If you’ve been in the fertility world for any length of time, you’ve probably noticed how quickly the conversation becomes about hormones: FSH, AMH, estrogen, progesterone, thyroid. Those labs matter. But in the clinic, I often find we need to zoom out before we zoom in.
I’m Dr. Bronwyn Storoschuk, ND. I’m one of the naturopathic doctors at Conceive Health and my clinical focus is preconception care—supporting people who want to optimize fertility before egg freezing, trying to conceive naturally, or undergoing IVF. My true professional “home base” is metabolic health, because I genuinely believe good metabolic health lays the foundation for optimal fertility.
And I know that phrase—metabolic health—can sound vague, trendy, or like it belongs in a completely different conversation than egg quality and embryo development. So let’s define it clearly, talk about why it matters, and then bring it back to what you can actually do in your real life (not in a perfect-life fantasy).
Metabolic health: your body’s ability to use fuel well
At its simplest, metabolic health is the way your body takes the fuel from food (carbohydrates, fats, and protein) and turns it into usable energy. We use primarily carbohydrates and fats as energy, and we want to be in a balanced state where that fuel is being used to power your day—not building up in the bloodstream, and not being stored in ways that promote body fat and drive inflammation.
When metabolic health is strained, we can see clues in standard bloodwork. For example:
- High blood sugar (or blood sugar that’s trending upward over time)
- High fasting insulin (often seen before changes in glucose levels)
- High fasting triglycerides on a cholesterol panel (a sign the body isn’t handling fuel efficiently)
We can also see clues in symptoms that people often normalize:
- The mid-afternoon energy crash
- Feeling exhausted after meals
- Feeling “hangry,” shaky, or headachy if a meal is delayed
- Feeling hungry again within 1–2 hours after eating
- Waking up tired even after a full night in bed
None of these automatically mean “something is wrong.” They’re simply signals—data points that help us understand how steady (or reactive) your internal fuel system is.
Beyond BMI: why body composition matters more than the scale
This is where the fertility conversation can get sensitive, and I want to name that upfront: metabolic health is not a moral issue. It’s not a measure of discipline, worthiness, or whether you’re “doing things right.” It’s physiology. And physiology can be influenced by many things—sleep, stress, genetics, medications, work schedules, past dieting, and hormone patterns (including PCOS).
Also, weight alone doesn’t tell the full story. BMI is used heavily in research, but it can miss important nuances in real humans. Clinically, I care a lot about body composition—how much fat tissue you have, how much lean mass you have, and (especially) whether there’s more visceral fat stored around internal organs.
Check out my recent clip on Why BMI Doesn’t Tell the Whole Story
Why? Because lean muscle is metabolically active tissue. It’s one of the places your body “spends” fuel. More muscle mass generally means better insulin sensitivity and better ability to use carbohydrates and fats effectively. That matters not because we’re chasing an aesthetic, but because we’re chasing a calmer, more stable internal environment for reproduction.
Why does a “fuel system” issue impact a reproductive one?
Reproduction is not a side project for the body. It’s energetically expensive. Ovulation, implantation, early placental development are high-demand processes that rely on consistent cellular energy and a steady hormonal signal.
A big part of the story lives in the mitochondria—the energy-producing structures inside your cells. Egg cells, in particular, have a high concentration of mitochondria because they need an enormous amount of energy to mature, divide, and develop normally.
When metabolic health is strained (for example, in insulin resistance), we can see downstream effects that matter in fertility care: more oxidative stress, more inflammation, and disrupted hormone signaling. In the context of egg freezing or IVF, that can show up as differences in ovarian response, egg quality observations, fertilization rates, and risk of complications.
Zooming out even further: metabolic health isn’t only about getting pregnant. It can also shape pregnancy outcomes—and, importantly, it can influence the long-term health trajectory of the child. That’s a big statement, and it’s one of the reasons I’m so passionate about this work. Preconception care is a chance to improve odds not only for conception, but for healthier pregnancies and healthier starts.
The 100-day window: a realistic timeline for meaningful change
One of the most helpful frameworks in preconception care is the 100-day window. That’s roughly the time it takes for an egg to move through key stages of development toward ovulation. (Sperm development has a similar timeline.)
This matters for two reasons:
- It’s not “too late.” If you’re planning egg freezing, TTC, or IVF, you may still have time to meaningfully influence the environment your cells are developing in.
- It’s not “overnight.” The goal isn’t a crash plan. Fast, aggressive weight loss can act as a stressor—especially if you’re under-fueling, over-training, or not sleeping. In fertility care, we’re almost always looking for the slow-and-steady approach that your body can sustain.
In research (and in clinic), even a modest shift in body composition can move metabolic markers in a meaningful direction. The win isn’t perfection. The win is momentum.
What I focus on first (because it actually works)
If you’re looking for a simple place to start, these are three “big rocks” I come back to again and again. Not because they’re trendy—because they’re effective.
1) Protein, evenly distributed
Most people trying to improve metabolic health do better when protein is consistent across the day (not all saved for dinner). Protein supports appetite regulation, steadier blood sugar, and muscle preservation while making changes to nutrition.
A practical target many people can use: aim for at least ~25g of protein at meals. That’s often the minimum needed to trigger “muscle protein synthesis” (the process that helps maintain and build muscle). Most people need more; it depends on body size, activity, and goals.
2) Strength training to support lean mass
You do not need to “live at the gym.” But muscle is metabolically active, and maintaining it matters—especially for those who are in a fat-loss phase or who are more insulin resistant.
A realistic baseline is 2–3 strength sessions per week. That might be dumbbells, machines, resistance bands, or bodyweight work. The most important part is consistency and progression over time.
3) Daily movement that steadies blood sugar
Structured workouts are helpful, but they’re only a small slice of a 24-hour day. For blood sugar regulation, the “boring” stuff is powerful: walking, taking the stairs, movement breaks between meetings.
A small habit with outsized impact: a 10–15 minute walk after your largest meal. It’s simple, it’s free, and it supports a steadier glucose response.
A quick note if you have “lean PCOS” (or a “normal BMI”)
It’s possible to have a BMI in the “normal” range and still have insulin resistance, higher visceral fat, or higher inflammation. It’s also possible to be in a higher BMI category and have better metabolic resilience than expected. This is exactly why we don’t rely on one number.
If you’re not sure where you fall, the most useful next steps tend to be objective: targeted bloodwork (including fasting insulin, not only glucose) and a body composition assessment. It takes the guesswork out—and it keeps the conversation grounded in data, not shame.
Where to learn more
If you’d like a deeper overview of metabolic health in a fertility context—and what structured support can look like—you can read more here: Conceive Health’s Metabolic Program. No pressure; consider it a resource if this is a missing piece in your 100-day plan.
