Improving fertility and preventing miscarriage by supporting healthy progesterone levels

By Sara Russell, Ph.D., NTP, CGP


Sara Russell is a nutritional therapist who works via phone and video calling with clients worldwide, specializing in fertility and pregnancy. Sara approaches each client’s health goals foundationally, from a root-cause-oriented, bio-individual and client-centered perspective. Sara lives in the Tuscan countryside with her husband and their 7-year-old son. You can learn more about Sara’s work and read her blog here.

Healthy progesterone levels are essential for a viable pregnancy and thus for preventing a miscarriage. In my nutritional therapy practice, I aim during the preconception period to optimize hormonal balance to the greatest extent possible. This ideally means identifying any stumbling blocks and addressing them before pregnancy occurs. 

During the first trimester of pregnancy, I like for my clients’ serum progesterone levels to be over 15 ng/mL, particularly if there is a history of miscarriage.

In this post, I share the top strategies I use in my nutritional therapy practice to help women achieve and maintain healthy progesterone levels.

Optimize your nutrition to balance your hormones

Nutritional habits of men and women greatly affects hormonal balance, fertility and epigenetic expression. Once you’re pregnant, your nutritional status will affect your hormonal balance as well as your baby’s in-utero development. Proper preconception nutrition isn’t just about what you should eat. It takes into account your goal to conceive and carry a healthy baby, as well as the full picture of your and your partner’s health status and family history.

Pre-conception nutrition focuses on a wide variety of foods that are deeply nourishing and rich in the nutrients that support fertility and fetal development. This isn’t the time to restrict calories, nutrients or food types beyond those you’re following for sound medical reasons. By working with a nutritional professional trained and experienced in pre-conception nutrition, you will learn to transform every meal into an opportunity to balance your hormones, enhancing progesterone production so your body is baby-ready!

Try Seed Cycling

Seed cycling is a fairly simple yet at the same time profound tool for hormonal balancing. It is predicated on the principle of consuming one to two tablespoons of seeds per day, alternating between estrogen-supporting seeds such as flax seeds and pumpkin seeds during the follicular phase (first day of menstruation up to ovulation) and on progesterone-supporting seeds such as sesame and sunflower seeds during the luteal phase (ovulation up to menstruation).

Limit Alcohol Consumption

It’s common knowledge at this point that alcohol and pregnancy don’t mix. But did you know that alcohol can diminish fertility by disrupting hormonal balance and by stressing the liver? Several studies have demonstrated that alcohol consumption increases estradiol levels and decreases progesterone, and can suppress ovulation, too. If you have a history of low progesterone, infertility and/or miscarriage, alcohol may be a deal-breaker.

Check Your Thyroid

In parallel with nutritional strategies for supporting fertility and pregnancy, I always take thyroid function into consideration. While the medical literature acknowledges that below-optimal thyroid function reduces fertility and increases the chances of miscarriage, sadly many doctors are not very thyroid-literate. Frequently, I’m the first person to recommend a full thyroid panel with antibodies to my fertility clients, even some with a long history of infertility and miscarriage.

Here’s what your doctor should order for you when checking your thyroid:

  • TSH (thyroid stimulating hormone)
  • Free T4
  • Total T4
  • Free T3
  • Total T3
  • Reverse T3
  • Thyroid peroxidase (TPO) antibodies
  • Thyroglobulin antibodies (TGAB)

Women with mild or subclinical hypothyroidism often find that properly dosed thyroid medication is a game changer for their overall health as well as in overcoming a history of infertility and/or miscarriage. Please note that thyroid markers that most doctors think are “fine” and “normal” are not necessarily optimal for achieving and maintaining pregnancy. I can’t emphasize enough how important it is to work with a practitioner who is familiar with the optimal reference ranges based on the data for preconception and pregnancy.

Putting it all together

The bottom line is that bio-individual nutrition promotes balanced hormones, including sufficient progesterone levels, which in turn increases fertility and decreases miscarriage risk.