Welcome to the Brilliant Fertility Podcast. I'm your host, dr Katie Rose, and this podcast is to help illuminate the path ahead of you. With expert interviews, clinical pearls and real client success stories, my intention is to bring you hope for what's possible on this journey and to give you tools and resources to navigate the ups and downs on the road before you. If you find this podcast helpful, don't forget to subscribe on your favorite listening platform. And I have a big request If you have a minute, can you leave us a five-star review and let us know what did you learn? What did you come away with? Did you leave with that spark of hope? This helps more people like you find the podcast. My mission is to support as many humans as possible on their path to become parents, and by you sharing and subscribing, you're part of that mission too, and I'm so grateful for you for being here here.

Welcome back to the Brilliant Fertility Podcast. This is our final installment on fertility testing, at least for the time being. Goodness, it is May somehow, and depending on when you're listening to this, at least gosh. We have so much going on in life right now. My kids are officially on summer break. We all just got over COVID. We're in the final stretch of construction on the new building for our practice and I think sometimes you know, in the middle of all of that it may be hard to step outside of it and see everything that's going on and give yourself grace. So I am trying to give myself a lot of grace and a lot of space for nervous system regulation, even in the small moments. But I'm still just an immense gratitude for all of you who are listening and all of you who have stuck with me through this transition of getting this building ready. For those of you who are local in Tucson or in Arizona and have traveled to see me, I just am in very deep gratitude for you.

So, with this conversation today around fertility testing, we're going to be diving into some of the functional medicine tests that we can utilize and, just as a disclaimer, I want everyone to know that there's really no way to comprehensively cover this in a podcast, because these conversations have to be individualized. You could have two people with the exact same diagnosis, for example, endometriosis but they have completely different underlying factors that contribute to that picture that need to be looked at differently. So I think the biggest takeaway from this entire series of fertility test conversations should be that you are unique and your approach should be customized to you as the unique individual that you are. So I do want to make sure that we cover some of these types of testing, and especially the ones that I find value in, because I do see a lot of content on social media, especially basically guiding people towards tests that I have not found much value in either. So there may be some controversial takes here today. So I want to reiterate that for any test we run, I am asking the question will this test give us anything that will change what we're doing? Are the results of this test going to change our plan and, if not, why are we testing it Now?

Sometimes that answer is going to largely depend on whether the practitioner has knowledge of something deeper. Who hasn't done any education in nutrition as it relates to fertility, they may tell you oh, nutrition has nothing to do with your fertility status, and we know, for those of us who have had hundreds and hundreds of hours in nutrition training, that that's bogus, that nutrition absolutely influences your fertility status. So that question, I think we also need to relate to who's asking it as well. But let's dive in. It's really important that I think we cover some of these so that you know that there are some options to dig deeper, especially if you're sitting in front of a provider who's run the bare minimum and is telling you we don't know, you just need to go pursue IVF. It is a bit of a dilemma because largely people can be asymptomatic with the symptom of infertility being the largest presenting symptom, infertility being the largest presenting symptom and if there aren't other things that guide a practitioner towards testing, that's where you may have some of that denial in testing. So go back to our part two in this series so that you can better understand how to get the test that you need run. Sometimes that does mean just looking into working with a different type of provider.

Okay, and so I'm going to discuss some of the popular tests that you've likely seen as you've scrolled through social media, like the Dutch test or the GI map test. I'm also going to cover some tests that I haven't seen a lot on social media about but that I have found immense value in in practice. Have these results we treat? Based off of them, and then we see a change in picture, an improvement in menstrual cycles or pregnancy, getting pregnant, staying pregnant, finally, after years of infertility or recurrent pregnancy losses. That is where I find value, right? So if we actually see a difference in a person's health, in their symptoms and in their body's ability to conceive. So what are some of these tests and and really, what is it that I'm looking for? What am I trying to understand about the body?

There are five areas that I want to highlight. So one is adrenal function. It's really challenging to assess adrenal function on a blood test, especially a single blood test alone. Mitochondrial function A lot of times we can gauge, based off of someone's symptoms, if there is mitochondrial dysfunction. But there are actually some pretty interesting tests that can give us more clues about how to properly support someone's mitochondria inflammation, the microbiome and underlying infections. So these are areas where functional testing can give us a lot more information than just brushing a symptom off as, like well, you're not dying, so it must be normal.

So let's start with the adrenal function. I already mentioned it's really challenging to get an idea of adrenal function from a blood test alone, because it's just such a brief snapshot into someone's hormones and, you know, something stressful happens on the way to a blood test or the phlebotomist has to poke someone four times, then your stress hormones are likely going to go up and skew the results of that test. So I like to use either a salivary or a urinary collection kit that allows someone to collect multiple times throughout the day and give us a better idea of not only their circadian rhythm but their total output of those stress hormones. This is where a test like the Dutch does come in pretty handy. It's probably one of the better bang for your buck tests because not only gives you that over the whole day picture of your stress hormones, but also how you metabolize stress hormones. And while you're at it, you can also look at the ovarian hormones, your metabolism of estradiol, testosterone and some of the organic acid markers that can tell us about antioxidant status and methylation B vitamin status. So it is a pretty interesting test.

I do wonder if it's being overutilized in the health coaching community. I see packages where people are offering a Dutch test to everyone who walks in the door, and where I may differ in that approach is I will often wait to utilize the Dutch until we've addressed some of the low hanging lifestyle pieces that we can address. So if someone comes in and they are not sleeping well, they're eating a largely standard American diet, they've got a lot of inflammation. I'm not going to have them waste $500 on a test that is probably going to show us that they're inflamed and not methylating well and their body is stressed, because we have some changes that we can make first. So I often utilize the Dutch test when someone's symptoms don't match what they're reporting in their lifestyle. If they're already eating in a way that's very nutrient, dense and anti-inflammatory and they're sleeping well and they're still experiencing a lot of symptoms, that's when I will usually direct them towards using the Dutch test. But again, I don't heavily rely on it right out the gate because it's out of pocket and I'm really mindful, with all of these tests that are not covered by insurance, that we want to meet someone where they are.

So the next test is the GI map. I actually no longer utilize the GI map. I actually no longer utilize the GI map. I used it quite a bit earlier in my practice years and found that you would get a lot of people who were showing up as having these infections and then you would try to treat off of them and maybe even mess up their gut microbiome and not actually see a positive result. So this has been an evolution of practice and I am cautious about how I approach this. I would highly advise anyone who has gut health issues to not only talk to their provider, but one of my favorite practitioners out there for gut health issues is Dr Nikki Deneza. She's also known as the gut microbiome cream. She has a great YouTube channel. She's done some a great debunking of these functional gut health tests like the GI map, and so for the last couple of years I've had some great conversations with Dr Deneza about these tests and in the sense she has validated so much of what I have experienced in practice when I used to order these. So I no longer rely on the GI map or some of these stool tests that claim they can show you exactly what's going on in your microbiome internally in the gut microbiome itself. I don't find a lot of value for that. For fertility purposes, however, gut health is important, and that is a completely separate conversation that we can have outside of testing.

One test that I do actually really like for understanding the microbiome is the tests that give us a better idea of the vaginal or the uterine microbiome. My favorite is Fertilisys. It's a testing out of Greece. Actually it's expensive, but I will say that the patients that I've had who have done this testing and we have treated based on this testing have gone on to get pregnant and stay pregnant. So it's one of the more expensive tests out there. I think it runs because it's you in Greece it's like 700 euros but it is extremely valuable because they are testing menstrual blood, vaginal discharge, they can do semen culture and there's so much value that can come from understanding the menstrual blood microbiome, as that relates to more of what's happening inside the uterus and the endometrial environment the vaginal microbiome and then the semen microbiome, because a lot of infections can be passed back and forth between partners and that's often missed in a clinical setting if people are asymptomatic. So that is one of my favorite tests. If we need to rely on a company that we can run through insurance MDL apologies, I actually can't remember what it stands for. Off the top of my head is a test that I've utilized in practice with my in-person patients, but the Fertilisys again is actually one of the most comprehensive out there for understanding the microbiome and whether there's underlying infections.

Now how about mitochondrial function and inflammation With the mitochondria? Often we will have someone experiencing some other symptoms, whether that's fatigue or brain fog or muscle achiness, and that can give us some clues about whether or not mitochondria need some extra support. Now we see a lot of people coming in already on high doses of CoQ10, theoretically to support their mitochondria, support their egg quality. But there's actually other cofactors that can be really important in supporting mitochondria as well. So this is a scenario when I highly suspect that there's an issue and someone's been trying for a while and we have already been utilizing good quality CoQ10, I don't want to miss an opportunity to support differently. So for this testing I like the Genova Metallo-Bulmex test. This is a kit that can be collected at home via urine. The urine is picking up the organic acids which are essentially metabolites of our cellular function. So as our cell metabolizes vitamins, nutrients, antioxidants, it will put out certain organic acids that tell us how well we're utilizing those, if we're getting enough of these cofactors.

I personally have done the metallobomics on myself. I found it very interesting and valuable. My unique situation was post-COVID. I experienced some menstrual irregularities, including short luteal phase, and I was also experiencing brain fog. So I suspected highly that there was some mitochondrial dysfunction occurring as a result of having had COVID, and that metallobomics test did pick up on increased inflammation and mitochondrial dysfunction and, spoiler alert, it wasn't CoQ10 that my body needed. So I was able to be much more targeted in what type of support I needed and recover more quickly as a result as well. So I do like that test. I've seen value in treating based off of the results that we get and it gives us an overview of not just the mitochondrial function but are there markers that show signs of increased toxin exposure, inflammation and overall cellular oxidation? So I find a lot of interesting markers in that test.

I mean, I am such a nerd. I actually really enjoy going through these tests and if someone has unlimited resources and they're just like money is no object and it's like this is fun because we really get to dive into these. But I also want you to know that you don't have to go spending $5,000 to run all of these tests when you also have someone who can do a really thorough intake and better understand how to target these tests towards the story that your body is telling. I'm just checking my notes to make sure I am not missing anything really important here, but I think I covered the majority of what I wanted to make sure I covered today in terms of how I utilize some of these tests, what I'm specifically trying to understand about the body by using these tests, and which ones have been of highest value for me in my practice, as always. If you found something valuable from this, please let us know.

I love when people reach out through Instagram, through email, to let me know what this episode gave them, and if you have a moment to pause and leave us a review, leave us a rating on your favorite platform. This helps get this podcast in front of more people like you who are looking for support, and I so appreciate that. I will say that I can't give individualized advice through email or Instagram, but I'm always open to your feedback. But I'm always open to your feedback and if you have questions, I can give you a direction on what the next best step might be. Um, but I can't give medical advice through those platforms, so just please be aware of that.

And in our next episode I'm super excited we are going to be covering one of our what I would call it one of our VIP case studies, which I'm just so thrilled to be bringing to the podcast, and in June next month, we'll be running our summer three-day fertility retreat, and so keep an eye out in your email. If you're not on our email list already, I will drop a link to our newsletter in the show notes for today so that you can make sure you're the first to know when we are enrolling for that three-day fertility retreat for the summer. That'll be starting June 12th. So have a wonderful rest of your day, and hopefully this gave you some insight into what other testing is available to understand your fertility and some of these underlying factors like your adrenal function, your microbiome and your mitochondrial function and inflammation.

These are all factors that can heavily influence fertility and there are ways to test and we have to be individualized about this. There's no cookie cutter approach that I would apply to every single person out there, so keep that in mind as you approach this. I know sometimes it can feel like you just want to test everything, you want to throw everything at the wall and see what sticks, but that tends to create more stress in the long run, right? So when we can get targeted, we can simplify, and when we can simplify, we can bring those stress levels down as well and create a lot more space for living life and enjoying life while you are awaiting your healthy baby, sending you so much love as always. See you next time.