Unveiling Fertility with Dr. Robyn Murphy, ND: Nurturing Preconception Health and Genetic Insights

Dr Robyn Murphy is a fertility Naturopathic Doctor at Conceive Health in Toronto and a scientific adviser for DNA Labs. She combines her strong background in research and clinical practice to bring the most effective treatment strategies for her patients. She’s a strong advocate for patient-centred care and aims to build trust and empower patients with reliable knowledge to inspire health. Her virtual fertility program, Fertility Essentials, has been developed to help people who need support with fertility.

3:43

Q. Why is preconception care important when it comes to fertility, and how does it influence the overall health of a pregnancy?

A. If we just think about the term itself, pre-conception, so when the fertilisation of the egg happens by the sperm, and we get an embryo, what people may not realise is for both sperm and egg, it takes roughly about three months for the full maturation process to complete.

For women, we’re born with all the eggs that we’re ever going to have. And with each cycle, those eggs are coming out of the world and starting to mature, but that is roughly a three-month process.

Similarly, with sperm, it takes about three months for immature sperm to form into the final product that we see typically that is going to be able to properly deliver the genetic information, reach the egg and fertilise the egg.

During this three-month period, there are things that we can do in our lifestyle. The way that I like to describe it is we have the microenvironment as well as our macro environment. So the microenvironment consists of nutrients, hormones, blood flow, and how well the body metabolises things. All these factors impact the quality of the sperm and egg.

In the macro environment, we look at the hormones and what the brain is telling the ovaries and testes, how well they are communicating and how in sync the body is and exposures like cigarettes, alcohol or caffeine that are known to have an impact on conception and health of the pregnancy.

6:28

Q. What are some dietary factors people should be considering when they’re looking at improving egg and sperm quality?

A. The purpose of our diet is to nourish the body. We want to be bringing in nutrients that are helpful to the different systems involved in fertility and the maturation process. We also want to look at nutrients required to protect DNA from damage, like antioxidants.

Most fertility diets out there stem from the Mediterranean diet. The principle that the Mediterranean diet uses and that we want to follow is getting a healthy serving of vegetables and fruits.

At least five servings of leafy greens and non-starchy vegetables and two to three servings of fruit per day, but avoid juices. You want the whole fruit. Also, look at including things like legumes and fish on a regular basis and bringing healthy oils. Plant-based oils like olive oil, nuts and seeds have anti-inflammatory components and also help with blood flow.

Oils or polyunsaturated fatty acids get integrated into the membrane of the sperm, as well as the ovary. So they can modify the membrane and how it functions. Nuts and seeds are also really important.

Avoid processed types of foods. Reduce the consumption of red and processed meats. Especially during barbecue season, avoid sandwich meats, sausages, prepackaged meats and refined grains.

Avoid things that are highly processed. White foods like white flour, white rice and anything made from them, like processed baked goods and bread.

Stay away from liquid calories and liquid sugar like soft drinks. Fast food, and precooked meals, tend to be highly processed, and the processing techniques will often leech out essential nutrients from the food.

When we look at couples who are trying to conceive and are on the Mediterranean diet or are adhering to it the closest, we see that their time to conception so the time it takes in order to conceive is less. We also see depending on the group we’re looking at.

For example, with PCOS, we see that women who are following the Mediterranean diet tend to lose weight using this diet. Their body weight normalises, and that can decrease the chances of pregnancy loss, which is a risk factor for this population.

So individuals with PCOS have higher rates of miscarriage, we do see that diet can help to normalise some of the hormone dysregulation that we see with PCOS and can help improve the likelihood of a healthy pregnancy.

10:44

Q. Are there any specific lifestyle strategies and nutrient supplements you use in your practice?

A. If we take a step back and look at the body, it’s obvious that the whole body is connected. Every single part of the body can potentially affect one another.
In terms of lifestyle, we talk about things like exercise, stress management and sleep quality. The reason these are important is because they’ll have different effects throughout the system and have either direct or indirect influences on fertility.

With exercise the recommendation is about 150 minutes of exercise a week. It can be moderate intensity, but you want about 30 minutes of sustained exercise at a time, and the max is around 300 minutes. Exercise is important because we’re looking to increase blood flow to the actual reproductive organs. Increased blood flow can help improve nutrient delivery, as well as the removal of waste products in the area.

We see that it can also help to regulate insulin, improve sleep quality and is a great stress reliever. If anyone’s going through the fertility journey, it can definitely be stressful. So finding ways to manage stress and a healthy way is key. It is always about finding something you can sustain because the habits that we create during the preconception period are most likely to be followed throughout pregnancy. And when we see that exercise is maintained throughout pregnancy, it lowers the risk factor for a number of pregnancy complications. We’re helping with blood flow to the placenta and the growing embryo and fetus, which will reduce risks of things like small for gestational age, small embryo or preterm birth and gestational diabetes as well.

Sleep is important as well. The habits we follow prior to going to bed, what we call sleep hygiene, are important. The biggest one that I see is screen time. People on their screens, being exposed to the blue light, down-regulates melatonin. Melatonin is the key hormone that we find helps with sleep onset and maintenance. Melatonin has a key role in fertility. It’s been shown to help improve quality in women going through IVF.

Because we have all the eggs that are present at birth as we age, those eggs actually age as well. The ageing process introduces the likelihood of more DNA damage or abnormalities. So if the genes and the chromosomes are abnormal, that increases the likelihood of pregnancy loss.

Moving into some of those supplements that I use – every woman should be on folic acid. It ensures that you’re getting the base nutrients that have been shown to reduce chances of pregnancy complications like neural tube defects.

With prenatal vitamins, there are variations where we see some people can’t process the folic acid as readily. Folic acid is synthetic, the body has to convert it into a usable form. And there are variations which can reduce that capacity by 90%.

So rather than using folic acid, we might use combined folic acid and what’s called methyl folate. Sometimes prenatal vitamins will include iron, which can be really important. For those who have a history of endometriosis or sometimes chronic inflammation, Thalassemia iron is actually contraindicated in that case.

We’ll also look at the type of vitamin A that’s included in the prenatal vitamin. Sometimes you’ll see beta carotene, which is the pre-form, this is what the body uses to make vitamin A. It’s important to do proper dosing because it can be toxic during early pregnancy.

My favourite vitamin is choline. Choline doesn’t get a lot of airtime, but it is so important. It is a derivative of a B vitamin, and it’s used throughout the body for a number of different reasons. We see it’s really important for the brain and spinal cord development of the baby. It also helps with placental development.

You’ll also see a lot of nutrients that support sperm quality. Typically these are antioxidants, and they help protect the egg and sperm against oxidative stress or DNA damage, the ageing process that occurs naturally as we age but also as we’re exposed to different environmental exposures.

CoQ10 is most commonly used, and the dose will range dependent on the age. We’ll look at certain parameters and see if there are any signs of premature ovarian failure or diminished ovarian reserve that can give us indications of the biological age and chronological age being different. There are studies showing that for people going through IVF, this can help to improve embryo quality and pregnancy rate.

We also use it for a male. It is shown to help with male infertility, helping with some of the sperm parameters. A semen analysis looks at the concentration and motility of sperm. There are other tests that can be done as well, like DNA fragmentation.

CoQ10, L-carnitine and Omega-3 all of these are commonly used to help with semen parameters to help with male infertility. We also use them in female fertility and egg support. L-carnitine doesn’t get a lot of airtime but essentially helps take the CoQ10 and shuttle it into the part of the cell where we need it to go, which is the mitochondria.

That’s something that I see missing in a lot of protocols, especially if people are protein deficient. Carnitine comes it’s an amino acid. It is especially important for those who aren’t eating enough protein to supplement, as well as if you’re taking very high doses of CoQ10. L-carnitine can help improve pregnancy rate and with PCOS.

22:44

Q. What is the role of genetics in fertility, and how do you form a personalised treatment plan for an individual’s unique genes?

A. We’re in a really exciting time because now we’re seeing an era of personalised medicine. It’s not that we haven’t had personalised or individualised medicine prior because we’ve always looked at past medical history and current symptoms, but now we have their genetic data.

Genes are an instruction manual for how your cells function and how they respond to the environment. So when we’re looking at particular genes, what we’re talking about is lifestyle and nutrient genetic panels.

The genetics that we’re looking at are the ones that play a role in the delivery and processing of nutrients. How we process nutrients helps us understand individual needs. It also helps with understanding the actual dose of nutrients required, the form they should be taken in and if you’re at risk for deficiency. Sometimes these nutrients aren’t tested commonly by medical doctors or fertility clinics.

When we’re looking at dietary interventions, there’s a goal that we’re trying to achieve when we prescribe a particular diet so if someone has PCOS, insulin resistance or endometriosis, the different aspects of their genes as well as their body of how they’re going to respond to certain dietary interventions.

When two separate populations are given the exact same diet, we don’t expect those people to respond exactly the same way. That’s because of the genetic variations.

We can look at certain genes and can see the risk factors for these commonly seen lifestyle diseases like obesity, type two, diabetes, and metabolic syndrome, all of these have an impact on the fertility process.

It’s in our best interest to make sure that we identify these risk factors and then provide the proper diet according to their genetics, their history so we know what is going to be the most effective.

And so when these genes are present, it helps us to understand some of the micro fertility issues. Issues where there’s a higher likelihood for DNA damage, or they’re not integrating that folic acid appropriately, so they’re not getting that into the DNA repair.

This helps uncover these things and gives us some more insight into a person’s case. I always describe the genetic panel as a roadmap and an instruction manual. It also gives you steps that you can take in diet, lifestyle and supplements, as well as working with your doctor to understand conditions that you may have a predisposition to.

About Dr. Robyn

Dr Robyn Murphy is a fertility naturopathic doctor at Conceive Health in Toronto, and the Scientific Advisor for DNA Labs. She combines her strong background in research and clinical practice to bring the most effective treatment strategies for her patients. She is a strong advocate for patient-centred care and aims to build trust and empower patients with reliable knowledge to inspire health. She is also thrilled to be an ambassador for Fertility Matters Canada.

Dr. Murphy uses a comprehensive approach to address underlying causes that impact fertility, including hormone, immune, digestive, and metabolic imbalances. She is most excited about supporting patients on a larger scale with her latest developments, including her virtual program Fertility Essentials and her collaboration with FERN DNA and their launch of the first Canadian lifestyle fertility genetics panel.

Dr. Murphy graduated with a Doctor of Naturopathic Medicine from the Canadian College of Naturopathic Medicine (CCNM) in Toronto and holds a Bachelor of Science from the University of Alberta. Her love of learning and honing her skills has led to advanced training and certifications in fertility, lifestyle genetics, functional gastroenterology, hormone therapy (BHRT), and advanced medical herbalism.