Office Hours: Preparing Your Body for Pregnancy — Fertility, Nutrition & Hormones

0:29Welcome to Office Hours. your own health. And for many of you, your family's health too. And you might not feel it all the time, but you have far more power and agency than you realize. I'm glad you're here. This episode is brought to you by Function Health, empowering you to live 100 healthy years with over 160 lab tests at just$365 a year. Sign up today at functionhealth.com slash mark and use code mark2026 to get$50 towards your membership. Today, we're diving into one of the most personal and the most emotionally charged topics I get asked about, fertility. Now, so many of you have written in with questions about unexplained infertility, irregular or missing menstrual cycles, hormone imbalances, PCOS, endometriosis, miscarriages, and what you can actually do to prepare your body for conception.

1:17Now, these questions are deeply real, and they often come with frustration, confusion, and heartbreak, especially when the answers feel limited or incomplete. And yet, what I want you to know is this. You have far more influence over your fertility than you've likely been led to believe. So today, we're walking through your listener-submitted questions and breaking down what's really driving infertility and what the challenges are today. From metabolic health issues, to inflammation, to nutrient status, to stress, to environmental toxins, my hope is that this conversation is going to give you clarity and hope and also practical steps you can start using right now.

1:57whether you're actively trying to conceive or whether you're simply planning to have a baby in the future. Let's start at the beginning here. Having babies, really important. This is where I see the most confusion, the most fear, and sadly, the most misinformation. The question is, what's actually driving infertility? Why is infertility on the rise? Is it age? Is it the environment? Is it our diet? Is it something deeper? Infertility rates are rising due to a lot of things. the primary reason and there was a book written about this by a harvard researcher named walter willett called the fertility diet about metabolic dysfunction and i know you think dr hyman you must be obsessed with this metabolic nonsense i hear about all the time from you i'm sorry it's just the thing that causes everything it causes heart disease causes cancer causes diabetes causes dementia, causes infertility, even causes acne, causes depression, causes mental health issues.

2:55I mean, it is a massive problem. So I'm sorry if I keep hammering on this, but this is the thing you need to understand. This is what's driving primarily so much of our chronic disease, including infertility. Now there's other things besides metabolic dysfunction, and that means metabolic dysfunction. I mean, sugar, blood sugar, insulin issues, which we've talked about a lot. infertility rates are going up because of that but also environmental toxins are on the rise plastics and pesticides and metals and so many toxins we're exposed to and i test these things in people and i can tell you folks they're rampant even myself i try to eat a low toxin diet i try to only have healthy cleaning products in my house use healthy skincare products i try to do everything right and it's just impossible it's just impossible to avoid this we live in a toxic stew Now, the other thing about toxins you should know is that they're highly hormonally active.

3:51Pesticides, petrochemical toxins. I read a book about this when I was starting to learn about functional medicine 30 years ago called Our Stolen Future by Theo Colmer. And in this book, she talks about basically our stolen future, how our offspring are being affected by these environmental toxins. and you talked about in animal models and all these hermaphrodites that were being born and now alligators and frogs and you know problems with fertility across the whole animal population it's a real issue and they are highly effective in binding to hormonal receptors particularly estrogens they call them xenoestrogens or foreign estrogens they're endocrine disruptors they disrupt your hormonal system also microbiome plays a big role in hormone function and we've taken so many antibiotics, we had such a crappy diet, our microbiome is actually a piece of shit, if you excuse my French.

4:41It's bad. It just needs, we need to really get our microbiomes healthy because that can play a big role in our health. And of course, stress. And there's actually another book I read many years ago about stress and infertility. And there was a whole program at Harvard where they taught people to meditate who were having infertility and they were getting pregnant at as high or higher rates than IVF treatment. So stress plays a big role. Now, Now, age is another thing. For some reason, you know, we used to have babies as teenagers in our 20s throughout human history. Now our women are pushing it up to their 30s, late 30s, often 40s.

5:14And they're wondering why there's so much infertility. Well, in medical school, I learned if you're 35 and over, we call it a geriatric pregnancy. It's a terrible term, I know, but it actually speaks to the idea that if you're 35, it's kind of late. So you got to be careful. Well, that doesn't mean you can't have babies after that. My sister had a baby at 42. A good friend of mine had another baby at 42. Naturally, it's possible to do. So I think if you keep yourself healthy and young, you can do it. All right, so what are the real drivers of infertility? It's a lot of things that we've talked about.

5:49It's metabolic health, it's inflammation, it's environmental toxins. These are the massive drivers. Now, what if you have normal labs? What if you have, quote, unexplained infertility? You've done proper imaging. You've done all the labs. you can conceive like, what do you do? This is where functional medicine really helps because you can dig into this real findings of what's going on. I've had women who have subtle thyroid dysfunction. And we just had a story on our function health email where a woman had been struggling for 13 years with all these health issues and her doctor never checked her thyroid.

6:18They didn't even check the right thyroid numbers. They checked maybe TSH, but they didn't check T3, T4, thyroid antibodies. So you have subtle thyroid changes. You can have inflammation that's causing infertility. You can have insulin resistance, which we talked about. You can be nutrient deficient, you know, folate. I had a movie that I was in called Fed Up, and it wasn't exactly infertility, but this woman had recurrent miscarriages. And she was just having miscarriage after miscarriage. And one baby, she got almost a term, and it was born without a brain. It's called anencephaly. It's terrible.

6:48She was just struggling. And she was the director of this movie, Fed Up, that I was in like 10 years ago. and in the kind of tour of the movie, we were going on tour, going on TV and radio, whatever. We were riding in a cab in New York City and she has her baby there and breastfeeding this baby in the back of the cab. And she's telling me that story where she read this article I wrote, I don't know, 20 years ago or something on methylation, which has to do with B vitamins and folate B6. And we know that if you're deficient in folate and it's one of the things you get in a prenatal vitamin, that actually you will have trouble potentially with birth defects or miscarriages.

7:28And she read this article. She went to her doctor. She had her doctor check homocysteine, which again, most doctors don't check. They'll check folate, which usually may not be a problem on the lab test. But the homocysteine is a better test. And we do that at Function Health. And that's part of the panel that we create as a baseline. And that was elevated. And the doctor said, okay, I'll just give you folate. She says, no, no, Dr. Hyman says to check this gene to see if I need a different kind of folate. And he checked the gene. She had the gene. And we also checked out of functional health called MTHFR.

7:56And then she took folate in the right form called methylfolate. And guess what? She was able to have a normal, healthy baby. So nutrients can play a big role. Toxins. So I've had other women who struggled and we've found lots of heavy metals. We've detoxified them. They've gotten babies after that. Gut health. Again, another important thing. A lot of women and people in general have gut health issues. number one reason people go to the doctor. So there's a lot of things you can identify and treat that you can really focus on. Subclinical thyroid issues, autoimmune issues, chronic stress, mitochondrial issues, gut issues, toxin load, all these things we can measure in functional medicine.

8:31And when you look at simple things that can actually help besides doing all this, there's simple lifestyle things that make your eggs better. Getting quality sleep, balancing your blood sugar, optimize your nutrient status, lowering your toxin exposure, where all these really help to improve the quality of eggs. And by the way, folks, sperm too, because it's not just women here that are the problem. It's guys too. Guys' sperm is a problem. Men's quality of sperm is going down and down and down. And stay tuned. I'm doing a podcast with Stanford urologist, Michael Eisenberg, coming up soon, that's going to go deep into the problems with sperm and sperm quality in society today and how that's contributing to infertility.

9:11And we're going to get into that. But right now we're going to talk about how to help improve your metabolic health because that's really important factor of the fertility diet is an example but i i would go even further people can go on the blood sugar solution 10 day detox diet you go to 10daydetox.com it's the best way to reset your metabolic health and of course i created it but it's out of my own practice and experience and you know what i've learned with patients i simply write about i talk about and i teach about because i want not just my patients to have the benefit i want everybody to have the benefit so balancing your blood sugar is key, getting rid of the starch and sugar, having more protein, having more good fats, having more fiber, lots of phytochemicals, getting your insulin stable, exercising, building muscle, all those things make a profound difference.

9:54And even small changes can make great improvement in ovulation hormone balance. And PCOS is the most important example of this, where women have a lot of infertility when they have polycystic ovarian syndrome, but it's not an ovarian problem. It's a nutritional problem. They call it ovarian syndrome, but it's actually nutritional syndrome because it's related to the starch and sugar in our diet. Okay, so, again, not everybody. Some small subset of people with PCOS are thin and healthy but still have this problem. But for the majority, it's because of our starch and sugar diet. So what else can you do to improve your quality of eggs, to improve your likelihood of having pregnancy that comes to term?

10:32It's eating real food. It's getting rid of ultra-processed food. It's having enough omega-3 fats. It's getting rid of inflammation triggers like gluten and dairy. Dairy is a big problem for a lot of people, by the way, and can cause a lot of inflammation in the body, a lot of gut issues, a lot of autoimmune dysregulation. I like goat and sheep better, but you just want to be careful. Next, you want to do the best you can. Now, not make yourself crazy, but the best you can to avoid environmental toxins. So there's a great website, ewg.org. I'm on the board of this group. It's the Environmental Working Group.

11:03And they've done incredibly deep research on how to source all the things that have low toxin levels what foods to eat what fruits and vegetables have the lowest pesticides what have the most to avoid what you know animal products you can eat that are safe and how do you choose animal products what about fish would have the least mercury and toxins what household cleaning products you should have what facial and skincare products you should have to go to skin deep it's really a great uh app it's part of their work i filter my water at home i have a reverse substance filter i have air filters in the house and actually i think i need more because i just did my indoor air quality and i had a device that i used to measure it and i actually have a fair bit of indoor air pollution and it's actually often a very toxic environment for people um and then just be smart like you know there's there's a lot of plastic so plastic bottles and plastic cookware and i mean people microwave in plastic just don't be stupid no the other thing people don't know is bpa is a huge endocrine disruptor bpa also causes some resistance or bisphenol A.

12:05It's the lime cans, bottles. They've taken some of that out, but they replace it with something just as bad till they, you know, ban that again. But BPA is also on credit card receipts. It's on the gas station receipts. It's on all that stuff. So you don't want to touch that stuff. People say, you want to receive? I'm like, no, thanks. You know, so be careful of those. Let's drop your hormones. Next thing you can do to improve fertility is help your gut. So lots more foods that support your gut microbiome. Lots of fiber. Nuts and seeds. fruits and vegetables, some whole grains, some beans can be very helpful.

12:38Fermented foods, sauerkraut, miso, kimchi, natto, tempeh, all these fermented foods can be very, very helpful. Prebiotic foods can be helpful. Asparagus and there's some artichokes and onions, and you can just kind of go on chat GPT and look up what are prebiotic foods and you'll see what they are. And then you can also use probiotics as a way to support your gut health. And I think most people in society today should be on a basic probiotic. It's almost like a foundational supplement. multi fish oil, vitamin D, and a probiotic. And I probably add magnesium to there. It's a basic foundation for everybody, given the massive nutritional deficiencies we have.

13:11And those can help estrogen metabolism. They can help your immune system, reduce inflammation. They can improve your ability to absorb nutrients. So they're all very helpful. Okay, what else can you do? Well, you can learn how to regulate stress in your nervous system. And when you're chronically stressed, it disrupts ovulation, lowers sperm count. I mean, if you take a bunch of soldiers who are healthy 20-year-old guys and you march them overnight, Their sperm count drops dramatically. Their testosterone drops dramatically. Their thyroid drops dramatically. So stress affects every system in your body, including fertility, ovulation, sperm production.

13:42So learn some simple practices because stress happens to you automatically, but learning how to activate your relaxation system is an active process. So meditation, breath work, Andrew Huberman calls it non-sleep deep rest, which otherwise is known as yoga nidra. that's been around for thousands of years. You can go to Spotify, just do Yoga Nidra or go on YouTube and do a 10 minute or 20 minute or 30 minute one. Very important. Getting your sleep optimized, also critical. Because if you don't sleep, your stress response is much higher. Exercise also really helps, helps reluce the stress, but also improves your reproductive hormones.

14:21These aren't really small tweaks. These are foundational things. These are root cause interventions that can really shift fertility outcomes. even when your regular traditional workup looks normal. Now, I mentioned PCOS earlier, polycystic ovarian syndrome. This is a common problem. It causes a lot of issues, causes irregular menstrual cycles, heavy bleeding, can link to obesity, facial hair, loss of scalp hair, acne. It can be kind of bad. And it's a fundamentally a metabolic problem, an issue of insulin resistance, inflammation, and all these things will affect your hormones. so the key is basically following what i just said which is get your blood sugar balance get rid of starch and sugar exercise strength train vitamin d omega-3 freeze and there's a particular compound called inositol particularly d-chironositol or myonositol also can be very helpful in improving this is a published i read this 30 years ago in the new england journal medicine so well validated natural compound you can get online and it's really important and i think, you know, getting your blood sugar balance is such a key thing.

15:25And I think we've talked about that a lot already, so I won't go over it, but that's really the fundamental issue here. Now, when you start getting metabolic health, then guess what happens? You start ovulating normally. You start having more regular cycles. You can do well. So I don't have to be cursed with this problem that's forever with PCOS. You can manage it. And I actually had just a good friend who had PCOS and she got really healthy and she's 38 and she just had a beautiful baby naturally. So the body can do that if you do the right things. Listen, every time you lift a fork to your mouth, you're making a choice.

15:56Because food isn't just fuel. It works with or against your genes, your hormones, and your immune system. It can lower inflammation, and it can even help reverse chronic disease. But here's the problem. You can't fix what you can't see. Are you actually low in magnesium, vitamin D maybe, omega-3s? Are toxins building up? Most people have no idea. And that's why we created Function, designed by the world's top doctors and trusted by hundreds of thousands of members. You get access to over 160 of the most critical lab tests for your heart, your hormones, your metabolism, nutrients, toxins, and lots more.

16:31For$365 a year, that's just a dollar a day. And once you have your data, everything changes. You stop guessing, you start eating for your biology, you take control of your health. Go to functionhealth.com and start now. What about coming off birth control and getting your body ready to have a baby. Someone asked, I've been on birth control for years. How do I transition safely off that? Well, I want to make sure, you know, people don't realize this, but the birth control pill actually depletes a lot of vitamins like B6, folate, magnesium, B12, zinc. So you got to get your nutrient levels up. And I'm talking about just a good multivitamin.

17:07It's not going to be a big deal. It might take your hormones about three to six months to reset after stopping the pill. And you want to just track your cycle, see how you're doing, get your nutrient levels up, support your liver detoxification, and help your body get back in its natural rhythm. Birth control doesn't cause infertility, but can actually mask underlying issues. So you want to make sure you check all that. Next thing we want to look at is something called AMH. Now, this is a basic test we do for women as part of the Function Health Panel, the company I co-founded. You can get a whole comprehensive view of your body for a dollar a day, 365 a year, and really look at everything that's going on, including all your hormones, all your metabolic health, all your nutrients, toxin levels, lots more.

17:51And there's a test we do called AMH. That means anti-malarian hormone. And that's a test that measures your ovarian reserve. Now, if it's low, does that mean you're infertile? And how do I kind of check about the fertile years, right, that I have left? So AMH is about the quantity of your eggs, not necessarily the quality. Now, quality is influenced more by things you have control over, like inflammation, your mitochondria lifestyle. Your egg reserve is what you get. When you're born, you have millions, it dwindles to maybe 100 ,000 when you're in your puberty, and then it dwindles even further.

18:27And by the time you're in your 30s, 40s, it's much lower. But the quality can be influenced by things that you have control over that manage inflammation, your mitochondrial health lifestyle. So if you have low MH, it doesn't mean you're hopeless. You can still conceive with low numbers. And it's possible to improve the quality of your eggs and actually have conception. So don't lose hope. Men also, as I mentioned, you know, sperm is a big factor here in having a baby. And that affects the quality of the embryo, the epigenetics, the way in which the sperm is developed is actually controlled by diet, lifestyle, toxins.

19:02all these things we're going to talk about with Dr. Michael Eisenberg from Stanford in the coming podcast. So speaking of sperm and male fertility, male fertility matters more than people think. People always think about the woman and doctors focus on the women, but you got to focus on the guys too. And diet plays a big role in sperm quality and sperm health is affected by a lot of things. Sugar, of course. Alcohol, really bad. Plastics and chemicals, toxins are causing low sperm count, they're endocrine disruptors. Heat, so like saunas, there's ice packs that guys use on their private parts for saunas, so you can do that if you want.

19:41Nutrient deficiencies also play a role. So you've got to get the nutrient levels up in men too. And the men's health has a lot of impact on many things that relate to pregnancy, like placental formation, your risk of having a miscarriage, maybe your long-term child's health is determined a lot by the health of the men. so what do men need they need antioxidants they need zinc they need omega-3s they need you know good quality multivitamin all that's really important and of course exercise also helps so as i mentioned we're gonna have a deep dive on male fertility don't miss my upcoming episode with dr michael eisenberg he's one of the leading experts in the field and we're gonna go deep into that all right so the next question is about in vitro fertilization or ivf and how to deal with the risks of the meds and how do they detox after a lot of people are asking about this So let's sort of get into what they do.

20:29What do IVF meds do? They stimulate your ovaries to make eggs and then to help you stabilize the pregnancy in the early parts of the pregnancy. So there's a lot of hormones involved, a lot of short-term side effects, but there are long-term side effects. The risk is generally low, but they're still being studied. Now, after you've kind of done this IVF treatment, how do you actually recover? How do you help? because the amount of energy required to stimulate ovaries to make eggs is a lot. And what drives the energy production? Your mitochondria. So the mitochondria are the energy factors in your cell.

21:06They help power hormone production, egg development, detoxification. They help your overall recovery. And there's lots of ways to support mitochondrial health. So you can eat rich foods and antioxidants, and lots of berries, leafy greens, colorful fruits and veggies, lots of omega-3s, salmon, sardines, walnuts, chia seeds, all great. Cook U10, also very important. Really important. Organ meats. Okay, people don't like them, but I love liver. They really help. They're the most nutrient-dense food in the planet. If you don't believe me, just go to Google and ask for a chart comparing the most nutrient-dense vegetable on the planet with liver.

21:41And you will see it's not even a contest. It's like this on the graph. Can't see my hands, but if you're listening, but it's a big delta. Oily fish really help. Broccoli helps. All that's great. Also, strength training, exercise, walking, cardio, all improved mitochondrial function, deep restorative sleep, also critical for healthy mitochondria. If you're working with a doctor or you want to try stuff on your own, you can try things like coenzyme Q10, N-acetylcysteine or NAC, alpha-lipoic acid. These are generally safe, but you want to choose the right products and really work with someone who helps you understand what they are because they're kind of not your general multivitamins.

22:21And they also help liver detox, actually, by the way. these can be very helpful. So your liver helps also clear hormones. They clear the medications used in IVF. You don't want to cleanse, but you want to just a general support of your detox pathway. So how do you do that? You eat foods that help detoxification. All the broccoli family, broccoli, collards, cabbage, Brussels sprouts, onions, garlic, these all have sulfur in them that increases glutathione. That is the main detoxifier in your body. Lots of water. Herbal teas can be helpful. Dandelion is a great detoxifier. Ginger, peppermint, many other things can be helpful too.

22:57Lots of fiber that helps get rid of the excess hormones from your gut that get excreted from your liver and you need to recirculate them, get them out of your body. Black seeds are amazing for this. Beans, veggies, also great. Alcohol, definitely bad for you. I'm sorry guys, I love a good drink now and then, but there's no world in which alcohol is good and the dose makes the poison. So higher amounts, more frequent amounts are dangerous. It really raises estrogen levels. It really screws up hormones. It really affects sperm. So if you're trying to have babies, don't drink. Also, sweating is really helpful.

23:33So detoxification through saunas, exercise, cycling, all break. Also, you want to reduce inflammation. So when you have hormonal stimulation, it can make your inflammation levels go up. That can show up as lots of symptoms like fatigue or mood changes, bloating, skin flares. The key is to lower inflammation by eating whole food, unprocessed food, lots of omega-3 fats, same diet for everything pretty much, right? Real food, low in sugar and starch, lots of omega-3s, lots of fiber, lots of colorful foods and vegetables, lots of anti-inflammatory foods like, you know, that you can eat, lots of turmeric, ginger, rosemary, all helpful.

24:07All get rid of all the starch and sugar that really helps to reduce so the inflammation in your body. Stress reduction, also stress makes you inflamed. So breath work, meditation, yoga, gentle movement all help. Get your nutrient levels up. That really helps lots of demand on reproductive health when you're doing IVF. So you need lots of nutrients. Get B vitamins, folate, B12 especially, zinc, magnesium, vitamin D, omega-3s, iron, all really important. So you can get them through food, right? Eggs, greens, beans, nut seeds, wild salmon. Lots of good quality nutrients also available. and a high-quality prenatal or multivitamin.

24:44You want to get your labs drawn to make sure you're knowing what you're doing. And that's really why I co-founded Function Health. So just go to functionhealth.com. It's$365 a year for membership. Twice your blood draws, a dollar a day. It's your health, folks. Prioritize protein. As your body goes through a lot, you need more protein. It helps you repair tissues and things. So make sure you get about a gram per pound of ideal body weight. 80 to 100 grams usually is pretty good depending on your body size, helps your hormones recovery from anything. Also, you know, your nervous system is, you know, taking a big toll when you're going through IVF.

25:21You know, a lot of people, it's a hard thing emotionally. You know, infertility is hard, it's psychologically exhausting, it's stressful, you know, and this all affects your biology. All affects hormones, thyroids, gut health, fertility, all this stuff. So simple practices meditation journaling breath work i do every morning breath work in bed for 10 minutes i do meditation in bed just before i get out of bed for the morning often i'm journaling practice in the morning if i can do that just simple things can help and it doesn't have to be a lot moving also helps you know getting all the energy out of your body like when you think about when you're chased by a tiger there's a book called why zebras don't get ulcers is they're chased by a lion and then they run like crazy they're freaking out they're stressed they're going to get eaten the The lion catches one of them and they all go back to eating and the lion's eating the other zebra, you know, in the midst of this big herd.

26:10They don't care because they know it's the lions they're eating this other guy. So they basically discharge the stress through running as fast as they can. So exercise really helps. Also, social connections are really important. Meaningful connections are really good for your health. So you can just get support through other people who've been through IVF or just friends in general. Make sure your sleep is good. Also really important. good hygiene like dark room no screens before bed you know just wind down time hot bath earplugs eye shades whatever it takes also you want to heal your gut because the gut plays a huge role in hormones um gut health and hormones are super connected ibf drugs can actually alter your gut motility they can change your microbiome they can affect your nutrients so make sure you eat a lot of the good stuff like probiotic rich foods yogurt if tolerated kefir sourcrate kimchi all that's great uh prebiotic fibers as i mentioned garlic onions asparagus flax seeds chia seeds plantains also good don't eat ultra processed foods never should eat those they're not food they cause lots of inflammation and then think about doing a gut reboot uh warm meals soup stews cooked veggies all that helps and give yourself time like it just takes time you need usually a couple months two three months recalibrate yourself after having ibf the hormones they need time to normalize your nervous system needs time to decompress, your nutrient stores need time to rebuild.