Fertility and Preconception
Functional medicine care for preconception, unexplained infertility, male factor, support alongside IVF, and pregnancy.
I'm Dr. Stephanie Daniel, DO. I founded Functional Medicine SF in 2012, and fertility has been part of my work from the start. I help women and couples prepare their bodies for pregnancy, whether they're trying naturally, about to start IVF, or have been trying for a while without answers.
Apply for a Welcome Consultation Take the 5-minute Protocol Audit →Who this page is for
This page is for you if you:
- Are planning a pregnancy and want to prepare well
- Have been trying to conceive without success
- Have been told your infertility is "unexplained"
- Have PCOS, irregular cycles, or a low or declining AMH
- Are preparing for IVF or egg freezing and want to support your results
- Have a history of pregnancy loss
- Are pregnant and want functional medicine support alongside your OB or midwife
- Have other health issues, such as mold illness, mast cell activation, thyroid problems or gut problems, and want to know how they affect conception
Why fertility problems are often missed or hard to resolve
Many couples who struggle to conceive are told there's no clear cause. Standard fertility workups focus on anatomy and on the reproductive hormones that assisted reproduction can override. They often don't look at the wider factors that affect fertility: nutrient status, blood sugar and insulin resistance, thyroid function, inflammation, gut health, toxin exposure, stress and sleep.
PCOS, one of the most common causes of fertility problems before menopause, is closely tied to insulin resistance. High blood sugar can shift the body toward making more androgens, raise inflammation and disrupt ovulation. That is often a metabolic problem as much as an ovarian one.
Male factor is often overlooked as well. Sperm health contributes to about half of the picture, yet the male partner may never have more than a basic semen analysis, if that.
How I evaluate fertility
I start with a detailed history for you and, ideally, your partner: cycles, prior pregnancies, past testing and treatment, diet, stress, sleep, exposures, and other health conditions. From there, testing may include:
- A comprehensive female panel, including thyroid, reproductive hormones timed to your cycle, nutrients, metabolic markers such as insulin, and MTHFR.
- AMH, which reflects egg quantity rather than quality. I read it alongside age, cycles and other markers.
- Minerals such as zinc and copper, which are often low because of absorption problems, diet or inflammation.
- A male panel and semen analysis, including motility and morphology.
- Vaginal microbiome testing when there's a reason to look, such as for ureaplasma.
- Testing for broader drivers when your history calls for it, such as mold, gut or mast cell evaluation.
I also help you track ovulation so we understand your cycle.
How I sequence treatment
My approach follows The Longevity Hierarchy™, a framework I developed for organizing care around what your body can tolerate right now. It has two aims: reduce the load your body is carrying, and expand its capacity to handle treatment. For fertility, I see the ability to conceive as rooted in whether the body has the physiological capacity to conceive and carry a pregnancy. My work is to help create those conditions.
Eggs take about 90 days to mature, so I usually plan preconception care over at least three months. I work across six areas:
- Nutrition to balance blood sugar, support hormone production and nourish the gut, starting with removing refined sugar.
- Gut health and detoxification, including reducing environmental toxins and supporting the body's elimination systems.
- Hormones, including estrogen, progesterone, cortisol, thyroid and androgens.
- Lab review and genomics, to understand your biochemistry, including methylation.
- Male factor, because the partner's health matters for conception and pregnancy outcomes.
- Mind-body work, including stress, sleep and emotional readiness, which runs through every phase.
Preparing for pregnancy also means knowing what to avoid. Some supplements, herbs, medications and procedures that are fine at other times aren't recommended while trying to conceive. If you're being treated for another condition, I review your plan and adjust it for this phase. Once you're pregnant, I continue to support you alongside your OB or midwife, adjusting your plan for pregnancy.
What working with me looks like
- A 20-minute welcome consult to talk through your situation and see whether my practice is a good fit.
- A 90-minute first visit. I review your history and prior testing and set out a testing plan, for you and your partner if they're involved.
- A written plan that maps out your next steps, with clear instructions and a preconception guide covering supplements, diet, lifestyle, and what to avoid while trying. You put it into practice one change at a time, at a pace your body can handle.
- 60-minute follow-up visits to review results, adjust your plan and coordinate with your fertility clinic if you're doing IVF.
I order labs that can be done at home or at a local draw site in California.
Frequently asked questions
- Do you offer fertility care for patients outside the Bay Area?
- Yes. I see patients for fertility and preconception care anywhere in California by video. I'm licensed in California, so patients need to be located in the state. If you live outside California, your own doctor can still get my guidance: clinicians can book a one-on-one case consult with me about your care, while they remain your treating physician.
- Can functional medicine help if I'm doing IVF?
- Yes. Functional medicine can complement IVF by supporting egg and sperm health, blood sugar, inflammation and stress before and during treatment. It can also be done before medical interventions, sometimes reducing the need for them. I'm happy to coordinate with your fertility clinic.
- How far ahead should I start preparing for pregnancy?
- Ideally, at least three months before you start trying or begin IVF. Eggs take about 90 days to mature, so the changes you make now affect the eggs you'll ovulate in a few months.
- Do you work with male partners?
- Yes. Male factor is often overlooked, but sperm health plays a major role in conception and pregnancy outcomes. Male partners can become patients themselves, with their own evaluation and plan.
- I was told my infertility is "unexplained." What does that mean?
- It usually means no anatomical or major hormonal problem was found. It doesn't mean there's nothing to look at. Nutrient status, blood sugar, thyroid function, inflammation, gut health, toxin exposure, stress and male factor can all affect fertility and are often not fully evaluated.
- I have mold illness or mast cell issues. Can I still prepare for pregnancy?
- Yes, but the plan needs care. Some medications and supplements used for those conditions, such as certain antihistamines, aren't recommended while trying to conceive. I adjust treatment for this phase and focus on reducing your overall load in ways that are appropriate before pregnancy.
Next steps
Related: Hormones and midlife · Gut health · Complex chronic illness
- Book a 20-minute welcome consult to see whether we're a good fit.
- Not sure where to start? Take the 5-minute Protocol Audit to see which areas may be adding to your symptoms.
- Already on a fertility or preconception protocol that isn't working? A Protocol Review looks at what you're doing and what might be holding you back.
Functional Medicine SF provides virtual care for patients located in California. This page is for education and is not individual medical advice.
