Fertility success: how Functional Medicine can boost your fertility [short read!]

Discover how to become pregnant, and maintain your pregnancy with a Functional Medicine approach to fertility

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 Functional Medicine approach can help.

We’ve already helped hundreds of individuals and couples to have children, and we’d love to help you too.

The Functional Medicine approach to fertility

Functional Medicine Fertility blog flyer

At Coho Health we have years of experience and success with fertility clients.

We deeply understand the emotional investment in your fertility journey can be difficult, sometimes heart-breaking, and often life changing.

Table of Contents

We have years of experience in natural fertility, working with both men and women, whether you’re:

Our success rate is so high because our Functional Medicine approach to fertility is so in-depth, and we often achieve success with those who have suffered many miscarriages or failed IVF rounds.

Book your free 15 minute Discovery Call with Dee Brereton-Patel now

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 alone20-30% 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 seeking a Functional Medicine approach to fertility 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: 

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.

PCOS infographic showing the difference between healthy and poly cystic ovaries

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 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 impact about 5-10% of women who have fertility challenges (9).

A Functional Medicine approach to fertility can help with fibroids and endometriosis:

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 Functional Medicine 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:

Many of our Functional Medicine fertility 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 Functional Medicine 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.

Book your free 15 minute Discovery Call with Dee Brereton-Patel now

Low Progesterone - Oestrogen Dominance

Oestrogen dominance increases the risk of fertility problems and the chances of pregnancy loss.

Other symptoms of oestrogen dominance include:

High oestrogen

High oestrogen can be due to:

High Oestrogen - Oestrogen Dominance in Fertility

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 Functional Medicine 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: 

‘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:

Low thyroid hormones (hypothyroidism) & female fertility

Thyroid hormones are an absolutely critical factor in fertility, and in our Functional Medicine approach.

Thyroid hormones:

In women, low thyroid hormones can impact:

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.

Hypothyroidism testing

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:

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:

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 Functional Medicine approach to male fertility article.

High insulin is a key driver of low testosterone.

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?

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:

Hormone disruptors compromise fertility by disrupting normal hormone signalling.

People are exposed to endocrine disrupting substances on a daily basis.

Functional Medicine Environmental Factors in Infertility

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.

Book your free 15 minute Discovery Call with Dee Brereton-Patel now

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 healthy babies, 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, Functional Medicine approach to fertility can help you, you can book a free 15 minute discovery call with us here.

We offer Functional Medicine consultations in the UK, in Mallorca, and to clients around the World through our virtual Functional Medicine clinic.

To your optimised, healthy future,

Dee & the Coho Health team

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