The Definitive Guide to

If you want to get pregnant, you need to read this guide. We worked hard to include all the juicy information we wished we’d had available when we started our preconception journeys—like what to eat (and not to eat), what toxins to avoid, what our partners could do to optimize their fertility…and loads more.

Don’t have time to read the entire guide right now?

No worries! We’ll send you a copy so you can read it when it’s convenient for you. Just let us know where to send it.


Your preconception
Lab testing we recommend
to support fertility
Understanding your cycle when trying to conceive
fertility diet
Prenatal vitamins
Other fertility
Mom’s gut
Environmental toxins and
pre-pregnancy detox
Medication use
How your man (or donor) can optimize his fertility
The most common causes
of infertility
Lifestyle factors that
influence your fertility

Your Preconception Journey


Your preconception journey

Welcome! We are doctors Alejandra Carrasco, M.D. and Christine Maren, D.O.

We’re here to provide a safe, science-based space where conscientious women can find information about their most burning preconception health and wellness questions.

This guide will walk you through everything you need to know to optimize your fertility and set the stage for a healthy pregnancy.


If you are embarking on the journey to motherhood congratulations and welcome!

We are doctors Alejandra (Alex) Carrasco M.D. and Christine Maren D.O., board-certified family medicine physicians who practice functional medicine. We’re also mamis of 3 (each), so we’ve been right where you are many, many times.

Chances are, you have a lot you’re considering with regards to your own health before getting pregnant.

And with all the information out there, coupled with well-meaning advice from friends and family, things can get overwhelming pretty darn fast, can’t they?

In all honesty, when the two of us started our respective preconception journeys, we felt there was a huge chasm of useful information missing for aspiring parents. We felt lost—and we’re medical doctors!

This is what inspired us to launch the Hey Mami community, to provide a safe, science-based space where conscientious mamis can find information about their most burning health and wellness questions (from preconception to mamihood).

We’re honored to share what we’ve learned with you and know you’ll find tons of value in this guide.

It is the culmination of our combined 14 years of academic medical training, 23 years of clinical practice, 30 years of scouring medical literature, 20 years of clinical experience in functional and integrative medicine, multiple pregnancies, multiple miscarriages, 6 births, and almost a decade of mamihood between the two of us.

We worked hard to include all the juicy information we wished we’d had available when we started our preconception journeys—like what to eat (and not to eat), what toxins to avoid, what our partners could do to optimize their fertility…and loads more.

Think of this guide as your secret weapon, here to help you cut through the preconception information clutter and get your family started on the best possible footing.

Focus on your own health to boost fertility​

Before you focus on trying to conceive, we encourage you to take some time to focus on your own general health and wellbeing.

This will set the foundation for a healthy pregnancy and a healthy baby, while helping you increase fertility.

How long do you need to focus on you (and your partner)?

Follicles are recruited up to a year in advance!! However, a follicle actively develops into an egg over the course of 90 days.1 Sperm takes between 64-74 days to fully mature. So in an ideal world we recommend you take at least 3 months to focus on YOU (and your partner).

To get started, ask yourself the following questions:

    • Do you have a chronic health issue?
    • Do you struggle with symptoms like insomnia, skin issues, digestive concerns, etc. (even if they don’t interfere with your life)? 
    • Do you take medications (even over-the-counter ones)? 
    • Do you have chronic low-grade stress (even if you handle it well)?

If so, these could interfere with your baby-making ability.

As functional medicine physicians, we work with a lot of women (and their partners) who are trying to optimize their preconception health. Our patients come to us because the functional medicine approach focuses on digging a little deeper than you might have time or space for during a conventional doctor’s visit.

Otherwise your OBGYN, Midwife, or Primary Care Provider can do a prepregnancy exam, check basic labs if indicated, and evaluate for sexually transmitted infections or other vaginal infections that could affect your health and fertility.2

And be sure to address your emotional health too.

Even the World Health Organization acknowledges that “Health is a state of complete physical, mental, and social well being and not merely the absence of disease or infirmity.”3


Lab testing we recommend to support fertility

Preconception lab testing is one of the most proactive things women can do to achieve a healthier pregnancy.

Here’s what you need to know.

Preconception lab testing​

We love data and subscribe to the philosophy: test don’t guess.

Your health and nutritional status play a huge role in conception, pregnancy, and in the postpartum period.

We advocate a proactive approach to preconception health and recommend that 3-6 months before conception you take an inventory of your nutrient levels, thyroid function, metabolic and inflammatory markers, genetics, and sex hormones.

If possible, get labs done 3-6 months before pregnancy to test:
  • Nutrient levels – including Vitamins A, B12, D, coQ10, homocysteine, iron and zinc.
  • Optimal thyroid function – and we’re talking a FULL panel including thyroid antibodies, TSH, free T3, Free T4, and reverse T3.
  • Metabolic and inflammatory markers – like fasting blood sugar, fasting insulin, hemoglobin A1C and high sensitivity CRP.
  • Unique nutritional needs – we use the Nutrition Genome DNA Kit to understand how genetic differences (like MTHFR, COMT, and PEMT) affect the way we respond to food and our environment (this is called nutrigenomics).
  • Sex hormones – while functional medicine testing is our first choice for this, there are useful markers you can check in blood like DHEA-S, SHBG, testosterone and progesterone (when timed after ovulation).

For more information on the best preconception lab work, including our optimal ranges, download our free guide to help you start a conversation with your doctor or midwife.


Understanding your cycle when trying to conceive

In this Chapter, you’ll learn about:

Understanding your menstrual cycle and ovulation​

A regular menstrual cycle is between 25-30 days.4

  • The follicular phase (when your eggs mature) occurs during the first half of the cycle.
  • Ovulation typically occurs in the middle of the cycle (i.e. for a 30 day cycle, it might occur around day 15), when your egg travels from the ovary through the fallopian tube and into the uterus.
  • The luteal phase (where your uterine lining thickens) follows ovulation and characterizes the second half of the cycle.
  • Your period comes when you slough off the uterine lining…and then it all starts over again, unless implantation has taken place.

Irregular cycles are usually due to changes during the follicular phase— either the absence of ovulation (called anovulation) or inadequate follicular development.5

Stay tuned for our article that details your body’s cyclical hormonal changes.

Hormone balance for better fertility​

If irregular cycles are an issue, it’s especially important to think about hormone balance and how that can influence ovulation. 

Symptoms of hormone imbalance include:

  • Irregular periods
  • Failure to ovulate
  • Heavy, painful periods
  • Breast tenderness
  • Loss of libido
  • PMS
  • Headaches around ovulation or menses
  • Hot flashes

In our clinical practices we see a lot of women with lower than optimal progesterone levels and estrogen dominance. We use speciality functional medicine testing to measure sex hormone levels in the urine, identify the specific imbalance, and address the root cause (which can be related to the detoxification pathways in the liver, digestive issues, nutrient deficiences like magnesium, environmental exposures, etc).

Ovulation trackers and tools​

Many women can recognize the signs of ovulation by tracking their cervical discharge, basal body temperature and resting heart rate.

Thankfully, modern technologies have made it a lot easier to track ovulation and fertility.

  • Ovulation calendars provide a simplistic predictions of your most fertile days based on the first day of your last cycle and the average length of your cycle (these are most accurate if you have regular cycles).
  • Electronic fertility calculators—like Daysy and Ava bracelet—look at additional data like basal body temperature, to help you more accurately monitor ovulation and fertility windows.
  • Over-the-counter ovulation prediction kits use urine to detect luteinizing hormone (LH), which typically surges 24 to 36 hours prior to ovulation.6  Click here for the one we recommend.
  • Over-the-counter fertility monitors use newer technology to measure both estrogen and LH in your urine. By detecting the rise in estrogen, you’ll have a bigger window of fertility than with an ovulation predictor kit.7 Click here for the one we recommend.

When to have sex to get pregnant​

The quick answer: often (more on this coming up).

The technical answer: Your eggs can survive in the fallopian tube for 18-24 hours after ovulation.

Sperm can survive for 3-5 days. That means you can get pregnant anywhere from 5 days before you ovulate to 1 day after. The best time to have sex to get pregnant is just before and during ovulation.8

Now, back to that “quick answer”.

New research has shown that having sex anytime NOT just during ovulation, causes changes in a women’s immune system that increase your chances of getting pregnant.9,10

So, why not take this time to have as much enjoyable sex as possible?

Sure, use the trackers and calendars to help increase your chances, but also be sure to add in a few spontaneous rolls-in-the-hay for good measure (and faster conception).

Want more details and tips for speedier conception? Check out our article Understanding your cycle when trying to conceive (and when to have sex to get pregnant).


Preconception fertility diet

Word is getting out about the critical role nutrition plays in fertility and a healthy pregnancy.

The foods you eat during the 6 months before conception are important determinants of your health during pregnancy, and your baby’s health throughout pregnancy and into childhood.

We’ll give you the scoop here.

Good nutrition can increase fertility and improve pregnancy outcomes​

We get so many questions from women about the best fertility diet.

And we think this is freaking awesome because it shows that word is getting out about the critical role nutrition plays in fertility and a healthy pregnancy.

In fact, there is a growing body of evidence that nutritional habits may have a significant effect on both male (that means you, gentlemen) and female fertility.11,12

And a nutrient dense diet high in vitamins and minerals has been shown to support fertility.13

Furthermore, increased antioxidant intake from healthy foods and herbs can result in a shorter time to pregnancy and is positively associated with female fertility.14

What’s more, the foods you eat during the 6 months before conception are important determinants of your health during pregnancy, and your baby’s health throughout pregnancy and into childhood.15

So, preconception is an important time to stockpile your nutrition, support your egg health, and set the stage for a healthy pregnancy and baby.16

But wait, there’s more.

Get ready…

Your maternal nutrition status can influence up to three generations!17

That means that your grandchildren could be impacted by your nutritional status at conception (this phenomenon is called epigenetics).

All that said, most mamis have the good sense to recognize that what they eat matters to their health and the health of their babies.

Bottom line: a nutrient-dense diet is your best ally in creating the ideal conditions for improving fertility and laying the foundation for a healthy pregnancy, baby, and postpartum recovery.18

Poor nutrition can make it harder to conceive​

Based on what you’ve just learned, this should come as no surprise.

However, when we refer to “poor nutrition” in this context we’re not talking about a lack of food in general…we’re talking about a lack of quality food.

Specifically, too much processed food, which has (finally) been proven to impact fertility.

Here’s the deal:

  • At least one study shows that women who consumed sugar-sweetened drinks, especially sodas, had lower levels of fertility.19
  • Another study found that the higher the glycemic index of your diet (AKA: how much the food you eat increases your blood sugar after you’ve consumed it, like refined sugar and carbs), the increased risk of ovulatory infertility.20
  • Yet another study found that consuming trans fats instead of healthy carbohydrates, correlated with a 73% increase in risk of ovulatory disorder.21

And finally, another study found that eating fast food was correlated with a higher rate of infertility, as well as an increase in the time it took to get pregnant.22

In other words: keep the junk food off your plate to increase fertility (or at least to a dull, dull roar).

What to eat when trying to conceive​

Here’s a bit of good news that should appeal to everyone’s commonsense: there is no perfect diet for everyone.

BUT there is great value in following foundational dietary guidelines for optimal fertility.​

We created the Hey Mami Diet to help you understand foundational aspects of nutrition, and how to best support yourself with food during the mamihood years.

In short, we encourage you to follow these 10 principles when it comes to nutrition:

  1. Listen to your body.
  2. Choose organic when possible.
  3. Aim for a variety of seasonal, whole foods.
  4. Load up on nutrient-dense foods.
  5. Eat plenty of colorful vegetables with an emphasis on leafy greens and cruciferous veggies.
  6. Enjoy healthy fats.
  7. Make clean protein a staple at every meal.
  8. Make sure your carbohydrates are a good source of fiber.
  9. Enjoy moderate amounts of whole fresh fruit.
  10. Stay hydrated.

We recommend avoiding these 10 bad food players:

  1. Foods high in pesticide residues (check out EWG’s Dirty Dozen list for a quick reference).
  2. Highly processed and refined foods.
  3. Refined sugar.
  4. Fake sugar like aspartame, sucralose, saccharin, etc.
  5. Trans fats, hydrogenated fats, and refined vegetable oils.
  6. Factory farmed meat.
  7. Seafood high in mercury.
  8. Food dyes.
  9. Sodas and diet sodas.
  10. Alcohol on an everyday basis.

We’ll walk you through everything in our article that outlines the Hey Mami Diet.

As doctors and mamis of 3, we know that getting any meal on the table (let alone healthy, whole food) is not always easy.

Even though we prioritize this in our homes, dang if it doesn’t still take some practice, flexibility, and creativity (not to mention patience, self-forgiveness, the willingness to fail, a big glass of wine…etc).

Stay tuned for our article on how to get healthy foods at your doorstep for our favorite resources and mom hacks.

Food intolerances when trying to conceive​

A food intolerance or food sensitivity is different than a full-blown food allergy in that it’s a delayed hypersensitivity response.

This response is triggered by IgG antibodies—food antigen and antibody complexes to which the immune system reacts, whereas an allergic reaction is triggered by an IgE-mediated response, which causes symptoms like swollen lips or hives.

In other words: food intolerances are more subtle, or can be delayed to the point you may not make a connection between that cheese sandwich you just ate and the stuffy nose you get the next day.

The most common food sensitivities we see in our clinical practices are gluten, dairy, and (we hate to say it) even eggs.

There is a well established association between celiac disease and fertility disorders.23 But non-celiac gluten sensitivity (NCGS) may also play a role in fertility challenges.24

So, while it can be easy to make fun of all those “gluten-free people” out there without celiac, the truth is many people experience a variety of reactions to gluten, as one example.

This makes sense given what we see in our clinical practices.

In most cases, we are not advocates of long-term uber-restrictive diets.

However, there’s a time and a place for an elimination diet, which can be of great help to uncover hidden food sensitivities.

If you’re struggling with infertility, any chronic health issues or pesky symptoms, we highly recommend giving this a try.

In our practices, we also test for these reactions which allows us to individualize patient care.

Finally, if you know you’re not tolerating certain foods, don’t stop at just eliminating them. Take it a step further by learning more about your gut health (intestinal hyperpermeability aka leaky gut) and how it impacts your entire body.

Check out Chapter 7 of this guide to learn more.


Prenatal vitamins

Prenatal vitamins are backed by decades of research and linked to better birth outcomes.

Pre-pregnancy supplementation has also been shown to support fertility, including a shorter time to pregnancy.

We’ll tell you what to look for (and what to avoid) in your prenatal vitamin.

Even when we eat well, we can’t meet nutritional
requirements with diet alone​

A healthy and varied diet is the best way of getting your nutritional needs met before pregnancy. It sets the foundation for full-body health and helps lay the building blocks for a successful pregnancy and postpartum recovery.

However, some nutritional requirements are hard to meet with diet alone…even if you eat very healthfully…​

Here’s why.

Since 1940 there has been a tremendous decline in the micronutrient density of foods.25 This is partly due to modern agricultural practices which have degraded our once nutrient-dense topsoil,26 but also the nature of our lifestyles which don’t leave much time or space for preparing food in traditional ways which would enhance their nutritional value.

Prenatal vitamins are important for boosting fertility​

Research shows that a proportion of women of childbearing age (including those who have fertility challenges), have lower than recommended levels of certain micronutrients27—AKA: vitamins, minerals, antioxidants, etc.

Now, listen up because this bit of information is important:

While micronutrient supplementation started during pregnancy can correct important maternal nutrient deficiencies, it is not sufficient to fundamentally improve the baby’s health.28

Which means (you guessed it), you’d ideally start supplementing with a high-quality prenatal multivitamin well before conception.​

Pre-pregnancy supplementation has been shown to support fertility, including a shorter time to pregnancy.29

Thus, by optimizing your preconception nutritional status, you can positively impact fertility, and support the health of you and your future child.

Bottom line: (ideally) don’t wait until you’re pregnant to start taking a prenatal supplement.

When should I start taking prenatal vitamins?​

In a perfect world we recommend you begin taking a prenatal multivitamin at least 6 months prior to conception, or longer, when possible.

In fact, the Centers for Disease Control (CDC) and American College of Obstetrics and Gynecology (ACOG) and other regulatory bodies recommend that all women of reproductive age take a supplement with 400 mcg of folic acid each day.30,31

However, we recommend you take an active form of folate (such as methylfolate) over plain old folic acid—keep reading for more info.

How to pick the best prenatal vitamin​

A high-quality pharmaceutical-grade supplement is what we recommend in practice, and you’d typically have your doctor or practitioner order them for you.

While there’s a lot to consider when looking for the best prenatal vitamins, there is an easy way to weed out the poor quality ones: look at folate and B12 on the label.

Your folate (or Vitamin B9) should be in the form of bioactive, methylated folate (sometimes called methylfolate, or 5-MTHF)—NOT folic acid.32

What does “bioactive” mean? It means a nutrient is in its most active and therefore most usable form.

When you eat leafy greens or take a methylfolate supplement, the folate is already in its metabolically active form.

On the other hand, synthetic folic acid, found in supplements or processed and fortified foods, requires many steps in conversion to get to the metabolically active stuff.33,34

This can be especially problematic for women with digestive issues and/or genetic variations in folate metabolism like MTHFR (which is very common!).35

Synthetic folic acid metabolism is also influenced by the dihydrofolate reductase (DHFR) gene. Women with genetic variations in DHFR may actually have a reduced ability to break down synthetic folic acid, potentially blocking folate receptors—leaving them worse off (we know, it’s crazy, and more research is needed).36,37

Along the same line, we look for activated B12 in the form of methylcobalamin, hydroxocobalamin, or adenosylcobalamin—NOT the synthetic cyanocobalamin.38

Bottom line: if you see “folic acid” and/or “cyanocobalamin” on the label, you can do better.

There is much more to say about this loaded topic. To learn more, check out our article: How To Pick the Best Prenatal Vitamin.

We recommend this prenatal vitamin that contains the right kinds of B vitamins including methylated folate and B12, as well as 100% daily value of the FDA’s new recommended dose of choline and trimethylglycine (TMG) to help fetal brain development, nervous system health, digestive health and more.


Other fertility supplements

Targeted supplementation can decrease your time to conception, optimize your egg health, and set you up for a healthy pregnancy.

This is especially relevant for women who struggle with hormone imbalance or who are starting their fertility journey later in life.

Following a healthy Hey Mami diet and taking a high-quality prenatal multivitamin should have most mamis covered with the basic fertility support they need.

However, for some women—especially those struggling with hormone imbalance or who are starting their fertility journey later in life—there are additional supplements to consider when trying to optimize egg quality and time to conception.

Now, before you go nuts and start ordering a bunch of fertility supplements, it’s important you work with a clinician who can help you determine which of the following could help support you (because there’s no sense in over-supplementing if you don’t need to).

Here are some of the most beneficial nutrients that have been studied to support fertility:

  • CoQ10 (especially important for women over 35)
  • Choline
  • Folate
  • Zinc
  • Iron
  • Omega 3s
  • N-acetyl-cysteine (NAC)
  • B complex
  • Vitamin C
  • Vitamin D
  • Chaste Tree (AKA: Vitex agnus-castus)
  • Magnesium
  • L-arginine
  • Ashwagandha
  • Myo-inositol

You can read more about these specific nutrients in: Top 15 Fertility Vitamins, Nutrients, and Herbs Backed by Science

One of our favorite supplements to support fertility, ovulation, and hormonal balance is this combination product that has Chaste Tree, Myo-Inosito and CoQ10.


Mom’s gut health

It is well established that a healthy gut microbiome is largely responsible for our overall health.

While there is still much to learn with regards to gut health and fertility/pregnancy, we know there is an important link.

In this chapter you’ll learn about why gut health is important, and how you can support a healthier microbiome.

What is your gut microbiome?​

Your gut microbiome is a collection of trillions of organisms—bacteria, viruses, fungi, and more—that live within us.

A healthy microbiome helps us to stay well by improving our digestion, hormone balance, gut permeability, and immunity to name a few of its functions.

An imbalanced microbiome, on the other hand, is linked to inflammation and chronic disease.

The balance of your gut microbiome is impacted by a multitude of things, especially:

  • Antibiotic use—a single course of antibiotics can change the gut microbiome for up to a year!39
  • Acid blocking medications, like proton pump inhibitors (i.e. Nexium, etc).40
  • Sedentary lifestyle.
  • Household chemicals and the hygiene hypothesis.41
  • Processed foods, toxic fats (fast foods, fried foods, refined vegetable oils, etc), and a high sugar diet.
  • Lack of diversity of foods.42
  • Too much stress.
  • C-section birth.

Gut health and fertility/pregnancy outcomes​

It is well established that a healthy gut microbiome is largely responsible for our overall health. Much of our focus as functional medicine doctors is on this aspect of health.

With regards to gut health and fertility/pregnancy, there is still much to learn.

We know there is a link between gut health and hormone balance, as the gut microbiota regulates estrogens through an enzyme called β-glucuronidase.

An imbalanced microbiome can alter circulating estrogens and may contribute to a number of hormonally driven conditions, including obesity, endometriosis, polycystic ovary syndrome (PCOS), and fertility.43

We also know that mom’s microbiome plays an important role in pregnancy outcomes, and influences baby’s microbiome too.44

As just one example, when mom supplements with certain types of probiotics before delivery and during breastfeeding, babies have reduced risk of developing eczema.

In fact, the World Allergy Organization recommends using probiotics in pregnant women at high risk for having a child with eczema and allergies.45,46

How to support gut health for optimal fertility, a
healthy pregnancy, and overall well-being​

A healthy microbiome is largely earned by avoidance (when possible) of all those “bad food players” and other toxins listed above, along with a diet of whole, unprocessed, organic food (like we recommend in The Hey Mami Diet).

In fact, a shift in diet can change your gut bacteria in a matter of days47

But, avoidance isn’t everything. You’ll also want to include the following types of foods in your diet to feed those healthy bacteria:

  • Fermented probiotic foods (lactofermented sauerkraut, kimchi, kombucha, etc)
  • Prebiotic foods (onion, garlic, asparagus, leeks, sunchokes, etc)
  • Resistant starch (green bananas, plantains, cooked and cooled rice, cooked and cooled potatoes and sweet potatoes, etc)48

In our clinical practice, we also find that taking a high-quality probiotic supplement can be helpful.

Grocery and health food stores are flooded with probiotics, but not all probiotics are created equal. So, given the extensive role gut health plays in the health of mami and baby, it really pays to get picky about this one.

One of our favorites is this product that has five researched strains of Lactobacilli and Bifidobacteria in acid-resistant capsule with pH targeted release to deliver maximal viable organisms to the digestive tract.


Environmental toxins and pre-pregnancy detox

Environmental toxins are everywhere, and can affect reproductive health for generations.

Preconception is a perfect time to focus on limiting these exposures—and it’s not as hard as you may think! In this chapter we’ll tell you what to do.

Environmental toxins are ubiquitous​

Just a decade ago, it may have been considered quackery to suggest that common household chemicals could influence conception and birth outcomes.

Not any more.

For example, a 2004 study showed 287 chemicals in the umbilical cord blood of babies taken at birth, including pesticides, consumer product ingredients, and waste pollutants, and over 180 carcinogens.49

The American College of Obstetrics and Gynecology (ACOG) along with the American Society for Reproductive Medicine published a formal committee opinion on exposure to environmental chemicals in 2013 acknowledging that: “Patient exposure to toxic environmental chemicals and other stressors is ubiquitous, and preconception and prenatal exposure to toxic environmental agents can have a profound and lasting effect on reproductive health across the life course.”50

What this data confirms is that environmental toxins are everywhere, and can affect reproductive health for generations.

Thus, preconception is a perfect time to focus on limiting these exposures (and it’s not as hard as you may think, so keep reading).

Environmental toxins wreck fertility​

Exposure to various environmental toxins can affect fertility in both men and women (and ultimately the health of your baby).

Some examples of how toxins can impact fertility include:

  • Disrupting your hormone balance (these toxins are known as endocrine disruptors)51
  • Damaging your eggs, causing impaired ovarian function, and infertility52
  • Depleting follicles and cause premature ovarian failure (early menopause)53
  • Decreasing sperm count and quality54
  • Increasing the risk of miscarriage or birth defects, and affecting fetal growth later in pregnancy.

How can you decrease your toxic body burden before pregnancy?​

While this may seem overwhelming, the truth is you can greatly reduce your exposure to environmental toxins by making some simple changes at home.

Our strategy for this type of “fertility cleanse” or “preconception detox” is twofold:

First—Avoidance, avoidance, avoidance. it’s important to look closely at your environment and think about any chemical exposures you may have in the places you spend the most time. This is the primary focus.

Second—support your body’s natural detoxification processes so you can better process and eliminate these toxins from your body.

Here are 10 simple changes you can make at home that will trickle over to the health of your growing family:

  1. Start by eliminating pesticides in your diet and opt for organic foods.
  2. Don’t spray your home, lawn, or garden with pesticides either.
  3. Make a no-shoes-indoors policy at home—shoes bring in a gross amount of pesticides, fecal matter, heavy metals, and chemicals from the outside world.
  4. Swap out plastics in your kitchen for glass, stainless steel, ceramic, or silicone.
  5. Stop drinking out of ALL plastic water bottles.
  6. Be sure you are drinking clean water and using a high quality water filtration system.
  7. Avoid chemical cleaning products and anything with “fragrance”, including candles, laundry products, and air fresheners. For an economical all-in-one cleaning product, we like Branch Basics, and recommend pure essential oils in place of fragranced air fresheners.
  8. Make a habit of opening your windows to purge stale air and improve natural ventilation. Even a few minutes a day can make a big difference.
  9. Use your vent hood when cooking and use the bathroom fans while showering.
  10. Clean up your personal care products by opting for natural/organic alternatives. This includes lotions, cosmetics, perfumes, deodorant, and tampons/pads. We’re big fans of Beautycounter for personal care products, organic feminine products like Seventh Generation or reusable period panties from Thinx.

This topic is so important, so under-reported, and so vast that we’ve written several detailed articles on the subject.

Since no one can avoid ALL toxins, it’s a comfort to know your body is already equipped to rid itself of many of them (this happens mostly through your liver and gut, urine and sweat).

As you clean up your environment, you can also support your body’s natural detox pathways.

Here are 5 simple ways you can help optimize this process:

  1. Aim for a daily BM (grandma was right about this one). Good hydration, fiber, and healthy fats can help with this. If you tend toward constipation then supplementing with magnesium citrate might be a good idea.
  2. Take good care of your liver. Minimize alcohol, Tylenol, bad fats, and other medications that can stress your liver out.
  3. Hydrate with about 80 ounces a day of filtered water in glass or stainless steel containers. This will help eliminate water soluble toxins through your urine.
  4. Sweat daily and keep things moving with regular exercise, and maybe even a sauna.
  5. Eat a variety of organic fruits, vegetables, and herbs to support detox. This includes cruciferous vegetables (like broccoli and cauliflower), onions, artichokes, lemons, rosemary, parsley, and cilantro.

Do I need a full-on preconception/fertility detox?​

Many women can prepare beautifully for pregnancy by following the strategies outlined above.

However, women with conditions suggestive of environmental toxicity (multiple chemical sensitivity, chronic fatigue, fibromyalgia, autoimmune disease), known toxic exposures, or genetic polymorphisms like MTHFR, may wish to work with a functional medicine physician.

We have comprehensive tests to measure the toxic body burden and guide appropriate and safe preconception/fertility detoxification.

Supplements we use in our clinical practices to help support detox in general include milk thistle, NAC, NAD+, and glutathione.

However, if you’re trying to conceive we don’t recommend you upregulate detoxification with supplements (except for NAC, which has evidence to support decreased rates of miscarriage in the first trimester.55

If you do think you’d benefit from a fertility/preconception detox, it’s important to note that a preconception detox should occur more than 6 months prior to conception.

We make this recommendation because follicles take ~6 months to develop before they are ready to release their egg.56 Plus, it is less than ideal to mobilize stored toxins just before becoming pregnant for obvious reasons.


Medication use

In this chapter we’ll address issues with some of the most common over-the-counter medications as well as birth control pills.

Which medications are safe to take when trying to conceive?​

The American College of Obstetrics and Gynecology (ACOG) states: “Some medications, including vitamin supplements, over-the-counter medications, and herbal remedies, can be harmful to the fetus and should not be taken while you are pregnant.”57 Some of these medications may also affect fertility.

For instance, something as commonplace as ibuprofen could affect your ability to conceive.

There is a link between NSAID use (ibuprofen, naproxen, etc.) and reversible female infertility, thus stopping NSAIDs should be considered prior to fertility investigations.58

It is important to discuss all medications you are taking with your provider—remember this means not only prescription medications but also over-the-counter medications, vitamins, and supplements (including