Fertility Protocol for Conception: Labs, Nutrition & Proven Strategies

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0:53Dr. Lara Brighten:today we're talking about science-backed ways to support your fertility because women are constantly being told one version of this story you're getting older so that's the only problem it could be i mean that's what i was told despite having a baby at 40 and at 41 every doctor i saw just kept saying you're too old you need ivf and as it turns out that was never the problem And listen, this is not to say that age doesn't matter. It does. I'm not going to lie to you about that. But if that's the only thing somebody is telling you about fertility, that's an incomplete conversation. That's why today we are talking about the difference between egg quantity and egg quality, how inflammation hijacks fertility.

1:38Dr. Lara Brighten:And we're going to definitely be talking a bit about PCOS, endometriosis, how those completely change the conversation. and I'm going to talk you through some of the top things you must be doing if you are currently trying to conceive. And yes, we're also getting into specific supplements and dosages and not take, you know, 27 pills and just try to manifest your way to becoming pregnant. By the way, I think that manifestation is a good practice, but I do want to ground this in science. And if you're new here, welcome to the Dr. Brighton Show. I'm your host, Dr. Jolene Brighton. I'm a hormone doctor, a nutrition scientist, and I'm someone who has struggled with secondary infertility.

2:20And if you can take a quick minute and subscribe, like, leave a review, that support would mean so much to me. Real quick, I do want to acknowledge that many of you have been asking for this episode for a very long time, especially as we were doing our endometriosis expert series. And I just want to say thank you for being patient with me. after I had my pregnancy loss last year. I've been very deep in grief and moving through that, but I understand that you need support, and I'm at a place where I feel like I can hold both

2:52Dr. Lara Brighten:my grief, my journey, and be able to support you, and that's exactly what I want to do in this episode. But I don't want to hold this up, so let's get into what you came for. Let's talk about that biological clock, but make it accurate. If you think fertility is about how many eggs eggs you have, I like to say this is like judging a restaurant by how many tables it has and never really asking, is the food any good? So we need to separate egg quantity from egg quality. Now, egg quantity is basically how many eggs do you likely have left? And your doctor will use anti-malarian hormone or an AMH if you're in the IVF process to try to estimate that for you.

3:37Dr. Lara Brighten:Egg quality is how likely are those eggs to fertilize, grow normally, and lead to a healthy pregnancy. Now, I'm going to tell you about one supplement that can help in this arena, but first I want to bust some myths about women, fertility, age, and we're going to throw in the male factor as well. So the first one is the cliff. Fertility doesn't stop instantly at age 35. It declines more significantly because both the quantity and the quality of the eggs is decreasing. But it's not like after age 35, boom, you're not going to be able to get pregnant. Now, when it comes to a rapid egg quality, people will tell you that that drops after age 35 as well.

4:21By age 35, about 35 % of women's eggs are lower quality.

4:26Dr. Lara Brighten:And as we get closer to 40, that's around 50%. But that doesn't mean you cannot still conceive naturally. If you're looking for a book that can help with some of these things, yes, you can get pregnant by Amy Robb. I think it's a great one because she integrates both conventional medicine and also her Chinese medicine practice. Now, this one is a big myth, and that is men can have babies forever. We now know that male fertility also declines. Starting in about their 40s, men start producing lower quality sperm. And that affects overall conception chances. So the chances of getting pregnant. And it can impact mom and baby's health during the pregnancy and sometimes long term as well.

5:12Dr. Lara Brighten:But what I want you to take away is that age is not the whole story. And pretending that's all it is isn't helping women. It's why so many of us get labeled unexplained infertility. or they just tell you that you're old and that you have to do IVF. I'm not bagging on IVF. As you guys know my story, I did IVF. But let's not pretend it's not expensive and not without risk and that not everybody gets the outcome they want, which is a baby in their arms. So as women, the reality is, is that you can have a woman with decent ovarian reserve, like AMH on paper looks good, and she could still have issues with ovulation, inflammation, insulin resistance, endometriosis, or just hormonal issues overall.

5:57On the flip side, you can have a woman who is younger and technically has more time,

6:03Dr. Lara Brighten:but her body is sending signals that something is off and she's still not able to get pregnant. So fertility is not just a birthday problem. It's also an ovulation problem, a metabolic problem. We're going to talk about inflammation in this episode. And sometimes it's also a diagnosis, you should have gotten years ago problem, but they put you on the pill instead and said, don't worry about it until you want to have a baby. I think it's also important to note that a normal basic workup does not always mean that your fertility has actually been evaluated in a meaningful way. It may be that no one has dug very deep just yet.

6:41And that matters because a lot of women are being reassured that, oh, you're young. Don't worry about it when they actually need answers or they're being told like, oh, you're old and that's all that's going on. I know I've said that a few times, but it's so important that if you've been struggling to get pregnant, you meet with a reproductive endocrinologist, especially if you're over age 35, especially if you know you have co-occurring conditions like Hashimoto's thyroiditis, which is hypothyroidism, endometriosis, PCOS, adenomyosis, celiac disease. The list goes on, and there's a lot of reasons to evaluate women's fertility sooner than later.

7:21Okay, so we can say, yes, age matters, but fertility is also more than age. And if someone's only focusing on your age, then they're missing real reasons that your body is struggling. Now, the supplement that can help your fertility is CoQ10. The ranges can be anywhere from 200 to 600 milligrams that you take three to four months before conception. This is especially helpful for women over age 35. So what CoQ10 does is that it boosts ATP energy, the energy of the mitochondria, and that supports your eggs. It's critical for proper maturation of those eggs. It also gives antioxidant protection. So it's going reduced reactive oxygen species that protects your egg and it protects sperm from DNA damage.

8:09Dr. Lara Brighten:There have been studies that show that CoQ10 supplementation is associated with increased egg maturation and improved embryo quality. There is also some research that suggests it can increase the number of retrieved eggs during IVF cycles in women who have had diminished ovarian reserve, but I would never want to say like this one supplement is a guarantee for you. So CoQ10 can help both natural conception and advanced reproductive techniques like IVF. And it does that by enhancing egg quality, increasing maturation rates, improving embryo quality, and there is some research showing that it can help with clinical pregnancy rates.

8:52So CoQ10 is definitely one to talk to your doctor about and consider on your fertility journey. Now I want to shift gears and talk about inflammation because as a woman with endometriosis

9:01Dr. Lara Brighten:and adenomyosis, I need you to hear about your inflammation and your fertility. Now, before I tell you how to lower inflammation fast, I need you to understand why inflammation even matters in this conversation because this is not just about like, am I bloated or am I retaining water or am I tired? Inflammation can make your entire reproductive environment less cooperative. It becomes hostile to your chances of conceiving and staying pregnant. And that's honestly a nice way to put it. So inflammation can interfere with how your hormones are able to signal to the cell's receptors. It can mess with your ovulation, worsen insulin resistance.

9:43Dr. Lara Brighten:It can affect the quality of the environment an embryo is able to develop in. It can disrupt sperm and egg's ability to meet, And it can create conditions that are not exactly making implantation any easier. Now, I want to be careful here because inflammation has become one of those words that people are throwing around like glitter. It's just, oh, inflammation. Everything seems like it's inflammation these days, right? And everyone's inflamed and all of that feels really stressful. So what we're actually talking about here is that the body is under repeated physiological stress. So it's chronic inflammation.

10:25Dr. Lara Brighten:Chronic inflammation is sneaky inflammation because it's creating symptoms that go unnoticed, but it's having a really big impact on your health and your fertility. Now, inflammation can come from things like blood sugar swings, insulin resistance. if you have really poor sleep or you're under chronic stress. As we get older and we accumulate more visceral fat, fat around our organs, that can lead to chronic inflammation. If we're eating a diet that's less nutrient-dense and it's more rich in ultra-processed foods, those fats can shift your inflammatory profile. Certainly things like drinking heavily, smoking, not moving your body, having a sedentary lifestyle, so not exercising regularly.

11:11Dr. Lara Brighten:Those can all contribute to inflammation. And in some women, chronic inflammatory conditions are existing alongside these same things. So like endometriosis, PCOS, celiac disease, adenomyosis, Hashimoto's, any autoimmune disease really. Now next week, I'm going to talk about how inflammation may be influencing the development of ADHD or autism in children. It will not be another blame mom talk or shame-filled lecture. It's going to be actionable and evidence-based. So make sure that you subscribe so that you don't miss that. Now, if we've got all this inflammation, why not just take an anti-inflammatory?

11:53I totally get that and I get asked this all the time, but the reality is that it could block ovulation and further hinder your chances to get pregnant. Now, one thing that can be leveraged here is progesterone.

12:08Dr. Lara Brighten:There is a myth that progesterone suppresses the immune system, but that's a oversimplification and just wrong. It doesn't suppress the immune system. It instead shifts it to being more tolerant to baby. And in that, it tells your security team that's your immune system to stop overreacting to everything. So your doctor may test your progesterone five to seven days post-ovulation. They may recommend progesterone therapy. But while you wait for labs, one move that you can make to drop inflammation quick is omega-3 fatty acids. Eating cold water fish, not just three times per week, but daily, and taking a quality omega at maybe 2 ,000 to 4 ,000 milligrams a day can help drop inflammation.

12:58Now, we're going to talk about stress reduction more.

13:01Dr. Lara Brighten:I know it sounds basic, but it's a biggie. So chronic inflammation demands a response from cortisol. Cortisol is a highly anti-inflammatory hormone, but chronically elevated, it can interfere with ovulation and progesterone production. But it's not enough just to deep breathe. I'm not going to tell you that because if you have chronic inflammation, we have to find that and address it. So it could be of endometriosis. It could be gut dysbiosis or even an infection. It could be autoimmune disease. Whatever it is, it has to be found and it has to be addressed because, you know, I would recommend eating an anti-inflammatory diet that's low in ultra-processed foods, rich in plants, high-quality fats.

13:45Dr. Lara Brighten:That helps inflammation immensely, but it will only take you so far if you do not address why you have that inflammation in the first place. So a fertility supportive plate is going to be colorful produce, healthy fat, lots of fiber. That's going to help your body with regulating insulin and inflammation. And please don't listen to anyone that's like, hey, you just need to do like a three-day detox and you won't have inflammation. If you have chronic inflammation, there's a reason for it. We need to figure out why the body is under attack. Will you also bring on anti-inflammatory therapies? Now, I mentioned PCOS and endometriosis.

14:25Dr. Lara Brighten:Those both, we know, are leading causes of infertility. And it's important if you're dealing with these conditions that you don't waste time in addressing them and seeing a medical provider who can help you and support you on your fertility journey. Now, I have other episodes on PCOS and endometriosis. I will link those in the show notes at drbrighton.com. PCOS is often an ovulation problem first. Women will have eggs, but they don't ovulate them regularly. and even if they do, they may not be the best quality because they have insulin resistance, inflammation, high androgens affecting the quality of that egg.

15:00Dr. Lara Brighten:In PCOS, I mentioned we see the insulin resistance. There's androgen excess, so that's that excess testosterone I was talking about. There's irregular cycles because your ovulation is irregular. There's also acne and hair changes, weight gain, difficulty losing weight. There's metabolic dysfunction at the core. And this matters because if insulin is high and blood sugar regulation is off, that feeds the whole system in the wrong direction. It becomes a pro-inflammatory direction and it causes the ovaries to make the wrong hormones. They're making more androgens than they are cyclical hormones of estrogen and progesterone.

15:38So with PCOS, blood sugar regulation, gut support, inflammation, anti-inflammatories coming in, and looking at how do we get you cycling regularly has to be part of the strategy. Now with endometriosis, that's chronic inflammatory disease.

15:56Dr. Lara Brighten:It's systemic. Women can have pelvic pain, pain with sex. So like, how can you get pregnant if you have pain every time you try to do it? One thing I hear from women all the time is that they're struggling with symptoms like hot flashes, sleep disruptions, and brain fog, but aren't sure where to turn to for help. Menopause is inevitable, but suffering through it isn't. That's why I want to tell you about Alloy. Alloy is a digital health platform that connects you with a menopause-specialized doctor who can create a personalized treatment plan tailored to your needs, all from the comfort of your home.

16:31Join the 95 % of women who tried Alloy and saw relief in the first two weeks. Head to myalloy.com and use the code DRBRYTEN. That's myalloy.com, M-Y-A-L-L-O-Y.com and the code DRBRYTEN, D-R-B-R-I-G-H-T-E-N.

16:57Dr. Lara Brighten:Share your symptoms and you'll get a fully customized treatment plan and unlimited messaging with your doctor. Plus, you'll get$20 off your first order today. That's M-Y-A-L-L-O-Y dot com code Dr. Brighton. They can have bowel symptoms, fatigue, anxiety, and the pelvic environment becomes hostile when it comes to the fertility conversation. Depending on if you have endometriomas or not can impact the quality of your eggs. So you want to have imaging, have an evaluation with an endometriosis excision specialist because sometimes you may need to go the route of IVF, but they may suggest they remove an endometrioma first.

17:43It's all going to depend on what your AMH is, what your health history is, how large the endometrioma is, what your past history is of

17:52Dr. Lara Brighten:getting pregnant. And so it's important that you work with a team, not just a reproductive endocrinologist. There are some who will just put you through IVF cycles without a care in the world of what happens to your endometriosis. And there are others who understand endometriosis and they will work alongside an excision specialist. They'll recommend you to an excision specialist. That's a green flag in a reproductive endocrinologist. If they're like, I'll just go in, I'll do a little bit of surgery. We'll see what we can do. Like, no, you want a full excision if that's the route you're going to go.

18:25Dr. Lara Brighten:So with PCOS versus endometriosis, we want to think ovulation, insulin resistance, metabolic signaling with PCOS. Endometriosis, we're thinking lots of inflammation, pain, pelvic environment is disrupted, and women usually have a delayed diagnosis. And some women can have both because apparently the body sometimes likes to be aggressively unhelpful. Now, if you are feeling overwhelmed at this point and you don't know where to start, I don't want you just starting with anything and just trying to throw everything at yourself or doing some weird supplement stock that somebody on TikTok swears changed their life.

19:05I want you starting with very specific non-negotiables. If you're in my endometriosis reset course, You know how I love my non-negotiables.

19:13Dr. Lara Brighten:So here are the big areas that we have to care about first. So stress regulation, sleep. We need to be thinking about nutrition. I mentioned it a bit earlier. Movement. Remember, a sedentary lifestyle is associated with chronic inflammation. And we have to reduce environmental toxins. These matter in the fertility conversation. Now, why all of these things matter is because they're influencing hormone signaling. They influence your blood sugar, inflammation, ovulation, the basic physiological environment that your body is operating in to help you get pregnant and stay pregnant. And I know they're not glamorous.

19:56And that's exactly why so many people skip them. And instead, they go to like, what is the bright, shiny object? Everybody wants a fertility hack, but the reality is, is that the fertility foundation is what we all should be working on because the foundation is what makes the other hacks because some of those supplements do work, like right? CoQ10. They matter, okay? The foundation matters. So we're going to go through them one by one, and I'm going to have a supplement list for you that you should consider talking to your doctor about and seeing if it's right for you on your fertility journey.

20:31Now, we got to talk about an ugly truth.

20:33Dr. Lara Brighten:You cannot expect a hormonally stable, fertile body out of a nervous system that thinks it's being chased by a bear every night at 11.47 p.m. Okay, so sleep is not a luxury. It is endocrine maintenance. And so poor sleep, that can impact your insulin sensitivity, your appetite regulation. It definitely affects stress hormones. It can increase inflammation and it also hinders your body's ability to recover, which is especially important if you do go through IVF. So if you're trying to conceive and you are sleeping five and a half hours, scrolling in bed, waking up wired, pretending that it's fine because you're used to it, I want you to know that your body is not used to it.

21:21Dr. Lara Brighten:Okay? And that doesn't mean your body likes it either. So I'm not judging you, but this is where I need you to shift and I need you to be boring and consistent and a grown woman doing sleep hygiene. So aiming for seven to nine hours, ideally getting a regular bedtime, waking up at the same time every day, even on weekends, opening up your curtains, getting morning light exposure, less caffeine later in the day, cool dark room in the evening, and stop treating your phone like an emotional support animal. Well, put it away. Put it away 30, 60 minutes before bed. Because if your sleep is chaotic, your hormones are going to be chaotic.