#175 | Optimizing Your Fertility at Any Age with Naturopath Dr. Aumatma

August 24, 2022

Dr. Aumatma is a holistic fertility expert who, through her own hormonal challenges, became impassioned about supporting and optimizing women's cycles and fertility irrespective of age. Today, she shares with us the three most common myths in infertility and fertility management, explains what tests we must do to better understand our hormones, and walks us through the key lifestyle factors, sleep, stress, and diet, and how they impact our fertility and conception. 


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I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Hi, my name is Dr. Aumatma and I am a naturopathic doctor certified naturopathic endocrinologist. And I specialize in fertility. And I'm so excited to talk to you both about what we can do to help women support their fertility.

We are very excited about this conversation as well, because it's really important to us to approach this from a holistic perspective, and to also speak about some of the myths and misconceptions around fertility and fertility treatment today. So why don't we begin there?

Yeah, absolutely. I think there are quite a few myths that are floating around. Either they they've just been like passed down and adopted by us as a society or we are actually like propagating them through media. So I think the biggest myth that I often am trying to coach my clients to let go of because it creates a block in their own mental, emotional, spiritual stuff, to stop believing that their fertility dropped off of a cliff at 35. And it's a hard one, like this one is so deeply ingrained, I believed it myself, when I was in my early 30s. I was like, oh my god, what am I doing cuz I should probably think about having a baby. So it really is, it's so deeply ingrained, I think that we're taught as doctors providers, we're all taught this. And then we like share it with our patients, and we freak them out. In reality that myth actually generated was generated in the 1800s in France, where churches found that women were not coming to baptize their children after the age of 35. Now, if you think about what was going on in the 1800s, were there women that were having babies at 35? Like, we were just choosing different lives back then, if we were even alive for that much longer after 35, you know,
somehow, after 35, we were no longer fertile. But what you're saying is women were simply choosing not to have babies that late because that wasn't a thing back then.

Yeah, for many reasons. Like if we started our fertile years at 14 1518, in the 1800s, which was probably true, I haven't like tracked this all down. But I imagine the 1800s were pretty like, traditional, and we were getting married early and having children early. And that was the thing to do. And women weren't opting to choose to wait till they were 35 or 40. to even think about having kids, which is the reality now. And there are so many things that are just simply said and repeated. It's just classic rhetoric, and no one stopped to say, Hey, where's actually the data on us? So this is just one of those things.

Yeah. Yeah. It's one of those things and similarly, like, once you're pregnant, oh, you're geriatric because you're over 35. Like just all of it is so antiquated. And what is it based on? So in in current times, there are studies that are happening, they're very small scale, and I've heard where reproductive endocrinologist poopoo it because it's a small scale study. And I'm like, well, at least there's a science behind it. So what some of these studies have found is that they've studied groups of women between the ages of 25 and 29, and 35, and 39. And what they actually found is that there's a 3% decline between those two age groups. So 35 to 39 has a 3%, lower chance of conception, then the 25 to 29 age group. Not a huge ordeal in the grand scheme of things. But we've like psyched ourselves out. And then we like put so much value in this in this ideal that I've had people come to me and say, Oh, I'm 32. And my doctor told me that it's my age. I'm too old. And that is why we're not getting pregnant. And not once they check, check the guy sperm. Not once did they do a thorough workup on him and I sat down, talked her through all nine of her IVF cycles. And I was like, this has to do with the guy like every single time the sperm interview went through nine. One time they check the sperm through all that they check the sperm for count, motility, morphology, the basics, but there's something called a DNA fragmentation study, which if you failed a few IVF cycles, really, that should be the next step. So he never had that checked. So we want to know is the DNA damaged? Is the sperm like putting out bummed DNA, which is then causing these eggs to not fertilize and make it two day three day five blastocyst, which is when they would do the implantations?

Is it correct that around 40% of fertility issues are related to the sperm? Is that the right number? Yeah, it's it's I like women are taking 90% of the brunt of the problem.

Absolutely. So the second myth is that we're going to walk in and walk out of an IVF clinic with a baby. Right? So there's this, this idea that, Oh, if I struggle with fertility, I'll just walk into the clinic and they'll give me a baby and I'll walk out. And in reality, like, why do we not talk about what that actually what that journey actually looks like? And the fact that most IVF clinics success rates are based on six IVF cycles. So if a clinic says, Oh, we have a 38% success rate in your age range with with your labs, that's based on six cycles that you've done with that clinic over and over and over again. So you've exposed yourself to those hormones six times, you've taken 150 shots with every single cycle 150 shots with every cycle, it's every six shots, give or take 50 shots in a month? Yeah. Oh, my gosh, I had no idea that women go through that much. Yes, it's all the women receiving them. So the woman receiving all the shots, right?

It's always it's all focused on the woman. She's the one receiving all the shots. Oh, my gosh, I had no idea. There were that many. Okay, it's a

lot in six cycles. Can Can you do cycles back to back is that six months, or is that over most several years, it's, it's usually going to be broken in, you want to give your body a little bit of a break. So they're probably not going to go back to back if, like the most it would be would be like every other cycle. Like do one cycle, take the next month off, do the next cycle, take the next month off.

So a minimum of a year to have a 30% success rate. Correct.

And I want to ask you why this is an important myth you feel we need to debunk what is it that expectations get off and and that causes more depression or suffering or what's going on? Well, it's not so much that it's it's partly that we we put so much trust in this one approach, right? Like we put all of our eggs in that basket, literally. And the rates of success are so skewed by the time a woman gets to 42. The success rate goes down to 3%. That goes that seems like it would support the age myth all over again, though, how can you reconcile the fact that age doesn't reduce fertility, but in the case of IVF, it does well, because IVF is not the gold standard for our fertility. Right.

Right. And also, I guess that means that that's the woman who, whose IVF didn't work all the previous years. So you're already looking at someone who has a greater fertility challenge than the average population. Okay, yes, there is a correlation between fertility and age. We can't say that there's no correlation, right? I mean, at this point, it does become more challenging. You're, we're just saying that it's not 35. And it's not like your fertility is perfect between 25 and 35. And then it falls off a cliff. Right? There's there's not that, right. It's not a clinical there is there is an age, there's definitely a component of age. But in my belief, it's not just that we're aging, right? It's not the fact that you had another birthday that you're suddenly like, less fertile than you were last year. It's everything you did up to that point, it's the fact that you're super stressed out, you worked 80 hours a week, you didn't take care of yourself, you didn't do all of the things that would support your fertility. So now you get a year older, quote, unquote. And all of those things are working against you. It's another year that you've been exposed to toxins, it's another year that your ovaries just struggled and did whatever they needed to to survive, but not necessarily thrive.

So a 40 year old could have better fertility than a super stressed out overworked, exhausted 32 year olds.

Absolutely, absolutely. So when we start disconnecting the age from our fertility, right, like if we could disconnect this idea that our age is what causes fertility or infertility, and really go to what are the actual factors like how could I do this differently? In in my opinion, I think it's a way better, way more effective assessment to do testing. And this really brings us to the third myth, which is in in on average, women are expected to wait 12 months if they're under the age of 35, or six months, over the age of 35. To get hormones tested, to assess whether or not they're going to struggle with fertility.

Let me ask you a question about this. Yeah. Are you saying that basically, everyone who wants to have a baby for a step is going hormones? Yeah, I think she, I think unless you're coming into it, if you're coming into it not feeling concerned, you are mostly seeing people who are feeling concerned about yes or no, you know, your hormones are not stagnant, right? Like they're not going to stay where they are forever. There are lots of tools that we have to like, shift and rebalance hormones. So your hormones are not the end all be all, but they're giving you information. They're giving you very logical pieces of data that you can then say, Yes, I need to take action, and I need to be more assertive about the action that I take. Or, actually everything looks great. Let me not stress myself out. Let's just wait and see what happens. Let's talk about what tests these are. There are four tests that are vital to understanding the basics of what's happening with fertility. Those four tests are follicle stimulating hormone, FSH, estradiol, luteinizing, hormone, LH, and anti mullerian, hormone Hmh. Now, these four will give context and information about what's happening with fertility. And if you're doing these tests, talk to someone about what those mean, or we have a cheat sheet we can point you to on our website that you can download for free to help understand what all of these numbers mean.

And women can get these tests through their gynecologist, they can get them through their gynecologist that gynecologist might say No, that'll be a very expected answer. If they haven't been trying to get pregnant and not getting pregnant after a certain period of time, like we toured the six to 12 months, okay? So if you want to do if you if you are like, hey, I want those tests anyway, there are labs like modern fertility is a really popular one. You get a kit at home, you do a little finger prick, you get a test. Simple, it's like $150 Yes, you're paying for it out of pocket insurance will not cover it. But you have information that then gives you power.

So can you share with us the most common scenarios that you see when you do these tests, whether it's a low LH or high yesterday, or whatever it is, and talk us through some of the things that you implement and recommend in your work.

So, one of the most common scenarios is a low am eh, anti mullerian hormone low means that it's below one. This number is also an age, like based on your age. There's an optimal range for that number. So if you're over 35, one, or one to two is considered normal, if you're under 35, it could be like all the way up to four. If you have low Hmh, that sometimes indicates low ovarian reserve. So this is the hardest one, that number actually became popular because of the IVF. World. What they found was when women had an H below 1.06, they had a lesser chance of conceiving through IVF. They never said that this meant you were not going to get pregnant, however, a lot of doctors have converted it to, you'll never do this on your own, you should get an egg donor, you should do IVF very soon. And it becomes like a pressurized thing. If your aim each is low.

And aren't women also told that their Hmh is not able to be influenced that that number is fixed. We can't,

we can't do anything about it. But you're saying we can, we can Yes, we can't always. So I don't want people to like hear this and say, Oh, I don't have to worry about this number. For some women, it's a legitimate like reflection of how many eggs there are in the ovaries. If that is an accurate reflection or depiction of what's happening in the ovaries, there will be two other changes that happen simultaneously. The first is that FSH will start to rise. And almost simultaneously, LH is going to start to rise. If that's happening, if your aim H is low, and FSH is high, then we have actual reflection of, Hey, your ovaries might be running out of x, possibly, in this case, we have several rabbit holes to go down. First is you might have an autoimmune condition that's causing M H to be low and FSH to be high. If that's true, it's actually very, I'm gonna say treatable, but it's very like you can rebalance this. And the way to do that is you can look into like an autoimmune protocol, that's a specific diet that you can be on for autoimmune conditions. That's a really great starting point. The other pattern that happens frequently is Hi Esther dial, it can be high in on that, like preliminary test that we did through the bloodspot. Or you might have symptoms of high estrogen in the latter half of your cycle, like PMS is a symptom, painful menstrual cycles, spotting, all of those can be the picture of too much estrogen, not enough progesterone. If that's the case, then what I usually do with our clients is something called a Dutch test. That is a test of what's happening at every point in your cycle with estrogen and progesterone, we get a whole map for a whole month, and we're able to see, oh, estrogen peaked at cycle day 12. And then it didn't actually go down, it stayed high. Your progesterone never got over that hump. And that is why you have what we call estrogen dominance. And I'm putting that in quotes because that word is getting so overly used. Estrogen dominance can be a thing. The other part of the Dutch test is how is the estrogen detox out of the body. And that process is there's three phases of estrogen detox. So what a lot of people have learned or heard on the interwebs is dim is going to support estrogen detox. And that is true, only if you have a specific issue with Phase One detoxification. If you don't have a phase one issue, then what dim is doing is actually over stimulating that phase one, but you don't have phase two and phase three working. You're basically creating a block that creates this more inflammatory estrogen.

Can you clarify for our listeners what dim is because most people aren't going to know so it stands for dye in dull methane and it's basically a broccoli extract and it up regulates this one part of the pathway. The problem comes when you don't need that one part of the pathway up regulated, right and a lot of women don't. A lot of women come in and they actually that part is working fine. Phase two and three are not working. So the best thing I I think the safest thing to do for estrogen detox. If you We're doing this on your own would be to support phase three, which is in our gut. So that gets supported with a good diet, lots of fiber, fiber will bind excess estrogen and pull it out of the body. And probiotics, it sounds super, super basic right. But those three things are actually the safest way to support getting rid of estrogen. If you have a defect in phase one or phase two, you need to know which phase you have the detail defect in to know which supplements to take for that issue. So getting way more targeted about how to get estrogen out is really important.

So this all makes it very clear why it's really important for a woman to be working with a provider because it's very specific how we kind of manipulate, understand what's happening in the body and manipulate the hormones. But just from like a bigger picture perspective, what can women do to ensure that these hormones are all balanced the way they need to be? Or maybe they're just slightly off? Like, what can we do to prevent them from getting out of out of balance? Or if we just feel we're slightly imbalanced? Like, what are the main contributors to imbalance? And what are the like key three steps we can do to get them in balance? Again, I love that question. Because I think we should all be doing this all the time. So the first I feel like the first foundational building block is sleep. And a lot of us don't prioritize our sleep. I can say this for myself, like I haven't valued myself enough at certain points in my life to sleep well. Right. So optimize your sleep, make sure you're getting the right number of hours for you, which is usually be somewhere between eight and nine, sometimes 10 hours. And then really making sure that when you wake up in the morning, you feel rested. And you're ready to function in your day without caffeine. That's the indicator of whether or not you got good sleep or not. And then you can get super sassy if you want to be like aura ring and like super biohacking all of it, get an aura ring. So Sleep sleep Sleep, that is the foundation you have to get sleep asleep will make your body more stress resilience. So we talk about like, Oh, I'm so stressed out or stress affects fertility. Absolutely. But what are you doing to antidote your stress? Sleep is the biggest component of that. Second is stress support. I often find that women and men actually will say, Oh, no, I'm not that stressed. I'm fine. And then I talk to them about their life. And I'm like, There's no way you're not stressed. And we can test it to know for sure. But I feel like almost everybody is stressed.

People actually get addicted to their stress, and they don't know how to be without it. And that's why they think they're fine, because they're actually addicted to that adrenaline that yes with being stressed. Absolutely. Miles wreaking havoc on their body. And when you're stressed, you're losing stress impacts your progesterone Correct. Like it steals away from building that progesterone, which is the first hormone to start dropping off. Yeah, we're in our 30s or whatever. Yeah, yeah. And so stress just really accelerates that process. Yep, absolutely. So So first stress, there are two things that I think are relatively safe for everybody to be on. And that is a good quality B complex. And magnesium.

Do you recommend that people are on a B complex with methylated folate? Or does it not matter?

Yes, it matters, it matters to the person who needs it, but do you just want everybody to go on that so they don't have to do that additional test? Or?

Yeah, I think it is wise, I feel like folic acid is really not good for anybody. So the alternative is a methyl folate and methylated B 12. And I think that it's like opposed to having folic acid which is made in a lab and methyl folate, which has to be extracted from vegetables to actually get it in that form. I would choose the the natural extract right so that is a big plus folinic acid is also okay and sometimes companies will do a combo of methyl folate and folic acid. Folic Acid also comes from vegetables. Those two are good. So that's a good actually a good way to say hey, this is a good quality supplement or not. If it has folic acid, probably not a good quality supplement.

What are the benefits of taking a B complex?

B complex, so B vitamins are required in every Part of our hormone production and neurotransmitter production, and those two are gonna keep us a our hormones in check and be like just feeling good, right? Like anxiety, depression, all of that can do a certain level not for everybody but to a certain degree can be supported and and prevented with negativity by being on a B vitamin, right. And when we're stressed, we're flushing through our B's faster, B vitamins are water soluble, so they're not getting stored in our body. If we need them, we use them up. And sorry, we don't have any more, we're not doing the work that we need to do. So B vitamins are cofactors, and every single pathway in the body, and magnesium is the same essential cofactor in every function of the body. And the problem is that our foods are depleted. Yes, we have sleep stress, what's the third?

The third is, I would say fruits and vegetables. But I'm going to change that to mostly vegetables. Eating lots of green leafy vegetables in particular, and you're getting a lot of the same things, you're getting folate, you're getting magnesium from leafy greens, but trying to get a variety of 30 different plant foods in a week. That's a nice goal to have. And that spectrum actually gives you an array of vitamins and minerals from all of the different foods you're eating. And it gives you kind of the the foundation for antioxidants. So you're gonna get loads of antioxidants from all fruits and vegetables, but your vegetables are going to give you really important minerals, which are cofactors, and a lot of processes and give you antioxidants, which support the quality of your eggs over and sperm over the course of time. So you're helping to negate some of the the impact of the environment, like we're not going to live in a bubble, we're not going to be free of toxins. But if we can help to negate all of the toxins going in with some antioxidants, that's a really great thing to do. And then I would say almost simultaneously or mirroring that is d detoxing our environment. So makeup products, health and beauty aids. The it said that an average woman walks out of the house or gets on Zoom these days, with 123 chemicals being applied to her skin in the morning. So between our hair shampoo, conditioner, soap, makeup, the water we drink, like just assembly, I love it.

I heard a great one years ago, I went to this fantastic talk on toxicity. And the woman said that the average American woman she used the word consumes five pounds of lipstick per year, because it goes right you know when your whip when your lipstick wears off, as long as it didn't come off, you know, on your on your glass when you're drinking, it disappears because it gets absorbed into the organ of your skin and goes right into your bloodstream. And that's a very compelling takeaway that you look at lipstick and think do I really want all of that in my bloodstream than what what's in my lipstick. And the word fragrance is a catch all for 1000s of toxins. And this isn't regulated in this country. And the 1100 chemicals that are legal here are illegal in the EU. You know, you have to take more responsibility for your health in the United States. And easy way to do that, especially for a woman who tends to wear makeup is to wear very simple things or just much less makeup.

Oh yeah, you can do less or you can. I'm like super pro makeup, as you can tell. But I I have switched out every single product for like actually clean makeup. And I stressed the actually part because there are a lot of brands that say that they're clean, and then you like dig in a little bit more. And it's not actually because it's not regulated. They can say whatever they want. It doesn't mean anything. Yeah,

there's a great website and app I believe it's called Think dirty. Yes. And you can put in any product that you're interested in and it will score the cleanliness of it. Yeah. What are some other easy ways to reduce toxicity right in the household?

Plastic getting rid of plastic. And we didn't talk about the men have in this equation, but male fertility is massively on the decline. It said that if we keep going at the rate we're going we're gonna have completely sterile men in 20 years. Sterile like zero sperm. So the biggest component of that I think it's plastic and And the consumption of plastic is happening on. It's like our containers, it's the stuff that we cook in. It's the stuff that we're storing our food in the water bottles, all of that. And then like the micro plastics, which are kind of scary non grata plastics are in our toothpaste like why is there plastic in our toothpaste I don't understand. Those like microbeads are actually plastic. That's how they make those microbeads grow. So anywhere that we can eliminate plastic is going to be pro fertility.

Can we talk briefly about exercise and how exercise is obviously very important for supporting fertility but it is also harmful if you are excessively exercising. So yeah, there are optimal ways to exercise during our menstrual cycle. So different phases should probably have different types of exercise. In general, the first half of your cycle, more intense exercise the second half of your cycle, less intense exercise, and that's regardless of whether you're trying to conceive or not I would just say like this is in your power. I truly believe that unless there's a genetic component of why we're not able to conceive that we are designed for this and that the cycle is our fifth vital sign and if we use it in that way we have the option to course correct every single month thanks for joining us at the down to burst show. You can reach us at downriver show on Instagram or email us at contact at down tuber show.com all have Cynthia's classes and Trisha is breastfeeding services are held live online serving women and couples everywhere.

Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit down to birth show.com/disclaimer Thanks for tuning in. And as always hear everyone and listen to yourself so I like did did all the research and that's kind of how I got into the fertility world was oh, I just couldn't believe all the garbage that we were feeding people and the garbage that I had learned in school that I had to unlearn to really like shift how we approach fertility and that's that was initially like I started talking about it with women your naturopath at the time. Yeah, yeah, I was a naturopathic doctor for five years into that and and it was like a massive turn in my the way that I like saw women and was working with women. It was like everything turned inside out at that point.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.

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About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

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