Monitor Your Entire Cycle, Beyond The Fertile Window

Amy Beckley, PhD

Thanks for having me. I am happy to talk about hormones. One of my favorite subjects.

Aumatma Simmons, ND, FABNE, MS

Let’s just start with the basics. I feel like everyone knows about progesterone, but I’m curious what your thoughts are or what you can share about the foundation.

Amy Beckley, PhD

Progesterone is probably the most important hormone, and a lot of people forget about it. The pro-gestational hormone is progesterone. As the name suggests, you need it for pregnancy. This is the hormone that is released from the ovary after you ovulate and prepares the uterus for implantation, and it is required the entire time during pregnancy. Progesterone is so important that if you don’t have enough or it drops too soon, it could cause issues with the inability to conceive, miscarriages, and preterm labor. It’s one of those hormones that is so important that not many people talk about it. It’s all estrogen. But you also need progesterone. If you don’t have it, you cannot get pregnant. You cannot stay pregnant.

Aumatma Simmons, ND, FABNE, MS

It’s such a vital hormone for our bodies, but specifically for fertility.

Amy Beckley, PhD

They call it nature’s Prozac.

Aumatma Simmons, ND, FABNE, MS

When should progesterone be high, and how long should it stay high?

Amy Beckley, PhD

Progesterone is the hormone, like I said, that’s released after ovulation. If you look at your cycle as a typical 28-day cycle, sometimes it’s 24 days and sometimes 35, which is normal, but your ovulation happens somewhere in the middle, and so you release an egg from your ovary. Then the ovary has another job: to facilitate digestion and to support implantation. progesterone should be low until you release that egg, and then it should be high. if you think about the process of conception, once your ovary is released, an egg has to go through the fallopian tube to the uterus, where it will implant. That journey takes anywhere from seven to 10 days from the time you ovulate, you have a positive ovulation test of your track attempt or something like that. From the minute you ovulate to at least ten days, preferably 12 days after that event, you want that hormone to be high because if that hormone is not high enough by the time that embryo comes into the implant, it can’t do it. After all, your lining is starting to slip off. You’re getting your period, or there’s not enough hormone there to support a healthy implantation. Ideally, you want your hormone to be high during that entire implantation window, which is about seven to 10 days after you ovulate.

Aumatma Simmons, ND, FABNE, MS

A lot of people are into at-home test kits. There are I just saw one that is like bugging me. We won’t get into that, like the FH test for menopause. I’m like, there’s going to be a nightmare in our heads because all these people are going to be messaging me like, What is your last chance? Like, you’re not menopausal. I’ll stop this. Stop doing that.

Amy Beckley, PhD

We’re not going to talk about it.

Aumatma Simmons, ND, FABNE, MS

It is going to be bad. But I’m curious that there are traditional ovulation strips. What else could people do to monitor their fertility at home?

Amy Beckley, PhD

Luckily for us, there are a lot of things to do at home to monitor fertility. My battle with infertility, I did it 13 years ago. The only tools I had were a thermometer and an ovulation test. Luckily, there are so many more things available that can help you. The first thing is, let’s talk about the man. We always focus our attention on the woman. When a pregnancy is half female, half male, half yourself, and half your partner, if you have a partner who’s a male, you need to get him tested. That is the first thing that I always tell women to do because it is not always us. Half of it is theirs. Getting a semen analysis is pleasurable for him. What’s different from what women have to do is that there’s a lot of cool at-home sperm testing. The ones that I always recommend are the ones that check motility as well. If you think about conception, sperm is deposited at the base of the cervix as it swims through the uterus into the fallopian tube to meet that egg that was just ovulated. you want sperm, a high sperm count, and high motility. so you can do home sperm tests. They have some that come to your house, and you can do it at home, or there are some that you can come to your house. You just deposit the sample in a little jar, and it goes back into it. Those are a little bit more expensive, but the first thing you do is test the man, and then for the woman, there are a lot of other options as well. There’s blood testing, there’s urine testing, and there’s saliva testing. I typically find that the urine tests are better because blood tests are very painful. They found in a study that 75% of women who did that finger prick test at home will never do it again because it’s so painful. I like that we have the option of urine and saliva. They’re not as painful. I feel like urine is a little more accurate than saliva because it’s so hard to not eat or drink anything, and it can mess up the measurements. urine-based testing, I like to look at the hormones themselves. If you look at them, you can look at the primary hormones, which are the urine and the urinary markers, or you can look at what’s called the secondary signals. the primary is a hormone. You can do an FSH test at home to look at ovarian reserve; you can do an LH test at home, which tells you your two most fertile days. You can do an at-home estrogen test, which can give you a longer fertile window. for six days instead of just two, and then there’s an at-home PdG test, which is a progesterone metabolite test to help you understand if you ovulated in that progress zone,  remaining high enough for long enough. Of course, an ACG test is needed to see if you’re pregnant. I go for the hormones themselves as being the best markers to show what your hormones are doing because you’re measuring the actual hormones, other things that you can do, or cervical fluid. There is a device that measures this, or you can do it with your fingers. so like fertile cervical mucus makes it stretchy. you can look at that and say that when you’re fertile, the estrogen content in your body makes that fertile cervical mucus. The reason this is important is that sperm can last longer in your reproductive tract with that fertile cervical mucus. that’s what gives you that six-day fertile window where you can have intercourse on day one, and then four days later you can have a sperm still sitting in your reproductive tract and get pregnant. If you have good-quality cervical mucus, There are devices to do that. There’s lots of online work that you can do. Temperature charting is another one. Wearables. A lot of wearables have temperature monitoring. There are thermometers. There are a bunch of different ways to do this. But the science behind that is that when you ovulate and make that progesterone, it increases your body temperature. You can see that slight temperature rise, showing that you have ovulated. These are the most common ways you can check your fertility at home. You can check your egg count so how many eggs you have left. This is important if you’re going to do fertility treatments or if you’re thinking about eggs, egg donation, or freezing eggs. Or should I start considering now or later timing your ovulation as well as understanding if you have an ovulatory issue and maybe you’re not making enough progesterone, and then you should talk to your OB about different ovulation dosing medications? There are a lot of options out there. It can be a little overwhelming, but urine over blood-modal sperm over just sperm.

Aumatma Simmons, ND, FABNE, MS

Add to that for the sperm. I also like to see morphology because that’s what’s going to tell us: is it going to break through the barrier of the egg to be able to fertilize it? I feel like all three are ideal. The cost keeps going up the more markers you want.

Amy Beckley, PhD

Just the basic sperm test, you’d be surprised, like, I’ve been trying for two years. My great. What’s your partner’s sperm count going well? Well, he’s never been tested. All right first thing you do. I’m tested. The other thing that people don’t understand is that sperm change. If your partner went out watching football and this buddy had a bunch of beers, and then you tested them the next day, he might have a low count. That doesn’t mean he always has a low count. It’s just like, you might not ovulate one month, but you ovulate the next month. It’s important to understand and track a few months, a few cycles, and test him once or twice, at least twice to understand. Is it always low? Is it always high? Did you just have an off day? Was he wearing his boxers? Different days of the week can affect your fertility. Not to take a single result, as this is it. I will never conceive. But to look at patterns and to look at things over time. A lot of times I see women get discouraged about a single result, like you said. FSH. My FSH is 20, I will never be able to conceive. It’s like, well, we know that if you just had COVID, your FSH goes through the roof, but the next cycle it comes back down. You could have had a sickness or you could have had something happen in a stressful situation that had that marker get suddenly up. Tracking these things over time is essential to understanding whether is a consistent issue or just a fluke.

Aumatma Simmons, ND, FABNE, MS

You have a good point. There is a little bit of a freak-out mode on all of these things. You test once, and you’re like, like, taking a step back and being like, What’s the pattern here? Does it keep repeating? That tends to be helpful, at least to alleviate that. Like the stress mode that’s created by some of these results. I don’t know if you hear this, but a lot of people will say that I don’t want to test because I don’t want to know what’s wrong with me. Like, well, then how are we going to fix it? 

Amy Beckley, PhD

There are like 99 different types of infertility, and some of them are bad. If you don’t have tubes or if they are both blocked or damaged, you have to go do IVF. That’s a very hard diagnosis to get. Whereas if you just had a simple ovulation issue, getting that information, going to your OB, and getting prescribed something like Clomid, which is a simple copay and a simple doctor’s office visit, that should be so empowering to say, This is my issue, I’m going to go get this medication. It’s a quote-unquote simple fix. It shouldn’t be nerve-racking to get these things. They’ve done studies where the longer you go without conceiving, the more expensive it is to conceive. Because health care is broken, if women don’t take it upon themselves to test themselves and monitor what they can do at home, they go 12 months without talking to a doctor. Then finally they go; they’re so broken and they’re so like—a pit of despair is what I call it—because negative tests are a negative test of negative tests. Then their doctor sits there and says,, the best path to pregnancy is IVF. Then you feel so stuck, like, I want to have a baby more than anything, and you’re telling me it’s a $20,000 procedure, and you’re just so conflicted, you’re so stressed out, where it’s like if you had taken that opportunity in a month, one a month, to do these simple screening things to see if everything looks good and if something is out of range or there’s a red flag, take it to your OB on month one and month two and say, maybe there’s something here. The best care that women can receive is when they have that active conversation where they know their body, they know medicine, and then the provider and the patient can get together and talk about and personalize that treatment for that person.

Aumatma Simmons, ND, FABNE, MS

It’s so much more empowering to be proactive in this process rather than reactive, and I like what you just said about the longer you wait, the more expensive the treatments because there’s so much truth to that. It makes sense if, if you have a heart issue and you let it go on for some years, you’re probably going to need surgery at some point. Whereas if you started doing stuff about that, you could have prevented that from happening. Similarly, fertility is like a smaller time, but it’s still a long time.

Amy Beckley, PhD

Forever when you’re in it like every single day is an eternity. I’ve had seven miscarriages and three years of infertility. I have been there. It is horrible. It’s just the worst process, if there’s anything you could do to spare yourself from it, plus, infertility is so common now. It used to be one out of ten couples. Now we have a more toxic lifestyle. We’re all living in big cities. We have more processed foods, more plastic, and more pollution. We’re waiting longer. We’re being responsible adults and waiting for our careers to be all nice and good jobs and good houses and all that stuff. then we’re too old, and we have trouble conceiving. It’s just that infertility rates are now like one in six couples. The odds are, you could have an issue. trying to be proactive about the journey is important.

Aumatma Simmons, ND, FABNE, MS

You talked a little bit about IVF, so I’m curious if you have any ideas or tips on what women should consider doing before they get to that point where,  well, maybe IVF is my only option.

Amy Beckley, PhD

The number one diagnosis for infertility is unexplained. That is insane to me. Like there’s a reason you’re not conceiving. It’s just somewhere along the way, and nobody found it. The way health care is done is that when you go to your OB, you’re like, I’m having trouble. They’re like, how long have you been trying to know? Like, eight months. You haven’t been trying long enough. Go back and try again. then you get into that pattern. Then you go to the reproductive endocrinologist or you get referred out, and they’re trying to consider if you are an IVF patient, and they’re assuming that you can’t get pregnant. There’s something wrong. They’ll maybe look at your tubes; make sure those are open. Maybe they’ll check her uterus and make sure there’s no, like, growths or abnormalities or something like that. They’ll do a typical hormone panel. It’s like a day-three hormone panel. that looks for certain hormones that could be affecting your ability to hold a pregnancy. Most of the time, that comes back to normal as soon as you get put in this bucket of unexplained infertility. I would always say, what are the things you need to conceive? Check those first before you consider IVF. Those things are: you need an egg; you need a sperm, you need them to meet, you need them to implant. As you think about what is involved in that process you need an egg. You want to do ovarian reserve, whether that’s an ultrasound at your doctor’s office, whether it’s a home test, a blood test, or whatever you want to make sure you have eggs left. Then you want to have a sperm. We talked about sperm and sperm testing. You want them to meet. Are you timing your intercourse correctly? you want to make sure the sperm goes through the fallopian tube to meet the eggs. You’ll make sure your tubes are open. Do you want to time that event? You want to do ovulation tests, or you want to use cervical mucus tracking. I do not recommend apps. They do not know your hormones. Do not use an app.

Then you want to look for implantation. Implantation involves the uterus and then our lovely friend progesterone. You want to check your uterus. Anything like that could prevent implantation. Then you want to check your progesterone levels again. You don’t want to just check them once. You want to check them and make sure they remain high during that entire implantation period, so you have the highest chance of conception. If you go through that whole cycle and check all these boxes, then it’s like, maybe let’s consider IVF. But there are so many things that doctors don’t do because they assume that you’ve already done them. It’s almost like I use this analogy a lot. If you go to a surgeon, you’re going to get surgery. If you go to a chiropractor, you’re going to get chiropractic care. If you go to an IVF center, you’re going to get IVF.

That’s what they’re trained to do. That’s why they have the highest success rates. If you’ve been told by your OB that you don’t know much about fertility, refer to over one IVF clinic; they’re screening you for IVF. That’s not what you want to do, or you’re not at that point yet. Find another practitioner, a naturopathic therapist. Some of these are good at this. There’s concierge medicine; there are online places. There are a lot of different places that are in that in-between stage between trying myself and IVF. There’s this huge space where nobody is talking to women, and then they get stuck and leap over it. There are other things you can do.

Aumatma Simmons, ND, FABNE, MS

Because by the time you end up at an IVF clinic, you’re already so frustrated and you’re like, tell me what’s going to work right now. Like I wanted to. When we have that perspective, there is only the most obvious solution. When that place that you’re going to only has one, possibly two, solution, they’re going to give you one or two things that they have to offer. I agree with that. I like how you broke this down into things to check for. Egg, sperm, are they meeting, and what’s implantation looking like? That makes it very simple to understand and visualize because those are the crucial pieces and quality sperm. Are they connected? I completely agree. There was something you said a while ago that said there are 99 reasons for infertile ladies. I would like to hear some of those if you want to share.

Amy Beckley, PhD

There’s a male factor. It could be no sperm, low sperm, not moving sperm, not moving in the right direction sperm. You said DNA fragmentation. There’s another mutation now that they have a new test for where it can’t like to eat through the egg lining to fertilize this. There’s a problem with the methylation of the DNA or something. It’s like you can say sperm male factor, or then you can say, well, it’s this male factor. Maybe they’re not making testosterone. They’re not making enough testosterone. Maybe they have sperm. They just can’t ejaculate. There are all these different reasons why something could be wrong. On the female side, it could say, Well, you don’t have any eggs. Well, you have eggs, but the DNA is bad, or you have eggs. The DNA is good, but the follicle is of poor quality, and you’re not making enough progesterone, or you have PCOS, and you’re making eggs, but they’re not releasing and ovulating so you don’t release the egg. It can’t get fertilized. implants, you have a blocked tube, and you have sticky tubes that can help with ectopic. It can cause ectopic pregnancies. There are so many different kinds of infertility that’s why doing the simple things where you just sperm-egg meet implants. What do I have to do? I’m just going to break it down into those four things, and we’re going to do what I can to say, I have this. Is this the end? No, but if you can check those four boxes, that’s 87% of the most common causes of infertility. You’re that much closer. then there are things that we don’t know about. But unexplained infertility should be like 5% of cases, not 34% of cases of infertility.

Aumatma Simmons, ND, FABNE, MS

But it was that high. I knew that it was high for us because that tends to be like, I’ve tried everything, people. I’ve already done the IVF. Now what? then people will come to us.

Amy Beckley, PhD

34% unexplained infertility, 30% ovulatory issues, and then 25% male factors.

Aumatma Simmons, ND, FABNE, MS

What about where are they putting things like PCOS and endometriosis?

Amy Beckley, PhD

That’s in the ovulatory dysfunction category. Ovulatory issues and endometriosis are a different category, and that’s about ten or eleven. Two factors are somewhere between ten and 12, depending on what study you look at. But it’s crazy to me that you go into the office like we’re going to check your tubes. That’s like a very small subsection of infertility. Not a single person tested to see if I was ovulating; this was the entire process, and that was my problem. I went all the way through IVF when I wasn’t ovulating.

Aumatma Simmons, ND, FABNE, MS

Then IVF worked because you were getting pregnant, but then it didn’t stick.

Amy Beckley, PhD

My issue was that I was producing the egg and it was getting fertilized, but my progesterone would drop too soon. By the time that embryo got down to the fallopian tube in the uterus, my uterus was already starting to slip off. I would get, maybe, one or two days of a positive pregnancy test and then I would lose that pregnancy. Then I was never heard by my doctor because it wasn’t a documented pregnancy. It drove me up a wall. They were like, you haven’t had enough losses. I was like, “I’m sorry. Do I have to have cancer five times before you give me something?” No. I don’t understand how miscarriage is so ignored and pushed off, as it’s so common. It’s common, but that doesn’t mean that it’s good or we should; it’s normal, and we should ignore it. Forget about it. There’s another amazing stat. 30% of miscarriages are preventable. One of them is progesterone. 

Some of them are hormonal. You don’t have enough hormones to support the pregnancy? Another one is folic acid or folate, so you don’t metabolize. These are the MHTFRs. But if you have that mutation, then you should be taking a different type of folate. A lot of the prenatal now have that. That’s not as big of an issue. Drinking too much, smoking too much—those things like those are all preventable issues. Another one is infection. A lot like these, the vaginal microbiome is becoming a hot topic. There is a subset—I wouldn’t say it’s huge—but there’s a subset of you who can have a bad vaginal microbiome that can make your pelvic area inflamed and can cause miscarriage. a lot of times, part of IVF is giving antibiotics to clear anything out. 30% of miscarriages are preventable. It’s a disservice to women to say, Well, you’ve only had one; you’ve only had to go back, try again, and let them have a 30% chance of having another miscarriage. It doesn’t make any sense to me.

Aumatma Simmons, ND, FABNE, MS

I completely agree. I just think miscarriages are subspecialties. I am very empathetic and frustrated—just frustrated when people are told, that it’s fine, it’s normal, and let’s wait till you have three miscarriages before we even start doing any workup. I’m like, just one is traumatic. Like, let’s go through this three times, especially if it took you a year to get that one positive pregnancy test. This is the dumbest thing I’ve ever heard.

Amy Beckley, PhD

Another thing about IVF, it is a medical Band-Aid.  In the process of IVF,  you have the sperm, and the egg, and you must implant them. They take those four things, and they’re like, What can we do in a lab or by ourselves or bypass certain systems to make it work the best?

You have to spend a lot of money for them to do this. What I did was hack it, and I was like, You give progesterone as part of IVF. Why? because progesterone is essential for getting pregnant, and it’s increased pregnancy rates by 50% if you put progesterone. Let’s skip IVF. Just give me luteal-phase progesterone. They’re like,  we don’t know if that works. You just told me you had 50% higher success rates when you added progesterone. He’s like, but that’s the context of IVF. I’m like, I’m going to risk it. But for my ten-year-old, it was just luteal-phase progesterone; that’s all it was. you can think of ways. Part of IVF is giving antibiotics. Maybe I have painful periods, or maybe I did one of those at-home vaginal microbiome tests, or something like that was another one you could do at home. It said I had Candida or something like that. Can I just get a course of antibiotics? If you understand the IVF process and what they’re doing, you can try to hack the system and get some of those things without context. You can do ovulation induction without having IVF. Another one is that they always try to push IUIs because, unless you have a male factor issue, IUIs are not much more effective than just time to intercourse, but it’s a couple thousand dollars more.

Aumatma Simmons, ND, FABNE, MS

About the male-factor issue, you do not need IUI to get the sperm to move up closer to the fallopian tube to get the egg fertilized. Outside of that, it doesn’t do anything.

Amy Beckley, PhD

Except it costs you money.

Aumatma Simmons, ND, FABNE, MS

Then if you’re doing a medicated IUI cycle, it could help with the ovulation too. Unless you have one of those two issues, IUI is not a great solution. 

Amy Beckley, PhD

If you’re a same-sex couple and you don’t have a male partner, you get a donor or something like that, then yes, you need an IUI, but like, it doesn’t go try by myself; do IUI and then IVF. That’s not how it goes. But people think I’m going to do it in IUI because it’s cheaper than IVF. You don’t just do an IUI, it’s not like you must do this, and then you must do this, and then you must do that. You have to have some reason to do it. 

Aumatma Simmons, ND, FABNE, MS

I like how you’re thinking; it’s like a logical way of thinking about it. I feel like so many things in the fertility world are not logical. Let’s just use our common sense here. If you did nine IVF cycles and every time embryo production dropped off when the sperm was introduced, it’s probably a sperm issue. Like just thinking it through. I’ve talked to women who are like, No, I did nine IVF cycles. They’ve never tested his sperm. What are you?  you have to do better than that. 

Amy Beckley, PhD

I got a better one for you. I know somebody who went through IVF and her husband did not have sperm. They knew he did not have sperm. She went through IVF, and they were going to biopsy it, squeeze it out, and see if there was any sperm in his scrotum. She went through the entire IVF cycle for nothing. I’m like, that’s not okay.

Aumatma Simmons, ND, FABNE, MS

At some point, you’re like, Is this just a money grab? Because I don’t see how this is possible. 

Amy Beckley, PhD

I had many miscarriages and many years of infertility. I sit down in my infertility center office, and I say, All right, we’re going to do these tests, check the uterus, all that stuff. Want to explain? I have no idea what’s wrong with you. What we can do is you can just keep trying on yourself, which is 15, 20%. Every single cycle, it’s 15, or 20, no matter who you are. Or we can do this thing called IVF, which is like 65–70% based on your age, which is true. It is but struggling and going through so much pain loss and being told you either have a 10%, 15%, or 70%, the way that it’s phrased makes you think you have to do IVF.

You do it because you’re just emotionally so distraught and then you feel like you’re just banging your head against 15%. It’s never going to work but that’s biology. It’s just the wave of your mindset, what you’ve been through, and your history. And then when you come in, like, it’s just so much; it’s so overwhelming. The best thing that I can say to women who are going through it is that if you do not want IVF, don’t go to an IVF clinic. There are other places that you can go. There’s what’s called a naturo physician, which is a natural procreative. They don’t believe in IVF, and so they use medications to help fix ovulation. There are functional medicine people, and naturopaths, who use diet, exercise, and lifestyle to fix hormone issues. It works well.   Acupuncture is another one. It works very well. To know what you want and how to get there, and to educate and not be fearful of spending money—that’s another one they go from, like, I’m never spending money. Take all of it. If you spend a couple of hundred dollars on some testing.

Aumatma Simmons, ND, FABNE, MS

That’s another one for which I haven’t figured out how that makes sense. I feel like, and the other piece is, I guess if you’re, if you’re phrased this idea of like, you’re going from 15% to 70% chances, then it makes sense for me to spend $20,000. But there are a few things that people don’t understand, which is that most success rates for clinics are based on six consecutive IVF cycles, not one. You’ve just signed up for $120,000, not $20,000. Then you add on the medications, which are about 7,000 per cycle, and then the act begins. What’s interesting is that there is a mismatch between what clinics say that their success rate is for a certain group or age versus what gets reported in the book or something. There’s a body that says I’m going to think of it.

Amy Beckley, PhD

SART.

Aumatma Simmons, ND, FABNE, MS

SART. Yes. Every year you have to report the success rates of IVF cycles, and those success rates are way more accurate and tell a very different story. Doing the research, taking a step back, and not making that decision out of emotion but instead out of logic. Let me break down what part of this process is not working the way that it should.

Amy Beckley, PhD

I will tell you, the entire process is illogical, and it’s so hard when you’re a woman and you just want to be a mom and you feel like a failure, and you don’t want to talk to anybody because they all have kids or they’re all pregnant or something like that. It’s so difficult. I’m thankful for summits like this where we can get that education. They have a community and people to talk to because I went through it and dealt with it. After that, I went on social media and said, here’s my story, and some people came to me privately to say that Amy and I have the same thing. Why did you do what you did?  I would talk to them about what you should tell your doctor about what tests you should ask for. They all started getting pregnant. it’s like nobody wants to talk about it, but so many people are struggling like it’s way more than you would think.

Aumatma Simmons, ND, FABNE, MS

It’s probably way more than is said in the statistics. Nobody is reporting that they’re quote-unquote infertile. I’m not saying infertility, quote-unquote. Is there anything that people could be doing to support their chances for implantation?

Amy Beckley, PhD

You want to have healthy, balanced hormones. You hear this phrase a lot like there are supplements that balance hormones and hormone imbalances, and all that stuff. This is important for implantation because the first hormone that is produced that matures that egg is estrogen. What that does is thicken. The lining makes it squishy, like a nice comfy bed, and then comes across progesterone, which transforms it into a receptive. Think of it as something sticky, like a peanut butter sandwich. It sticks there. You have to have a healthy estrogen level and then a healthy progesterone level to support the implantation process. anything you can do to support that healthy lifestyle and those healthy hormones—you don’t necessarily have to do supplements. Something that I talk about a lot is seed cycling. it’s eating nutrients that support the hormones in the first half of your cycle. It’s flax seed and pumpkin seed, preferably raw organic. Then, to support progesterone, it is sunflower and sesame seeds again, preferably organic and raw. The other thing is Mediterranean diet has been shown to improve fertility diets high in vitamin C, and vitamin D help get pregnant, and lower miscarriage risk. D Vitamin is good for hormone production, specifically progesterone.  Getting a high-quality prenatal starts a good six to nine months before you’re trying to conceive. A lot of people don’t realize that hormonal birth control can deplete a lot of nutrients. Trying to get off that hormonal birth control for a good six months or so and get a good, healthy, prenatal, healthy diet, exercise, all these things that we all know we should be doing. We don’t necessarily always do. But that’s a good thing for implantation: monitoring hormones to make sure you’re making enough estrogen and enough progesterone. If you’re not talking to your doctor about medications that can do that, supporting a healthy lifestyle, talking to a nutritionist or fertility dietitian, or purchasing books, I just got the new edition of It Starts With An Egg, so I’m excited to read that one. But do you have any other tips on supporting implantation?

Aumatma Simmons, ND, FABNE, MS

What are my tips? Outside of what you said, I love to get women to do some hip circles to help blood flow and circulation to the uterus. that’s one of my favorites. Then we’re thinking about what comes before that egg is released. Things that will support and quality will help to make sure that estrogen and progesterone are released at the right time and support the implantation when it’s time.

Amy Beckley, PhD

I’ve not heard of these hip circles, but I like them. That’s another thing: acupuncture is good at increasing blood flow. I’ve tried it a few times; it didn’t particularly work for me, but I’ve heard a lot of people have had success with it.

Aumatma Simmons, ND, FABNE, MS

I’ll just say that acupuncture is awesome. If you have one of these underlying things, like nutrient deficiency or calorie deficiency. Calorie deficiency is a real thing these days or your hormones are not harmonious. If they’re releasing all kinds of weird things at the wrong time, then acupuncture isn’t going to fix it. A lot of people will come and say, I’ve been doing acupuncture for three years. What the heck? It’s not working. I’m like, but you have all these underlying things that were never addressed. Unless you’re dealing with all of those things, doing all the acupuncture in the world is not going to fix the problem. I’m a believer in acupuncture and do all the other things. Then you talked about it a little bit. I’ve been knee-deep in vaginal microbiome research because it is cutting-edge. There’s a lot of research on which microbes are pro- or anti-fertility. We test everyone just because we want to not take any chances and have success rates because of it. But some women with hidden vaginal infections don’t have any symptoms,, They’ve never had a vaginal infection. 

Amy Beckley, PhD

This is another one. Imagine you have a hidden infection, and you do IVF because you can’t get pregnant. They give you just a prophylactic antibiotic treatment, and then IVF works. Then you’re telling everybody IVF worked and it was amazing. They’re going to do IVF for all your kids when all you need is an antibiotic. If you’d started by just doing the simple testing, that’s another good example of something that got fixed during IVF, but can you try not to do IVF by that first?

Aumatma Simmons, ND, FABNE, MS

Very few doctors are doing the vaginal microbiome testing. There are a lot of different layers. Some at-home companies are like they’re testing maybe my five microbes, compared to some of the other ones that are still at home. You’re still doing your swab, but they’re testing like 50,000 microbes. The difference between the two is big because you’re not going to find everything if you only test four or five things.

Amy Beckley, PhD

Because it is another thing with home testing if you go into your doctor and you say, Hey, this home test showed me I had this or that or whatever, and they go, You shouldn’t listen to that; don’t worry about that. Then they try to push IVF on you. You should question that as well. If you go into a physician’s office, someone, or some health care provider and you bring them some type of result, it should be up to them to confirm that with another test. If those are dismissed, you need to walk out the door and be like, See, because they’re not listening to you. They’re not listening to what you have to say. I’m not saying the doctors have to trust all home tests. I’m saying they should listen to you and say,  it showed that you weren’t ovulating. cool. Let’s do some more blood work, or let’s do some ultrasounds, and let’s figure this out. Sure enough, you’re not ovulating. Here’s some Clomid instead of IVF.

Aumatma Simmons, ND, FABNE, MS

That’s again, and the logic of it is just so clear. But thank you for sharing all of that because I heard it from someone who’s been through the journey, and I feel like you took all of your experiences and turned them into this beautiful process that people can reflect on and say, This is maybe where my problem is. How do I work on that? I don’t need to work on everything. If this is where my problem is, it helps to simplify and take some of the pressure and burden off of all of the things that you could be doing. Because of the number of people in my office, like, here’s my garbage bag full of supplements, no, don’t do that to yourself. I appreciate your perspective. This is awesome. Thank you for being with me today and sharing all of your wisdom. We love having you.

Amy Beckley, PhD

Thanks for having me.