Fertility and Gut Health

July 1, 2020

Hippocrates said, “all health begins in the gut.” And way before he said this, ancient medicines like Ayurvedic medicine, TCM, and indigenous practices throughout the world stated the importance of maintaining optimal gut health for overall health and definitely for fertility.

The theory of evolution places importance on reproduction yet about 12-13% of couples report difficulty conceiving or maintaining a pregnancy.

In our society, most of the blame is put on the female for infertility but about 40% of infertility in couples is due to male infertility. This only includes male infertility in terms of conception and does not include the percentage of men with poor sperm health that increase a woman’s risk of miscarriage.

This is why this article is not just for women. It is imperative for both partners to have optimal gut health when working toward a healthy pregnancy and baby. And for those who experience no digestive symptoms, don’t be fooled. An impaired gut does not always present with digestive symptoms and may present in other ways like infertility.

Women’s reproductive hormones and gut health:

The gut microbiome is responsible for converting bound estrogen to free estrogen and therefore with gut dysbiosis estrogen metabolism and function is impaired. This can lead to many hormonal imbalances like PCOS, endometriosis, fibroids, infertility, and more.

It has also been found that women with undiagnosed celiac disease have an increased risk of infertility. Currently we know about 1-4% of the population has Celiac and the majority of those are undiagnosed. And just like with infertility, you can have celiac disease without any digestive symptoms.

Men’s reproductive hormones and gut health:  

Standard American diet (SAD), lack of movement, chronic stress, sleep deprivation, and environmental toxins like plastic can lead to significant amounts of inflammation. Doing anything that can increase in inflammation throughout the body can lead to intestinal permeability (leaky gut) which allows an endotoxin, lipopolysaccharide (LPS), to travel from the gut to one’s bloodstream. LPS directly inhibits the Leydig cell and indirectly reduces Leutinizing Hormone (LH) drive therefore lowering testosterone production by the testis which results in a decline in sperm production and quality.

What can you do to optimize gut health?

  • Diet: Eat more whole foods and diversify your vegetables. I usually recommend trying to get about 7-9 cups of vegetables daily.
  • Water: Drink at least half your body weight in ounces. Avoid alcohol, store-bought juices, and soda. Limit carbonated drinks and coffee to 1 cup a day.
  • Exercise: The type of exercise you do may differ based on your health issues and body type but what has been researched to be most effective is a variety of exercises. Strength training, cardio, low-impact exercises like yoga, pilates, and barre are all great ways of changing up your exercise routine. For the ladies, you can check out my post on exercising with your cycle to optimize your hormones.
  • Sleep:  Prime restoration of the digestive system happens between 10 pm and 12 am. Ideally get to bed by about 10 pm. And if you struggle with falling asleep or maintaining sleep, it’s time to address that. Start by turning off all electronics (including your phone) and I’ll make another post on sleep hygiene with more recommendations.
  • Stress management: Chronic stress can literally affect everything and our gut is no different. We must have healthy stress management techniques that do not include alcohol, marijuana, TV, or social media. I’m constantly posting ways to relieve stress in a healthy manner on my socials. Follow me to get more insight.
  • Sunlight: Getting sun exposure helps optimize Vitamin D levels which is essential for gut and hormone health. It has also been associated with increasing testosterone levels in men. Redlight therapy has become a common practice and something I also recommend for optimizing testosterone levels and this therapy was created based on the red light emitted from the sunrise and sunset.
  • Supplements:
    • Prenatal vitamin: This absolutely crucial for fertility but make sure the prenatal has methylated folate because many cannot methylate folic acid and therefore actually becomes difficult to get pregnant if taking conventional folic acid.
    • Magnesium: Most people are not getting enough Magnesium in their diet and therefore its always a good idea to start supplementing to optimize gut health, hormone health, brain health, and more.
    • Vitamin D: Vitamin D is the precursor to our reproductive hormones and deficiency has found to be very common in those with IBS and IBD.
    • Other supplements should definitely be more individualized but can include things like Althea, Glycyrrhiza, Vitex, Shatavari, Tribulus, Yohimbe, and more. These are herbs I would recommend after doing extensive bloodwork, a stool test, and the DUTCH hormone test.

This is definitely just the start to optimizing your gut health and as I mentioned I prefer testing to see what exactly is going on so we can get to the root of your health issues.

If you’re struggling with unexplained infertility and believe your gut may also be compromised, schedule your complimentary call. I’d love to support you and your partner on your conception journey!

*Please note this article only covers information relating to fertility as it pertains to cis-gendered heterosexual relationships. For additional resources on fertility, please visit the following resource: Progyny


Colldén H, Landin A, Wallenius V, et al. The gut microbiota is a major regulator of androgen metabolism in intestinal contents. Am J Physiol Endocrinol Metab. 2019;317(6):E1182-E1192. doi:10.1152/ajpendo.00338.2019

Kaliannan K, Robertson RC, Murphy K, et al. Estrogen-mediated gut microbiome alterations influence sexual dimorphism in metabolic syndrome in mice. Microbiome. 2018;6(1):205. Published 2018 Nov 13. doi:10.1186/s40168-018-0587-0

Larsen, E.C., Christiansen, O.B., Kolte, A.M. et al. New insights into mechanisms behind miscarriage. BMC Med 11, 154 (2013). https://doi.org/10.1186/1741-7015-11-154

Lasa JS, Zubiaurre I, Soifer LO. Risk of infertility in patients with celiac disease: a meta-analysis of observational studies. Arq Gastroenterol. 2014;51(2):144-150. doi:10.1590/s0004-28032014000200014

Tabatabaeizadeh SA, Tafazoli N, Ferns GA, Avan A, Ghayour-Mobarhan M. Vitamin D, the gut microbiome and inflammatory bowel disease. J Res Med Sci. 2018;23:75. Published 2018 Aug 23. doi:10.4103/jrms.JRMS_606_17

Tremellen K. Gut Endotoxin Leading to a Decline IN Gonadal function (GELDING) – a novel theory for the development of late onset hypogonadism in obese men. Basic Clin Androl. 2016;26:7. Published 2016 Jun 22. doi:10.1186/s12610-016-0034-7

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  1. Lakshmi Kassetty says

    That’s a wonderful information. Which probiotic s are the best?? What is your comments on Nutrilite Probiotics??

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