Fertility Planning

This protocol is for the PRECONCEPTION window — actively trying to conceive (TTC) or in the preparation runway 3-6 months before TTC starts. It covers BOTH partners: male-factor and female-factor infertility contribute roughly equally to fertility concerns, and the standard pattern of outsourcing all the work to the female partner misses half the relevant biology.

The protocol is structured around a hard pivot: while preconception support is reasonable, the moment pregnancy is CONFIRMED — by a positive home pregnancy test or quantitative beta-hCG — all Phase 2 peptides are off-table without exception. Phase 1 cofactors (B12, plus oral prenatal vitamin) transition to standard prenatal supplementation; the rest of the protocol stops.

This protocol does NOT replace reproductive endocrinologist (REI) or fertility-specialist workup. Standard guidance is: REI evaluation at 12 months of unsuccessful TTC for women under 35, at 6 months for women 35+, immediately for known risk factors (irregular cycles, prior pregnancy losses, suspected male factor, prior pelvic surgery, endometriosis, PCOS, history of cancer treatment). For the male partner: semen analysis is the cornerstone workup and should happen by month 3 of TTC if not already done — it is non-invasive, inexpensive, and frequently identifies issues that change the entire fertility strategy.

It is NOT for users with active or recent (5 years) breast, ovarian, prostate, or other hormone-sensitive cancer history (Phase 2 sex-steroid-axis stimulation is contraindicated); active fertility-treatment cycles (clomiphene, letrozole, gonadotropins, IVF stim) without explicit specialist guidance; or any confirmed pregnancy.

Phases

1. Phase 1 — Preconception cofactor foundation (both partners)

   starting 3-6 months before TTC, throughout TTC, transitions to prenatal at pregnancy

   Standard preconception guidance for BOTH partners includes folate (via oral prenatal vitamin — 400-800mcg/day for women, 400mcg/day for men, started 3+ months before TTC for neural tube defect prevention and for sperm DNA integrity respectively) and a comprehensive B-vitamin status. B12 1000mcg SubQ weekly addresses B12 deficiency that is common and under-recognized in midlife users; B12 deficiency in either partner can impair fertility (low B12 affects ovulation in women + sperm quality in men) and even mild deficiency during early pregnancy contributes to neural-tube-defect risk. This phase continues through TTC and converts to standard prenatal supplementation on confirmed pregnancy. Important: this protocol does NOT include folate in the peptide stack because folate is not a peptide and is best taken via oral prenatal vitamin (better controlled dose, dietary integration, lower cost). Standard preconception supplementation includes folate 400-800mcg/day from an OTC prenatal vitamin starting at least 3 months before TTC; do not skip it.

   • B12 (Methylcobalamin)1 mg · once weekly · morning

     1000mcg SubQ once weekly. Methylcobalamin is the bioavailable form (some users have functional MTHFR variants that slow conversion of cyanocobalamin). Continues throughout TTC; on confirmed pregnancy, transition to prenatal vitamin B12 unless a clinician advises continued supplementation for documented deficiency.

   What “working” looks like

   Energy + cognitive baseline supported. No specific fertility-outcome change expected from Phase 1 alone — this is the foundational nutrition layer that good preconception care includes regardless of any peptide adjuncts. The cleanest read is at 3-6 months of consistent Phase 1 + REI / urology workups done: you've established the foundation AND identified any specific factors that warrant Phase 2 specialist-guided peptide adjuncts.

   Decision criteria

   Phase 1 continues throughout TTC. Decisions about Phase 2 should be made WITH a fertility specialist — REI for women, urologist or REI for men. If TTC has been unsuccessful for 6 months (women 35+) or 12 months (women <35) and basic workups suggest a specific issue (cycle irregularities, low ovarian reserve, suspected male factor with abnormal semen analysis), specialist consultation is high-leverage. Phase 2 peptides should not be self-determined.

   Labs to pull

   • Female partner: AMH (anti-Müllerian hormone — ovarian reserve), FSH + estradiol day 3 of cycle, antral follicle count on transvaginal ultrasound, TSH + free T4 + TPO antibodies, prolactin, vitamin D, ferritin + CBC, B12 + RBC folate, A1c
   • Male partner: semen analysis (volume, count, motility, morphology) — repeat at least once if abnormal, ideally with a fertility-specialist-affiliated lab; total + free testosterone, FSH, LH, prolactin, vitamin D, ferritin, B12, A1c
   • Both partners: cycle tracking (ovulation prediction kits, basal body temperature, fertility app), preconception genetic carrier screening (cystic fibrosis, spinal muscular atrophy, fragile X, expanded panels per clinician guidance)

2. Phase 2 — Specialist-guided adjuncts (kisspeptin for women / CJC-Ipa for men preparation)

   weeks 12+, ONLY under fertility specialist guidance

   OPTIONAL AND SPECIALIST-GUIDED. This phase splits by partner-specific context and should never be self-determined: For the FEMALE partner with cycle irregularities (hypothalamic amenorrhea, hypothalamic-axis dysfunction, low-amplitude LH pulses on workup), kisspeptin has Tier 2 evidence in research-clinical contexts for restoring LH pulsatility and menstrual cyclicity (Imperial College / Dhillo lab; Jayasena 2014 and follow-ups). Community single-daily SubQ dosing is extrapolation from research pulsatile protocols (~6.4-12.8mcg per pulse every 90 minutes); for fertility-planning specifically, REI involvement is non-negotiable — they may use kisspeptin as part of structured fertility-treatment cycles where the dosing follows research-protocol patterns rather than community simplifications. For the MALE partner in the PREPARATION WINDOW (3-6 months before active TTC starts), CJC-1295 / Ipamorelin may support body composition and recovery. HOWEVER: there is no published data on GH-axis stimulation effects on semen quality or epigenetic effects during spermatogenesis (~74-day spermatogenic cycle). Conservative practice is to DISCONTINUE CJC/Ipa at least 8-12 weeks BEFORE active TTC starts, allowing a full spermatogenic cycle in the absence of any GH-secretagogue exposure. Continued use during active TTC is NOT recommended without explicit urologist or REI input. Continue Phase 1 B12 + oral prenatal throughout.

   • B12 (Methylcobalamin)1 mg · once weekly · morning

     Continue Phase 1 cofactor.

   • Kisspeptin100 mcg · once daily · morning (community extrapolation; REI may prescribe pulsatile)

     FEMALE PARTNER ONLY, under REI guidance. 100mcg SubQ once daily is community extrapolation; REI-managed protocols may follow research pulsatile patterns (~6.4-12.8mcg per pulse every 90 minutes) instead. The strongest evidence-base indications are hypothalamic amenorrhea (restoring cyclicity) and IVF oocyte maturation triggering — both REI-managed. Self-determined community use for 'fertility support' without confirmed cycle dysfunction lacks evidence.

   • CJC-1295 / Ipamorelin250 mcg · 5 days per week (preparation window ONLY) · before bed, fasted 2+ hours

     MALE PARTNER, PREPARATION WINDOW ONLY (3-6 months before TTC starts). Discontinue 8-12 weeks BEFORE active TTC begins to allow a full spermatogenic cycle without GH-secretagogue exposure. 10 units SubQ (250mcg CJC + 250mcg Ipa) 5 days/week, before bed, fasted 2+ hours. NOT for use during active TTC without explicit urologist/REI input — no published data on semen quality or epigenetic effects during spermatogenesis.

   What “working” looks like

   For the female partner: kisspeptin-responsive cycle dysfunction shows LH pulsatility restoration (specialist-monitored), cycle regularization, and improved odds of conception in subsequent cycles. For the male partner: kisspeptin and CJC/Ipa are not expected to improve semen analysis values in users with baseline-normal semen analyses; for users with documented low T + secondary hypogonadism, the Andropause protocol's Phase 2 kisspeptin layer may be more appropriate than fertility-specific use. NO direct fertility-outcome data exists for any of these peptide adjuncts in unselected eugonadal users — the strongest evidence is in specific reproductive endocrinology contexts where the specialist drives the protocol.

   Decision criteria

   Phase 2 is specialist-managed. Decisions about continuation, dose adjustment, or discontinuation belong with the REI or urologist, not with this protocol. On confirmed pregnancy (positive home test or quantitative beta-hCG): STOP all Phase 2 peptides immediately without exception. Phase 1 cofactors transition to standard prenatal supplementation per OB-GYN guidance.

Often combined with

• Postpartum Recovery

  Postpartum users may re-enter fertility planning after weaning (typically 6-12 months postpartum minimum; longer is reasonable). The lab workup baseline often differs from a first-pregnancy preconception workup — ferritin and thyroid status may need re-establishment after the postpartum window. Coordinate transition with OB-GYN.

• Energy & Vitality

  B12 + B-vitamin overlap with Energy Phase 1. If you're running both protocols (e.g., addressing fatigue alongside preconception planning), do NOT double-dose B12 — single weekly dose covers both surfaces. Energy protocol's broader cofactor work may also benefit preconception nutrient status.