Transcrição completa de Functional Labs for Fertility with Nora DeBora

fibroids? 00:03:43.080 --> 00:03:44.039 Are there polyps? 00:03:44.199 --> 00:03:46.199 Do you have a uterine septum? 00:03:46.360 --> 00:03:51.639 Is there is your uterus abnormally shaped, which might imply implantation? 00:03:52.280 --> 00:03:56.599 So conventional opium tube obstruction, which would, you know, where sperm can't meet egg. 00:03:56.680 --> 00:04:04.280 That's certainly exactly anatomically, we really need to understand and make sure like are our reproductive organs functioning properly? 00:04:04.439 --> 00:04:08.919 Is everything nice and open and receptive to um conception? 00:04:09.159 --> 00:04:12.599 And then on the flip side of that, we also have blood labs. 00:04:12.919 --> 00:04:20.439 So we go into the doctor and we tell them we want to conceive, and then they say, okay, well, maybe we'll run some um blood labs for you. 00:04:20.600 --> 00:04:22.360 Usually this is cycle day three labs. 00:04:22.519 --> 00:04:24.199 So period is cycle day one. 00:04:24.360 --> 00:04:33.800 On cycle day three, maybe you'll get tested FSH, LH, estradiol, prolactin, potentially TSH, maybe AMH, depending on where you are in your reproductive years. 00:04:34.120 --> 00:04:51.960 But it is very, very minimal and basic when it comes to understanding your body on a more, I guess, functional root cause level to give you the details and information that you'll need so that you can really start to optimize your health as best as you can as you plan or prepare for pregnancy. 00:04:52.120 --> 00:04:57.800 So, really traditional labs, you have some imaging and you have some blood labs that you can get done cycle day three. 00:04:57.960 --> 00:05:04.199 Sometimes they'll also give you seven days post-ovulation labs as well, maybe to test progesterone. 00:05:04.360 --> 00:05:05.399 But as we know, Dr. 00:05:05.480 --> 00:05:12.680 Susan, these are really just skimming the surface when it comes to understanding uh a little bit more about your health. 00:05:13.159 --> 00:05:19.399 I mean, any blood lab is a simple snapshot of that moment in time that the blood was drawn. 00:05:19.560 --> 00:05:23.960 And there's and what what the medical community does is make an inference. 00:05:24.120 --> 00:05:33.720 Well, if your FSH is indicating that your brain is having a hard time or having to work hard to uh stimulate those follicles, then therefore you probably have a problem. 00:05:33.800 --> 00:05:46.839 And then of course they add age as a factor as well, which you know it is a factor, but but there's I think too much um uh uh uh importance put on chronological age exclusively. 00:05:47.720 --> 00:05:56.920 Again, I'll I will repeat, age is a factor, but it is not an exclusive factor and it's not an exclusion to someone getting pregnant and staying healthfully pregnant. 00:05:57.160 --> 00:06:00.920 So then we have functional labs and and what what are they? 00:06:01.639 --> 00:06:06.199 Functional labs really help you understand what really drives fertility. 00:06:06.360 --> 00:06:13.319 And if you think about the word functional labs, it's really gonna help you understand how your body is functioning on a day-to-day basis right now. 00:06:13.399 --> 00:06:17.079 And functional labs can range from a variety of different tests. 00:06:17.240 --> 00:06:21.560 Now, we can look at blood labs and interpret them from a functional lens. 00:06:21.800 --> 00:06:30.279 So when we're looking at traditional blood labs, a lot of the time we're looking at these really wide reference ranges that we know are not really optimal for health. 00:06:30.439 --> 00:06:40.519 So when we're looking at blood labs from a functional lens, this range is really a lot more narrow to help us really find that optimal space of health that we want to be in. 00:06:40.600 --> 00:06:41.720 So that's number one. 00:06:41.959 --> 00:06:50.360 Number two, outside of functional blood labs, just understanding the range and then obviously testing a lot more blood labs, just in addition to what I had explained. 00:06:50.680 --> 00:06:53.480 Um, there are tons of other tests that could be done. 00:06:53.720 --> 00:06:56.839 And one of my favorites is understanding somebody's microbiome. 00:06:57.079 --> 00:07:04.439 So you can look at somebody's microbiome from a bunch of different lenses, the gut microbiome, the vaginal microbiome, and the uterine microbiome. 00:07:04.839 --> 00:07:10.040 So, you know, as we know, Susan, we are actually bacteria having a human experience. 00:07:10.439 --> 00:07:11.879 There are more bacterial cells. 00:07:12.199 --> 00:07:13.879 I've never heard it phrased that way before. 00:07:14.040 --> 00:07:14.519 I love it. 00:07:14.600 --> 00:07:15.720 Yes, we are. 00:07:16.120 --> 00:07:21.560 I I remember when I went to holistic nutrition school over a decade ago, they put it to me that way. 00:07:21.639 --> 00:07:24.920 And I was like, that is really cool to think about that way. 00:07:25.160 --> 00:07:26.519 I never thought about it, right? 00:07:26.600 --> 00:07:29.800 We actually have more bacterial cells than we do have human cells. 00:07:30.040 --> 00:07:33.639 So we are, yeah, but bacteria having this human experience. 00:07:33.800 --> 00:07:46.439 But um, so if we understand the bacterial colony with the microbiome in different areas of our body, because our skin has a microbiome, our mouth, we have an oral microbiome, in our nose, there's a microbiome. 00:07:46.680 --> 00:07:48.519 There's essentially microbiomes everywhere. 00:07:48.600 --> 00:07:58.600 And these colonies of microbiome microbiomes are gonna shift and be different on what is optimal, depending on the organ, the organ that it lives in, so to speak. 00:07:59.000 --> 00:08:05.480 So to understand the function of the body, you can do some functional lab testing to understand gut, vaginal, and uterine microbiome. 00:08:06.040 --> 00:08:09.959 You're not gonna get this tested, typically when you're going for traditional labs. 00:08:10.519

--> 00:08:18.519 Some other um of my favorite functional lab tests uh would be more comprehensive hormone reading through something called the Dutch test. 00:08:18.680 --> 00:08:24.680 I love to use this particular company or the company's precision analytics, and they run what's called the Dutch test. 00:08:24.839 --> 00:08:33.480 This is the dried urine test for comprehensive hormones, which is really going to help you understand your hormones from a much deeper picture. 00:08:33.720 --> 00:08:51.879 And it's not only gonna help you understand where your hormones are at a specific point in time, but it's also gonna help you understand how your body is breaking down and metabolizing those hormones, which can tell a much different picture from just only looking about looking at the hormone level, looking at the hormone level. 00:08:52.200 --> 00:09:01.960 So I just want to I want to put a pin in this because I uh want the the listening and viewing audience to understand that blood tests are testing what you're producing. 00:09:02.440 --> 00:09:10.519 Dried urine tests, the Dutch test, is testing the metabolites, which indicate how you're using what you're producing. 00:09:10.759 --> 00:09:15.000 And so it really it really is telling a very different story. 00:09:15.319 --> 00:09:16.120 Absolutely. 00:09:16.360 --> 00:09:29.000 And then from the comprehensive hormone tests, we're not only just looking at your estrogen, progesterone, and your androgen hormones, but we're also understanding and looking at what your entire cortisol picture looks like, the adrenal profile. 00:09:29.160 --> 00:09:39.240 We're getting some organic acid test markers, which can help us understand a little bit more about neuroinflammation, about oxidative stress in the body, about different nutrient marker stores. 00:09:39.399 --> 00:09:57.320 So it really does help kind of pull a full picture together and give you a lot of data points to really help you put a plan together and really help you kind of again get yourself to that optimal health or move the needle forward in your health, depending on where you are on the fertility journey and what you're dealing with. 00:09:57.799 --> 00:10:02.200 The data that your body is revealing helps give you the plan. 00:10:02.279 --> 00:10:14.279 I mean, it's basically saying, here's the problem, now let's lay out the plan to address the problem, not necessarily to just kind of throw spaghetti at the wall and uh and hope it sticks with all of the various supplements, et cetera, that are out there. 00:10:14.440 --> 00:10:31.320 Because if your body is not absorbing, for instance, then or if you're vitamin D deficient, or if your cortisol is high at the wrong times of the day, it's going to have an adverse effect downstream at the level of a healthy ovulation and therefore a healthy conception. 00:10:31.639 --> 00:10:32.039 Exactly. 00:10:32.200 --> 00:10:38.440 And I want to make a point there as well, because in my practice, I have seen hundreds and hundreds of clients over the years. 00:10:38.600 --> 00:10:42.600 And I would say most people coming to me are on a really long list of supplements already. 00:10:42.840 --> 00:10:44.200 And we know this, right? 00:10:44.360 --> 00:10:51.159 Like, you know, you're you're searching, you're doing all the things to, you know, figure out what you can to give yourself the best possible chance. 00:10:51.559 --> 00:10:53.399 And cousin Sally said, Oh, this worked for me. 00:10:53.559 --> 00:10:54.679 I started it and I got pregnant. 00:10:54.759 --> 00:10:56.279 So you're like, okay, I guess it's a good thing. 00:10:56.360 --> 00:10:57.080 I'm gonna add this. 00:10:57.480 --> 00:10:57.879 Exactly. 00:10:58.039 --> 00:10:58.759 I'm gonna add this. 00:10:58.840 --> 00:11:01.320 You're spending a lot of time, you're spending a lot of money. 00:11:01.639 --> 00:11:11.639 And, you know, while a lot of these supplements are still good and great, they're not necessarily the ones that maybe your body needs to help you, again, move that needle forward in your health. 00:11:11.960 --> 00:11:16.039 Susan, I'd also love to just share one thing before we kind of continue deep diving. 00:11:16.360 --> 00:11:27.080 When we're looking about, when we're looking at traditional and convention, traditional slash conventional and functional labs, I want to just provide a little analogy just to help kind of crystallize this in people's minds. 00:11:27.559 --> 00:11:46.440 Now, um, a lot of the time we hear of like that iceberg analogy, but I'd actually like to use the maybe analogy of let's think about kind of if you're looking at a tree and everything above ground, um, which is the trunk and the leaves at the top, you can look at that as maybe like conventional testing. 00:11:46.600 --> 00:11:52.440 This is gonna give you your basic blood labs, the basic imaging, sperm parameters, that's another conversation as well. 00:11:52.600 --> 00:11:59.799 But these are the kind of data points that we're given from our doctors, our conventional labs to understand our bodies. 00:11:59.960 --> 00:12:35.720 But then if we kind of step back and we like slice what's in front of us and we're able to look underneath the ground and we see all of these massive, beautiful roots, those roots really encompass, in my opinion, what really drives fertility, which is metabolic health, blood sugar balance, nutrient status, toxic burden, microbiome environments, um, nutrition, movement, all of these variables which are gonna be able to then give the tree what it needs to build and grow into its beautiful, most abundant tree. 00:12:35.960 --> 00:12:53.080 So on the top surface level, there we're getting those conventional, traditional labs, but really underneath in the roots is where we're gonna find those functional labs and all of those functional components that can really help us build this healthy, robust, beautiful tree that needs to grow and thrive for many, many, many years.

00:12:53.639 --> 00:12:55.480 And the leaves being the ovaries. 00:12:56.279 --> 00:12:57.000 Oh, I love that. 00:12:57.320 --> 00:13:00.759 And the follicles and the eggs and the fruit. 00:13:00.919 --> 00:13:01.799 Yes, indeed. 00:13:02.039 --> 00:13:02.679 Yes, indeed. 00:13:03.080 --> 00:13:09.159 Okay, so we've got so so it it sounds like you know a Dutch test is pretty is pretty much almost like standard. 00:13:09.240 --> 00:13:18.919 Like if you're coming in to see you, expect to do the Dutch test to do that deeper dive into your microbiome and and your hormonal testing. 00:13:19.000 --> 00:13:21.879 And oh no, the microbiome is is a is a gut test. 00:13:23.080 --> 00:13:24.360 Tell us about that gut test. 00:13:24.840 --> 00:13:25.159 Yes. 00:13:25.320 --> 00:13:27.559 So let's talk about the gut microbiome. 00:13:27.799 --> 00:13:30.759 So there's a couple tests that I love for the gut microbiome. 00:13:30.919 --> 00:13:35.080 Depending on the tests, there's going to be um different markers that are gonna be tested. 00:13:35.399 --> 00:13:42.120 But really, the gut microbiome, when we think about the gut microbiome, again, this is like the or the, it's like an organ in and of itself. 00:13:42.200 --> 00:13:45.320 It's the colony of bacteria that live inside of your gut. 00:13:45.639 --> 00:13:51.960 And when we look at the microbiome, we can think about categorizing the microbes into three different categories. 00:13:52.200 --> 00:14:05.000 The first one is kind of like the green light, the protective, beneficial bacteria that we want an abundant amount of, because this is going to protect us from maybe pathogenic bacteria that we won't want there. 00:14:05.159 --> 00:14:09.559 So we want to see that our protective bacteria is really high in an abundant amount. 00:14:09.799 --> 00:14:12.279 Then we have kind of like the yellow category. 00:14:12.440 --> 00:14:23.320 There's what's called commensal or opportunistic bacteria that, you know, they're okay if they're there, depending on how much of them are in there, which species are which species of them are in there. 00:14:23.639 --> 00:14:34.200 But if there is an environment where they can overgrow and you don't have enough of that green good bacteria, it can actually grow and thrive and then become pathogenic. 00:14:34.360 --> 00:14:44.919 And this is kind of like the red column of the um the bacteria, which is known as pathogenic, which creates what's called a diotic environment in the gut. 00:14:45.159 --> 00:14:49.480 We don't want to have too much of that yellow and red bacteria hanging out. 00:14:49.720 --> 00:14:53.480 We want really beautiful amounts of the green protective bacteria. 00:14:53.559 --> 00:14:55.080 I'm just using these colors as analogies. 00:14:56.200 --> 00:14:58.120 We all know, we all know that we all drive. 00:14:58.759 --> 00:14:59.399 Yes, exactly. 00:14:59.879 --> 00:15:00.120 Exactly. 00:15:01.639 --> 00:15:14.440 And so so if there is, for instance, a you

know, a too much of the um pathogenic bacteria or too much of the opportunistic bacteria, what is the consequence of that? 00:15:14.600 --> 00:15:16.120 What happens in the gut? 00:15:16.600 --> 00:15:17.320 Absolutely. 00:15:17.480 --> 00:15:30.840 So this is a great segue into what else the the stool test tests because it doesn't only test the microbiome, but it looks at all of the different markers in the gut, which can tell us if there is more systemic inflammation, a higher immune response in the gut. 00:15:31.000 --> 00:15:41.159 So if we have an elevated amount of pathogenic bacteria, depending on which one it is, some of them are more autoimmune related and can lead to autoimmune conditions down the road. 00:15:41.320 --> 00:15:45.960 But this can really create low-grade systemic inflammation in the gut. 00:15:46.440 --> 00:15:54.039 Again, if there's an overgrowth of fungus or candida, which can be pathogenically overgrown, this can also cause a little bit of leaky gut. 00:15:54.200 --> 00:16:14.759 So, really kind of compromising the lining of the mucosal cells in the small intestines, which can make those holes a little bit bigger, allowing for more pathogens and parasites or bacteria that we don't want to pass through into our bloodstream, which can create an immune response and have a lot of different side effects down the line. 00:16:15.000 --> 00:16:18.600 Everybody's body is going to respond differently and have different symptoms. 00:16:19.080 --> 00:16:24.679 So it really creates more inflammation and some gut dysbiosis and potentially leaky gut. 00:16:24.919 --> 00:16:25.240 Yeah. 00:16:25.559 --> 00:16:48.759 And so if there is inflammation in the gut, we can presume, anticipate that there will be inflammation in the body because because of the inflammation in the gut, and because of that, that inflammation is creating leaky gut, and because then therefore particles that should be too big to pass into the bloodstream, get into the bloodstream, that inflammation is not sequestered to the inside the gut. 00:16:48.840 --> 00:16:51.639 It is happening systemically throughout the body. 00:16:52.279 --> 00:16:53.080 Absolutely. 00:16:53.240 --> 00:17:01.720 And this then is going to impact your just your environment for creating healthy eggs and for having healthy hormones. 00:17:01.879 --> 00:17:08.360 There's so many nuances in different ways that all of this can kind of manifest as different health conditions down the line for an individual. 00:17:08.519 --> 00:17:17.000 But specifically for fertility, you know, really at the end of the day, fertility is an extension of your overall health, if we're really just thinking about it simplistically, right? 00:17:17.320 --> 00:17:26.440 And so that's why it's not just about let me take this supplement for improving my egg quality or let me just make sure my progesterone levels are good in my luteal phase. 00:17:26.599 --> 00:17:27.320 Well, guess what? 00:17:27.480 --> 00:17:37.480 All

of that is going to be an extension of how your systems in your body are working, including the gastrointestinal tract, which encompasses this entire microbiome. 00:17:37.960 --> 00:17:49.400 So the stool test, actually, amazingly enough, not only gives you the whole microbiome picture, what is pathogenically there, but it's also going to give you different inflammatory markers in the gut. 00:17:49.480 --> 00:17:56.039 So we can see if there is elevated inflammatory markers in the gut that you can't necessarily see from a blood lab. 00:17:56.200 --> 00:18:00.920 It's going to give us more information on if your immune system is ramped up in the gut. 00:18:01.079 --> 00:18:07.720 It gives you markers on digestion and absorption and how well or not so well your body is digesting and absorbing your food. 00:18:07.960 --> 00:18:11.159 It gives you pH, you know, it tells you about the pH in your gut. 00:18:11.240 --> 00:18:15.960 If you remember back to like grade nine science class, the acidity and alkalinity. 00:18:16.119 --> 00:18:25.559 We want there to be a nice sweet spot of, we want our stool to be um, you know, a nice sweet spot of acidic and alkaline, but not too acidic or not too alkaline. 00:18:25.639 --> 00:18:35.720 So all of these markers will really help us um pull together a plan, depending on what we see, that can really help um improve the individual's health. 00:18:36.200 --> 00:18:52.200 And and one thing about inflammation is I remember listening to a reproductive endocrinologist, in fact, share that we can see inflammatory markers inside the follicular fluid in which that egg is growing. 00:18:52.279 --> 00:18:55.480 So that's how how pervasive it is. 00:18:55.640 --> 00:19:01.480 It's not just in your gut, it's not just in your bloodstream, it's in that follicle that that egg is growing. 00:19:01.640 --> 00:19:21.319 And I think that for people who want to have children and are wanting and are and are you know ovulating this month, um, that that has a we have a responsibility then, therefore, to this egg, which will become an embryo, which will become a fetus and a baby, to uh not have that environment be so polluted with inflammatory chemicals. 00:19:21.640 --> 00:19:22.359 Absolutely. 00:19:22.519 --> 00:19:25.000 And another point, there's two more points that I want to make. 00:19:25.079 --> 00:19:30.680 One that's just gonna echo what you're saying, um, and then another one that I just don't want to forget about the pathogenic bacteria. 00:19:30.759 --> 00:19:32.519 So let me remember to say that after. 00:19:32.759 --> 00:19:46.920 But the um what we do know about follicular growth and develop development, the follicular genesis, the development of the egg that's gonna be released for ovulation, the entire growth phase is really about 220 days. 00:19:47.000 --> 00:19:48.039 It's pretty long. 00:19:48.359 --> 00:20:04.039 It's it's you know, there is definitely that three-month maturation period before it's released for ovulation, ovulation, that you know, nutrient stores and uh the environment in your body really um is gonna dictate the health and the robustness of the quality of that egg. 00:20:04.200 --> 00:20:09.640 But it's actually 220 days long, which is like almost seven to eight months. 00:20:09.880 --> 00:20:20.519 So if you think about the egg that you are releasing today, this is gonna be reflective of your health inside of your body, the environment in your body from the last seven to eight months. 00:20:20.759 --> 00:20:49.000 So this is why I think it's so important for anybody who's looking to start a family or um, you know, think about wanting to have children, especially if you are in your later reproductive years to really be proactive and start to think about these things, maybe do some of these tests, especially if you are dealing with symptoms and discomforting symptoms that you know you you can't you can't kick with, you know, drinking ginger tea or figuring out how to make your time and feel better. 00:20:49.240 --> 00:20:53.720 They're not one-offs, they're they're chronic, insidious, and and and it they need addressing. 00:20:53.880 --> 00:21:07.640 And I think this is how you and I see the so-called like miracles of someone uh being told egg donation was her only option to then falling pregnant naturally, not just once, but twice in her in her 40s. 00:21:07.960 --> 00:21:12.599 But I had an assignment was to was which was to remind you about pathogenic bacteria too. 00:21:13.240 --> 00:21:19.799 Yes, I do want to say this because I see this a lot, and um, and I'm I'll just call out some of these tests if you're okay with that. 00:21:19.960 --> 00:21:37.160 But there are um the uh some of the incredible things about some of the gut microbiome tests or the stool analysis that I should say are out there right now is when we're looking at pathogenic bacteria, and this also goes for the vaginal and uterine microbiome, so this might be a good segue, and we can like maybe move into that after. 00:21:37.480 --> 00:21:46.039 So I've put together a free 28-day detox masterclass that you can access by clicking on the link below. 00:21:46.359 --> 00:21:51.559 But when we are looking at different pathogenic bacteria, there are a lot of different ways that we can eradicate this. 00:21:51.720 --> 00:21:55.160 Most of the time we're we're familiar with taking antibiotics, right? 00:21:55.400 --> 00:21:59.400 You're you've got you're sick, you have an infection, take an antibiotic, it will go away. 00:21:59.559 --> 00:22:03.559 So, yes, we can't do antibiotics, but we know it kills out all the good bacteria. 00:22:03.720 --> 00:22:25.000 So if we're looking at the more holistic functional realm, and this is the way that we want to kind of move forward with our health or treat ourselves, then the stool tests that I offer from doctor's data, again, the comprehensive stool analysis or another one called the GI 360, if they see a pathogenic bacteria, what

they end up doing is they culture it in a petri dish. 00:22:25.319 --> 00:22:34.359 And then they will remedy it with a bunch of different remedies to see which remedy is going to kill off that bacteria. 00:22:34.759 --> 00:22:37.880 So we might be familiar, Susan, with like very efficient. 00:22:38.359 --> 00:22:38.759 Exactly. 00:22:39.160 --> 00:22:43.640 We know oil of oregano is really good for it's like a really good antimicrobial. 00:22:43.880 --> 00:22:55.160 And a lot of the times these are oil of oregano, black walnut, uva ursi, caprylic acid, these are all different antimicrobials that you can find in different gut uh supplements. 00:22:55.720 --> 00:23:06.359 But if we're not getting the right protocol or the right antimicrobial specific for that microbe that we're seeing, um it sometimes doesn't work. 00:23:06.440 --> 00:23:09.160 And I've seen this, I've seen this time and again across the board. 00:23:09.319 --> 00:23:20.920 So um anyways, I just wanted to know I think this is actually really important because oftentimes what what happens is that there appears to be an initial response of, oh, I think I got it. 00:23:21.160 --> 00:23:24.519 And then two or three months down the road, you're like, why am I dealing with this again? 00:23:24.599 --> 00:23:35.480 And it Reason is is that you did not have the right antimicrobial, you did not kill off that that you know that red or yellow or yellow bacteria. 00:23:35.640 --> 00:23:36.519 So exactly. 00:23:36.839 --> 00:23:38.039 And yeah, let's go ahead. 00:23:38.200 --> 00:23:38.359 Yeah. 00:23:38.440 --> 00:23:50.440 I was gonna say we can take it one step further and even just say when we have a lot of pathogenic bacteria, again, a lot of people become, let's say, if you're having chronic UTIs, chronic BV, um, again, this is all stemming from different bacteria. 00:23:50.680 --> 00:23:55.640 Um, when these this bacteria really wants to be able to live inside you, you're the host. 00:23:55.799 --> 00:23:58.039 It's like, I'm gonna make myself a cozy home here. 00:23:58.200 --> 00:24:01.400 So that bacteria will also lay down what's called a biofilm. 00:24:01.480 --> 00:24:07.480 And this is a very sticky, mucusy-like substance where it can be very difficult to eradicate that particular bacteria. 00:24:07.640 --> 00:24:18.119 So it's really important you find the right practitioner who understands all of this because first we have to disrupt the biofilm, then we have to go in and then kill it with the right antimicrobial. 00:24:18.359 --> 00:24:31.319 So there's a lot of different layers to all of this, but um different things that I I always like to be able to kind of share, share my knowledge because this is how I really see um the needle move forward with my clients in my practice. 00:24:31.559 --> 00:24:47.000 And what I will say is as complex as it may sound in this conversation, the actual treatment is not that complex and convoluted because you have done all of the work to understand the complexity and to treat efficiently. 00:24:47.160 --> 00:25:00.200 So I don't want people to think, oh my God, this is gonna take seven months to get ready, um, and because you've done all the all the hard work for the last 20 years in order to be able to provide the right protocol to that person. 00:25:00.359 --> 00:25:04.359 So let's segue, if you don't mind, because you had mentioned to the vaginal microbiome. 00:25:04.519 --> 00:25:15.799 Um, to and and how how do you see disrup disruption, dysbiosis in the gut microbiome, then therefore affect a dysbiosis in the vaginal microbiome. 00:25:16.440 --> 00:25:18.680 And I will say in the vaginal and the uterine microbiome. 00:25:19.960 --> 00:25:24.200 I will also share quickly a client's story on this because I think it will help crystallize it. 00:25:24.279 --> 00:25:29.000 But before I do, um, we know that the anus and the vaginal opening are are very close. 00:25:29.079 --> 00:25:32.200 They're connected by the perennium, which is not very long. 00:25:32.519 --> 00:25:46.279 And so, depending on how you're wiping, not even how you're wiping, but just wearing thong underwear, just just being a human, you are going to pass microbes from your bum into your vagina multiple times all the time. 00:25:46.519 --> 00:25:56.359 So when we're looking at the gut, uh sorry, when we're looking at the vaginal and uterine microbiome, so remember I was talking about the green good bacteria that we want in abundance in the gut. 00:25:56.599 --> 00:26:02.119 Well, one of those species, without getting too technical, it's called lactobacillus species. 00:26:02.279 --> 00:26:20.359 Now, in our vagina in our uterus, we don't want to have sorry, we only want to have a really high population of the lactobacillus species because this is going to keep the vagina and the uterine microbiome acidic and acidic enough to ward off pathogenic bacteria. 00:26:20.680 --> 00:26:27.960 So the gut mic, the colony of the gut microbiome and the good bacteria looks a little bit different from the vaginal and the uterine microbiome. 00:26:28.279 --> 00:26:30.039 And if we actually think about this, Dr. 00:26:30.200 --> 00:26:31.079 Susan, what was it? 00:26:31.160 --> 00:26:36.039 Only 10 years ago, um, like medicine thought the uterus was a sterile environment. 00:26:36.680 --> 00:26:47.559 This is really, really cutting edge and new research, which is I'm giggling because it's it's it's funny in hindsight that we ever thought that when I mean it's a human organ. 00:26:49.319 --> 00:26:49.799 Exactly. 00:26:50.279 --> 00:26:50.440 Yeah. 00:26:50.680 --> 00:26:57.000 It's so it's so, you know, this is still relatively extremely new area of research. 00:26:57.240 --> 00:27:08.200 And we know it takes how many, what, seven years by the time like research kind of gets to the forefront for like for for uh you know to get to the forefront to doctors to be able to prescribe prescribe to us. 00:27:08.359 --> 00:27:10.519 So

um nowadays we are really lucky. 00:27:10.599 --> 00:27:36.440 There's a lot of at-home um vaginal and uterine microbiome test kits that you can actually test at home, just like you're doing with the gut microbiome, to understand your full profile of what's going on in both of these microbiomes, looking at the good bacteria, looking at the bad bacteria, different STIs, um, there, and and really understanding the full profile so that again, depending on your case and your situation, you're really able to optimize this environment. 00:27:36.599 --> 00:27:44.200 Because at the end of the day, we know the uterus is literally where the embryo is housed and it's gonna hang out there and grow for the nine months. 00:27:44.440 --> 00:27:56.200 So we need to make sure that the environment inside of the uterus is robust and healthy enough so that we know that there's no, you know, again, low grade systemic inflammation if there's elevated levels of pathogenic bacteria. 00:27:56.279 --> 00:27:57.880 And same with the vaginal microbiome. 00:27:58.359 --> 00:28:02.759 So is it a different test for the uterine microbiome than it is for the vaginal microbiome? 00:28:02.920 --> 00:28:04.839 Can you describe the I can explain? 00:28:05.079 --> 00:28:06.119 Yeah, yeah, absolutely. 00:28:06.519 --> 00:28:10.119 I the vaginal one we know is a swab that you correct. 00:28:10.440 --> 00:28:16.839 You can you do the vaginal microbiome as a swab, and then the uterine microbiome you're actually testing through menstrual blood collection. 00:28:17.559 --> 00:28:23.160 And so um now you can get a biopsy if you're working with a fertility clinic. 00:28:23.240 --> 00:28:31.720 Um, a lot of the times, people listening who are maybe struggling and have been on a journey for quite some time, uh, you can get a biopsy to test for what's called endometritis. 00:28:31.960 --> 00:28:40.440 Endometritis is really, again, inflammation of the endometrial lining, which most of the time is caused by elevated pathogenic bacteria. 00:28:40.599 --> 00:28:44.440 But you don't necessarily have to go and get that uncomfortable procedure. 00:28:45.000 --> 00:28:47.240 We can test through the uterine microbiome. 00:28:47.400 --> 00:28:50.599 There's at-home test kits, screen me is one of my favorite ones. 00:28:50.759 --> 00:28:52.759 It is based in the UK. 00:28:52.920 --> 00:29:01.640 Um, we're just still, I think, on the cusp of getting some tests in North America available for like direct-to-consumer at-home tests. 00:29:01.720 --> 00:29:03.799 I just don't think there's that many available yet. 00:29:03.960 --> 00:29:05.319 No, so the one that I like to use. 00:29:05.640 --> 00:29:06.359 I shouldn't say the only one. 00:29:06.680 --> 00:29:11.000 The one that I tend to use for it's a vaginal microbiome test, it's called EVI, EVY. 00:29:11.480 --> 00:29:12.200 EVI is really good. 00:29:12.359 --> 00:29:17.559 Tiny Health has a really good one as well for they're very similar, the EV and the

Tiny Health as well. 00:29:17.799 --> 00:29:20.680 Both of those are beautiful, great at-home test kits. 00:29:20.839 --> 00:29:24.759 They also offer, you know, free consultations based on what your results look like. 00:29:25.000 --> 00:29:32.759 Um, and they're pretty good with also understanding this whole biofilm component, especially in the vaginal and especially in the vaginal microbiome. 00:29:32.920 --> 00:29:40.599 I get a lot of clients coming to me with chronic UTIs, chronic BVs, and chronic yeast infections that just do not resolve themselves. 00:29:40.759 --> 00:29:43.319 Like you said, they'll get resolved and then they come back. 00:29:43.480 --> 00:29:45.079 They get resolved and then they come back. 00:29:45.240 --> 00:30:02.839 And once we actually take the time to look at the full profile, because when you go to um conventional medical doctor and they do the swab, they're gonna test for pathogenic bacteria, but they do not look at the good bacteria and they do not help you understand what the protective bacteria looks like. 00:30:03.079 --> 00:30:10.759 So if you just keep killing off this bad bacteria with antibiotics and you're never repopulating, which means you're killing off the good bacteria. 00:30:11.160 --> 00:30:11.720 Exactly. 00:30:12.039 --> 00:30:13.559 It's just gonna keep coming back. 00:30:13.720 --> 00:30:19.799 You've got to make sure that you're really optimizing the environment and looking at this from this holistic angle. 00:30:19.960 --> 00:30:28.519 Um, because and and uh, you know, depending on the individual, I've had clients who have had chronic BV on and off for years. 00:30:28.680 --> 00:30:34.359 And sometimes we have to do two rounds of um treatment to get to where we need to. 00:30:34.759 --> 00:30:39.160 So so this is has been a conversation for the female body. 00:30:39.400 --> 00:30:41.480 What about for the male body? 00:30:41.640 --> 00:30:50.599 Because sometimes a disrupted uh you know vaginal microbiome is uh repeatedly disrupted by the male partner. 00:30:51.319 --> 00:30:52.519 Correct, exactly. 00:30:52.759 --> 00:30:55.400 So we can do there was one point actually, sorry, Dr. 00:30:55.480 --> 00:31:02.359 Susan, I just remembered, I wanted to just quickly plug in a quick client story because I think it will help pull it together here. 00:31:02.519 --> 00:31:04.599 So I recently had a client come to me. 00:31:04.680 --> 00:31:12.359 She's been struggling to conceive for quite some time, her and her partner, and she was working with a fertility clinic uh six, seven months ago. 00:31:12.599 --> 00:31:18.759 They did a endometrial uh biopsy and they found pathogenic bacteria in there. 00:31:18.839 --> 00:31:22.440 It was overgrowth type of candida, a certain candida strain. 00:31:22.599 --> 00:31:27.160 She took antibiotics and she decided not to retest, but she's still not pregnant. 00:31:27.400 --> 00:31:30.200 She finally came to me, we did a stool analysis. 00:31:30.440 --> 00:31:31.319 Guess what we found? 00:31:32.119 --> 00:31:36.519 We found that exact candida strain in her stool. 00:31:36.680 --> 00:31:48.119 And then remember, the stool, that particular test cultured the um that particular candida strain with different antimicrobials and antibiotics. 00:31:48.279 --> 00:31:52.119 And we found that the antibiotic that she had taken, she was resistant to. 00:31:52.359 --> 00:31:53.000 Oh, interesting. 00:31:53.880 --> 00:31:57.799 So now we were like, oh no, is it still hanging out there? 00:31:58.039 --> 00:32:00.440 So she might be doing a uterine microbiome test. 00:32:00.519 --> 00:32:04.279 So this is how you can see all of this kind of comes together and connects. 00:32:04.440 --> 00:32:12.519 And again, why doing the cult like the culturing and understanding of the antibiotic resistance is so important and part of that proper treatment plan. 00:32:12.599 --> 00:32:16.839 So I just wanted to plug that in because I thought it was uh an interesting story. 00:32:17.160 --> 00:32:18.119 Yeah, for sure. 00:32:18.440 --> 00:32:21.880 So talking about the semen, um, sorry, what was the exact question? 00:32:22.279 --> 00:32:26.920 The male partner, I mean the the the the frequency with which the male partner is reinfecting. 00:32:27.000 --> 00:32:42.119 Um depending on what is going on in the female partner, um, depending on the different uh pathogen that is there, yes, the male, if the male partner is not treated as well, he can absolutely continue to reinfect her. 00:32:42.279 --> 00:32:47.240 So it's really important that as the female gets treated, the male gets treated as well. 00:32:47.480 --> 00:32:56.759 And we also know that there, I don't do this too much in my practice, um, but there are also semen microbiome test kits where you can understand the microbiome of the semen as well. 00:32:57.000 --> 00:32:58.200 Okay, that's what I was getting at. 00:32:58.279 --> 00:33:11.640 I'm wondering if if uh I'm thinking of uh and I need to go look it up to see if this particular uh company that does semen analysis, including DNA fragmentation, if they will also if they also have a um the semen microbiome. 00:33:12.039 --> 00:33:12.200 Yeah. 00:33:12.519 --> 00:33:19.880 I know the company Screen Me that I use that's again based in the UK, they offer uh semen semen call semen microbiome testing as well. 00:33:20.039 --> 00:33:23.079 So yeah, I I don't do too much of that in my practice. 00:33:23.240 --> 00:33:27.640 Um I've done it a couple times, but I'm not as proficient as I am with all the other pieces of it. 00:33:27.960 --> 00:33:29.000 Sure, sure, sure. 00:33:29.240 --> 00:33:31.240 And and so that's a lot of testing. 00:33:31.400 --> 00:33:36.279 And so my I I imagine the listeners are out there saying, Do I have to do it all? 00:33:36.519 --> 00:33:38.039 Is it a sequence? 00:33:38.279 --> 00:33:51.400 Is there a point at which, you know, if we find something, you know, upstream with the with either the

Dutch testing or the GI testing that we feel like that we were complete and we don't have to then go further with the vaginal and the uterine microbiome testing? 00:33:51.880 --> 00:34:02.599 This is a great question, and I'm really happy that you asked it because sometimes I can just get into the weeds in my practitioner brain and I'm so obsessed with you know all of these little nuances that I love to just share and share and forget. 00:34:02.759 --> 00:34:06.839 Okay, we have to remember this can be a lot and overwhelming for those listening. 00:34:07.000 --> 00:34:21.880 So, and I think this is where, again, uh in my practice, when I do one-on-one fertility coaching, really it all starts with a very robust intake to really identify and understand what functional labs are necessary for you and your partner. 00:34:22.279 --> 00:34:24.359 We really have to look at the full picture, right? 00:34:24.519 --> 00:34:25.559 Where are you on the journey? 00:34:25.720 --> 00:34:27.079 How long have you been on the journey for? 00:34:27.239 --> 00:34:29.079 Have you been dealing with recurrent loss? 00:34:29.319 --> 00:34:31.079 Failed treatments, how old are you? 00:34:31.239 --> 00:34:32.119 What are your symptoms? 00:34:32.199 --> 00:34:33.079 What's your food diary? 00:34:33.319 --> 00:34:34.519 What's your health history? 00:34:34.760 --> 00:34:36.840 We've got to look at the entire picture. 00:34:37.079 --> 00:34:41.559 The way that I typically do it is I do my uh robust intake first. 00:34:41.720 --> 00:34:49.800 I look at their blood labs, I look at their symptoms, and then from there, I will help identify, okay, what's the lowest hanging fruit here? 00:34:49.960 --> 00:34:53.000 Um, you know, what the best bang for your buck, so to speak. 00:34:53.239 --> 00:34:53.800 Exactly. 00:34:54.039 --> 00:34:54.519 Exactly. 00:34:54.680 --> 00:34:56.920 Some clients are like, just give me it all, Nora. 00:34:57.000 --> 00:34:57.960 I want everything. 00:34:58.359 --> 00:35:05.400 Or most of the time, it's I say, like, I'm gonna be very intentional and strategic and decide which test is gonna be necessary for you. 00:35:05.480 --> 00:35:17.319 But again, if somebody is coming with chronic UTIs and BV and they've never done a full vaginal microbiome panel through the companies that we've been talking about, that will likely be one of my first priorities. 00:35:17.559 --> 00:35:18.440 Of course, of course, yeah. 00:35:19.079 --> 00:35:21.559 And so we can we can layer it too, right? 00:35:21.720 --> 00:35:24.680 Like I see clients and work with them for extended periods of time. 00:35:24.840 --> 00:35:40.039 So it can be quite overwhelming doing all of the tests at once, getting all of the results at once, and then having to do a protocol for all that because we know, Susan, it takes, you know, the body, first of all, the body is very adaptable, it's very smart, and it's very resilient. 00:35:40.280 --> 00:35:48.119 But also, if we're gonna go and start to

support it low and slow, low and slow is the way to go, and we have to be gentle. 00:35:48.360 --> 00:35:53.159 So, um, you know, doing this as a phased approach typically is the way that I like to do it. 00:35:53.400 --> 00:36:02.119 And I figure out what's the lowest hanging fruit first, go there, and then, you know, sometimes we realize they get pregnant, they don't have to do the other tests that we thought we were gonna do. 00:36:02.360 --> 00:36:02.519 Yeah. 00:36:02.760 --> 00:36:03.800 That was my next question. 00:36:04.519 --> 00:36:09.639 There's a conundrum here in that the the this population wants to get pregnant quickly. 00:36:09.880 --> 00:36:35.400 And so if sometimes they're concurrently going through IVF, sometimes, you know, or or they're beginning to work with us and they and they get pregnant, it is that at at what point do you say, okay, we're gonna hold off doing, you know, rigorous detoxification because you're pregnant and we're gonna do something a little bit, you know, more gentle using foods and you know, supplements that are safe during pregnancy. 00:36:35.880 --> 00:36:36.519 Absolutely. 00:36:36.679 --> 00:36:39.800 Well, I mean, ultimately the goal is to get and then also stay pregnant. 00:36:39.960 --> 00:36:51.239 I have a lot of clients who come to me with recurrent loss, and sometimes we actually say we need to take a pause on trying to conceive, especially if there is that recurrent loss that happens over and over again. 00:36:51.639 --> 00:36:56.119 The the definition of insanity is doing the same thing but expecting a different result, right? 00:36:56.199 --> 00:37:08.360 And so we really want to, I really try and be intentional with figuring out what is the best course of action to move forward here so that we can actually get you get you pregnant and keep you pregnant as quick as possible. 00:37:08.519 --> 00:37:13.719 And a healthy baby, yes, exactly what you want, not a positive pregnancy test. 00:37:14.039 --> 00:37:15.320 Exactly, exactly. 00:37:15.559 --> 00:37:24.920 So if um a lot of the times I do have clients who do tests and get the results and we see pathogenic bacteria, but then in the meantime they fall pregnant naturally. 00:37:25.159 --> 00:37:33.239 And so, no, we cannot do major detoxification or really potent antimicrobial herbs, especially early on in the first trimester. 00:37:33.320 --> 00:37:34.199 It's too risky. 00:37:34.519 --> 00:37:52.519 So, yes, at that point we will be working more with foods and you know, you know, gentle probiotics, different ways that we can really support the ecosystem as is and um you know, and just continue to do that and and hopefully the the female stays pregnant ongoing. 00:37:52.599 --> 00:37:59.719 If not, and they have a loss, then we will take that time to start to treat it and then they'll start they'll try again. 00:37:59.960 --> 00:38:06.440 I will sometimes uh if if a patient uh one of my first questions is how many children do you wish to have? 00:38:06.679 --> 00:38:19.559 And if she's you know 36, 37 and wants to have three children, then I'm actually wanting to support her going through an IVF process so that she can bank some embryos or eggs, whichever, which whichever is better for her. 00:38:19.800 --> 00:38:37.079 Um but I will say, you know, let's have you bank the eggs or bank the embryos, and then before we do a transfer with an embryo, that's when we have that time because you've you've literally suspended time with this with the cryopreservation of the embryo. 00:38:37.159 --> 00:38:42.360 Um, and certainly you've suspended more time if if you're freezing eggs and then you need to create embryos from that. 00:38:42.440 --> 00:38:54.039 So you can use that time to do optimize these more rigorous protocols so that by the time you're doing a transfer, you can really feel like, okay, you've you've created a new foundation. 00:38:54.199 --> 00:38:54.440 Yeah. 00:38:54.840 --> 00:38:55.320 Absolutely. 00:38:55.960 --> 00:38:57.079 Thank you for bringing that up. 00:38:57.159 --> 00:38:58.039 Yes, exactly. 00:38:58.199 --> 00:39:10.360 It's every every scenario is gonna look so different, but yes, it's really nice to kind of pull out these hypothetical situations because a lot of, you know, a lot of my clients are over the age of 35 and feel the same way, right? 00:39:10.679 --> 00:39:12.280 I want multiple kids. 00:39:12.440 --> 00:39:21.559 Um, you know, either we're looking to get pregnant naturally, like as soon as possible, or we're looking to freeze our eggs and then, you know, so we don't feel that that that pressure. 00:39:21.719 --> 00:39:25.320 Um and then how do we optimize for up for for transfer? 00:39:25.480 --> 00:39:26.440 Yeah, wonderful. 00:39:26.679 --> 00:39:37.880 So I've been I've been kind of interjecting because I'm I'm so interested in the conversation, and I want to make sure that my my ad libs are not having you miss any important information that you want to make sure you're conveying. 00:39:38.039 --> 00:39:41.880 Is there anything that you want to say as we as we get close to wrapping up? 00:39:42.039 --> 00:39:44.679 Um but but wait, there's more. 00:39:45.800 --> 00:39:50.840 You know, I think I I think I interjected all my, but wait, there's more pieces already. 00:39:51.000 --> 00:39:55.480 I really I think one of the big things is um is the antibiotic resistance piece. 00:39:55.559 --> 00:39:57.079 Uh, this is that and the biofilm. 00:39:57.159 --> 00:39:59.239 I think not a lot of people understand and know this. 00:39:59.400 --> 00:40:09.639 And um I just want you to know and understand if you are struggling with chronic issues that are not going away um through treatment with conventional care, then there are other options. 00:40:09.719 --> 00:40:10.920 There are other ways. 00:40:11.159 --> 00:40:16.760 And um, you know, I I just want all of those listening to understand that there's hope. 00:40:16.920 --> 00:40:17.800 There's lots of

hope. 00:40:17.960 --> 00:40:38.840 I've seen so many cases, so many cases of clients and couples and women coming to me with like low, low, low AMH people have been told um egg donor or fertility treatment is their only option, and we have gotten them pregnant naturally, or they've gone through multiple rounds of failed treatment, and then we've prepped them for that successful treatment. 00:40:39.079 --> 00:40:48.599 So, you know, I think the important thing is to tune in, tune into yourself, feel, you know, really at the end of the day, you are you are your own best health advocate. 00:40:48.840 --> 00:40:49.000 Absolutely. 00:40:49.719 --> 00:40:56.440 I would say tune into yourself, tune in to Root Cause Fertility Summit coming up in great plug-in. 00:40:57.079 --> 00:40:58.119 So many more pearls. 00:40:58.599 --> 00:41:00.599 We just covered functional lab testing. 00:41:00.679 --> 00:41:03.480 This this summit is going to be covering so much more. 00:41:03.639 --> 00:41:09.159 And I would also just add, yes, there's hope, and it's hope through science. 00:41:09.320 --> 00:41:12.360 This is not, you know, hope, a wing and a prayer hope. 00:41:12.440 --> 00:41:23.800 This is there's actual evidence to that we can help you improve your whole health, which improves your fertile health, which improves the health of your baby and your family and your future. 00:41:24.119 --> 00:41:24.840 Absolutely. 00:41:25.079 --> 00:41:25.559 Exactly. 00:41:25.639 --> 00:41:29.559 Yes, that's um that's a great way to end off the conversation. 00:41:29.880 --> 00:41:30.599 All right, then. 00:41:30.760 --> 00:41:32.440 So I think we will use this time. 00:41:32.519 --> 00:41:33.559 Thank you so much, Nora. 00:41:33.719 --> 00:41:36.119 This has been really, really invaluable. 00:41:36.280 --> 00:41:38.599 Um, listeners, viewers, thank you for your time. 00:41:38.679 --> 00:41:42.679 We know it can be uh held anywhere where there's so much vying for our time. 00:41:42.920 --> 00:41:52.039 If any of this resonated with you, all of Nora's information will be in the show in the show notes, including the um the summit to register for for the free free summit. 00:41:52.199 --> 00:42:02.679 Um, and then if if this resonates with you, or if you think of someone, know of someone, because we know one in five here in this in the states anyway, are struggling, share this episode. 00:42:02.840 --> 00:42:11.480 You know, you you could be doing the very singular singular thing that's going to help someone you know and love enjoy realizing the family of their dreams as well. 00:42:11.639 --> 00:42:12.679 So exactly. 00:42:12.840 --> 00:42:20.679 And thank you, Susan, for having, you know, um doing this podcast and for sharing all of this knowledge and education uh as well. 00:42:20.840 --> 00:42:35.079 Because I think the more of us that we can continue to spread and share the word, uh, the more, the more people out there can take this knowledge on, empower themselves, advocate for themselves, and and really fulfill their dreams of building their family. 00:42:35.400 --> 00:42:36.280 Absolutely well. 00:42:36.440 --> 00:42:38.519 And on I I think that there's nothing more to say. 00:42:38.679 --> 00:42:41.400 So we will just say once again, thanks for your time. 00:42:41.480 --> 00:42:46.119 Share and share like, and we'll see you at the Root Cause Fertility Summit. 00:42:46.360 --> 00:42:46.599 Yes. 00:42:46.760 --> 00:42:47.719 Thank you, Susan.