Sarah Clark is the founder of FabFertile, author of Fabulously Fertile: Supercharge Your Fertility Naturally, and host of the Get Pregnant Naturally podcast. She has supported hundreds of women on their fertility and health journeys.
What we Discuss
How gut health impacts your fertility
Elimination diets, including which is best for fertility
Tests to measure fertility health
Symptoms to look out for to better understand what you can do to optimize your fertility
Studies on mind-body connection and fertility
Georgie: tell us about yourself.
Sarah: I have my own journey with infertility. In my early twenties I was having irregular cycles, maybe a couple of times a year. I started getting acne. I had a weird fungal rash on my chest and yeast infections. I didn’t realize at the time those were connected to fertility. I went straight to my doctor and was put on the pill, which was a bandaid.
I had a life plan to get married at 25 and have kids at 28. When I came off the pill at 28, my cycles were still irregular. I went to see my OB GYN and was told I had premature ovary failure. She gave me an IVF brochure. I didn’t even get a second opinion but went straight to the fertility clinic and got on a list for a donor egg. On our first transfer, I had our daughter who is about to turn 19.
Back then, people didn’t know much about donor eggs. Now there is embryo adoption and all other situations. I had two embryos leftover and wanted the kids close together. I was bound and determined but it didn’t work. We went on a separate list for a separate transfer egg and had our son, who is about to turn 17.
And then after I had my kids, my health crashed. I remember having nine colds in one year. Each cold turned into a sinus infection. I took antibiotics for all of them and started getting bladder infections. I had chronic yeast infections, seasonal allergies, dandruff, etc., my immune system was so low. I didn’t even think of myself as a sick person. I was still in corporate HR at this point.
I took a life coaching course and had my own personal wake up call and took a health and wellness course and realized I was sensitive to gluten and dairy. My symptoms started to go away. Then, I took out corn and started taking allergy tests and realized I had a huge array of issues. I was fully in menopause and not cycling naturally. My goal is to get the word out that we should get to the root cause of symptoms.
Georgie: tell us about FabFertile.
Sarah: we take a functional approach to fertility. We have access to functional lab testing. We use food sensitivity testing, hormone testing, stool testing and more to develop a protocol that helps people make diet and lifestyle changes to improve the chances of conception. These are foundational changes to diet and sleep, working on movement, addressing mental-emotional stresses and more. Most people think they eat a great diet and don’t have a food sensitivity, but in 99% of the people we work with, there is a food sensitivity going on. We have both partners do an elimination diet. The other common issue is gut infections. In a lot of people, there are bacterial or fungal infections that put the body in survival mode. Another stressor is environmental toxins. Most of us live in a toxic soup that impacts our endocrine and reproductive systems.
Our goal is for people to come to these fixes first and not last. The mental emotional stress is huge. Most people are in a panic. This is a stressor in the body. At the end of the day, we have a mind, body, spirit approach to the whole thing.
Georgie: some of the issues you mentioned, like food sensitivity, are fairly clear. For the gut infection, is it about healing the microbiome?
Sarah: we use the GI stool test to look at the health of your gut. Depending on what that finds, we develop a protocol for healing. If you take that to your conventional doctor, they may recommend an antiparasitic or antifungal, which is like an atomic bomb going off in the body. Instead, we recommend a low and slow approach. You still have to heal your gut.
Many people have leaky gut. Foods come in and end up with infections.
A lot of people have been on long-term hormonal birth control, which predisposes you to food sensitivities and gut issues. You may be eating a nutrient-rich diet but your body can’t absorb any of it.
As in my situation, I was on heaps of antibiotics. I destroyed the bacteria in my gut. That with ten years of birth control and chronic stress just completely destroyed my gut health. So, I work to rebuild it with bone broth and collagen powder and reduce stress.
Georgie: I actually just interviewed a woman who specializes in recurrent miscarriage. She talked about the training that OB GYNs go through (this episode will be launched in October). What she shared was how OB GYNs are trained on birth control and pap smears and some surgery. Very general health knowledge. When she said the word birth control it just clicked: no wonder all these women are going to their OB and the first thing they do is give birth control. That’s what they’re trained to do. I don’t think any of us are saying, “never go on birth control,” but there are different types and they have different consequences.
Even in a well-known resource like The Period Repair Manual by Lara Briden, she talks about different kinds of birth control. That training does influence the care we all get.
Sarah: my daughter who is almost 19 went to the doctor after some issues. She was having a heavy period and the first thing a doctor said was for her to go on the pill. She looked over at me and it was evident she was getting a band-aid approach.
Most people I speak to didn’t go on the pill for prevention but because they had heavy or light cycles, acne, irregular cycles. The pill doesn’t address the root cause.
There’s something called post birth control syndrome. Not everyone who goes on the pill is going to have issues when they come off. But the people I see are worse after the pill because the issues it suppressed come back to the surface.
We look at things like the fertility awareness method. I lost my period at 40. People need to tune in: look at your basal body temperature and cervical mucus. We’re using the ovulation predictor kits. Being able to understand our bodies is empowering. As girls, we’re taught that we’re fertile all month long but that’s just not the case.
There is an idea that the pill is women’s liberation. If there’s a side effect of stroke or death, why are we taking this?
Georgie: I think it’s great that these questions are becoming mainstream. The goal of looking at the root cause and the growth of naturopath movements is powerful. The shift is evident.
On our podcast, Aimee Raupp talked about Epigenetics and the elimination diet. Kim Ross talks about nutrition. There are a lot of resources on the nutrition part but let’s talk more about the stress part. There are mixed reviews on whether or not stress causes infertility.
No one running clinical trials is really analyzing these dynamics. But speaking from your experience with patients, what do you see in the connection between stress and fertility? What is the importance of destressing and how can it realistically be done given the society we live in?
Sarah: there are actually studies, with Alice Domar on fertility and stress. She’s the pioneer of mind-body fertility. As a Harvard researcher, she studied this for over 20 years and did practice groups. She really shone a light of compassion in her methods. Of the women that were in her groups, 55% became pregnant within six months and 95% became pregnant by some means within two years.
We run a mindfulness group a couple of times a year. There are so many triggers in this journey with comparison, feeling your behind, uncertainty. It will showcase every last pattern or issue you may have. We all deal with stress. The functional approach looks at the physical side of stress, but if you’re stuck in a mindset that “this will never work,” we look at the spiritual side too. In this very masculine culture of ours, we’ve beaten out our intuition and outsourced our health to someone else. We identify with the language of the diagnosis. Look at me, I didn’t even get a second opinion! What was I doing? I’m a smart, educated person. I thought I had it easier than other people. I visualized a positive outcome and knew it would work. I thought it was easy because I didn’t have to go through years of fertility treatment. I could just use donor eggs and have my children.
The spiritual side of things is important: looking at the signs, knowing that the soul of your baby is waiting for you. It’s easy to get stuck in the uncertainty or the pushing and controlling.
We encourage people to actually delete social media and see how they feel. In one group, all of them did it except one person. That person came in every week with no changes. Once she deleted it, she said it was life changing. She kept seeing baby showers, gender reveals and it triggered her into a spiral. Her pattern or looping thought was that, “it will never work.” That stress alone is heartbreaking.
We urge people to get honest about their mental emotional stress. Join a support group or get help.
Georgie: speaking of the comparisons, people will often post specific questions about what other people go through. For example, “when did you start to feel symptoms?” “How many people got pregnant on the keto diet?” You and I have discussed before that it’s really individualized. Given that you’ve seen so many patients, can you talk about that. I want women to hear loud and clear that it’s not, “do X = baby.”
Sarah: women should also tune into this: what is the emotion that comes up in you when you’re in those groups and that information is being said? Do you leave feeling empowered? Do you spiral? A lot of times, after infertility research, people don’t feel better. They feel overwhelmed.
The functional side of things takes a very personalized approach. A lot of things work for someone, but are they right for you? The gold standard for diets is the elimination diet. If you’re struggling with infertility, start there. Take out the top allergens for 10 days and then reintroduce them. Generalized recommendations put you down a rabbit hole.
Most people who come to see me are on a laundry list of supplements. They spend a lot of money. Some of them have fillers and dyes and even allergens.
Georgie: on the flip side, I like that people are asking these questions. The information isn’t centralized. That’s one of the things we’re trying to do at Fempower Health. Many women aren’t even aware of potential solutions. It shouldn’t be overwhelming, though. It’s a hard place to be. Ten years ago when I started my journey, there was hardly any information. Now it feels like too much information.
What you’re doing feels more like: “scrap the research, let’s research you.”
Tell us about your patients. For all of the combinations of people who want to have children, how does it work for them to come to you? We know the message is, “come early,” but what happens when they come to you?
Sarah: we do work a lot with same sex couples. We work with some single women who are using donor sperm. All of them start with the elimination diet. Even if it is female-factor infertility, there are things we can do to help both members. We tweak that further with the Zoomer panel, which is a comprehensive food sensitivity test. There are various options: soy Zoomer, dairy Zoomer, etc. and goes into it with a granular level. It includes an IgG test, which is pretty common. But some people have delayed food reactions. We do cutting edge tests.
We also look at food chemicals. Most foods can be brought back in but the top allergies are dairy and gluten. Our elimination diet is no dairy or gluten for 30-60 days. We’ve had some people who are intolerant of lettuce. You never know what it will be.
At one point, I was literally intolerant to almost anything I was eating. When I took inflammatory foods out (reduced the fire), I could work on gut health and chronic stress and then slowly reintroduce some things back in. The diet issue is a key that many people get quite wrong.
There is no perfect food sensitivity test because it always is a snapshot in time.
Then, we do the DUTCH test for sex hormones and cortisol levels. Some people are completely burnt out on cortisol. A lot of people supplement with melatonin which makes it sky high. Some providers take a very allopathic approach to hormones. Instead, we dig into why.
The stool test is the GI Map stool test. The majority of people we work with have a bacterial infection, fungal infection, worm, parasite. If you have low stomach acid, you can’t even absorb nutrients. You may be well fed but malnourished.
The last test is the Hair Tissue Mineral Analysis Test. You can tweak this with diet and supplements.
From all of those tests, we develop protocol. The testing is the beginning and then the implementation happens.
We help people see things differently. A lot of people who come with infertility have trouble visualizing things working. It’s equally important that we look at the mental-emotional side of things. People want to beat it up, attach it, achieve it. We have to move back into our feminine side and pay attention to spiritual nudges. It’s equally important as addressing the physical things. This all includes a partner. Unless you’re getting a donor. Many women have chosen donor eggs, which still requires a preparation for implantation. There are often other issues as to why women weren’t able to get pregnant. We address healing opportunities that, on the conventional side of things, are often missed.
Georgie: I’m one of those people who likes to try everything. I’ve tried it all over the past 10 years. I did the elimination diet last year. I cannot say enough about that and the stress. For me, with an elimination diet, I learned that red meat makes my nose run. It runs all day long. It seems like I have a cold or something but it’s red meat.
If I eat too much sugar, it’s like a bloat all around in my body. If I cut out sugar, I lose five pounds in a week. It overall creates a healthy self.
I’ve found that anything in life that doesn’t make you feel good has an impact. From friends you’re spending time with, social media, how you’re spending free time. I’ve learned that if I listen to music at night instead of watching a TV show, I feel better. I do notice the difference. We’re all so busy and live on auto pilot.
I’m 46 and my cycle is regular after a year and a half or two of it being long cycle-short cycle-no cycle. It’s now regular because I’m taking care of myself. It is not a joke what Sarah is saying here today. It’s great to see what you’re doing.
What would you say to women who are starting on this journey? Many of us are thrown onto the IVF track. What should people know and what are the gaps?
Sarah: get the basic tests done. Hormone testing, pelvic ultrasounds and more. The basic tests are part of it. There are a huge amount of things that are missed. From that, it’s a referral right to a reproductive endocrinologist, who is trained to point you toward IVF. They’re not going to look at the whole body and identify clues. There are huge clues that can change what you should pursue.
For tubal issues or cancer, maybe IVF is the right choice. To me, there are a lot of things that are missed. Fertility clinics are big business. In 1985, there were 44 fertility clinics. Now there are over 2,000. We’re in a huge food experiment and exposed to environmental toxins. Male sperm are really impacted by environmental toxins. EMFs are linked to low motility and sperm count.
I know there are so many more things you can do than just going to an IVF clinic. All of this is a personal choice. There is work you have to do. If you think it won’t work, you’re probably right because you’re going to sabotage yourself. If you’re starting out, look at the basics of your sleep (insomnia, interrupted sleep, feeling exhausted). Overexercising and underfueling. Some people are underweight, which is equally as dangerous as being overweight. In a functional approach, weight balances out. Stressors are a big problem too. Most people struggle with infertility for years. It can bring you together or tear you apart. That’s why I coach couples. Men may feel they just have to support but they’re equally in pain. Men typically aren’t joining Instagram and telling all his friends about it.
If something is wrong, your body will start shouting. Tuning into your intuition is key.
Georgie: what about women who say, “I don’t have six months for a program, I want IVF so I can have my baby now”?
Sarah: an average IVF is 2.5-3 cycles, for a cost of $60k. That is a massive investment. Let alone, going through these cycles and experiencing emotional heartache. If you want to increase the success of that, get to the underlying issues as to why it’s not working. We’re doing a blood chemistry review and catching thyroid issues, blood sugar issues, absorption issues, all sorts of issues. There is never a negative side to working on your health. It’s a healthy mom and dad, healthy pregnancy, healthy postpartum period, healthy child.
Taking six months is worth it. In Dirty Genes by Ben Lynch, he says: why are we spending 12-18 months planning a wedding and want to get pregnant in one month? Why don’t we reverse that and spend time working on our health and preparing for children? That doesn’t resonate with a lot of people because they’re in a panic.
You still need to invest in this process and then make real changes. When you move ahead quickly, you have to ask yourself why you’re running? It’s our culture and conditioning. There’s a pattern. I was super impatient. I have to continually work on that or I become very frustrated and it shows up as anger or irritability. In life, in general, I try to be more engaged in the journey and not pushing ahead. Patterns will show up more during times of struggle.
Georgie: over the years, I’ve realized that feeling good is priceless. For me, after three years of trying the wrong things and being wrong, I would even argue with my doctor. I got so frustrated but the reality was I started feeling good. Over time, I evolved to understand: I didn’t even know that my “normal” was bad. There’s no price on feeling good.
Sarah: the people that come to me aren’t a sick population. They feel fine. You don’t know how poorly you are feeling until you start feeling freaking awesome.
Georgie: what surprises the people who work with you the most?
Sarah: the fertility journey will impact all aspects of your life. The functional side of things does as well. You start seeing how food impacts your health. You start to figure out the correlation between your common health symptoms and food. You can make the links. Some of your friends and family will change along with you.
I had friends in the beginning who didn’t agree with me who, over time, have come alongside and begun to see the changes in their own bodies. I don’t preach to my friends or family. They see things I’m doing and ask.
It’s not about deprivation. It’s not about starvation. I eat awesome food. There is no suffering.
Our bodies don’t want to eat junk in a can or brown stuff on a plate. You learn to eat stuff that makes you feel good.
Georgie: when you start to pay attention, the transformation is amazing. Your podcast, Get Pregnant Naturally, has amazing episodes. If you were to pick a couple of favorite episodes or unique topics, what would you call out?
Sarah: we see a lot of people with anxiety or depression that then struggle with infertility. We have an episode on that.
Another one is about what to do after reading It Starts With an Egg by Rebecca Fett. It was published in 2014 and most people in the fertility community have read it. It is geared to IVF success but the updated version has a lot more information in it. We talk about a functional spin on those recommendations. We get myopically stuck on egg health but we should be looking at the whole body.
Georgie: the work you’re doing is incredible. I wish this had been around when I was struggling. I certainly did the research and think that you are setting people up for success. Even while patients still have to go to IVF, you set everyone up for success.
What is your greatest hope for people who struggle with infertility?
Sarah: build a board of directors that includes your OB GYN, your chiro, your fertility coach, your masseuse, etc. When we get to the diagnosis, we go to your OB first and the REI (Reproductive Endocrinologist), but what about the other people on the team? Most of all, what about you? What about those common but not normal symptoms? I have never had someone come in where the only thing they come in with is an infertility diagnosis. There are always numerous healing opportunities. Listen to yourself.
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