The Infertility Explosion: Why Fertility is Declining Faster Than Ever with Dr. Aumatma Simmons

What’s Inside This Episode?

• Staggering fertility stats: Find out why male fertility has dropped by over 60% in just 50 years—and what that means for future generations.
• Hormone imbalances and “male menopause”: Understand why testosterone clinics might be a “hidden trap.” 
• The “root cause” approach: Find out what is silently creating this reproductive crisis and how to address it.
• DNA fragmentation and recurrent miscarriage: Find out how poor sperm DNA quality might be contributing to IVF failures and pregnancy loss—and what can be done about it.
• Actionable tips for practitioners: Find out how practitioners can evaluate and support fertility at every stage, from lifestyle foundations to advanced functional testing.

Resources and Links

• See the Full Transcript here
• Download our FREE Metabolic Health Guide here.  
• Join the Next-Level Health Practitioner Facebook group here for free resources and community support
• Reserve your spot for ReInvent 2025 here for a deep dive into the impact of the microbiome on brain health including lab testing and genetics
• Visit INEMethod.com for advanced health practitioner training and tools to elevate your clinical skills and grow your practice by getting life-changing results. 
• Check out other podcast episodes here

Dr Aumatma Simmons Resources and Links

• Dr Aumatma Simmons’ Website:www.holisticfertilityinstitute.com and www.madrefertility.com
• Check out Fertility Secrets: What Your Doctor Didn’t Tell You About Baby-Making – Dr. Aumatma’s best-selling book on holistic fertility approaches
• F.E.M Training: Practitioner Training Program
• Follow Dr Aumatma  on Instagram @holisticfertilitydoctor 
• Follow on LinkedIn: https://www.linkedin.com/in/aumatma/

Dr. Aumatma Simmons Bio  

Dr. Aumatma Simmons is a double board-certified Naturopathic Endocrinologist with nearly 20 years of experience. She founded the Holistic Fertility Institute to support couples in achieving their dreams of starting a family and to train doctors specializing in fertility. Dr. Aumatma is the bestselling author of *Fertility Secrets: What Your Doctor Didn’t Tell You About Baby-Making* and is passionate about creating healthier families and a healthier planet. She co-founded Madre Fertility, a fertility platform that personalizes fertility journeys with tailored dietary, lifestyle, and supplement guidance. Dr. Aumatma has been featured on ABC, FOX, CBS, KTLA, MindBodyGreen, and The Bump as a leading expert in holistic fertility. Reach out to work/ train with Dr. Aumatma: IG/TikTok @holisticfertilitydoctor or www.holisticfertilityinstitute.com

Transcript

DrRitamarie (00:00)

Welcome back to the podcast. In today’s episode, we’re going to talk about a serious issue that impacts a very large, unfortunately, percentage of the population in today’s modern world. Many people think infertility is just bad luck, but in reality, there’s a little-addressed reason why so many couples are struggling. And that’s what this episode is all about.

So infertility is at an all-time high and our guest today is on a mission to help bring healthier babies into the world by creating healthier parents and a healthier planet. So let me tell you a little bit about her.

She is a double board certified naturopathic endocrinologist. She’s been in practice for close to 20 years. She founded the Holistic Fertility Institute to support couples in creating the family of their dreams and to train doctors who want to specialize in fertility. And I would take it beyond that, not just specialize in fertility, but we’re seeing people who are struggling with that, even if they may come in with a different problem, and we find out that they’ve been trying to have a baby for years.

So it’s really helping us as practitioners to be able to understand what are the things that we’re going to look at and when we need to refer them out to a specialist. So she is the bestselling author of Fertility Secrets, What Your Doctor Didn’t Tell You About Baby Making. And she’s been featured on a lot of different outlets like ABC, CBS, KTLA, Mind Body Green, and The Bump. So let’s welcome Dr. Aumatma Simmons.

Dr. Aumatma (02:24)

Thank you so much for having me, Dr. Ritamarie. That was a beautiful intro and I love your energy. Great. Awesome.

Dr Ritamarie (02:31)

My energy. Yes, energy is good, right? Energy is good. So I want to just jump in and, knowing our audience is mostly health practitioners, we have a lot of self healers that listen in because they really want to understand their bodies and really take charge. But a lot of folks that listen could be doctors, nurses, health coaches, and all sorts of other kinds of health professionals that are tired of the broken system and are looking for solutions to the problems that our clients are facing. So here’s the deal. Like I see fertility rates at an alarming rate. 

Fertility rates seem to be declining at an alarming rate in many parts of the world, including the U.S. big time. So let’s talk about some of that.

Some of the really striking statistics I’ve heard you speak, and you’ve thrown out statistics that floored me, so what are some of those statistics about fertility that we should be aware of?

Dr. Aumatma (03:29)

Well, I think the biggest one comes from the male fertility world, actually. And that is that in the next 20 years or so, we expect to see most men having zero sperm, and that’s called azoospermia. 20 years to me is like right around the corner. I have a six year old. So in 20 years, he will literally be reproductive age, and hopefully potentially trying to have a baby. So this is deeply personal on so many levels for me. 

And I do think that that’s a very alarming statistic. But it’s based on the fact that in the last 50 to 75 years, we have seen massive drop off in sperm counts. So in the 1960s, the average sperm count was 120 million.

And average is an average, right? It’s not every single person, but that’s kind of where men were falling in the sixties. And now literally like less than 75 years later, the average is at 40 million. It’s already at a huge level to have dropped off. 

People might be listening to this and they’re like, well, that’s just men, right? Like that’s just happening to men. What I often say is, that’s easier to measure in men, but the same stuff is happening to our bodies as women. So there’s a little bit of a question mark as to what’s going on? Why is this happening?  

Dr Ritamarie (05:23)

Exactly. That was what I wanted to ask you. Why do you think that’s happening? Why such a significant drop off?

Dr. Aumatma (05:29)

I think a big portion of it is certainly waking up to the fact that the toxins, the microplastics, the things in our environment are very detrimental to fertility. And we kind of underestimated the impact of those things when they were created, right?

Dr Ritamarie (05:49)

Yeah, convenience over health over proper bodily functions.

Dr. Aumatma (05:55)

Totally. I think a lot of it is the environmental toxins, but we are also not accounting for the fact that male testosterone levels are also dropping at alarming rates. The kind of solution that our society is coming up with is to give men testosterone, which you may have heard me say this before, is like the best way to give men birth control. So what they’re not being told in these testosterone clinics is that taking testosterone shuts down sperm production. 

So a lot of men are getting on testosterone in their 20s because they’re like, I don’t feel good. My testosterone is low. I don’t have a great sex drive. Why do men at this level not have a sex drive? That’s a very different conversation. But I think that the impact of that is that they’re going into these over the counter clinics that are like, Sure, happy to prescribe you testosterone. And then they come into our office in their 30s and 40s. Like, hey, what happened to all my sperm? What’s going on? You took testosterone for 12 years. What do you think was going to happen?

Dr Ritamarie (07:13)

And I want to dig deeper with that because why does taking, we would think logically that taking testosterone would increase sperm count, right? Why does this happen, is it the negative feedback loop or what is it?

Dr. Aumatma (07:21)

Yes, exactly. The loop is essentially, the brain in men produces FSH and LH. LH stimulates testosterone production, and then that stimulates sperm production. Then you need FSH to actually make the sperm. So it’s two signals to produce sperm.

But if you weirdly or exogenously increase testosterone levels, when there’s too much testosterone floating around the body says, I don’t need sperm. So it stops sperm production, and it feedback loops to the brain to shut down the production of LH and FSH. Iit sets up a weird loop in the brain, which I feel like happens with exogenous hormones in general, right? 

People take thyroid hormone, it loops back and the TSH goes down, because you don’t need it anymore. Right? Anytime you take a hormone, you’re going to have a negative feedback loop to something else. And it’s usually at the level of the brain. 

Dr. Aumatma (08:46)

If we keep doing these exogenous hormones, but we haven’t addressed why is your testosterone low? Why are your sperm counts low? Then it’s just doing feedback loops to something that’s actually needed by our bodies. And it’s the wrong signal. We don’t want that signal to actually be going out.

Dr Ritamarie (09:04)

No. And the other issue that I find a fair amount, because I look at a lot of tests, is that when men are given testosterone without checking their aromatase enzyme status, they oftentimes go from, “I have no sex drive, and I don’t have any libido” and this and that. They are not checked, and they are aromatizing which means that they’re converting testosterone to estrogen. 

They go in because they can’t have erections, they don’t want to have erections, they have no interest, they have infertility, and they end up growing boobs because nobody really checked them well for the estrogen testosterone ratio. Now, is that an epidemic proportion? I don’t know the exact proportion that that happens in, but I know that aromatase inhibitors, to keep that at a level that a male should have, include a lot of the good foods and nutrients that the modern society is low in. Zinc is an important one. Omega 3 and 6 ratios are important for that. GLA is important. There’s all these things that the average male doesn’t have in balance, because they’re eating processed foods with microplastics and devoid of nutrients. So we create this loop for that.

Dr Aumatma (10:24)

We do and just to what you said, men are aromatizing to estrogen, that’s a very natural process. But if you push testosterone too much, you’re also going to push estrogen. And estrogen also has a feedback loop to the brain to shut down the production of FSH and LH. 

Dr Aumatma (10:52)

The second layer of this is because there are so many estrogen mimicking compounds in our environment, that’s another feedback loop to the brain to shut down the production. So I think that’s causing some of the testosterone-sperm epidemic issues. But I also think that it’s fed even more by taking testosterone. 

Dr Ritamarie (11:04)

Naturally, it’s a natural enzyme, and we do convert some of it. So, it’s not just a problem with over aromatasing. It’s a problem with providing too much of the substrate, the testosterone to that enzyme. And it’s just going, whoop, how do I get it out? It’s too much, let’s go to estrogen, right? 

And so they have this decrease in sperm count. They have a decrease in sex drive, because they have more estrogen. They’re becoming more nurturing, which is nice, but it’s just not the way they want. And the muscle value goes, right. So those are really good reasons. And the microplastics and all this stuff. So estrogens in the environment are rampant, right? They’re in dental materials, they’re in cosmetics, they’re in hair care products, they’re in body care. So address that. 

Dr Aumatma (12:18)

And phthalates.. So DEHP, which is a specific kind of phthalate, I was just at a reproductive medicine conference. This presenter was talking about DEHP and the impact that that has on fertility is that it causes rapid aging. They’re doing it in mice models, they have also studied this in human ovaries. So what they’re seeing is that these phthalate compounds that are estrogen mimicking are causing our bodies to act and behave as if we’re a lot older than we actually are. 

Dr Ritamarie (13:18)

And what happens to females? Males don’t necessarily have that, after age X, Y, Z they can’t produce. I know men in their seventies who are having babies with much younger partners. Right. And they’re able to procreate, but women have eggs that have run out. We go through menopause where, unless we go through in vitro or whatever, we’re not going to be able to reproduce.

Dr Aumatma (13:28)

Men don’t have that as much. I’ve been tracking this for a little while. I do think that andropause and that transition into the next stage of life for men is not a complete cutoff as it is for women, but it is a massive drop off.

So by the time they’re in their 50s, it actually is getting a lot harder for them to sustain sperm production in the same way that they did when they were younger.

Dr Ritamarie (14:25)

So there’s a lot here and a lot of it goes back to a lot of the things that we as functional practitioners, nutritionally oriented, naturopathic, the things that we naturally do are going to go a long way in helping this area. So let’s talk about some of the steps that we as practitioners can take to help people who are struggling to conceive and stay pregnant too, because that’s a problem I see a lot more now, women having miscarriages.

Dr Aumatma (15:01)

It’s a problem that’s just normalized in so many settings. So they go to an OBGYN and the OBGYN says, one in three pregnancies end in pregnancy loss, totally normal. Don’t worry about it. Just try again. Try again. Try again. So like the most severe I’ve seen is a woman with nine pregnancy losses, no workup. She doesn’t know why she’s having a pregnancy loss.

And then they’re told, just do IVF, because we can PGT test the embryos and hopefully that will have a better outcome, or we can put you on prednisone and shut your immune system down, and that’ll help you have a baby. Pregnancy loss is a big one for me. 

In terms of what we can help people with, I think there’s a lot and I think that it goes to what’s the root cause, right? I know that you work a lot like this, what’s happening under the surface that’s causing lower testosterone levels, if we just start with that. What I’ve seen a lot is, it’s often nutritional deficiencies and blood sugar and metabolic dysregulation that’s driving so much of the hormone dysfunction. If we can get them eating well and regulating their blood sugar and insulin, magic happens. 

We have a 54 year old male right now who is trying to get his wife pregnant, and she’s 42. He’s a functional medical doctor, functionally trained, but his approach has been, I’m going to take this list of peptides, HCG, Clomid, and he came to us, he’s been working on this for three years on his own. And he’s like, I don’t know why this is not working for me, because it works for everyone else I see. And so we looked at him, and we’re like, okay, no more peptides.

No more of this stuff, let’s get to the root of it. And yes, we’re going to give you some herbs to support your adrenals. Stress is a big factor. We talk about it all the time with women, but we don’t talk about it with the men. If they’re stressed out, this man has a multimillion dollar business practice clinic. And he’s like, of course I’m stressed. How do I not be stressed? 

So really working on the stress, the blood sugar, the insulin and his nutrition, he was eating total garbage, total garbage, right? I don’t have time to eat, but I’ll take all the supplements. And I’m like, you have to eat.

Dr Aumatma (18:22)

And you have to eat vegetables. Like the basics. So he’s been doing that for six, seven months now. And he finally was like, yes, the testosterone is the best that it’s ever been. His sperm counts are the best they’ve ever been. The quality of the sperm is the best that it’s ever been. And the first few months that we started seeing improvement, he was like, no, no, no, I’m still taking HCG. It’s the HCG finally clicking, And I was like, listen, you’re off of all of the peptides. You’re off of all of the other supplements you were taking. You’re just taking our supplements and HCG. And we couldn’t convince him to get off of the HCG. So that was it. He was like, I got to stay on that because if my testosterone tanks, that’s it.

He’s obsessed with testosterone levels. Okay, fine, keep taking HCG, we’ll do everything else. And then four months in, we were like, hey, maybe get off the HCG now, like you’re seeing improvements, things are way better than they were. And he’s like, maybe in another month or two. Now  everything is at the best he’s ever been. He feels the best that he’s ever felt.

Is he doing something for the stress? Yes. We’re just doing herbal support because this man has no time, right? He’s going to stay stressed out. Okay, if we can give you herbal support that just gives your body a little bit more stress resilience, then that’s a win. That’s a win for us.

It’s helping your body just adapt to whatever is happening under the surface. And then the second piece for him was to just eat food. Like you absolutely have to eat food. And it must be in regular intervals so that you’re not tanking your blood sugar. And having this metabolic dysfunction where your body is freaking out, because there isn’t any food in your system.  

Dr Ritamarie (20:46)

Right, and then you go into more stress, because cortisol gets released to try to bring up the sugar, and then it compounds, and then the cortisol steals, from the pregnenolone steal, a production of your sex hormones. So, we have to be looking at that.

Dr Aumatma (20:56)

It sounds and feels relatively simple to me, but it’s amazing when I look at someone who is functionally trained, he’s a little bit newer to this, but a lot of the medical world is still using functional medicine as a way to replace the things that they were doing before, right? 

Like, I want to take Ozempic, because it’s going to support my GLP-1 and all this stuff. And, okay, maybe that’s a good solution down the line if you have done the foundations. But you can’t skip the foundations in order to do the medications. 

Dr Ritamarie (21:47)

And I think that there’s a difference between allopathic thinking and a more naturopathic thinking, is looking for root causes, because someone that comes from a straight allopathic approach and realizes these drugs are not working, and we’re just suppressing symptoms and whatnot, and they learn about functional medicine, and they start to learn, a lot of them are like this guy where they’re just giving people substitutes for the drugs, which may be a little bit better, because they’re not just for some symptoms suppression, but we’re not looking for those underlying root causes and the metabolic imbalances that contribute and not paying enough attention to food and nutrition. 

That’s a huge gap in medicine, obviously. And then when people move in, and they maybe take some I.F.M. courses or other things, they don’t necessarily get all they need about food and nutrition, they get more about testing and what supplements to use, right? And what you said about getting to the core, getting to the foundation. So those of you who are in our community here and have been listening to my podcast or a part of our practitioner training programs, you know that we harp on that right from the beginning. Foundations, foundations, foundations. We’ve got to get the foundations, the lifestyle stuff, the diet, the stress, et cetera.

And, we have got to get the blood sugar balances and the gut balances and start there. But typically when there’s a fertility issue, hormonal imbalances, I have a pyramid that I’ve drawn out and higher in the pyramid, the sex hormones are up there at the top in the pyramid, right? And you have to go through the bottom, what’s causing that? So we have to go through that.

So keep doing what you’re doing if you’re studying here, then when you get to certain steps, so say, you get somebody, and they are doing all of that, right? They’re eating well, they’re avoiding their toxins, they’re eating organic, they’re drinking their water, they’re hydrated, they’re meditating, they’re exercising. Where do you go or do you go from there?

Dr Aumatma (24:02)

I think at that point, if they’re still not getting pregnant, my question mark is, OK, what’s missing? Like, what where did we miss? Things go awry that they can’t get pregnant, because there’s always a reason. Right. And I have practiced in Berkeley for 15 years. So that was my client.

Most of my clients bring a binder, here’s all the stuff I’ve done, I’m already doing all these things, right? Talk to me about something else. So that’s really where I think functional medicine testing plays a huge role for me, because I can look at a DUTCH test and say, okay, you’re doing all the right things. Yet, estrogen, E1 is converting to E3 and not leaving out of the right pathways, let’s reorganize this so that your estrogen gets metabolized in the right way in the right pathways. And voila, like that is often the magic for some people. There are a lot of tweaks that  are higher up in the the pyramid, if we want to think about it that way. 

I feel like we probably have very similar pyramids. And I know we’ve talked before and I’m like, yes, I know you get it. I know we’re on similar planes. So, at that point, you can really target with the hormones, or I’ve seen so many people that are like, I eat all the right foods. I’m gluten free. I’m dairy free. I do all of the things that I’m told to do. Yet, they will continue to have gut symptoms. 

And then I’m like, okay, well, let’s check your food sensitivities. And voila, there’s the answer, you’re eating things that you’re sensitive to, your gut is responding, inflammatory, immunologically, and that inflammation is often going to create uterine inflammation, and it’s going to make it that much harder for you to get pregnant and stay pregnant. So it’s for the people that are doing everything, even from the functional medicine side, I think that they don’t know how to put the pieces together for themselves, right? 

I kind of see myself as an interpreter, I’m taking what their body is telling them and converting it into something that makes sense for us to test, prove, and improve. So we can really hone in. I’m glad you’re doing all the foundations. I’m glad you’ve done all these detoxes. Sometimes they’re doing too much. It’s like, I’ve done all these different parasite cleanses. And I’m like, OK,  let’s really figure out if you needed to do that, or if you’re depleting nutrients in the process of doing those cleanses. So we really have to hone in at that point on, what’s the missing piece? Because there’s usually one or two things that as soon as we see it on a test, it’s easy. let’s fix that.

And I think that our job is to really to be able to listen deeply and be able to be that interpreter to take their list of symptoms and say, huh, okay, I think we should do this test, because if you have joint pains and post-nasal drip, that’s going to relate to leaky gut, that has no symptoms in the gut.

And they’re like, what? But my stomach is fine, I’m good. I don’t have any digestive symptoms. I’m like, yeah, let’s just do this on my suspicion. And then that’s where the answer is. So we’re a little bit of a detective, a little bit of like, how do we take what they’re saying, what they’re experiencing in their bodies and be able to connect it to what’s actually going on under the surface that’s hidden from plain sight.

Dr Ritamarie (29:07)

That’s not obvious. And so, what I’m hearing and correct me if I’m misinterpreting, is that when we do a history, we all should be doing a thorough history. We’re looking at all the places in the body where things are going awry, not just going, you have a fertility problem, let’s do a hormone panel, right?

Dr Aumatma (29:56)

Yeah, definitely not. Hormones are like the end of the road for us. It sounds like it is for you too. DUTCH Tests have gotten so popular these days, the number of times people come in, I already have a DUTCH Test. Okay, cool. And what?

we have so much work to do before we get to dealing with the DUTCH test. And they’re like, wait, what? You’re not going to detox by estrogen? no, let’s fix your gut microbiome first. Because if that’s not working, how is your estrogen going to detox? Right? We can upregulate all of these pathways and give you DIM and give you all the things. But if you don’t have the right microbes in your gut that are going to take that estrogen metabolite and get it out of your system, there’s nothing. So, it feels like working backwards for so many people, but it’s really that the pyramid that you’re talking about is like setting up the foundations so that everything works smoothly, before you get to the point of the hormones. 

Then for us it’s egg quality and sperm quality. So that’s what everyone thinks they’re coming in for.

Dr Ritamarie (31:26)

Egg quality is hard to test, right? That’s not something like sperm , just ejaculate into a cup, and we can test your sperm quality. We can’t do that with women, right? It’s very invasive.

Dr Aumatma (31:37)

There is no great test for egg quality. The best is probably if they have undergone an IVF cycle already, then you can see on their outcomes how many eggs were retrieved and then how many made it, how many survived the retrieval, right? So if they started with 20 eggs, and only 10 of them made it to the point of fertilization that were good enough to fertilize, then that’s really poor egg quality versus 20 and 18 made it to fertilization. That’s pretty great. And then from the point of fertilization on, you’re going to get either day three or day five embryos. And if we have day three, it depends on the clinic. 

So that’s not something you can really request. But if you have 20 eggs that were fertilized, how many made it to day three, or five, will give you a pretty good sense of embryo quality. And that is going to be a combination of egg and sperm quality. So a lot of times, women, I had a woman who was 32, nine IVF cycles at three different clinics. And she knew all of her numbers. She literally came in and was like, this is how many were retrieved, how many made it to fertilization, how many fertilized. And I basically looked at her chart for nine cycles. And I was like, it’s the sperm. It’s literally the sperm. I’m looking at this and I was like, have they ever done a DNA fragmentation test. She’s like, what’s that? They do that on the sperm. 

I was like, you just need to go to the IVF clinic and ask them why they didn’t do a DNA frag. And sure enough, she came back a few weeks later and said, the doctor said DNA frag has not enough data on outcomes of IVF cycles. And I said, well, you have no IVF cycles. She gets maybe one or two embryos after 20 eggs are retrieved in each cycle. I said, it’s definitely the sperm. I would suggest you pay for this out of pocket. And she messaged me a few weeks later and said, you’re so right. It’s the sperm.

We need to deal with the DNA frags. You can tell a lot from the IVF process. And it breaks my heart that this woman went through that. But she started at 29 years old, by 31 and 32, she was told by multiple clinics that she was too old. And it was her age that was the reason that she was not getting pregnant. And I was just like, flabbergasted by all of it, because I’m like, you didn’t even test the sperm fully, let alone a more thorough evaluation on her partner. Like that is way down the line, but you should at least have done DNA fragmentation.  

Dr Ritamarie (34:55)

So you’re saying they should do that before they do an IVF cycle.

Dr Aumatma (35:16)

Well, not necessarily, but when we have failed cycle after cycle after cycle, then I really think it’s important to figure out the why, right? So too many people will say, it didn’t work at that clinic, maybe I just need a different clinic. And because they’re not exposed to, there’s another way, there’s another way to think about this, there’s something else happening under the surface.

They buy into clinic after clinic after clinic and every clinic has a selling proposition, right? Every clinic is like, yeah, I want to make $80,000 from three cycles. A lot of clinics say they don’t believe in DNA fragmentation studies. However, the data shows that when DNA fragmentation is high, that basically means that epigenetics of the sperm is whack, whack-a-mole, right? So we know how much epigenetics plays a role in the health of your future child, but it’s also playing a role in the health of the sperm that’s going to fertilize this egg. 

If you start with poor DNA, that mix with the embryo or mix with the egg DNA and create this embryo, then of course the DNA of the sperm is going to have an impact on whether or not this embryo is of healthy quality. it just makes no sense that there’s even pushback about this, right? 

Dr Ritamarie (37:04)

But there haven’t been enough double-blind placebo-controlled studies, right, supposedly. Anyway, but what did they do? Now, what do you do when somebody has that? Is that fixable? Is it changeable? Do they need donor sperm?

Dr Aumatma (37:08)

They could do donor sperm if they were really adamant about just being in the conventional path. Yes, use donor sperm. But there’s so much you can do from the natural side. So for that guy, we’re basically like, OK, what is it? What’s causing the DNA to be fragmented? So we started with toxin testing. That’s going to be the first thing.

Nutrient testing, are you absorbing nutrients well? Are you utilizing them well? What’s missing? And then the third is epigenetic testing. And we’re looking at SNPs that can cause DNA fragmentation. So if we can look at a profile and say, here are some SNPs that are not functioning properly. Let’s nutritionally support your body to have those SNPs work better, right? Like we’re not going to change them, but we can at least see how we can help the function of those epigenetics, then you’re good. So it’s all changeable. You can change it. It can take up to 12 months to change DNA fragmentation.

Dr Ritamarie (38:21)

So you’d go back in again at 12 months then and test it again.  

Dr Aumatma (38:45)

Yes, yes, or even sooner. You could go in at six months and say, hey, is it changing in the right direction? Are we on a good plan to keep going? And the fragmentation test is expensive, and all the functional tests I just listed are sort of expensive. But it’s way less expensive compared to 9 IVF-sequences. 

Dr Ritamarie

Why not go in if you are going to go that route, go in with all your ducks in a row and make sure everything’s working, you know, in the rare exception. And I’m sure you see that, right? Not every couple that you work with has success. Do some of them then go on to IVF?

Dr Aumatma (39:19)

Yes, absolutely. We have right now actually two couples. Both of them are high achieving women, Indian women at that. And there’s something about Indians. Anyway, they might not be having as much sex as they should. That might be the reason why they’re not getting pregnant. But they came in from failed IVF cycles. Both had three or four failed cycles.

We did a six month process with them to address all their underlying stuff, improve the sperm health, blah, blah, like we did all the things. And both of them are pregnant from IVF. So yes, absolutely. Like we get them to a point of okay, you’re optimized. Now go for this IVF cycle. You’re going to have way higher chances of it being successful.

And our goal is, ideally, cut down on the number of IVF cycles you need to do, right? Because the amount of hormones that you’re exposed to in those cycles, the amount of trauma, stress,, forget the money, right? Money is part of it. But besides that, there’s so many components that are being impacted in a negative way that are just setting couples up for failure. So if we can set them up from all of these different angles to optimize IVF cycles, it’s always going to work, because when they have addressed all of those factors, the likely chance that

IVF is the golden ticket at that point. It is really high, really high. But without those things, IVF has a 20 to 40% success rate, depending on age by the time.

Dr Ritamarie (41:28)

Is that on a single cycle or is that overall after several cycles?

Dr Aumatma (41:42)

That’s a really great question. So the CDC publishes data based on six IVF cycles. Clinics don’t tell you that it’s based on six cycles, but the published data is on six IVF cycles consecutively. yes.

Dr Ritamarie (41:59)

Wow. Okay, so 20%, 20 to 40 % success rate with six cycles and you’re saying consecutive, so they can’t take a break and then go back. 

Dr Aumatma (42:13)

Well, they’re consecutive in that regard just as saying that they’ve done IVF after IVF after they might have taken breaks in the middle. 

Dr Ritamarie (42:23)

So let’s go back to this DNA fragmentation. Does that play a role, if it plays a role in failed IVF, does it play a role in recurrent miscarriage?

Dr Aumatma (42:35)

Yes, yes. I think we see recurrent pregnancy loss patients a lot. It’s our subspecialty. It’s kind of like my secret passion is to not have pregnancy losses, because it’s normalized to the point where it seems like it shouldn’t be a big deal. But if you talk to any woman who has been through a pregnancy loss, she’s like, how do I never have this again? Right? It’s so traumatic. And just the trauma of that alone is being re triggered every time she’s pregnant. 

Once you have one loss, it’s very likely that you’re going to have a second and third loss because that trauma is actually putting the body in a stressed out state, which is then going to lead you to a likelier chance. So there’s that piece of it. But DNA fragmentation is likely playing a huge role. From the study side, there are studies that have shown that men with higher DNA fragmentation, higher than 17%, I believe is the research, are going to be likelier to have a woman with a pregnancy loss.

We don’t do DNA studies a lot out of the gate. And the reason is most of the DNA frag has to do with methylation and detoxification. So if we address those before we even get to a pregnancy loss, then theoretically we’ve prevented a couple from having a pregnancy loss if we’ve worked on methylation and detox, which we do all day. And we know to do that through basic biomarker testing. 

If we can look at, is your liver functioning well? Is your blood sugar functioning well? And is your homocysteine low, below 7.2? If those three factors, usually on basic blood chemistry, are enough to interpret whether or not they’re going to have good quality sperm or not. And those factors on their own are also connected in research to pregnancy loss. So 80, maybe 90% of couples with recurrent pregnancy loss have a male partner that has one or more of those three things going on.

Dr Ritamarie (45:22)

Wow. This has been fascinating. There’s just so much to unpack here. And you know, my takeaway here is there’s a lot that we can do before having to send somebody off to a specialist, right? And depending on where the person is in the cycle, but the things that we do on a day-to-day basis, which is address those foundations and get people balanced is contributing to  better pregnancy outcomes and the crazy statistics that we see with all the infertility happening these days is a lot of times a huge part of it is the foundations are out of balance. 

Ultra processed foods, metabolic imbalance, blood sugar irregularities, high stress, affecting cortisol, affecting the hormones. So those are all the things we need to be taking into account. So finally, what’s some takeaways that you would give practitioners who want to work with couples struggling with fertility or want to specialize in working with couples.

Dr Aumatma (46:29)

That’s a great question. I think every functionally trained practitioner, especially those in your community are very capable of doing the foundations, right? So do the foundations with everybody. There’s no reason not to. If they’re trying to have a baby or not, you’re doing the stuff, you’re doing the big deep work. At that point, you want to evaluate or know how to evaluate whether or not they have their fertility in an optimal place. Knowing how to evaluate whether or not fertility is optimal is step one. And I have trainings on that. So I don’t know when this will go out, but I’ll share the info if you want to share it with your community.

Dr Aumatma (47:25)

The foundational training is just understanding, is this person at optimal fertility or not. And if they’re not at optimal fertility and you want to specialize in supporting those people, then do more training, right? Like do a deeper dive. If they are at optimal fertility, good, great. Like keep working with them because not everyone needs someone like myself. And we’re working with those people that are like recurrent pregnancy loss, unexplained infertility, you’ve done the foundations, but their hormones are still out of whack, then what? Right? 

So we’re working with those weird cases that you’re like, I’ve done everything, but they’re still not getting pregnant. What’s going on? Right? Like, how long do I wait before having them reach out to someone who can help them deeper. That’s the point at which you either want to refer, bring someone on to their case that can at least evaluate and say, hey, you’re on the right track, keep going, or, hey, they’re going to need a little bit more support than the foundations, then it’s a good point for referral.

And I have a quick story about that. I started my fertility work at an acupuncture clinic. And I signed on to this clinic just because my friend ran it. And he was like, my ND just quit. Can you come help me? And I was like, sure, no problem. I go in. The head acupuncturist was a fertility specialist, did not know that at the time. And she had heard me on a podcast and was like, you do fertility. 

Here’s like 150 people that I cannot work with that have been at this clinic for years not getting pregnant, can you help them? And I was like, sure. Haven’t you already done all the things with them? Like you’re a fertility specialized acupuncturist, right? So she gives me all of their case files, and I just start going through them one by one. And I was like, I see the patterns. I see what’s missing.

It was beautiful to watch, because she had done the foundations, right? She did them from a Chinese medicine perspective, but that’s all the same. There were pieces that were still not clicked into place. And those people went on in three or four months, they were just like, we’re pregnant, we’re pregnant, we’re pregnant, we’re pregnant. And that was the beginning for me of realizing that we have this really unique role to play in the field of fertility, even where acupuncture is regarded as the epitome of fertility support. 

But there are still missing pieces of the people that didn’t get pregnant. So really my takeaway from that was, don’t wait super long before you bring someone onto the team. Those people could have prevented years of suffering. If she had just known there’s this missing piece that I could have someone else support with, then they’re going to get pregnant faster. So really building a team around you or knowing what your limitations are in the way that you have the approach and either fill those limitations with a referral or collaboration or more training. Those are all great ways to continue supporting those people deeper.

Dr Ritamarie (51:13)

For everybody listening, perhaps the fertility issue may be personal for you. It might be personal for someone you love. It might be personal for your clients or patients and people you take care of. Either way, I trust you learned a lot of things today that you can just take action on right now. And so Dr. Aumatma, how can people stay connected with you?

Dr Aumatma (51:41)

The best place is Instagram at Holistic Fertility Doctor. Reach out, get connected. We always start our practitioner training programs in the early part of the year. So if that’s something that they want to explore, definitely reach out sooner rather than later. 

Dr Ritamarie (51:45)

Before it gets filled, right? Thank you so much for being here today. 

Dr Aumatma (52:05)

Thank you for having me. This was so much fun.

Dr Ritamarie (52:21)

And I think it was great, great stuff that people need to hear. So, you know, those of you who tune into my podcast all the time, you know I say this all the time, we are the future of healthcare. We’re putting the care back into healthcare, and we’re replacing the outdated symptom chasing, symptom suppression with truly helping people to get to the root cause. So whether it’s fatigue and gut issues and brain fog and brain issues or serious autoimmune conditions or infertility, all the work that we do to do these foundational things with people, super, super important. So you can check out our website at inemethod.com if you want to learn more about how you can learn these foundational principles, learn how to do the functional testing, learn how to truly take people from being victimized by medicine, telling them there’s nothing they can do to being empowered to take charge of their life. 

So together, let’s continue the movement together to reinvent healthcare. And until next time, shine on.