Discover the secrets of natural fertility support, whether you're trying to conceive, suffering miscarriages, or going for IVF...
Right now, around 8-12% of couples have problems conceiving, and sadly, 10-15% of pregnancies result in miscarriage.
If you’re experiencing fertility challenges, our you=2 Fertility Success Path can help.
We’ve already helped hundreds of individuals and couples to have their little one, and we’d love to help you too.
The you=2 Fertility Success Path
We have over a decade of experience and success with our amazing fertility clients.
We understand the emotional investment in your fertility journey can be difficult, sometimes heart-breaking, and often life changing.
We designed and refined the Coho you=2 Fertility Success Path over the last decade to optimise your fertility and pregnancy journey, so you can have your baby as soon as possible.
Table of Contents
We have years of experience in natural fertility, and our you=2 Fertility Success Path simply works time and again, for both men and women, whether you’re:
- Trying for a natural conception
- On an IVF or other assisted treatment journey
- Looking at surrogacy
- Or using an egg and/or sperm donor
- Have suffered multiple IVF round failures
- Have suffered miscarriages
you=2 works because we assess the root cause of fertility challenges.
It’s an approach that works whether you’re preparing to conceive naturally, struggling to conceive, have suffered recurrent miscarriages, or failed IVF rounds.
Fertility statistics
Around 48 million couples, and 186 million individuals around the world, have fertility problems.
The fertility rate has fallen by half in the past 50 years.
About 50% of infertility problems are due to female factors alone, 20-30% are due to male factors alone, and 20-30% are a combination of male and female factors.
So, in 40% of cases, there is a fertility problem in the male partner.
However, often it’s the female that’s left carrying most of the burden on the fertility journey.
Fertility success starts with a proper analysis
Our experience as clinicians is that many people struggling with fertility simply haven’t had a thorough analysis of the factors involved.
A semen test might have been done for the man, and perhaps some basic hormone testing for the woman.
Our perspective: our extensive experience suggests that this basic testing is totally inadequate, and does not help in identifying the underlying issues underpinning many fertility problems.
Infertility: the male factor
Guys – getting on board the fertility journey is non-negotiable.
At Coho we have been lucky enough to work with amazing men who are totally on this journey with their partner.
Unfortunately in our experience, there are also a good number of men out there who see the fertility journey as a ‘female only’ responsibility, refusing to make the necessary nutrition and lifestyle changes.
We’ve even worked with some who refuse to take a supplement!
So we have to be clear, if you’re in the 40% of infertility cases where the male is playing a role, you need to get in the game.
Infertility: root cause factors
Many factors can be involved in fertility problems, and in issues with maintaining a healthy pregnancy.
Addressing infertility problems can therefore be a very difficult thing to do by yourself:
These infertility factors are also deeply interconnected and can be seemingly completely unrelated to your fertility challenges.
This can make solving fertility problems yourself almost impossible.
While the you=2 Fertility Matrix only scratches the surface of how complex these factors can be, it gives you an idea of the expertise and detective work needed in order to solve many fertility challenges:
In the rest of this article, we’ll be taking a closer look at many of these factors, so let’s get to it, and deepen your understanding of how to solve fertility problems!
Female structural abnormalities
Fallopian tubes that are blocked may stop sperm from travelling through the fallopian tube, where it can fertilise the egg:
PCOS (Polycystic Ovary Syndrome)
PCOS is a significant cause of fertility issues in women.
In PCOS, the eggs don’t fully mature because of the hormonal changes that occur.
The follicles develop, but don’t release the egg(s), and there’s no ovulation:
Endometriosis
Endometriosis often affects fertility, and it occurs in around 25 to 50% of women with fertility problems (7).
This is because the endometrial tissue can affect the uterus, the fallopian tubes, and / or the ovaries.
Fibroids
Fibroids impact about 5-10% of women who have fertility challenges (9).
The Coho you=2 approach to fertility can help with fibroids and endometriosis:
- Help to reduce the underlying drivers of these conditions
- Improve the hormonal imbalances that often exist in these conditions
- Improve the non-structural consequences such as inflammation
Inflammation, no matter the cause, can negatively impact fertility in both women and men.
Male structural abnormalities affecting fertility
We’ve got a whole article on male fertility factors, and how our you=2 approach to male fertility can help.
Just head over to that article, where you’ll be able to learn all about structural abnormalities affecting male fertility!
Female hormone imbalances
Many of the scans and tests you might have, assume a 28 day menstrual cycle.
And there are some problems with this assumption, because many people don’t have a 28 day cycle.
This means that your test results are at best useless, and at worst, misleading.
Chief among the hormones regulating the menstrual cycle are:
- Oestrogen
- Progesterone
- Luteinising hormone (LH)
- Follicle-stimulating hormone (FSH)
Many of our you=2 Fertility Success Path clients have a longer menstrual cycle (for example 35 days), less frequent cycles, or no cycle at all.
The Day 21 Progesterone test is a common fertility hormone check.
Progesterone levels are tested at day 21, as progesterone levels should be highest at that time if the cycle is 28 days long.
However, it can be that ‘Day 21’ progesterone is low in one cycle, and normal in the next cycle.
What would be better is frequent progesterone testing throughout a full menstrual cycle, instead of just a single test on day 21.
It’s important to know that your test day needs to be adjusted if your cycle length is not 28 days.
For instance, if your cycle was 31 days long, you’d want to do your ‘day 21’ test on day 24 to get a clear picture of your peak progesterone level.
There are other problems with the day 21 test, because peak progesterone also depends on when ovulation occurs, which can vary from person to person and cycle to cycle.
Irregular cycles also mean that it could be difficult to know when ovulation is occurring, and when the progesterone peak is going to be.
Additionally, the timing of the test can be important because progesterone is secreted in pulses, so a sample taken at 9am on day 21 could give a different result to a sample taken later on day 21.
The day 21 progesterone test isn’t a good tool; it can be misleading and can cause unnecessary worry.
Better female hormone testing
For hormone testing in general, and especially in fertility, we use the DUTCH test.
The DUTCH (Dried Urine Test for Comprehensive Hormones) test allows us to understand all the relevant hormone levels over the entire course of a menstrual cycle.
Being able to see the levels of your hormones over the course of a full cycle has obvious advantages compared to a day 21 test, and gives us the high quality information we need to optimise your you=2 fertility journey.
Oestrogen testing & oestrogen dominance in fertility
Oestrogen dominance happens when oestrogen is higher, relative to progesterone.
If progesterone is low, even a normal oestrogen level can mean you are oestrogen dominant.
So a normal oestrogen test result doesn’t always tell you if you’re oestrogen dominant.
Oestrogen dominance increases the risk of fertility problems and the chances of pregnancy loss.
Other symptoms of oestrogen dominance include:
- Miscarriage
- Fibrocystic breasts
- Headaches
- Heavy bleeding and clotting
- Poor memory
- Fatigue
- Short luteal phase
- Brain fog
High oestrogen
High oestrogen can be due to:
- Increased exposure to xenoestrogens (xenoestrogens, for example from plastics, mimic oestrogen in the body)
- Decreased oestrogen detoxification
- Increased hormone production
There are three stages to consider when thinking about oestrogen balance:
1/ We produce oestrogen
2/ Our body uses oestrogen
3/ Then our body should detoxify and eliminate oestrogen
These processes depend on a healthy liver that’s capable of clearing oestrogen, and a healthy gut with normal stool frequency.
Your ability to effectively process oestrogen is definitely something we assess in our Coho you=2 approach to fertility.
Adrenal Stress Hormones
Adrenal (stress) hormones are a significant factor in fertility challenges.
We know that when stress is reduced, fertility improves.
This is because stress, and stress hormones, are so deeply interlinked with many other functions and systems of the body.
Stress hormones that are too high or too low affect the:
- Pituitary hormones
- Thyroid hormones
- Sex hormone levels
- Egg quality
- Sperm quality
- Circadian rhythm
‘Stress summates’ is a popular saying, which means that your body responds the same way to all kinds of different stressors, whether they’re physical, emotional, due to poor sleep, toxins, and so on.
We use the comprehensive DUTCH hormone tests by Precision Analytical to take a better look at stress hormones and how they’re impacting other hormones and systems.
We often implement some (or all) of these strategies with our clients in order to support optimal stress hormone levels:
- Build good sleep / wake cycles
- Establish stress reduction strateges
- Implement the right kind of exercise at the right time of day (guided by stress hormone test results)
- Balance blood glucose through nutrition strategies
- Introduce nutrients or herbs to support stress hormones and processes
Low thyroid hormones (hypothyroidism) & female fertility
Thyroid hormones are an absolutely critical factor in fertility, and in our you=2 Fertility Success Path.
Thyroid hormones:
- Reduce the risk of early pregnancy loss
- Support implantation
- Support ovulation
- Help to maintain a fertilised egg
- Affect menstrual cycle length
In women, low thyroid hormones can:
- Impact ovulation
- Shorten the luteal phase of the menstrual cycle
- Impact the functioning of the endometrium and placenta (increasing implantation problems and increasing miscarriage risk)
- Increase the risk of pregnancy loss
- Cause heavy or light periods
You don’t need to feel symptoms, or have abnormal test results – hidden or silent thyroid problems can still be affecting your fertility.
If you have fertility challenges, or you want to optimise your health for pregnancy, comprehensive thyroid testing is essential.
High anti-thyroid antibodies in female fertility
Anti-thyroid antibodies are an autoimmune problem that’s involved in 90% of people with hypothyroidism.
But these antibodies can affect fertility and increase the risk of miscarriage regardless of whether they impact your thyroid hormones.
While at Coho we always test for thyroid antibodies, it’s hardly ever included in standard testing.
Elevated anti-thyroid antibodies are associated with:
- Problems with egg fertilisation
- Lower quality of embryos
- Reduced pregnancy rates in IVF
- Increased early miscarriage rate
Low thyroid hormones and / or high thyroid antibodies can affect your ability to become pregnant, as well as increasing the risk of miscarriage.
Prolactin in fertility
Prolactin should be quite low both in males and females, only becoming higher in women to support milk production after birth.
In both men and women, elevated prolactin can be an important fertility factor.
Communication between the pituitary gland and the ovaries and testes is essential, as it controls fertility hormones and functions.
Insulin in fertility
For men and women, insulin problems, pre-diabetes, and diabetes, are a big fertility risk.
Insulin resistance increases the risk of:
- Reduced egg quality
- Reduced sperm
- Higher androgen hormones
- Metabolic syndrome
- Inflammation
- Imbalanced pituitary hormones, leading to oestrogen and progesterone imbalances
- Higher blood pressure
- Oxidative stress
If you have insulin resistance, it can be a real issue for fertility.
We use a fasting insulin test (which isn’t a routine test) to assess insulin problems, and this test is especially good at identifying early insulin resistance issues.
Insulin resistance is a driver of infertility.
The earliest indicator of insulin problems is an elevated result on a fasting insulin test.
Nutrition and lifestyle are the main factors in determining optimal insulin sensitivity.
High insulin, men, and fertility
To learn about the role of insulin and how it impacts male fertility, plus much more, head over to our main you=2 approach to male fertility article.
High insulin is a key driver of low testosterone, low testosterone can seriously impact male fertility
Polycystic Ovary Syndrome (PCOS) in fertility
PCOS is a health condition that is associated with elevated androgen hormones.
The most common androgen is testosterone.
Androgens can be problematic for fertility as they can cause more follicles to grow in the ovaries.
However, these additional follicles are not healthy, and make fertility more challenging, even in IVF.
A significant cause of high androgen hormones in PCOS is insulin.
The best way to manage insulin and insulin resistance is through lifestyle and nutrition – Functional Medicine can really help both with fertility and PCOS.
The symptoms of PCOS can present themselves in different ways:
PCOS doesn’t always mean the presence of ovarian cysts that can be picked up on an ultrasound.
Increased androgen hormones by itself can mean you have PCOS.
PCOS is also associated with inflammation, and this can impact egg implantation, as well as the number and quality of eggs.
PCOS can be improved by identifying and addressing the root causes – such as stress, diet, inflammation, microbiome, and lifestyle.
The immune system link to fertility
Our experience is that in a many complex fertility situations, there’s an immune system factor, and in many cases, this can be key to unlocking fertility success.
What can be triggering our immune system?
- High oestrogen levels
- Chemical or environmental toxins
- Stress
- Infections
- Increased adipose tissue (fat)
- Poor liver detoxification
- Chronic pain e.g. back pain
- Food sensitivities or allergies, or high sugar, caffeine, or alcohol, sugar
- Microbiome changes
- Medications
- Poor digestion
Autoimmunity in fertility
Autoimmune conditions happen when the immune system attacks the tissue of the body by mistake.
If you have an autoimmune condition, it can be more challenging to become pregnant, and to maintain pregnancy.
In unexplained fertility challenges, there are specific autoimmune diseases that we can explore.
Environmental chemicals and pollutants
Environmental pollutants and chemicals (either increased exposure or compromised capacity to detoxify them) can impact fertility for both men and women.
Many common chemicals can disrupt hormones:
- Phthalates (plastics)
- Chemicals in cosmetics
- Pesticides
- Dioxins
- Parabens
- Air pollution
- Growth hormones in animal produce
- Triclosan
Hormone disruptors compromise fertility by disrupting normal hormone signalling.
People are exposed to endocrine disrupting substances on a daily basis.
Body composition, body fat percentage, and fertility
Body fat (either too high or too low) can be an important factor that may impact fertility.
Low body fat or BMI can cause problems with pituitary hormones, and this can lead to irregular (or no) menstrual cycles, as well as problems with ovulation.
For women who have a high body fat percentage, this can compromise egg development and how receptive the uterus is to the egg.
Even moderate fat loss can help to reverse the fertility problems associated with having a higher body fat percentage.
For men, obesity can compromise sperm production and can mean damage in sperm DNA.
Sperm DNA problems are a significant factor in both the ability to become pregnant, and in maintaining pregnancy.
In men, reduced testosterone levels can be caused by too high, or too low, body fat percentage.
The wrap: the natural approach to fertility is complex!
Many of the amazing people we’ve helped on their fertility journey have found it emotionally challenging, and we understand just how difficult the journey can be.
Through our years of experience, and success, in helping so many people to have their happy, healthy baby, we’ve learned that:
– Everyone is unique; due to the number of systems and factors at play, fertility is often a really complex and highly personalised journey
– Whatever your situation, there’s a lot that can be done to optimise your journey and your chances of success
– Trying to work out what’s compromising your fertility by yourself is difficult, and can mean unnecessary years of heart ache, frustration, and wasted rounds of IVF
We’d love to help you on your fertility journey.
If you think our natural, you=2 Fertility Success Path approach can help you, you can book a free 15 minute Fertility Success Call with us here.
We offer consultations in the UK, in Mallorca, and to clients around the World through our virtual Coho Fertility clinic.
To your baby, love, and joy filled future,
Dee & the Coho Fertility team
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