Get Pregnant Naturally

Your clinic told you donor eggs. You walked out wondering how much time you actually have left. Whether waiting six months means missing your window. Whether trying with your own eggs one more time is brave or stupid.
The honest answer is longer than your clinic implied. And the window is not your AMH number.
In this episode:
- Why a 2024 study in Archives of Gynecology and Obstetrics found that ovarian reserve markers like AMH do not significantly predict natural conception in women with regular cycles
- What the 90-day window before ovulation actually is, and why the eggs you work with six months from now are not the eggs you are working with today
- The inputs your clinic's timeline assumed would not change: mitochondrial function, inflammation, iron, B12, zinc, vitamin D, cortisol patterns, toxic load
- The clinical pattern we see over more than a decade of cases: month zero to six is where the picture comes into view, twelve to eighteen months is where it can start to move substantially
- Why some pictures do not move, and why that is still a reason to look before you decide
If this is the first episode you have landed on in this series, go back and listen to "Told Donor Eggs Are Your Only Option? Ask This First" and then "The Gut Findings Your Clinic Did Not Look For." This episode builds on both.
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WHAT YOUR CLINIC MISSED
The full thyroid panel, not just a TSH. The iron panel that flags ferritin. The gut microbiome testing that your REI does not order. The inflammatory markers no one notices. The male side that almost no one investigates.
Email [email protected], subject line MISSED, and we will send you the guide.
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FUNCTIONAL FERTILITY SECOND OPINION
A free 45-minute call where I review your labs, your history, and your partner's results with you. You leave knowing what your biology has been telling you and what your next decision could be.
Email [email protected], subject line FERTILE, or book here.
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ABOUT THE HOST
Now in its eighth year, Get Pregnant Naturally was one of the first podcasts dedicated to the functional fertility approach for low AMH and failed IVF. Hosted by Sarah Clark, founder of Fab Fertile, author of Fabulously Fertile, and host of a podcast with over one million downloads. Fab Fertile is a functional fertility team that works with couples to review the lab work most fertility clinics do not run: gut microbiome, food sensitivity, vaginal microbiome, nutrigenomics, HTMA, DUTCH, full thyroid panel, the iron panel, and inflammation markers, alongside nervous system work. Each week Sarah brings you what the team sees across more than a decade of cases.
Sarah Clark, founder of Fab Fertile, host of Get Pregnant Naturally (1M+ downloads), and author of Fabulously Fertile.
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TIMESTAMPS
00:00 The Donor Egg Recommendation and the Real Question
01:00 Who's Reviewing Your Case at Fab Fertile
01:30 AMH Is Not the Countdown Clock
03:00 The 90-Day Window Before Ovulation
04:30 What Actually Changes In 90 Days
07:00 The Fab Fertile Method: What We Investigate
08:30 Why Some Cases Do Not Shift
09:30 The Functional Fertility Second Opinion

Told donor eggs after failed IVF? There is a category of testing that your fertility clinic does not run. We rarely run a stool test and find nothing.
The IVF cycle did not work. Maybe it was poor response. Maybe it was canceled before retrieval. Maybe you got embryos and they arrested. Maybe the transfer failed. Your clinic looked at your numbers and told you donor eggs.
In this episode, Sarah Clark walks through the gut pattern the Fab Fertile team sees in women who come to us after failed IVF with a donor egg recommendation, and why this pattern changes the picture before the next decision.
What this episode covers:
H. pylori. One of the most common findings in the women who come to us after failed IVF. It impairs absorption of iron, vitamin B12, and zinc, the nutrients that affect egg quality, thyroid function, and hormone production. It is passed back and forth between partners through saliva. If you have it, there is a strong chance your partner has it too.
Parasites, giardia, blastocystis. Common findings. Rarely tested at the fertility clinic.
Bacterial overgrowth, including streptococcus. Fungal overgrowth and dysbiosis. The reason chasing an anti-candida diet without testing moves you in circles.
Elevated calprotectin. A signal of gut inflammation, often present in women with IBD, Crohn's, colitis, and women with no formal diagnosis.
Elevated zonulin. A marker of intestinal permeability. The pattern we see after rounds of antibiotics, sinus infections, UTIs, birth control, and high stress.
Why this matters before a donor egg decision:
H. pylori impairs iron absorption. Ferritin reads low or low-normal. The clinic says iron is fine because the lab range starts around 15. The fertility-optimized range is closer to 50. Iron is foundational to egg quality. The oxygen carrying capacity to your follicles depends on it.
B12 affects methylation, the process your body uses to produce the co-factors needed for egg maturation.
Zinc affects ovulation and progesterone production.
Chronic gut inflammation affects ovarian response to stimulation, implantation, and miscarriage risk.
When your clinic looks at a canceled cycle, arrested embryos, or a failed transfer and recommends donor eggs, they are responding to the outcome. They are not asking what is driving the outcome.
This episode is for the woman sitting with a donor egg recommendation who is not ready to agree before she understands what was actually evaluated.
Next steps:
Access the free guide: What Your Clinic Missed. It walks through the markers we review before a donor egg recommendation, including the thyroid panel, the iron panel with the fertility target, the gut testing your REI does not order, the inflammatory markers, and the male side.
Email [email protected], subject line MISSED.
Book a Functional Fertility Second Opinion. We will review your labs, your history, your full picture, and your partner's picture together. You will leave knowing what your biology has been telling you and what your next decision should be informed by.
Email [email protected], subject line FERTILE. Or apply here.
About the Host
I'm Sarah Clark, founder of Fab Fertile and host of Get Pregnant Naturally, a podcast with over one million downloads. My functional fertility team works with couples navigating low AMH and failed IVF, reviewing functional lab results, gut microbiome, food sensitivity, vaginal microbiome, nutrigenomics, HTMA, DUTCH, toxin testing, and 
bloodwork alongside nervous system work, to help identify patterns that may not have been considered. We work alongside your medical team, not instead of them.
Subscribe to Get Pregnant Naturally for weekly episodes on fertility optimization, IVF preparation, and the lab work your doctor probably isn't running.
Timestamps
[00:00] Told Donor Eggs After Failed IVF
[01:00] Why the Fab Fertile Team Reviews Your Picture
[02:00] H. pylori: The Most Common Gut Finding We See
[03:00] Parasites, Streptococcus, and the Bacteria Most REIs Do Not Test
[04:00] Why a Single Gut Test Without Fertility Context Misses the Picture
[05:00] Iron, Ferritin, and the Fertility Range vs the Lab Range
[06:00] B12, Methylation, and Egg Maturation
[07:00] Zinc, Ovulation, and Progesterone
[08:00] What Your Clinic Missed: The Markers Before a Donor Egg Recommendation
[09:00] Why a Donor Egg Recommendation Responds to the Outcome, Not the Cause
[10:00] The Functional Fertility Second Opinion: What the Call Covers

The donor egg recommendation rarely comes after a complete workup. It comes after AMH, FSH, and an antral follicle count. That is usually where the investigation stops.
In this episode, Sarah Clark walks through what is missing from the workup before women are told donor eggs are their only path: the full thyroid panel, not just TSH. Stool DNA testing for H. pylori, parasites, and food sensitivities. The vaginal microbiome. The male partner's blood work, which most clinics do not run. The nervous system patterns most REIs do not connect to fertility.
Sarah shares Rebecca's case as a proof point. Rebecca was 27. Her AMH was 0.04 ng/mL. POI diagnosis. Told donor eggs were her only option. Her stool DNA testing revealed H. pylori and a parasite. Her food sensitivity testing showed gluten, dairy, and egg intolerance. She had adrenal insufficiency, thyroid imbalance, mineral depletion, and toxic load on her workup. Her eczema, migraines, and asthma were not separate issues. After targeted work, she conceived naturally in month five. Outcomes vary. Rebecca's case is one of many we use to illustrate what completing the workup can look like.
This episode is for the woman sitting with a donor egg recommendation who is not ready to agree before she understands what was actually evaluated. The goal is clarity. Not opposition to your clinic. Not a guarantee of any outcome. Clarity on what your workup did not include, so that whatever you decide next gets made on the full picture.
What this episode covers:
The diagnosis is real. The investigation is incomplete. Why TSH alone is not a thyroid panel. H. pylori, hidden food sensitivities, and the gut inflammation driver. Eczema, migraines, and asthma as fertility signals. The male partner's workup should include beyond a semen analysis. Nervous system patterns most REIs do not connect to fertility.
Next steps:
Access the free guide: What Your Clinic Missed. The guide walks through the markers that the Fab Fertile team reviews before a donor egg recommendation. Email [email protected], subject line MISSED.
Book a Functional Fertility Second Opinion. We'll review your labs, your history, your full picture, and your partner's picture together, so you know what your biology has been telling you and what your next decision should be informed by. Email [email protected], subject line FERTILE, or book here.
About the Host
I'm Sarah Clark, founder of Fab Fertile and host of Get Pregnant Naturally, a podcast with over one million downloads. My functional fertility team works with couples navigating low AMH and failed IVF, reviewing functional lab results, gut microbiome, food sensitivity, vaginal microbiome, nutrigenomics, HTMA, DUTCH, toxin testing, and bloodwork alongside nervous system work, to help identify patterns that may not have been considered. We work alongside your medical team, not instead of them.
Subscribe to Get Pregnant Naturally for weekly episodes on fertility optimization, IVF preparation, and the lab work your doctor probably isn't running.
Timestamps
[00:00] The Donor Egg Recommendation and the Investigation Underneath It
[01:00] The Diagnosis Is Real. The Investigation Is Incomplete.
[02:00] Sarah's POI Story and Why Fab Fertile Exists
[03:00] Rebecca's Case: POI at 27, AMH 0.04, ng/mL Told Donor Eggs Were Her Only Option
[04:00] Functional Lab Testing Before a Donor Egg Decision
[05:00] What We Found: H. pylori, Parasites, Food Sensitivities, Adrenal Insufficiency, Thyroid
[06:00] Eczema, Migraines, Asthma: Not Separate Issues From Fertility
[07:00] Rebecca Conceived Naturally in Month Five
[08:00] What Your Clinic Missed: The Markers Before a Donor Egg Recommendation
[09:00] Why a Standard REI Workup Cannot Answer Why Your Numbers Are What They Are
[10:00] Medical Gaslighting and the Permission to Investigate Further
[11:00] The Functional Fertility Second Opinion: How It Works

Low AMH, high FSH, two miscarriages, told donor eggs were her only option. At 43, she conceived naturally. Here's what her clinic missed before the donor egg recommendation.
This episode is for the woman sitting with a donor egg recommendation. Low AMH or high FSH on the chart. Failed IVF or recurrent miscarriage in the history. A clinic that said the numbers leave you no other options.
Sarah Clark walks through the case of a 43-year-old client whose REI told her IVF or donor eggs were her only realistic path. Her FSH was 13.6. Her AMH was low. She had two pregnancy losses behind her. The diagnosis of diminished ovarian reserve was not wrong. The numbers were what they were. What had not happened was a structured investigation of why those numbers looked the way they did and whether the rest of the picture had been missed.
Eighteen months later, she was pregnant naturally with her own eggs.
What the clinic had not investigated was a long list. Her TSH was 3. Accepted as normal, but well above the range her own REI would have flagged before IVF prep. A full thyroid panel was never run.
Her stool DNA test showed H. pylori, an infection that impairs nutrient absorption and drives inflammation. She had been gluten-free everywhere else for years, but she had been taking a weekly communion wafer every Sunday without realizing it counted. The cabergoline she was on was lowering her cholesterol and impairing her ability to make sex hormones.
Her male partner had not been worked up. His semen analysis showed low volume and low concentration. His blood sugar was elevated. His kidney markers showed stress.
The vaginal microbiome had not been tested. The seminal microbiome had not been tested. Her night sweats and disrupted sleep had been mentioned and dismissed.
Her case is not a guarantee that anyone else will get the same outcome. Every case is different. The patterns we found in hers may not be the patterns in yours. But the principle holds: a diagnosis of diminished ovarian reserve, low AMH, or high FSH is a starting point for further investigation, not a complete picture of what is possible.
What this episode covers:
Why low AMH and high FSH are not the complete picture when donor eggs are recommended
Why a TSH of 3 is not normal for fertility even when a clinic accepts it
How H. pylori, hidden gluten, and gut infections affect egg quality and miscarriage risk
What a full male partner workup looks like when there has been pregnancy loss or implantation failure
What a structured second opinion covers when you have been told IVF or donor eggs are your only path
This episode is for you if:
You have low AMH, high FSH, or a diminished ovarian reserve diagnosis
You have had a failed IVF cycle, recurrent miscarriage, or implantation failure
You have been told donor eggs are your next step and you are not ready to agree before you understand what was actually evaluated
You are in your late 30s or 40s and want to understand whether natural pregnancy with your own eggs is still possible
Timestamps:
[00:00] Low AMH, High FSH, Donor Eggs Recommended at 43
[01:30] Functional Fertility Testing vs Standard REI Workup
[03:00] Thyroid and Fertility: Why TSH 3 Is Not Normal
[04:30] Cabergoline, Cholesterol, and Sex Hormone Production
[06:00] H. pylori, Hidden Gluten, and Gut Infections in Low AMH Cases
[08:00] Vaginal Microbiome and Implantation in Recurrent Miscarriage
[09:30] Male Partner Workup: Seminal Microbiome and Sperm Health
[11:00] Night Sweats, Sleep Disruption, and the Nervous System
[12:30] Constipation, Liver Function, and Hormone Clearance
[14:00] Pregnant Naturally at 43: The 18-Month Timeline
Take action:
If you have been told donor eggs are your only option and you want a structured review of your timeline, your labs, and your IVF history before the next decision, the Functional Fertility Second Opinion is where that review happens.
👉 Apply for a Functional Fertility Second Opinion: https://fabfertile.com/pages/book
Not sure what has been fully evaluated in your workup? Download the free Embryo Audit Checklist to map your past cycles and labs and see what may have been missed.
👉 Download the Embryo Audit Checklist: https://fabfertile.com/pages/embryo-audit-checklist
Or message the team directly: [email protected], subject line FERTILE to apply for a second opinion or CHECKLIST for the audit.
About the Host
Sarah Clark is the founder of Fab Fertile and host of Get Pregnant Naturally: A Functional Fertility Second Opinion, a podcast with over one million downloads.
For over a decade, Sarah and her functional fertility team have worked with couples navigating low AMH, high FSH, diminished ovarian reserve, failed IVF, embryo arrest, implantation failure, and recurrent pregnancy loss, reviewing functional labs and patterns that standard care often misses.
This episode is a re-aired case study originally shared in 2025. Client details have been anonymized.

Most women with low AMH and high FSH get one of two answers about their iron: "it's fine," or "it's low, here's a supplement." Both leave the real problem untouched. Failed transfers, failed IVF cycles, miscarriage, irregular cycles, exhaustion that won't lift, and nobody asking why the iron is low in the first place. This episode shows you what the full iron panel actually reveals.
In this episode, Sarah Clark sits down with Fab Fertile clinical advisor Katy Bradbury (registered nurse and nutritional therapist) to break down the iron panel every woman trying to conceive should be looking at. Not just the one number your doctor checked, but the full picture. They get into why the standard iron prescription is one of the worst forms you can take, why high dose iron can actually make things worse, and why symptoms you've been told are unrelated (brittle nails, cold hands, hair loss, ice cravings, exhaustion) could all be pointing at the same thing.
What you'll learn:
The full iron panel every woman trying to conceive should request, and what the numbers actually mean
Why being told "your iron is fine" off one number is missing the picture
The link between low iron and failed transfers, miscarriage, irregular periods, and pregnancy complications
Why low iron is so common with low AMH, high FSH, DOR, and POI
The thyroid and iron connection most doctors miss, especially with Hashimoto's and hypothyroidism
Hidden reasons your iron is low even when you're eating well: gut infections, H. pylori, SIBO, low stomach acid, celiac, heavy periods
Why the standard iron prescription often makes you constipated, nauseous, and no better off
What to take instead, and why every other day often works better than every day
Iron rich foods that actually move the needle, plus the foods and drinks blocking your absorption without you knowing
The thyroid medication timing rule nobody tells you about
This conversation is for women navigating low AMH, high FSH, DOR, or POI who have been told their iron is fine without anyone running the full panel. It's also for women who have been on iron supplements for years without anyone asking why the iron got low to begin with, and for anyone who has had a failed transfer, a miscarriage, or a failed IVF cycle and is trying to figure out what was missed.
Not sure what's been fully evaluated?
Download the free Embryo Audit Checklist to map your past cycles and labs so you can see what's been looked at and what may have been missed. 👉 Download the Embryo Audit Checklist here.
Ready to go deeper? If you want an expert review of your labs, IVF history, and full health picture before your next cycle, this is where we start. 👉 Apply for a Functional Fertility Second Opinion here.
About the host: I'm Sarah Clark, founder of Fab Fertile and host of Get Pregnant Naturally, a podcast with over 1 million downloads. My team works with couples navigating low AMH and failed IVF, reviewing functional lab results including gut microbiome, food sensitivity, vaginal microbiome, nutrigenomics, HTMA, DUTCH, toxin testing, and bloodwork, alongside nervous system work, to help identify patterns that may not have been considered. We work alongside your medical team, not instead of them.
Subscribe to Get Pregnant Naturally for weekly episodes on fertility optimization, IVF preparation, and the lab work your doctor probably isn't running.
Originally aired October 22, 2022. Rebroadcast for our growing community navigating low AMH, high FSH, and DOR.
Keywords: iron and fertility, low iron and miscarriage, iron and failed IVF, iron and failed transfer, anemia trying to conceive, low AMH iron, high FSH iron, DOR iron deficiency, POI iron, iron and pregnancy loss, iron and Hashimoto's, iron and hypothyroidism, why is my iron low, ferritin trying to conceive, Sarah Clark, Fab Fertile, Get Pregnant Naturally
Timestamps:
00:00 Why this episode matters if you have low AMH, high FSH, DOR, POI, or have had a failed transfer or miscarriage
02:00 Why iron matters for getting and staying pregnant: ovulation, miscarriage, and pregnancy complications
03:00 Why the standard "you're anemic, take this supplement" approach misses the bigger picture
06:00 Hereditary anemia and why some women look fine on paper but aren't
07:00 Symptoms of low iron most women don't connect: fatigue, hair loss, cold hands, brittle nails, ice cravings
11:00 The full iron panel every woman trying to conceive should request
15:00 The thyroid and iron connection: why Hashimoto's and hypothyroidism almost always need iron checked
17:00 Heavy periods, blood loss, and ruling out internal bleeding before anything else
19:00 Why your gut decides whether iron actually gets absorbed: H. pylori, SIBO, low stomach acid, celiac, Crohn's
23:00 When pregnancy, breastfeeding, endurance training, and even turmeric can drain your iron stores
26:00 The thyroid medication timing rule, plus the foods and drinks blocking your absorption
28:00 Iron rich foods that actually work: grass fed red meat, organ meats, salmon, dark leafy greens, blackstrap molasses
33:00 What to take instead of the standard iron prescription, and why every other day often works better
35:00 The vitamin C piece, and why store bought orange juice doesn't count
36:00 Final thoughts: get the full iron panel as part of your fertility workup