Why you don’t need IVF to get pregnant with a missing period

Feb 8, 2024 | Blog


TTC, IUI, timed intercourse, trigger shots, gonadotropins, egg retrievals, IVF…

If you’ve been there – you know.

Many women assume that starting a family will be a pretty straightforward process when the time is right. I’ve worked with several women. To their surprise, they learned they had hypothalamic amenorrhea (HA). If you’re unaware: HA means you aren’t getting a period at all and therefore not ovulating. Most Obygns and Reproductive Endocrinologists often tout fertility treatment, especially in-vitro fertilization (IVF), as the only way to achieve pregnancy. But as a Registered Dietitian who specializes in fertility with HA, I am here to tell you that isn’t true.

Now, before we jump into details, make no mistake – I am not anti-fertility treatment, and I am not anti-Western medicine. In some infertility cases, IVF truly is the best option. However, for Hypothalamic Amenorrhea (HA), IVF is often not necessary nor effective in some situations.

Women with HA do not ovulate regularly due to nutritional imbalances created by stress, under-eating, and over-exercising. Because ovulation – the release of an egg from one of your ovaries – is not occurring, there is no egg for the sperm from a male partner to fertilize. There is a reason I don’t believe IVF is the “solution” to conceiving without a period. It is because it doesn’t address the whole reason you can’t get pregnant in the first place: stress and undernourishment. 

When your body shuts down reproduction due to stress and inadequate energy availability (meaning you’re not eating enough to ovulate and make a baby), forcing pregnancy with expensive injectable hormones becomes unnecessary. It’s not a reliable solution. You need to address the underlying fertility issue first, then reevaluate. I have often observed that individuals with HA may require fertility treatment based on their unique circumstances. However, based on my experience, I seldom find the need to consider it necessary in the majority of cases. Over 80% of my clients get pregnant without fertility treatment despite being told they have no other options.

If IVF is an Option, Do I Really Need to go Through the Struggles of HA Recovery?

IVF outcomes are well-documented in the general public. However, the data on IVF in women with HA is lacking. Bodies that are over-stressed and undernourished should not be forced to handle a pregnancy. No good outcome can come from that. Addressing the cause of infertility nourishes your body and your mind and cultivates a favorable environment for pregnancy. When done correctly and with the right level of support, women with HA can recover their cycles and conceive naturally.

Also, let’s imagine that a woman with HA avoids HA recovery, has a successful IVF cycle, and becomes pregnant.  All is well, right? … Not so fast. Even if she can conceive, this doesn’t correct the underlying nutrient imbalance. Therefore, she’s still at risk for the concomitant risks associated with HA. Examples: osteoporosis, heart disease, and mood disorders like anxiety and depression, just to name a few.  Also, if she’s like many of my clients who developed HA due to a poor relationship with food and an unhealthy dependence on exercise, these issues will continue to affect her during the pregnancy and beyond. These struggles are not something anyone wants to battle through during pregnancy and postpartum. Neither are they habits that one wants to pass along to the children that she worked so hard to conceive. 

Aside from this, remember that IVF is extremely expensive – one cycle can easily cost $30,000 or more, due to the fact that women with HA often require higher doses of medications and multiple rounds of egg retrievals. The emotional toll of frequent appointments, constant monitoring, and stress about whether or not it will work can also take a big toll on your mental and emotional health. 

If this is All True, Why is my Doctor Recommending IVF?

Many doctors are not aware of who may be affected by HA and how to treat it, contributing to numerous misconceptions about HA.  This is not necessarily his or her fault, but as the patient, please know there is so much hope for you, and it doesn’t have to cost thousands and thousands of dollars.  Trust me, I’ve been there before (full story my infertility journey here).

Quick Summary…

I’ll always remember the day I left my endocrinologist’s office. Tears flowed down my eyes. My body felt broken forever. I had been working with him for several weeks trying to figure out why after eating more and gaining weight I STILL wasn’t getting my period.

He told me I was perfectly healthy – I just didn’t get a period. He also said “Come back when you want to have kids.”

I felt frustrated. I spent so much time, money, and energy trying to understand my health issues. They told me I couldn’t do anything, then they dismissed me.

Each week I hear very similar stories from my clients about their doctors continuing to dismiss missing periods as no big deal. I’ve heard countless stories of Obgyns dismissing an HA diagnosis because someone “isn’t thin enough” or “doesn’t have an eating disorder” (as I alluded to, VERY few doctors know how to properly screen for EDs and disordered eating and many assume that someone in a normal sizes body can’t have and ED – which is simply not true.)

If you’ve been questioning something your doctor tells you because deep down in your gut you know something isn’t right, my biggest encouragement to you is to advocate for yourself! Yes, doctors are experts in medicine but YOU are the expert in your own body. 

Had I not advocated for myself a few after that reproductive endocrinology appointment, I probably would have ended up with a very long, very expensive fertility journey. 

Luckily, I kept digging and self-diagnosed with Hypothalamic Amenorrhea (HA). 5 years, 3 natural pregnancies, and countless regular cycles later I am helping other women do the same!

Interested in Learning More?

Trying to conceive with fertility treatments can be emotionally exhausting, incredibly expensive, and,  no matter what you’ve been told, unnecessary for women with HA.  If you’re ready to embark on a different journey – one where you heal your relationship with food and exercise so your body is truly ready to support a pregnancy – please don’t hesitate to reach out.  The team at the Food Freedom Fertility Society is excited to meet you!

You Can Recover from HA and Restore Your Fertility

Apply to Join the Food Freedom Fertility Society.

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1 Comment

  1. b

    Can I ask what was the missing piece if you were gaining weight and not exercising and eating every 3-3 half hours? I am eating over 3000 daily, not doing cardio, and up 3 sizes for 6 months no period.


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I’m a fertility nutritionist and registered dietitian who specializes in hypothalamic amenorrhea. My passion is helping women trying to conceive find freedom with food and exercise, so they can recover their period, and get pregnant naturally.

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Jan 19, 2022

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