The full fertility workup (both partners)
- Complete thyroid panel — subclinical hypothyroid is a top miscarriage driver.
- Methylation panel — MTHFR, MTRR variants affect folate status.
- Cycle mapping (DUTCH) — full hormone rhythm, not single time-point.
- Nutrient status — vitamin D, B12, iron, zinc, selenium.
- Heavy-metal load — mercury, lead lower fertility in both sexes.
- Partner semen analysis + lifestyle audit — 50% of infertility involves male factors.
