Fertility Testing Explained: What You Actually Need to Know

Discover which essential lab tests—ranging from hormones to inflammation markers—can reveal hidden fertility issues in both men and women that are often missed in standard care.
Understand how stress hormones, thyroid function, and sex hormone binding globulin directly impact fertility by altering hormone availability and blood flow to reproductive organs.
Learn how modern at-home testing tools and functional lab strategies empower you to track ovulation, assess hormone balance, and take control of your fertility journey.

About the Expert

John Nieters, LAc, DAOM, CFMP

Dr John Nieters

Dr John Nieters has been teaching and practicing the combination of Functional Medicine paired with Traditional Chinese Medicine for several decades. He has been practicing Tai Qi, Qi Gong and meditation for 50 years.

He has hosted over 500 call-in talk radio shows on "The Balancing Point." He currently lives in Alameda, CA with his wife, Jenny and son, Johnny. His wife, Jenny, is the acupuncturist for the 49ers football and St Mary's Rugby team.

He has authored the book "The Sweet Spot," on how to read your blood work and plans to have two additional books published this year.

Dr John's patients, staff and listeners call me the "Story-teller".

So for the sperm testing, I usually have them ask their MD for their test. They're set up to do it. However, what's really cool is there is now at home sperm-testing and it's very cool.

So this male fertility kit. You place some sperm on a slide, it goes under a viewing unit, and it will actually share the screen with your TV. So you can see the sperm in real time for yourself and really get a great idea about how healthy the sperms is.

Less than $100 and, really, a lot easier than going into the lab. Hi and welcome to The Balancing Point. I'm Dr. John Needers and I am here to make traditional Chinese medicine.

functional medicine and integrative health simple, practical and fun so you can restore balance, boost vitality and enjoy a healthier life every single day.

Hi there, this is Dr. John again. I want to thank you for joining us for another episode of The Balancing Point. And today's one of my favorite topics.

Again, my doctoral work is in gynecological endocrinology. So I've done a lot of fertility work and a lotta gynaecology work, which I really enjoy. Today I'm gonna talk about Western testing.

Now in Chinese medicine, we have all kinds of things that we look at around fertility and have different ways to kind of figure things out. But today I'm going to talk about the functional medicine aspect of this.

So we're going take a quick run through some tests that you want to consider or should be considered if you're looking at fertility. And these don't have to be run by a fertility physician.

Most of these are fairly inexpensive, some are really inexpensive. And you can kind of take charge of your fertility whenever you're ready. Okay. So let's go ahead and take a run through these.

First, we're going to talk about male testing and then female. And we'll talk About male first, because it's a lot simpler. okay. so male Testing, We look for hormones.

We're looking for sex hormones, so that's testosterone, free testosterone estrogen. That's A surprise for a Lot of people, but it It's really important thing.

And then I have sex hormone binding globulin with an extra X in sex. So there you go. These are all very important. I'm going to show a lab result looking at testosterone and free testosterone.

Now a lot of Doctors will only look at total testosterone and that's a real mistake because it's free testosterone that really gives you the bang for your buck.

And I've seen people with perfect testosterone levels have really low free-testosterone levels. So they had, you know, all the symptoms of low T. Estrogen, because if you're not producing enough free testosterone, sometimes you are converting the testosterone to estrogen, which can then be a problem.

And you see this in men that do testosterone supplementation or steroid supplementations will often get what we colloquially call man boobs, right, from all of the estrogen activating their breast tissue.

Sex hormone binding globulin is really, really important, very important. And it's not run nearly often enough. So you can have perfect testosterone for a female.

You could have a perfect progesterone, perfect estrogen. But if your sex hormone, binding, globilin, is too high, and that's a hormone that is just what it says, it binds your, your.

Sex hormones. so you, can't utilize them. and I've seen, had many women come in. progesterone was fine, testosterone was find, everything was fun. And then we'd run sex hormone binding globulin, and it was too high, so they weren't utilizing those hormones.

Sex hormone-binding globilin is one of those hormone that goes up with stress. So this is typical, I'd guess that 90% of my patients, female patients that come to me, with unexplained infertility, 90% of the time that is explainable by stress.

And if they take some time off, if go on vacation, often they get pregnant because their sex hormone binding globulin goes down. Then we test for inflammation and immunity, C-reactive protein, CRP, which is a systemic quantitative measure of inflammation.

C reactive protein is something that is produced if there's inflammation, but then we go a step further and then, we do HS-CRP which has high sensitivity, sometimes called cardiac CRB to see if, there is inflammation in the heart and or the arteries because if it is, it's very hard to get pregnant.

You really want to know the blood flow is getting where you want it to go without inflammation. Homocysteine, it'll give you a lot of information about B vitamin levels.

It's very inflammatory, so we want check that. Then we do just a simple metabolic panel. We want see how the kidneys, liver, gallbladder, everything are working.

A CBC, which is a complete blood count, Unfortunately, when most medical doctors read that, they're taking out about 10% of the available information.

They're just looking at levels. Is it too high? Is that too low? For one thing, their levels are not accurate. If you're trying to get pregnant, there were far too wide.

You can be have a six times greater chance of dying than if you were at the sweet spot and still be in a so-called normal level. So we really want to really fine tune it.

And then thyroid hormones. Thyroid hormones, if you're hypothyroid, very very difficult to get pregnant unless you are taking something for the hypathyroidism.

Want to check your neurotransmitters. We'll check metabolites of your serotonin, of you dopamine, your melatonin. And then we're going to look at stress hormones, cortisol, epinephrine, norepinephrin.

Now, Cortisol gets a lot of airtime these days, and cortisol is the hormone that activates your blood sugar, affects blood-sugar levels quite a bit. Epinephrine, you know, makes your heart beat fast, And nerepinepherine is often overlooked.

Uh, its job is to pull the blood out of your center and get it to your extremities and your brain so you can run away from the tiger. Well, as you can probably imagine, that's a real problem if you're trying to get pregnant, because it's going to pull the blood away from the ovaries and the uterus, where you need a very high blood supply in order to nurture everything.

And then reverse T3, T 3 is a thyroid hormone. If you are under stress, you'll produce reverse-T3 which tricks the body by blocking the T-3 receptors so that you get very little bioactivity.

So that's the kind of the basic hormones. And again, these are not particularly expensive. Sperm testing. This I just wanted to show you. This is someone that had been on testosterone.

You can see up here, the total testosterone was 1595. That's very high. And now it's a more normal 750.9, but the Energizer Bunny is this 10. Now that's kind of a medium range.

I'd rather have it a little higher, But you can say 750, units of that is really bioavailable to use. Hemoglobin A1C to measure blood sugars over a three to four month time.

And then sperm testing. So they're going to test for motility. Can it swim? And they actually have put them, they used to, I'm not sure if they still do this, but they put it on a little grid system and see how long it takes the sperm to swim from point A to point B, because it's a long, long trip up those fallopian tubes.

My son once was watching a Nova video and he said, daddy, watch this. And it was the first time they'd ever actually photographed a sperm inside a fallopian tube.

It looked like a little tiny fishy trying to swim up the Amazon. it's a lot of hard work. And so we want to know that sperm are healthy enough to get to where they need to go.

Morphology to show if we have viable, healthy sperm, if the shape's okay. And then we're going to look at the sperm level per unit of volume. Then the semen volume, because there needs to be enough seman also to carry out the load.

And so here's a picture of some, here is a normal oval form here just looking beautiful, beautiful head, the neck and the tail. So the genetic materials carried in the head.

The neck is where the nutrients are and that's one of the reasons men are easier to treat because there are a couple of basic supplements that can really energize the sperm and really get that neck full of proper nutrients.

And then we can see the other morphological problems. You don't want a two-headed sperm, you don' want to tail sperm. So they look at the motility. Now here's the problem.

Getting to the lab can be quite inconvenient. At one time the major lab testing company in this area had only one place that was doing sperm testing and you only had a 20-minute window from the time you ejaculated until you got the sperm delivered.

Well, what if you live 30 minutes away? I'll let you figure out how inconvenient that would be. For the sperm testing, I usually have them ask their MD for the test.

They're set up to do it. However, what's really cool is there is now at home sperm-testing, and it's very cool. So this male fertility kit, you place some sperm on a slide, it goes under a viewing unit, And it will actually share the screen with your TV.

so you can see the Sperm in real time for yourself, and really get a great idea about how healthy the sperm is. It's less than $100 and, really, a lot easier than going into the lab.

Then, female hormones. And so, blood testing, just as it sounds, you're going to get blood draw, saliva testing. The two most common places that people go for that are doctors' data and ZRT labs.

I do almost no saliva test anymore. because there are much simpler methods that don't require you to sit around all day and spit in a tube, which doesn't sound that hard, but trust me, my patients have gotten very, very frustrated by that.

Now my favorite test for female hormones is dried urine testing. Couldn't be easier. Several times a day you pee in cup, you put a piece of cloth in it, that they provide, and then you let it dry.

So it's dried urine testing. Very, very accurate. And so Dutch testing is the company I most use, but Andolisite at US Biotech also does a good test. Then at-home testing, we've moved into a whole new world here over the last decade or so.

We've got Mira and Inito. There are others. Those are the ones that we have used. And so here's a ZRT report. Here's the first page of a Dutch test. Dutch has changed the appearance a little bit and I like the new appearance better.

But as you can see, if we look up here, we see the estradiol is at the end of the green stage. It's really maxed out and there's no progesterone. So this is someone that is completely estrogen dominant.

Their testosterone is fine. Its mid-range. We've got estrogen dominance. And down here, this is a circadian cortisol. So they did it four times this day and the cortisol level is bottomed out.

This person is totally and completely burned out, so one of the things we're going to have to do with them is get them to relax. And we have lots of methods to that, but we really, really got to get that up because When cortisol is at such a high demand, it will lower DHEA levels, dehydroepiandosterone levels which are the precursor for the sex hormones.

So we really need to work with the cortisol and the stress even though we're really looking for pregnancy here. This is another page on it. And you can see how, and it's got all the pathways.

There's pregnant alone, off the scale low. And it the major precursor for progesterone. So this person is going to have, they won't be able to maintain a pregnancy, right?

Progesteron is named for protestation, for maintaining a pregnant. This person would need very significant amounts of progesterone supplementation in order to maintain a pregnancy.

And then there's tons of other stuff down here that is relevant for likelihood of developing breast cancer, your ability to methylate. This person can't methylated at all.

The ratios here between the 2 and 16 hydroxyprogesteron are not so good. And here's just another way to look at this. Again, you can see that the cortisol is low.

The melatonin is very, very low, progesterone helps you sleep, melotonin helps, this person doesn't sleep. It's one of the reasons they're so burned out.

Now, getting to the fun stuff, here's a mirror. We've used mirror quite a bit with our patients. Again, you take first morning urine. You have a little dipstick or wand that you put in the urine, and then you'll put the urine in this little round device, right here, little around device.

And in about 20 minutes, it will show your hormone profile. So these, it's tracking your estrogen, your progesterone, you're follicle stimulating hormone and your luteinizing hormone.

So you can see exactly what day you are the most fertile and if you even ovulating. It's just an amazing technology. Down here is the INITO fertility tracker, which we are now switching to.

We find it's a little easier to use for us and easier for patients to track it. So we're using the Inito primarily. Same idea. Here, the annito tracks all four of the primary fertility hormones.

It says the four, there are actually more, but these are the biggies. And you can see here, right? You'd go along here. The purple's luteinizing hormone.

You get a big surge of lutenizing hormones, and then you're going to get big surges of progesterone. Then you could see, here's peak fertility, And here is a confirmation that there was ovulation.

So it's kind of foolproof. Now, If you want more information about fertility hormones or fertility or traditional Chinese medicine, actually about any subject, I do free 15-minute discovery calls.

I find, and I just started doing this in the last year, but I found that people often didn't know where to start. Do I start with my chiropractor? Do start my medical doctor?

Uh, do I with an acupuncturist, an herbalist? So I free fifteen minute discovery call several times during the week. uh, to help people, you know, kind of guide them in a certain direction.

Uh, and so all you have to do is go to alamedaacupuncture.com and there'll be a box there for you to schedule your free discovery call. Available California residents only, but feel free, just give me a 15 minute call and we'll just talk about stuff.

So I want to thank you for joining me today. I love talking about this stuff and I'll. Be back with you next week. Thank you. Thank you for joining me on The Balancing Point.

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Fertility Testing Explained: What You Actually Need to Know

About the Expert

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Interested in knowing if we are the right fit for you and your condition?

Alameda Acupuncture

Ancient medicine for our modern world

Fertility Testing Explained: What You Actually Need to Know

About the Expert

Recent Posts

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Interested in knowing if we are the right fit for you and your condition?