If you want to become pregnant over 40 and think it’s not possible, this post is for you. These questions and answers are from a podcast episode featuring Dr. Jeanie Schlafy’s pregnancies with donor eggs over 40. I wanted to provide these questions on their own because it’s such valuable information about many women’s fertility concerns. The questions I asked were inspired from many comments we’ve gotten on Instagram and podcast listener comments. Dr. Schlafly was completely unprepared for my questions, and I love how she answered each of them. She gives hope when many have given up any possibility of having a baby.
Dr. Jeanie Schlafy is a mom of two and is a holistic fertility specialist located in Denver, Colorado. Her program has helped countless families across the country successfully overcome their infertility challenges. Her contact information is provided at the end of this post.
Q: Many of our listeners are trying to conceive naturally, what advice would you have for them?
A: Lifestyle, lifestyle, lifestyle is very important. Stress. And I like to say stress resilience versus just getting the stress out of your life. Obviously, we must be real, we’re always going to have stress in our life, because it’s part of being a human being. It’s how we cope with stress and how we go from our bodies being in a sympathetic state, which is the fight or flight. Your sympathetic nervous system is like your heart rate is going and you’re anxious and you’re like, okay, you feel like you are overwhelmed and have so many things to get done.
We want to go to the parasympathetic state instead. A state where we’re rested, we’re relaxed and it gives our bodies an opportunity during the day time to relax. It is so very important. I love meditation and I’m relatively new to it, but it has helped my life tremendously. I like to stress that part with the couples that I’m working with. If meditation is not for you (it’s not for everybody), there are other ways to get your body in that parasympathetic state, whether it’s just taking a few nice deep breaths and being mindful of breathing in and out and a longer exhale. Even that will help your body transition into a parasympathetic state. Maybe it’s taking a walk out in nature if you have a few minutes or doing yoga. There are various options. Eating as healthy and clean as possible is very important. Sleep is a big piece. Hydration, definitely. Those are good ones.
Q: We have many women that can’t afford IVF. What would you say to those women?
A: I am finding more and more insurance companies are covering reproductive endocrinology, so I would say it’s worth a look into your insurance. You might be pleasantly surprised they cover more than you expect, or they cover almost the whole thing. I’m hopeful that it will change in our medicine and our way of treating patients that we look at root causes. Know there is something in between being with your OBGYN with Clomid and the recommendation to go to the reproductive endocrinologist. The reproductive endocrinologist will say your only chance is IVF, and it’s a very low chance. There’s a lot in the middle there. Looking at it from a holistic lens with a functional medicine approach to optimize both couples’ health. It’s so important. I’ve worked with quite a few patients who are going to the reproductive endocrinologist that want to optimize their chances of success there to have a family. That’s another piece of that approach. I highly recommend getting as healthy as possible before that to increase the chances of success.
Q: A lot of women have also mentioned low AMH. What would you say to those women?
A: AMH does not define you or your fertility is what I would say. We look at AMH, but we also look at FSH and your other hormones, like your day three labs are really important. If we see somebody’s AMH quite low but FSH fine, (comparing those levels in the twenties and then again in the forties) then we might tell her the chances might be a little lower of natural fertility because of her hormones. She might be perimenopause and her hormones are shifting a bit, but we have seen women with AMH test result levels below 1 that have gotten pregnant naturally. Your AMH does not define your fertility. I’ve repeatedly seen AMH levels that have increased, which is amazing. We’ve seen that number rise and we’ve seen people get pregnant with a very low AMH level. Again, it’s not just the AMH level we look at. We’re looking at the other hormones. If a person is perimenopause, it’s much more challenging to conceive naturally, and other times it’s not possible hormonally to work. With Western medicine, we have not come up with a standard group of AMH numbers for each age range. We see a huge variation in all women. If somebody has PCOS, their AMH is going to be quite a bit higher because many times they’re not ovulating, so they have a larger egg reserve which means their AMH is going to be higher. It doesn’t necessarily mean they have good quality eggs. If their hormones aren’t lined up, then it doesn’t matter what their AMH is if they’re not ovulating. I would just like to advise people, don’t put all your eggs into the AMH basket because there’s so much more to your fertility than just your AMH.
Q: How would you help somebody if they aren’t ovulating or even have a cycle at all?
A: We would do what’s called a progesterone withdrawal. We would start progesterone and then do a withdrawal bleed. Sometimes a person’s cycle will start to regulate from that. Then other times, it’s looking at all those lifestyle pieces and changing that with maybe doing the progesterone piece to see if we can get the cycle going again. It depends on the root cause. I love to go back to the root cause of why, why is the woman not having a cycle? Is she not having a cycle because she was on birth control for a long period of time? Then yes, there are things that we can do to help reset that. Is it because menopause has set in or is close to perimenopause, then maybe we might not be able to change that. Is it because of diet or lifestyle, even over exercising or just stressors on our body that’s why she isn’t cycling? Yes, most likely we can make changes to get the cycle to come back.
Q: What are your tips for improving egg quality?
A: So many things we can do to improve egg quality are going back to the lifestyle pieces. Oxidative stress is so hard on our reproductive system because we have cell turnover, meaning the eggs and sperm cells are just really susceptible to oxidative stress. Oxidative stress can come in many forms: It comes from toxins, it can come from air pollution, it can come from lack of good quality sleep, really any kind of stressors. Trying to change any of that for the better will help. Trying to look at the products in our house. I can tell the people I work with used to go to Target thinking, “Oh, okay. I’m at Target, not thinking anything about it.” Honestly, I went to Target and brought home toxic products. Just go through your house and look at the chemicals in all of the products. I like to use the Think Dirty app. You can scan the bar code, and it comes up with a toxic rating. It is good to keep your products to a four and under which are more clean. Are your products clean and if not, swap them out. We went through our house; it took a while to do all that. Even thinking about your cookware, you don’t want to use nonstick cookware because of the toxins that are heated and get into your food. Look at eating organic. As I had mentioned before, any other toxic products, like beauty products, it’s good those are as clean as possible. We live in a world that’s going to have toxins. There are some things we can control and others we obviously can’t. If we can change the things we can, that’s great. That’ll be helpful. Eating as clean as we can, getting good sleep, and listening to our bodies is wonderful. Movement outside is great, but we don’t want it to be a stressor. We’ve definitely seen over exercising as a stressor that causes oxidative stress that can decrease our egg quality.
Thank you Dr. Schlafly for sharing your story and answering our listeners’ questions! For more information on Dr. Jeanie Schlafy’s practice: