Fertility

Getting in the Family Way — A Physiological Approach

And as for you, be fruitful and multiply;
Bring forth abundantly in the earth
And multiply in it.” — Genesis 9:7

Preliminary Matters

It has been a while since my last post, and a lot has happened in the interim!

In the summer of 2025 I was called to the Bar in Ontario and got married. I’ve also started full-time as a lawyer practicing health, employment and labour law.

As a reminder, I currently have 35 articles up on my Substack - Maladies & Remedies, the vast majority being free (for example, my articles on ADHD, OCD, Asthma, Depression, Anxiety, and Insomnia etc.) with some being premium articles (for example, Brain Fog, UTIs, GERD/Acid Reflux and Motion Sickness). I have plans to upload many more articles.

Most notably, I will be finishing Part 3 of 3 for the '“Maintain Your Brain” series. So far, Part 1: ALS, MS and Huntington’s Disease and Part 2: Parkinson’s Disease are both up. Part 3 will be on Alzheimer’s Disease and Dementia.

Now that the preliminary matters are discussed, on to the substance of the article: Fertility.

Fertility

This article discusses fertility. Its focus is on how to conceive, rather than on best practices during pregnancy. However, in the future there will be a follow-up article regarding what to do while pregnant, so stay tuned!

When it comes to improving fertility in both men and women it is at least as important to avoid things that negatively affect fertility as it is to partake in things that improve fertility.

Things to Avoid

For instance, achieving an optimal hormonal profile requires avoiding harmful foods, substances, and practices just as much as adopting beneficial ones.

Optimal metabolism, including thyroid hormone production and conversion, is required to convert cholesterol into the various steroid hormones that are required for fertility, such as progesterone and testosterone. Thus, avoiding things that harm metabolism is crucial, as is doing things which support optimal metabolism.

Common metabolic “blocks”, as it were, include consuming excessive amounts of polyunsaturated fatty acids (PUFAs), which are commonly found in many foods these days. For example, canola oil, soybean oil, safflower oil and sunflower oil are cooking oils that are very high in PUFA (such as Omega-6 fatty acids) and are used widely in packaged foods and in restaurants.

Dietary PUFA causes (reversible) male infertility and androgen deficiency

PUFA can cause male infertility by inhibiting oxidative metabolism (OXPHOS)

Cholesterol and saturated fat are anabolic; PUFA/MUFA akin to chemical castration

Exposure to plastics is another major issue. Polyester/nylon/acrylic and other petroleum-based clothing should be avoided as best you can, and this type of fabric should certainly be avoided for undergarments that have direct contact with the gonads. Better fabric options for clothing and bedding would be wool, linen, organic cotton, hemp and even fabrics that are derived from different plants such as viscose, lyocell, modal and bamboo.

It is also important to drink and bathe in clean water. Lots of municipal water throughout the world is filled with harmful chemicals that will negatively affect fertility, especially when taking long, hot showers or baths. For example, municipal water can contain high levels of chlorine, which is not ideal to bathe in, especially when the water is very hot. Filtering the water you bathe in and wash your clothes and dishes in is therefore a good idea. The best solution would be a whole-house filter, but these can be very expensive. Another option is to install shower filters and use a bath filter and a water filter for the kitchen sink so that you can drink and cook with filtered water.

When it comes to drinking the best-quality water to avoid harming fertility (among other things), a reverse osmosis (RO) water filter under the kitchen sink is the best option. This is an especially good option if you get a RO with an add-on remineralizer option, which adds back certain minerals to the water like magnesium. RO removes many harmful contaminants in the water that normal water filters cannot remove, such as VOCs and PFAS (forever chemicals) and other harmful impurities that negatively affect health.

I anticipate many people asking whether a Brita water filter is sufficient, and my answer to that would be that Brita is supposedly good at removing certain chemicals from the drinking water, such as chlorine, so it is better than nothing but is certainly not a replacement for something like a RO filter.

Water filters can be quite expensive, and I want to stress that it isn’t necessary to use filtered water to be healthy and optimally fertile; however, it is an investment worth considering. This is especially the case for the water you drink and cook with. As such, if someone were to invest in only one type of water filter I would suggest a RO filter which at least means the water you drink and cook with is safe; bathing water is secondary.

Microplastics – known endocrine disruptors- found in blood, gonadal organs

In addition to the chemicals we get by bathing in unfiltered water, our body also absorbs many chemicals from what we put on our skin, such as perfumes and different creams/moisturizers, deodorants (containing aluminum, for example), shampoos, and soaps. It’s best to avoid these products if they have many harmful chemicals and substances in them, opting for more natural products is ideal. At the very least it is important to choose “less bad” products as opposed to picking perfectly healthy products. For example, getting aluminum-free deodorant and paraben-free shampoo.

I also want to mention that many “scented” products are quite harmful, such as scented candles and garbage bags. It is best to opt for beeswax candles, which may actually be beneficial to health (negative ions) as opposed to harmful scented candles.

It is also important to keep stress low when trying to conceive. My article on Anxiety will hopefully be helpful. Getting enough sleep is also of utmost importance, and hopefully my article Insomnia: A Paradoxically Low Energy State will be helpful if you have trouble sleeping.

Nutrition

For an optimal metabolic rate there needs to be enough nutrients present in the diet, such as zinc, selenium, iodine, and magnesium, so it is very important to have adequate nutrients, with supplementation if necessary. Beyond micronutrients, there must also be adequate macronutrients as well (carbs, proteins, and fats). It is important to eat enough in addition to eating well. So prolonged fasting and dieting are not good approaches when someone is trying to conceive.

Having said that, being overweight is also not ideal for fertility, in both men and women. Exercise is beneficial, especially strength training and consistent movement, such as taking brisk walks. Its even more beneficial to walk outside in nature, which has added stress reducing effects. Overtraining may have negative effects on fertility, which is often seen with young female competitive athletes.

For instance, in addition to thyroid hormone (T3, the active thyroid hormone) and cholesterol, vitamin A is required to create steroid hormones (pregnenolone, progesterone, testosterone etc.) which are vital for fertility.

Vitamin A is required for male fertility

Vitamin A is thus one of the most important nutrients for anyone that wants to improve their fertility (it is also a very crucial nutrient while pregnant). Vitamin A comes in two main forms, retinol and carotenoids. Retinol is the important form. Carotenoids (such as from carrots and other orange foods like pumpkin) need to be converted into retinol, which is not an efficient process. The retinol form of vitamin A is very rich in organ meats, especially liver. As such, it is best practice to consume organ meats occasionally, or at least to try and eat liver. Beef liver and liver from other ruminant animals such as bison and lamb, are the best forms of liver to eat for vitamin A content; however, other animal livers, such as chicken liver and goose liver, are also good sources. Many people cannot stomach organ meats, so dried liver “jerky” can be another good option, or even desiccated non-defatted liver supplements. However, organ meats are not the only form of retinol out there. Dairy (butter, ghee etc.) and egg yolks are also good options and should be consumed regularly.

Other than vitamin A, various other nutrients are very important for optimal fertility. One such nutrient is zinc, which is also required to utilize vitamin A effectively (which is why some vitamin A deficiency symptoms can be improved with zinc). I discuss this further in my article on Vision and Eye Health. Zinc is extremely high in oysters, and is also high in shellfish, fish and red meat. Zinc is not particularly high in poultry or pork, and the plant sources (such as pumpkin seeds) are not ideal, at least as a primary source of zinc. When it comes to zinc supplementation I think zinc carnosine is the best source as in addition to being a source of zinc it also has added benefits such as improving gut health.

Gut health is also very important when it comes to fertility. Poor gut health can lead to GELDING (Gut Endotoxin Leading to a Decline in Gonadal function). One of the best and easiest ways to improve gut function and avoid intestinal permeability (leaky gut) is to consume the daily raw carrot salad, which is shredded raw carrots with olive (or coconut) oil, vinegar, and salt. The combination of these ingredients helps remove endotoxin from the gut effectively and can help prevent this GELDING effect which leads to issues with fertility. Zinc carnosine, glycine/collagen, and taurine are also very helpful.

Endotoxin has a G.E.L.D.I.N.G effect, causes obesity and hypogonadism

The B vitamins are also very important, and most of them are very high in organ meats, egg yolks, and red meat in general. A vitamin B-complex supplement can be a good addition as well. I like LifeBlud’s B complex, they use good forms of each B vitamin (such as P5P for vitamin B6) (link at the end of the article, you can use discount code DEAN).

Many other vitamins and minerals are important for optimal fertility, and most can be adequately obtained by a good diet filled with eggs, dairy (A2 dairy is best, or goat dairy), meat, fruits, roots (like potatoes), shellfish, and well-cooked vegetables (such as cooked broccoli, etc.) and certain supplements when needed. For instance, copper is an important mineral for fertility, and is very high in shellfish and seafood in general.

Hormonal Considerations

The focus of this article is not on PCOS, but it is a very relevant topic. I suggest reading my article PCOS - A Proposed Root Cause. My article on PMS (PMS - Common, Not Inevitable) is also relevant, as women with very bad PMS symptoms may struggle with conceiving and may have a more difficult pregnancy.

Hormonal health is a crucial aspect of optimal fertility. As mentioned earlier, optimal thyroid hormone levels / metabolic rate are required to produce enough steroid hormones, as thyroid hormone is needed to convert cholesterol into pregnenolone. Pregnenolone is the first steroid hormone in the chain, and then it can be converted to the other steroid hormones down the line such as progesterone, DHEA and so on.

For example, the thyroid hormone, triiodothyronine (T3) is a key element in producing the energy needed for pregnancy to begin, but if there isn't enough cholesterol circulating in the blood, it will be impossible to synthesize enough progesterone (and other steroids). Too much carotene, too little vitamin A, not enough magnesium or sodium, and too much cortisol are commonly overlooked factors in infertility.

-Ray Peat, PhD

Other than doing things to increase the production of thyroid hormone and steroid hormones (such as a good diet and avoiding harmful substances) there is also an option to directly increase these hormones via supplementation. Ray Peat PhD was a big proponent of supplementing thyroid hormone, T4 and T3 together. He was not a proponent of supplementing T4 as a monotherapy (for example, Synthroid). This can also be obtained from natural desiccated thyroid (NDT). I suggest reading the book “Hypothyroidism, the Unsuspected Illness” by Dr. Broda Barnes, in addition to Ray’s books and articles for more information on how thyroid is very beneficial in general, and for fertility. Needless to say, improving the metabolic rate is crucial for improving fertility.

Since both parents are involved in reproduction, couples that want to have children must consider the health of both. Thyroid and pregnenolone and vitamin E are as important for male fertility as thyroid and progesterone and vitamin E are for female fertility. (For example, supplementary thyroid and pregnenolone can raise a man's sperm count, by overcoming the effects of stress.)

-Ray Peat, PhD

In addition to improving thyroid directly via supplementation, Ray Peat was also a huge advocate for supplemental progesterone (dissolved in vitamin E), and also suggested supplemental pregnenolone (if good quality).

Ray stressed the importance of progesterone being dissolved in vitamin E (whether taking the progesterone oil orally or using it topically). He discusses this in various articles, newsletters and books, particularly in the book “Progesterone in Orthomolecular Medicine”. Progest-E is the product he suggested, but other companies such as Ona’s, LifeBlud and Health Natura have similar products as well. Links at discount code at the end of the article.

These hormones, when supplemented, help to increase the body’s natural production of them in women. This is not the same as men supplementing testosterone. If a man supplements testosterone this does lower his own natural production. However, if a woman supplements progesterone, this does not stop her own production but can actually help the body produce more of its own progesterone, the same idea applies to pregnenolone. This is discussed by Ray in various articles and newsletters, and is also discussed in his books such as “From PMS to Menopause”, which I highly recommend reading.

“Pregnenolone (produced from cholesterol in the mitochondria), which is the precursor to progesterone and other steroids, has been used successfully to restore fertility (sperm count and motility, and, according to the wives-libido) in men” -Ray Peat, PhD

As such, supplementing progesterone and pregnenolone strategically can be very beneficial for fertility in women, and is very beneficial during pregnancy as well.

Pregnenolone (P5) fully prevents testicular atrophy due to steroid (ab)use or high estrogen

Progesterone can prevent recurrent miscarriages

Progesterone (or pregnenolone) – a cheap, safe and effective treatment of infertility

My good friend Andra Sitoianu, who is a wonderful ND, is a fantastic resource for improving fertility and having a healthy pregnancy, and she also recommends the strategic use of progesterone. Andra has a new Substack (The Bioavailable ND) and I highly recommend it!

Progest-E is a great progesterone supplement, as is the progesterone from Ona’s (which is a company affiliated with my good friend Kitty from Stuff Your Doctor Should Know ) and the progesterone product from LifeBlud. When it comes to pregnenolone powder, I really like Health Natura’s product, and Ona’s has a great pregnenolone cream. Links to Ona’s, LifeBlud and Health Natura are at the end of the article, and discount code DEAN works for all of those shops.

Sometimes, a single dose of progesterone can normalize a pregnancy, but both thyroid and progesterone should be considered for improving fertility and preventing miscarriage.

-Ray Peat, PhD

In addition to increasing beneficial hormones for fertility, it is also important to keep certain hormones that have ill effects on fertility from being elevated. For example, it is best to keep prolactin, estrogen and serotonin from being too high, as these can all negatively affect fertility.

Vitamin B6, zinc and vitamin E are all great supplements for lowering prolactin. Also, avoiding gluten and A1 dairy will help prevent prolactin from elevating. Estrogen can be elevated for many reasons, progesterone helps oppose the effects of estrogen, as does vitamin E. Trying to elevate serotonin (such as via an SSRI) can lower fertility. There are other options for depression than SSRIs and I suggest reading my article on depression for further information. Elevated TSH can also be a problem, indicating the body requires more thyroid hormone.

Serotonin puts the brakes on libido, by lowering dopamine

Stress ups cortisol/estrogen/prolactin, drops DHT, causes male infertility and prostate issues

Estrogen lowers T, DHT, and fertility; inhibits 5α-Reductase (5-AR)

TSH in the mid-normal range can cause female infertility

Other Useful Supplements for Fertility

I have already mentioned a few useful supplements for fertility so far, namely non-defatted desiccated organ / or liver capsules (for vitamin A, copper, various B vitamins, etc.), vitamin A / retinol (such as retinol palmitate), zinc (such as zinc carnosine), vitamin B6, thyroid hormone, progesterone and pregnenolone.

I also mentioned how vitamin E can be very helpful in lowering prolactin and estrogen. Vitamin E in general is a very useful supplement to support fertility, for men and women. I like the Vitamin E from LifeBlud personally (antidote), link at end of the article.

In fact, the common forms of vitamin E are the “tocopherols” and this comes from the Greek “tokos” = offspring and “pherein” = to bear, meaning vitamin E/tocopherol is the vitamin of “bearing offspring”. In other words, vitamin E is literally named for its fertility-boosting effects!

There are various other supplements that are very beneficial for fertility. Vitamin D is one such supplement. Getting lots of sunlight is a great idea for many reasons, such as increasing vitamin D levels, but it’s also a smart approach to supplement vitamin D as well. I supplement vitamin D that is in soft gels with olive oil, but coconut oil options exist too and are also fine. In addition to regular sunlight, red light is very beneficial for fertility and hormonal health for men and women; as such, red light therapy may be worth a try for individuals struggling with infertility.

Vitamin D improves ovarian reserves in women with infertility

Vitamin D may prevent (and even reverse) uterine fibroids

Vitamins and minerals that help produce energy are also very important for fertility. Some examples would be niacinamide, vitamin B1 and magnesium. Energy production and utilizing glucose well are very important, and I suggest reading my article How to Utilize Glucose Well for more information.

Male fertility depends on intensity of (sperm) metabolism

Niacinamide may restore female fertility in old age

Low-dose (but not high) niacinamide reverses reproductive decline in old females

Fertility depends on metabolism (ATP), not age

Eating 1 lb of sugar daily has strikingly positive effects on (male) fertility

Lastly, there are certain herbs and foods that can help with fertility, some have been mentioned before. For example ashwagandha is supposedly very helpful, as is honey, pomegranate, pineapple (food and juice) and oysters.

Summary List of Useful Approaches to Increase Fertility

1. Avoid wearing petroleum-based clothing (polyester/nylon/acrylic) and opt for wool, linen, organic cotton, hemp and viscose/lyocell/modal/bamboo.

2. Drink and cook with filtered water (RO is the best option as it removes “forever chemicals” and other harmful impurities). Best to also shower/bathe in filtered water as well.

3. Avoid consuming too much PUFA (soybean oil etc.) Cook most of your own food and use safer cooking fats such as coconut oil, beef tallow, and butter/ghee.

4. Consume enough food and enough nutrients.

   1. Vitamin A (liver, organ meats, organ supplements, egg yolks, dairy, retinol palmitate supplements)

   2. Zinc (oysters, red meat, zinc carnosine)

   3. Other important nutrients such as magnesium, iodine, selenium and copper

5. Hormonal Support

   1. Progesterone oil dissolved in vitamin E, orally or topically

   2. Pregnenolone supplement

   3. Thyroid (T4+T3) or good quality NDT

6. Utilize useful supplements:

   1. Vitamin E (I like LifeBlud, link below)

   2. B-vitamins, such as niacinamide

   3. Vitamin D

*Nothing in this post constitutes medical advice. The information provided is for educational purposes only. I am not a medical professional, always consult a licensed healthcare professional before making changes to your diet, supplements, medications, or treatment plans.*

If you enjoyed this article, please consider checking out the other articles I’ve written. Also, please feel free to subscribe (it is free to do so) and share the articles with others. Thank you!

BTW: I am a frequent guest on the podcast “Stuff Your Doctor Should Know”.

Discount code DEAN works at:

1. Ona’s Naturals (progesterone oil, topical progesterone and pregnenolone creams)

2. LifeBlud (Magnesium, Vitamin E, Taurine, Theanine, B vitamins, Methylene Blue)

3. Health Natura (oral pregnenolone, Methylene Blue)