The Workup Most REIs Skip Before Recommending Donor Eggs

The Workup Most REIs Skip Before Recommending Donor Eggs

May 18, 2026 · 13 min · Episode 558

About this episode

In this episode, Sarah Clark discusses the incomplete workup often conducted before recommending donor eggs and highlights the importance of a comprehensive evaluation.

The donor egg recommendation rarely comes after a complete workup. It comes after AMH, FSH, and an antral follicle count. That is usually where the investigation stops. In this episode, Sarah Clark walks through what is missing from the workup before women are told donor eggs are their only path: the full thyroid panel, not just TSH. Stool DNA testing for H. pylori, parasites, and food sensitivities. The vaginal microbiome. The male partner's blood work, which most clinics do not run. The nervous system patterns most REIs do not connect to fertility. Sarah shares Rebecca's case as a proof point. Rebecca was 27. Her AMH was 0.04 ng/mL. POI diagnosis. Told donor eggs were her only option. Her stool DNA testing revealed H. pylori and a parasite. Her food sensitivity testing showed gluten, dairy, and egg intolerance. She had adrenal insufficiency, thyroid imbalance, mineral depletion, and toxic load on her workup. Her eczema, migraines, and asthma were not separate issues. After targeted work, she conceived naturally in month five. Outcomes vary. Rebecca's case is one of many we use to illustrate what completing the workup can look like. This episode is for the woman sitting with a…

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