties and forties worry about when they think about conceiving is the risk of miscarriage. A miscarriage is devastating, and any woman who has had one knows the unique and exquisite pain it can cause, and the fear it can project into future pregnancies. Sadly, miscarriage is a possibility for any woman, no matter her age. There are myriad factors that must miraculously intersect to conceive and carry a healthy baby. That so many healthy babies are born every day is truly amazing, considering how many things could potentially interrupt the process of natural conception and pregnancy.

The probability of miscarrying increases from 15 percent before age thirty-five to as much as 35 percent in a woman’s late thirties, according to a compilation of multiple studies published in the International Journal of Obstetrics and Gynaecology.⁹ But again, when looking further into some of the studies that these statistics come from, you’ll find the following: The odds of miscarriage increased significantly if the pregnancy resulted from infertility treatment, the highest from intrauterine insemination or artificial insemination. And the most significant to us was that BMI and pre-pregnancy weight influenced miscarriage by 72 percent, but not in the direction you are likely thinking. It was for women who were underweight and whose BMI was less than 18.5 percent. So although these stats can be scary, we also know that focusing on the fearful—particularly the factors that you have no control over—is not only fruitless, but it actively hurts you by increasing your anxiety and setting off a ripple effect of unhealthy physical responses.

Actively focusing on the positive really does wonders to reduce your anxiety and to help you conceive more easily. We guarantee that if you intentionally choose life-enhancing foods and attitudes every day, you can’t help but feel happier and healthier. Good things come from this point of view and way of living, including natural conception, healthy pregnancies, and happy babies.

When you become pregnant or if you are delivering your baby after the age of thirty-five, you are medically considered high risk, and the pregnancy is even considered—get this—a geriatric pregnancy. Talk about a negative connotation. Can we all agree to banish this term from our vocabularies and refuse to accept it from the medical community? Great. With that settled, it is important to know that there are statistically more cesarean births for women thirty-five and older simply because of their age. Doctors may be more likely to offer induction to any woman who goes past her due date, according to the Mayo Clinic. It is an intervention-begets-intervention scenario—when one intervention is introduced, the most common being an induction, the likelihood of more interventions and a cesarean section is much higher.¹⁰ Simply being aware of this fact will help you make better decisions about the type of birth you prefer to have. Unforeseen circumstances are always a possibility, but we encourage you to figure out what you want for your birth experience and clearly communicate that to all involved, including your doctor.

Not every (or even many) woman over thirty-five needs or wants a cesarean section. Talking with your doctor about options may be one way a bridge can be built between medical doctors, midwives, and naturopathic or holistic practitioners to allow for the body’s natural delivery process while also creating a safe environment with interventions ready if need be. Also, see the section on Selecting Your Prenatal Care here for more advice on how to set up your birth team and have an amazing birth experience.

The final challenge we want to address is evaluating how old is truly too old to try to conceive naturally. We have spoken and worked with many women in their thirties and forties who want nothing more than to have a child naturally. Our first stance is one of support and empathy. Our second is always education. Obviously, this book is a wellspring of information on everything we collectively know and have experienced.

That said, we agree that forty-four or forty-five is likely the ceiling for conceiving naturally with your first child, taking into consideration all the factors of age and fertility. We understand if many women find this heartbreaking or even unacceptable. As students of the body, we strive to understand and respect its abilities and its limits, even when that sometimes falls short of our expectations.

It is during these times that we try to take a more philosophical approach. The best stories always have unexpected twists and turns. Because real mothers are not just women who have carried a baby: There are many women who love unconditionally, encourage endlessly, teach and guide courageously, and always show up for a child. That is a true mother. And that can be any of us, at any age.

TAKING CHARGE AND MAKING IT HAPPEN

The rest of this chapter is your guide for how to become your own best clinician, depending on how proactive you want to be or if you are already having difficulty getting pregnant. It provides options and opens doors for peeking at the possible root causes of infertility, slow fertility, and numerous other health challenges.

Our preconception plan takes a total of three months to prime your body for optimal nutrition and prepare yourself to get pregnant. That’s all well and good, you say. But I am ready to get pregnant right now, not three months from now. What can I do right now?

If you want to get pregnant as soon as possible and already live a healthy lifestyle without any major health issues, you can start incorporating our action items from our Preconception Action Plan in a shorter amount of time. But remember that our bodies do their reproductive “prep” three months prior to conception in both men and women. Because both the sperm and the egg develop a few months before conception, we highly recommend taking the time to do the full 12-week plan outlined in this book.

FACTORS IN CONCEPTION

Progesterone is an important hormone for fertility. It prepares the uterus for implantation by signaling the endometrium, or mucous membrane inside the uterus, to start thickening. If ovulation has occurred, it continues to provide the uterine lining with what it needs to make a safe and suitable environment for a developing embryo.

The Role of Progesterone

Many women are low in progesterone. This can happen naturally, especially when women have a condition like polycystic ovary syndrome (PCOS), a leading cause of infertility in women. When a woman isn’t pregnant, progesterone regulates her menstrual cycle by preparing (and shedding) the uterine lining that protects an implanted egg after conception.

When a woman is pregnant, progesterone becomes even more important because it protects the embryo and helps the placenta function normally. After the baby is born, progesterone helps stimulate breast tissue growth in preparation for breast-feeding, and does even more!

Often, clients come to us with symptoms of progesterone deficiency, including appetite changes, depression, mood swings, anxiety, irritability, weight change, fatigue, irregular menstruation, headaches, low sex drive, painful intercourse, vaginal dryness, PCOS, lack of concentration, and insomnia. Although low progesterone levels and PCOS are usually discovered when women seek help for infertility, some women can actually experience low progesterone and PCOS as early as adolescence.

The causes of low progesterone levels are not well known, but some specialists hint at the fact that poor nutrition, stress, and lack of exercise might play a role. Some medications might also reduce progesterone levels.

There are two vitamins we find particularly important in maintaining healthy progesterone levels:

1. Vitamin B6: Your body requires adequate amounts of vitamin B6 to maintain optimal levels of progesterone. The lack of this important vitamin may decrease the production of progesterone. Vitamin B6 is also necessary for the liver to break down estrogen. If it does not break it down, the levels of estrogen increase, creating hormonal imbalance. This means that levels of estrogen become higher than progesterone levels. Good amounts of vitamin B6 can be found in walnuts, gluten-free whole grains, lean red meat, poultry, seafood, bananas, spinach, beans, and potatoes.

2. Vitamin C: A study has shown that 750 milligrams of vitamin C taken every day for six months can considerably increase progesterone production, which resulted in pregnancy in 25 percent of the women in the study.¹¹ Those in the control group who didn’t receive vitamin C had a luteal phase defect. This is when the uterine lining does not become thick enough for implantation, which is triggered by progesterone. Either the ovaries aren’t producing enough progesterone or the uterus isn’t responding to the progesterone. This study found that women who suffered from luteal phase defect who increased their vitamin C experienced a significant increase in their progesterone levels, which led to conception.

The Role of Balanced pH

You may or may not remember what pH is from your high school chemistry class, so here’s a quick refresher: pH stands for potential hydrogen and refers to how acidic or alkaline your body chemistry is. We relate it to a swimming pool: If a pool is too acidic, it rusts; too alkaline, it grows mold. And no one wants to swim in a rusty or moldy pool, right? Especially when it involves creating a new life.

A woman’s body’s pH must be balanced if the sperm are to survive. Most Americans are way too acidic thanks to the Standard American Diet (SAD… what an appropriate acronym) and a stressful lifestyle that routinely pushes both the body and the mind past their natural limits. But many MDs don’t test for pH balance, which makes perfect sense because the pH of our blood doesn’t change. It always stays between 7.25 and 7.45. That’s because if it were to shift out of that range, we would die. So our bodies work very hard to keep our blood pH in that narrow range, but that doesn’t mean that our overall pH levels are actually healthy.

A pH test of urine and saliva will allow you to see how hard your body may be working to maintain that very narrow range of blood pH levels. This is crucial information to have. If you are overly acidic, your body will leach the minerals that it needs out of your bones and donate it to the blood to keep your blood pH balanced and keep you functioning. That’s bad news for your health, because mineral deficiencies can lead to a host of dis-ease and dis-order (as in lack of ease and lack of order) within the body. They can knock your thyroid out of balance and put the rest of your hormones into overdrive in order to compensate. When this negative cascade ensues, it creates an inhospitable environment for conception and implantation, and conception becomes much tougher.

To go back to our example, a rusty or moldy pool is not a very desirable place to live. You will put great thought and care into decorating and prepping your baby’s room to welcome this little soul into the world; do the same with your body. Prep it and your womb because it will be your baby’s very first home.

The good news is, it is very easy for you to test and balance your own pH to create a welcoming environment for the egg and sperm to have successful fertilization. You can get pH strips at any good health food store, or your local pharmacy or drugstore. Using the following test, track the pH of your saliva and urine for six days. This will give you a good barometer of where you are. PH strips are available online and in the supplement section of health food stores.

The pH Home Test

Upon waking, test your saliva with the pH strip by wetting the end of the strip with your saliva before you brush your teeth, or eat or drink anything. Note the color change and write down the pH number below. Ideal pH levels fall between 7.0 and 7.2.

TEST START DATE: __________________

SALIVA
Day 1:	Day 2:	Day 3:
Day 4:	Day 5:	Day 6:

We’re also going to test your urine two times in the morning for six days. The first urine test should be urine your body has collected and stored in the bladder overnight. Urinate on a strip of pH paper, record the color change, and write down the pH number. First morning urine is any time between 5 and 8 a.m., so if you get up to pee after 5 a.m. and go back to bed, make sure to pee on a strip and record it. No worries if you sleep in, or have an alternative schedule, just test your first urine after sleep, whatever the time of day. The first urine should optimally run between 7.0 and 7.2, but don’t worry if it doesn’t. If it is more acidic than the second morning urine, that indicates you are sleeping deeply enough the first four hours of sleep for your body to eliminate acid from the joints and pass it through the kidneys and out of your body upon rising.

FIRST URINE
Day 1:	Day 2:	Day 3:
Day 4:	Day 5:	Day 6:

You also need to test the urine from your second morning urination before eating any food, if possible (it’s only for six days). Do your best to record this number because it paints a good picture of the biochemistry you live with every day. This number indicates your pH after you have eliminated the acid load from the day before. The acidity should be less the second time you urinate, so ideally your urine pH should be around 7.0 to 7.2. Don’t worry if you are a bit acidic. Our dietary recommendations will help you become more alkaline very soon.

SECOND URINE
Day 1:	Day 2:	Day 3:
Day 4:	Day 5:	Day 6:

Where did you end up? Acid? Alkaline? Balanced? Have a look at our fun chart in the back of the book that shows you Food Effects on Acid-Alkaline Body Chemistry (see Appendix C here). Knowledge is power, and by learning how food affects you, you can begin to use it as your medicine.

If you are too acidic (under 6.8), instead of trying to eat less acidic foods, which will happen automatically as you take our advice in this book, just add in more alkaline-forming foods like sweet potatoes, pumpkin seeds, sea vegetables, lemons, and limes.

But wait! Aren’t lemons and limes acidic? Yes, they are acidic, but the cool thing is that when they mix with human biochemistry they stimulate the formation of calcium carbonate, which neutralizes acids like uric acid. So they have an alkalizing effect in the body. Upon waking, try drinking 16 ounces of room-temperature water with the juice of a full lime squeezed into it. Your pH will thank you.

The Role of the Thyroid

The thyroid is one of the largest endocrine glands in the body. Located in the front of your neck, it is both the furnace and the thermostat of the human body, which means it makes and stores hormones that regulate growth, metabolism, heart rate, blood pressure, and body temperature. When it is not functioning optimally, it can create havoc in your life because it is responsible for: making energy (working hand-in-hand with your adrenal glands); regulating metabolism to keep you at a healthy weight; keeping your moods happy and balanced; and allowing deep sleep and smooth-flowing digestion. When your thyroid is even slightly out of whack, you simply don’t feel like yourself. And when there is a thyroid problem for any length of time, ovulation is halted.

The thyroid gland controls many things: how quickly the body makes and uses energy, how quickly the body makes protein, and how sensitive the body is to other hormones. So when the thyroid is off, the rest of the reproductive hormones become unbalanced.

The best way to check your thyroid is to take your pulse and temperature. The thyroid is the temperature regulator of the body and the body is supposed to maintain 98.6°F to keep everything functioning well. Pulse rate helps us understand our metabolism a bit better. And since the thyroid is also the metabolic regulator of the body, your pulse will tell you if it is high or low.¹²

If your waking temperature is cooler than 97.4°F and your waking pulse is less than 70 beats per minute, then your thyroid is probably a bit low and we have to figure out why and how to boost it. We give you details on how to do this (see here). It is a good idea to take your temperature before bed and twenty minutes after each meal as well. This gives you an idea of how optimally your thyroid is working throughout the day, and whether your food choices are working for or against your fertility. How your temperature and pulse fluctuate after a meal also gives you an idea of how that meal worked for you (or didn’t work for you, as the case may be). Does it positively impact metabolism and the thyroid, or does it negatively impact metabolism and thyroid? Food can be our medicine or our slowest form of poison.

If your body temperature goes down after a meal, that’s a sign that the meal was not helpful to your metabolism or supportive for your thyroid. When your body temperature goes up significantly after a meal (more than 1.5–2°F), that signifies an immune response, and it is typically a sign that you have a food sensitivity or reaction to something you ate. Ideally, you’ll want your body temperature to stay the same or go up by .5–1°F (as close to 98.6°F as possible). A food sensitivity is an immune system response to a food the body believes is harmful. (For more on food sensitivities, turn to The Role of Food Sensitivities here, or Appendix D: The Five Most Common Food Sensitivities here.) For example, if you have sensitivity to gluten, corn, soy, or dairy and you eat them, rising body temperature is the sign your immune system is reacting to a food it believes is harmful.

Your core body temperature should be around 98.6°F (give or take a few tenths of a degree) throughout the day. Once you find your base temperature in the morning, see how close you can get to that during the day and after meals by adjusting the percentage of carbohydrate, fat, and protein within each meal. If your thyroid is low, you should shoot for a macronutrient combination consisting of 50 percent carbohydrate (not from gluten, or refined or processed carbs), 25 percent fat, and 25 percent protein ratio (in grams) for a short while until your temperature normalizes.

The following tests are easy, free, and very accurate, so give them a try.

Simple Thyroid Test

Record your temperature and pulse five times a day for three days to see if your thyroid might need a boost (which our program does naturally).

DAY ONE
Waking pulse:	Temperature:
After breakfast pulse:	Temperature:
After lunch pulse:	Temperature:
After dinner pulse:	Temperature:
Before bed pulse:	Temperature:

DAY TWO
Waking pulse:	Temperature:
After breakfast pulse:	Temperature:
After lunch pulse:	Temperature:
After dinner pulse:	Temperature:
Before bed pulse:	Temperature:

DAY THREE
Waking pulse:	Temperature:
After breakfast pulse:	Temperature:
After lunch pulse:	Temperature:
After dinner pulse:	Temperature:
Before bed pulse:	Temperature:

Even if you don’t have a problem with your thyroid, we are going to boost it with our diet plan by:

• Effortlessly eliminating soy.

• Effortlessly eliminating gluten.

• Adding the six key nutrients that keep it thriving: iodine, selenium, copper, iron, essential fatty acids, and raw saturated fat. Yum!

Blood work prior to conception is always a good idea if you have the luxury of doing so. When you get your thyroid checked, make sure you request tests for all four thyroid hormones: T3, T4, TPO (thyroid peroxidase), and TSH (thyroid stimulating hormone). Usually when you ask for a thyroid test, labs will only run the TSH, so it is important to request the full panel. It will give you a total picture of what may or may not be out of balance so that you can be more precise with your troubleshooting.^*

So we are all on the same page now, right? Our new mantra is “Progesterone, pH, and thyroid are king!” They are three of the most important markers for any woman who wants to naturally conceive—and feel good doing it!

THE WHAT AND WHY’S OF TESTING

Of course, there are a few other things that would be helpful to look at more closely if you have trouble getting pregnant or if you are really ambitious about your health and want to make it sparkle as brightly as possible prior to conception. The following are our recommendations for tests you may want to consider, what they reveal about your health, and why they could be helpful on the road to baby-making.

Following the diet and lifestyle advice in this book alone can improve digestive and hormonal health to the point of success with conceiving naturally and healthfully. We only suggest running lab work, working with a practitioner, or joining a gut-repair program if you have a history of having these issues or problems and have been unsuccessful in conceiving after taking the advice in this book and making lifestyle changes.

Stress and Sex Hormone Test (Four-Point Cortisol Panel)

If you have been trying to get pregnant for a while to no avail, have irregular periods, or just want to know where you stand hormonally beyond the tests your medical doctor has run (FSH, LH, and prolactin), then we recommend running a four-point saliva panel that includes both your sex and your stress hormones. Here, our main focus is your adrenal health. Your adrenal health is your energy health in a nutshell. Your adrenals want to support your energy levels, but if stressed or overtaxed by lack of sleep, gut disruption, etc., they will get worn out. This is when a person is left with adrenal fatigue.

Medical doctors usually only test the sex hormones but have the ability to test cortisol if you ask. As a holistic practitioner, Christa tests the adrenal glands and precursor hormones (cortisol, DHEA, pregnenolone) to see how your body is creating and managing stress hormones. Generally, by the time the adrenals are affected, brain chemistry has been out of balance for quite some time, and the person is likely experiencing chronic exhaustion, light-headedness, insomnia, and either anxiety or depression or both.

When working with a client who is struggling with fertility, Christa likes to give her digestive health a boost, repair her adrenal glands, balance her brain chemistry, and boost her thyroid. More often than not, the sex hormones then have everything they need to make their own balanced hormones so that the client can conceive naturally and quickly.

IgG Blood Serum Test for Food Sensitivities

Food sensitivities are an immune system response to a food the body believes is harmful. The five most common food sensitivities are wheat, dairy, corn, soy, and eggs. However, many people are also sensitive to peanuts, sugar, artificial sweeteners, and even bananas.

Food sensitivities are very different from full-blown food allergies, which can cause serious reactions to foods that usually require Benadryl, an EpiPen, or a visit to the hospital; sensitivities are way more subtle than that. The symptoms they cause are not usually attributed to food, making them much trickier to detect.

Sometimes the symptoms go unnoticed because the sensitivity could lie in a healthy food, one that we would never guess our body would be sensitive to. It might sound silly, but our bodies operate a lot like custom cars: We all have a specific formula of nutrients and foods that fuel us best. In the decade that we’ve been practicing, many clients who were tested were shocked to find out that they were sensitive to common foods such as asparagus, onions, and oranges.

Christa had a client who suffered from chronic headaches for more than twenty years. After doing everything she would normally do for headaches (fixing a magnesium and vitamin B2 deficiency, hydrating the body, boosting cellular energy, relaxing tension, flushing and building the liver), nothing worked until she ran a food sensitivity panel on the client. We found a high sensitivity to eggs—something she ate five days a week for breakfast. When the eggs went away, so did two decades’ worth of headaches (and brain fog and 40 pounds). Sometimes there can be simple answers to seemingly complicated questions!

Symptoms include feeling bloated, gassy, or suddenly irritable or tired after eating a certain food or a particular ingredient in a food. Another very common symptom of food sensitivities is dark circles underneath the eyes, which indicate a negative liver response to a food. Headaches can also indicate a food sensitivity.

It’s smart to get tested whether you experience symptoms or not, because it’s important to find out if you have any unknown sensitivities lurking about that might be doing harm to your body. As a general rule, if you are eating food that nourishes and supports you physically, you should feel mentally clear and energized after eating it.

It is helpful for you and your partner to run blood tests for food sensitivities prior to conception so you can avoid those foods in preconception and during pregnancy. The most common and accurate blood test for food sensitivity is the IgG blood serum test. The “I” in IgG stands for immunoglobulin, the most common antibodies or proteins made by our immune system. The immune system produces immunoglobulins in response to antigens, or any substances that pose a threat. An antigen is usually a foreign substance like an environmental toxin, bacteria, pollen, or viruses, but can also be a food as well.

Thus an IgG test is essentially checking to see whether our immune system is fighting some of the foods we eat as if they were antigens. Our immune system will continue to react this way as long as that offending food(s) is ingested. In other words, once someone develops sensitivity to a food, immunoglobulin antibodies will wage war and continue to produce more antibodies to fight in anticipation of the next conflict. So the problem is exacerbated every time that person unknowingly eats a food that they are biologically sensitive to. If you even suspect that you or your partner may have food sensitivities, it’s important to be tested to find out for sure, because repeated consumption of a food that your body has an immune reaction to potentially causes long-term damage to the body over time, leading to autoimmune diseases. The more accurate tests available to doctors today are Alcat and Cyrex, but always do your own research, as the field of testing is quickly evolving.

Another way to figure out if you might have sensitivity to a particular food is to try an elimination diet. This removes the five most common food sensitivities, which are wheat (gluten), dairy, corn, soy, and eggs, for 21 days, and then slowly adds them back in (bring back one food at a time every four days) to see how your body reacts.

With a little detective work and experimentation, you can easily find out what foods are not supportive to you, and eliminate them to start improving your health immediately. Eventually you will be able to be intuitive with your nutrition because you’ll learn the subtleties of how foods affect you. Truly knowing and understanding how your own body functions best is one of the greatest gifts you can give yourself because it’s the most empowering way to achieve lasting health and well-being.

And now, more than ever, it is really important to avoid your high food sensitivities because they could be one of the main causes of intestinal permeability, known as leaky gut (which we’ll explain here).

Generations ago, not many people experienced food sensitivities. That’s because people in our grandparents’ generation (and before) ate naturally grown and harvested crops. Today, many of us are consuming genetically modified organisms, or GMOs.

You may have heard this term on the news, or seen “non-GMO” listed on foods in your local grocery store. As the public becomes more aware of how potentially dangerous and prevalent these foods are, GMOs are becoming highly controversial.

Most wheat grown in the US today is hybridized and most corn and soy is genetically modified. Genetic modification isn’t necessarily new, or harmful in and of itself. Farmers have been cultivating different qualities into crops for generations in order to produce more nutritious, stronger, faster-maturing plants and there has been nothing wrong with that “survival of the fittest” breeding technique.

However, what most clinicians—including Christa—are concerned with are the GMOs that arrived on the scene in the late 1990s. These foods have been created through biotech techniques of gene-splicing. These are foods created in a lab that take the DNA from one species of plant and inject it into another to create combinations of plants that do not occur anywhere in nature or through traditional crossbreeding methods. These GMOs were created to grow more food, faster and cheaper. These “food products” were created with little regard for their nutrient density or effect on human health, but with more concern for industrialization and profitability. This type of genetic modification began proliferating in the late 1990s and, coincidentally, our fertility as a nation began declining around that time. Studies also corroborate the anecdotal evidence, with several experiments showing significant declines in fertility when rats fed a diet laden with GMO foods had declined fertility within one generation of consumption, and lost the ability to reproduce by the third generation.

While more studies are needed to see if this “new” form of genetic modification will truly be a detriment to human health, it seems like an enormous coincidence that there are eleven times more fertility clinics in the US today than there were before the proliferation of GMO food products. Corn and soy seem specifically harmful to fertility, which is why Christa advises her clients who are pregnant or trying to conceive to eat only organic and fermented soy, in moderation, and organic corn products. This is also why she recommends consuming only pasture-raised animal products to ensure the animal meat or dairy does not contain GMO corn or soy (which has become a staple in the diet of factory-farmed animals, and we eat what the animal eats). As labels stand now, if a food is organic, then it is non-GMO.

It should also be noted that in thirty other countries around the world, including Australia, Japan, and all the nations in the European Union, there are severe restrictions or outright bans on the production of GMOs because these food products have not yet been proven safe. These countries employ a “guilty until proven innocent” philosophy to protect their food supply and citizens, but in the United States that’s not yet the case.

It’s up to consumers to decide whether the risk is worth it for cheaper food. We feel strongly that paying a little extra—whether it’s for stone-ground organic or for organic-pastured chickens that eat bugs, worms, flies, and grass in lieu of GMO corn and soy—is 100 percent worth it.

Making sure that our food and our gut get along is absolutely crucial to conception and overall health. We believe that the gut (which includes the digestive system and intestinal tract) is the center of the human universe, and we’ve already stated the importance of the gut microbiome to the health of your body, your baby, and future generations. It is the cornerstone and foundation of your health, so if you do not have a healthy gut, you simply cannot be a healthy person—everything else will suffer as a result, including the immune system, the liver, the heart, the blood, and the endocrine (hormonal) system. When we boost gut health, we see a dramatically positive effect on the immune system. A strong immune system, in turn, naturally boosts the thyroid, adrenals, and sex hormones.

Leaky Gut or Intestinal Permeability

When you have food sensitivities, it most often means that food particles (and other nasty stuff such as bad bacteria, toxins, and pathogens) are wrongfully escaping out of the intestinal wall and into the bloodstream where they don’t belong. This puts an extra and unnecessary burden on both the liver and the spleen, the two main filters for our blood.

Think of your intestinal wall as a brick wall; when you eat foods that don’t agree with you, they contribute to inflammation, and inflammation left unchecked can contribute to a thinning intestinal lining. It’s similar to chipping away at the mortar of a brick wall. The wall is no longer airtight and secure, and undigested food particles are able to escape and enter your bloodstream. It is called intestinal permeability or leaky gut syndrome, and we believe it is one of the leading underlying causes of most of today’s modern autoimmune diseases. This also makes you tired, achy, bloated, and unable to think clearly most of the time.

When this happens, the liver and the spleen have to work double-time to do the job of the gastrointestinal (GI) tract.

In an optimally functioning healthy person, clearing food particles out of the blood is not part of the spleen or the liver’s daily job description. Those food particles are supposed to stay in your digestive system so you can absorb nutrients from your food and excrete the waste that belongs outside your body, not inside your bloodstream.

Studies show that food sensitivities, while one of the main causes, aren’t the only cause of leaky gut, and ultimately, you will need to figure out if and why you have leaky gut.

Other common culprits that can contribute to leaky gut include chronic high cortisol (stress hormone production), the use of antibiotics, prolonged use of NSAIDs (non-steroidal anti-inflammatories like ibuprofen), the use of prescription steroids, bad bacteria overgrowth, candida or yeast overgrowth, a parasite or pathogen your body cannot eliminate on its own, and excess mold.

After you eliminate the causes of leaky gut, you can seal up the lining of the gut, re-caulking it, if you will, and repopulate your tummy with healthy, life-promoting bacteria, et voila! A healthy, shiny new digestive system. Now the rest of the body can do what it does better, and move on to baby-making.

Complete Blood Count (CBC)

A complete blood count is usually the test we all get once a year (hopefully) at our regular physical with our doctor. It tests our red and white blood cell count, liver and kidney function, electrolyte balance, cholesterol, glucose levels, and, typically, part of thyroid function. Any medical doctor can run a CBC, just remember to ask for the full thyroid panel (not just TSH).

This is a great test for the preconception phase as it shows how strong your immune system is (your white blood cell count); how you are transporting oxygen, which provides you energy and vitality (your red blood cell count); and how much inflammation is present in your body (your cholesterol/lipid panel). It also acts as a barometer for the health and function of your liver and kidneys and your mineral balance.

When you decide you want to conceive, it is especially important to test your hemoglobin levels. If they are low it will be important to find out why by testing your iron, B12, and folate levels. Low hemoglobin is caused by a deficiency of one or all of these essential nutrients for conception and a healthy pregnancy, so these tests will give you the information you need to get on the healthy baby-making path.

Blood Test for Heavy Metals

Heavy metal poisoning is the toxic accumulation of metals in the soft tissues of the body. Symptoms and physical health issues associated with heavy metal poisoning vary according to the metal accumulated and can potentially be a root cause of candida or hormonal imbalances. Metal toxicity can impair the eliminative organs, namely the liver and kidneys.

If you were recently exposed to metals; have many mercury fillings; have metal pins, plates, or implants in your body somewhere else (knees, elbows); have had more than one tattoo; have had many vaccines; have had toxic exposure to lead; or have eaten a lot of farm-raised fish, it would be a very good idea to test your blood to be sure you are clear of heavy metal toxicity. This type of toxicity can imbalance your hormones and transfer to your baby. A blood test will show the recent exposure of metals circulating in the blood. Implementing our program will strengthen and nourish your body and prepare you to cleanse these metals prior to conception. It’s important to know that heavy metal toxicity is linked to a higher incidence of autism and Asperger’s syndrome.¹³

If you want to dig deeper, a hair analysis test will show around two months’ worth of stored metals. If you suspect a lifetime of toxicity and wish to take on a full metal detox cleanse, we recommend you get a urine test for long-term stored metals and work with a skilled functional medicine, integrative medicine, or naturopathic practitioner.

If a heavy metal test comes back high, then you’ll want to select a knowledgeable practitioner who has great success and a balanced approach to eliminating heavy metals from the body rather than trying to do it yourself. Metals should be the last port of detoxification once you have tuned up your colon and your liver and kidneys are supported and strong.

If you only have low metal toxicity or want to get a gentle jumpstart before working with a practitioner, try our cleansing pesto recipe (2 to 4 tablespoons daily for 6 weeks) and some simple chlorella tablets. These are two ways to very gently and effectively cleanse metals.

Test for MTHFR Genetic Mutation

If you have had more than one miscarriage or have had a history of depression, it is important to check for the MTHFR genetic mutation to rule it out. Several of Christa’s clients have miscarried due to undiagnosed MTHFR.

It is very likely you have never heard of this gene mutation, so we will try to summarize it as simply as possible. Each cell of our bodies contains the MTHFR gene, which helps produce the nutrient methylfolate, the body’s most active form of folate that initiates a long series of essential enzymatic reactions. A successfully functioning MTHFR gene will determine healthy neurotransmitter production (neurotransmitters are chemical messengers in the brain), DNA regulation, immunity, and cardiovascular health. In short, it is vitally important to the proper functioning of many of our body’s systems, not the least of which is reproductive health.

An improperly functioning MTHFR gene can create (through a series of intricate cellular actions) elevated homocysteine levels (a naturally occurring amino acid in blood plasma, which when high is believed to increase the risk of heart disease and stroke), and can trigger multiple miscarriages, preeclampsia, or infertility, increase the risk of having a baby with Down syndrome, or introduce a host of other pregnancy-related concerns.

The good news is, if you are tested and find out you do, in fact, have the MTHFR mutation, there are steps you can take to counteract its effects and have a healthy conception and pregnancy. Taking the right supplements, including eating organic and non-GMO foods (how convenient: we want you to do that anyway!); reduce your intake of synthetic folic acid (more about this in Chapter 3); increase and supplement with natural-food folate; and supplement with added antioxidants like l-carnitine and n-acetyl cysteine that help compensate for the mutation.

MOVING TOWARD A MORE FERTILE YOU

Now that you are questioning your current health state and possibly suffering from Medical Student Syndrome, relax and take a deep breath, for it is doubtful that you suffer from everything we’ve just mentioned. However, not to make light of it, we also want you to get tested. It’s not mandatory, but you have the option of running a food sensitivity test or getting a hormone panel done. Simply following the advice in this book very likely will be enough for many of you to get pregnant. However, we want you to be empowered with knowledge and a game plan if you need to dig deeper, perhaps after your lifestyle changes have been made and you are gaining more health and balance.

With the results in hand you’ll be able to tailor your action plan and make it even more specific to your needs. And with the addition of our favorite supplements and vitamins from the next chapter, you will continue to become a healthier, more vibrant, and fertile you!

CHAPTER TWO

Boosting Your Fertility

Understanding and taking control of your body chemistry to optimize your reproductive health