fertility FAQs: Your Questions About Naturopathic fertility Care, Answered

A fertility specialist (reproductive endocrinologist) focuses on diagnosing infertility and delivering assisted reproductive technologies like IUI and IVF. That's important, essential work — but it leaves a significant gap. Naturopathic doctors at The Clara Clinic focus on the underlying factors that affect whether conception happens and whether a pregnancy is sustained: egg quality, ovulatory function, immune regulation, hormonal balance, metabolic health, nutritional status, and stress. We run comprehensive labs that go well beyond standard fertility panels, and we build individualized treatment plans based on what we find. Most of our fertility patients see us alongside their fertility clinic, not instead of it — the two approaches are highly complementary.

Yes. The Clara Clinic has a dedicated fertility care team available both in-person at our Gerrard Street East clinic in Toronto and virtually throughout Ontario. Our fertility team includes Dr. Alessia Milano ND, Dr. Kelly Clinning ND, Dr. Jessica Nazareth ND, and Dr. Simone Pirita ND — each of whom focuses specifically on reproductive and hormonal health. We offer free 15-minute introductory consultations so you can connect with the right doctor before committing to care. Whether you are trying to conceive naturally or alongside IVF or IUI, we have experience supporting both paths.

This is one of the most common questions we receive, and the honest answer is: naturopathic care cannot guarantee IVF outcomes, but there is meaningful evidence that optimizing your health in the months before a cycle can improve your chances. The key window is the 90 days before egg retrieval — this is how long it takes for follicles to develop, which means the nutritional, hormonal, and metabolic environment during that period directly affects egg quality. We recommend connecting with us at least 3 months before a planned IVF or IUI cycle so we have time to make a real difference. Our support during IVF also focuses on reducing side effects, supporting implantation, and helping you navigate the emotional demands of treatment.

Unexplained infertility — where standard fertility testing comes back normal — accounts for roughly 10% of infertility cases, and it is one of the most frustrating diagnoses to receive. In our experience, "unexplained" often means "not yet found." Standard fertility panels don't assess everything: subclinical thyroid dysfunction, insulin resistance, endometriosis, environmental toxin burden, subtle immune dysregulation, and mitochondrial function affecting egg quality can all impair fertility without showing up on routine testing. At The Clara Clinic, our unexplained infertility workup goes significantly deeper than standard panels, and we frequently identify contributing factors that had previously been missed.

Yes. Infertility is a shared concern — approximately one third of infertility cases involve male factors, one third involve female factors, and one third involve both. Male factor fertility is an area where naturopathic medicine has a lot to offer: sperm quality, motility, and DNA fragmentation are significantly affected by oxidative stress, nutritional deficiencies, and lifestyle factors — all of which are modifiable. We assess and treat male fertility concerns as part of our integrative approach, and we welcome both partners into care.

Yes, and this is an area we take very seriously. Recurrent pregnancy loss — typically defined as two or more consecutive losses — is heartbreaking and often inadequately investigated in conventional care. Our workup for recurrent pregnancy loss goes much deeper than standard panels and considers factors that may not have been assessed. We work to identify the most likely contributing factors and build a targeted preconception plan to reduce the risk of future loss, while also supporting you emotionally through what is an incredibly difficult experience.

PCOS is one of the leading causes of ovulatory infertility, and its impact on conception goes beyond irregular cycles alone. The key fertility barriers we see in PCOS patients include ovulatory dysfunction — inconsistent or absent ovulation that makes timing conception significantly more difficult — poor egg quality driven by oxidative stress and metabolic dysfunction, lower implantation rates linked to the inflammatory and hormonal environment PCOS creates, suboptimal progesterone levels in the luteal phase that compromise the uterine lining's ability to support a developing embryo, and broader metabolic dysfunction including insulin resistance that affects reproductive function at every level.

Our approach to PCOS-related infertility addresses each of these barriers directly, targeting the root causes driving your specific PCOS type. Many of our patients with PCOS-related infertility begin to ovulate regularly within 3 to 6 months of targeted naturopathic treatment. For those pursuing IVF, we also focus on optimizing the ovarian response and reducing the risk of ovarian hyperstimulation syndrome (OHSS), which PCOS patients are at higher risk for. You can learn more about our PCOS care here.

Endometriosis is far more common in women experiencing infertility than many people realize. Endometriosis is present in approximately 30 to 50% of women experiencing infertility. A 2024 systematic review found that among couples diagnosed with unexplained infertility who underwent diagnostic laparoscopy, 44% were found to have endometriosis — with the majority (74%) classified as minimal or mild disease. This means endometriosis is frequently present, frequently missed, and frequently contributing to infertility even when it isn't severe enough to cause obvious structural damage.

It can affect fertility through inflammation in the pelvic environment, structural changes to the fallopian tubes or ovaries, impaired egg quality, and immune dysregulation affecting implantation. Our naturopathic approach to endometriosis-related infertility focuses on reducing systemic and pelvic inflammation, supporting immune regulation, optimizing egg quality, and working alongside any surgical or hormonal management your gynecologist has recommended.

We also provide individualized counselling to help you navigate one of the most difficult decisions endometriosis patients face: whether to pursue surgery, IVF, or a combination of both as your path to pregnancy. This is rarely a straightforward decision, and it depends on your stage of endometriosis, ovarian reserve, age, and personal circumstances — we help you understand the evidence behind each option so you can make an informed choice in partnership with your specialist. We also stay current on emerging medications and adjunctive therapies being studied to support fertility outcomes in endometriosis patients, and can discuss whether any of these may be relevant to your situation. You can learn more about our endometriosis care here.

Reference: https://pubmed.ncbi.nlm.nih.gov/38943813/

Several supplements have strong research support for fertility. Coenzyme Q10 (CoQ10) is among the most well-studied for improving egg quality and mitochondrial function, particularly in women over 35 or with diminished ovarian reserve. Folate (as methylfolate, not folic acid, for those with MTHFR variants) is essential for healthy cell division and neural tube development. Inositol is particularly well-supported for PCOS-related infertility. Vitamin D deficiency is consistently associated with poorer fertility outcomes and is highly prevalent in Canada. NAC, melatonin, and omega-3 fatty acids each have meaningful evidence for specific fertility concerns. That said, the right supplement protocol depends entirely on your individual lab results and fertility barriers — blanket protocols frequently miss the mark.

Thyroid dysfunction — even subclinical hypothyroidism — is one of the most commonly overlooked contributors to infertility and recurrent pregnancy loss. Thyroid hormones play a direct role in ovulation, implantation, and early fetal development. Many fertility clinics use a TSH threshold of under 4.5, but most reproductive endocrinologists and naturopathic doctors now recommend keeping TSH under 2.5 when trying to conceive, and under 2.0 in early pregnancy. Thyroid antibodies (Hashimoto's thyroiditis) can impair fertility even when TSH appears normal. At The Clara Clinic, we always include full thyroid panels — not just TSH — in our fertility workup, and we treat to optimal rather than just "normal" ranges.

Yes. We offer virtual naturopathic fertility appointments to patients anywhere in Ontario. Everything available in-person — comprehensive intake, lab requisitions, supplement protocols, treatment planning, and ongoing monitoring — is available virtually through our secure, PIPEDA-compliant Jane platform. Many of our fertility patients see us exclusively virtually and achieve excellent outcomes.

This depends significantly on what's driving your fertility challenges and where you're starting from. As a general guide, we recommend a minimum of 3 months of consistent treatment before a planned IVF or IUI cycle, as this aligns with the development window for eggs and sperm. For patients trying to conceive naturally, meaningful improvements in cycle regularity and ovulatory function typically emerge within 3 to 6 months. Egg quality improvements take at least 90 days to reflect the full follicular development cycle. We are always honest about timelines and realistic about what naturopathic care can and cannot do, but consistent, targeted treatment during the right window makes a real difference.

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