How Common Is Infertility?
An estimated 1 in 10 women experience infertility at some time during their reproductive years (2).
When your doctor diagnoses infertility, he or she will either tell you why (i.e. lack of ovulation or poor sperm quality) or infertility will be “unexplained”.
Let’s take a look at the most common causes of infertility in men and women, and discuss how integrative medicine can help you improve your fertility.
Top 5 Causes of Infertility
1. Ovulatory Dysfunction
While the occurrence of a female period might be the most noticeable aspect of her cycle, ovulation is the main event for fertility. Ovulatory dysfunction includes any event which can affect the release of an egg from the ovaries. And without ovulation, pregnancy cannot occur.
This includes disorders such as polycystic ovarian syndrome (PCOS), as well as environmental factors like stress or overexercising.
There are many different factors that can impact ovulatory function, including:
- PCOS
- Stress (acute or chronic)
- Overexercising
- Toxin exposure
- Illness
- Nutrient deficiencies
- Hormone imbalances
- Bodyweight (underweight or obesity)
Ovulation is influenced by the following factors, and you’ll find advice later in this article about how to support healthy ovulation and egg quality to support healthy conception.
2. Hormone Imbalance
In terms of infertility, hormone imbalance is often at least part of the problem. Hormones dictate almost every step of conception, including the building of the uterine lining, ovulation, and egg quality.
Common hormone imbalance conditions include:
- PCOS
- Hypothyroid (like Hashimoto’s Thyroiditis)
Environmental endocrine (hormone) disruptors, diet, and stress can all impact hormones like estrogen and progesterone. Because we can’t readily see these chemical messengers, it can be difficult to identify a hormone imbalance before you reach your doctor’s office.
A regular menstrual is a helpful barometer of hormone health, and sets the stage for healthy conception and pregnancy. If your cycle is long (more than 35 days), short (less than 21 days), you’re spotting mid-cycle, skipping periods, or don’t have a period–hormones are likely a part of the issue.
Endometriosis and Other Medical Conditions
There are other hormonally driven problems like endometriosis, which, while not caused directly by hormone imbalances, are made worse by estrogen dominance.
Endometriosis, in addition to things like previous infections or pelvic inflammatory disease, can damage the uterus or fallopian tubes, making conception difficult.
3. Micronutrients and Diet
Fertility and healthy ovulation depend on adequate dietary protein, healthy fats, and nutrient-dense fruits and vegetables.
These foods supply the micro- and macronutrients necessary for conception and hormone balance. For example, women who experienced ovulatory infertility were more likely to conceive after supplementing with B vitamins, including folate, and B12 (3).
Similarly, if your diet is high in sugar or processed foods, there’s a good chance your toxic load is high, and your blood sugar balance is less than ideal.
Women with normal blood sugar levels have a greater likelihood of conceiving than those with blood sugar imbalance and insulin resistance.
4. Acute or Chronic Stress
When your period comes early, or PMS symptoms get more severe, the first place you should look is your daily stress levels.
Having a baby requires a lot of resources, both in your body and in your environment. Depending on your stress levels, your body might be sending a message that this environment just isn’t safe to carry a baby right now.
Stress can come in the form of emotional, physical, or mental triggers, and affects:
- Hormone production
- Ovulation
- Cortisol levels
- Blood pressure
- Digestion
- Energy production
When stress levels increase, your body produces stress hormones–cortisol, epinephrine, norepinephrine–and your fertility hormones back seat to survival. This is your body prioritizing survival over creating a baby.
Your stress response is a highly complex system designed to keep you safe and alive, but it also can’t tell the difference between primitive stimuli like a predator or natural disaster, and financial worries or extreme pressure at work or in your personal life.
5. Underweight or Obesity
From a fertility perspective, bodyweight matters, but it’s much less about what’s occurring on the inside than what you see on the outside.
To make hormones, your body needs a certain percentage of body fat–this is one reason why women tend to have higher body fat percentages than men. Too little, and we don’t have enough building blocks to produce hormones like estrogen and progesterone at adequate levels to sustain a pregnancy.
But, the opposite is also true. An excess of body fat can complicate hormone function, interfere with insulin, and increase inflammatory markers–all of which communicate to your body that having a baby isn’t sustainable.
When Infertility is ‘Unexplained’
Commonly, if a woman has been trying to conceive for at least a year, and all of the standard “routine” fertility tests have normal results, she is diagnosed with “unexplained infertility”.
Generally speaking, unexplained fertility is an elimination of other more obvious causes of infertility, but it doesn’t account for factors we know affect fertility, but don’t have a way to measure or test for yet.
This includes:
- HPA/HPO Dysfunction
- Autoimmunity
- Hormone Imbalances (low progesterone, high androgens, thyroid disease, etc.)
- Nutritional Deficiencies
- Increased Inflammation or Oxidative Damage
- Environmental Endocrine-Disrupting Toxin Exposure
About 1 in 4 couples who experience infertility will be diagnosed with “unexplained fertility,” which means that even though ovulation and sperm and function are healthy–you’re still unable to get pregnant (4).
Integrative Medicine Solutions for Infertility
A ‘Preconception Physical’
Schedule an appointment with your functional medicine doctor where he or she will evaluate your overall health, address any underlying health conditions, and help you build an optimal environment in which to conceive.
The Importance of Environment
Your lifestyle, and what your body is exposed to has an impact on your health–the same goes for your fertility. Nutrient status, stress levels, and toxin exposure affect ovulation and the ability to become pregnant.
Improving Egg Quality (and Fertility)
Toxins can also do damage at a cellular level–increasing oxidative stress and harming a developing egg cell, which takes up to 90 days to mature before ovulation (5).
To protect developing eggs and increase antioxidant activity, consider:
- Foods to support hormone balance
- Antioxidants
- Reduce environmental toxins
- Improve stress reduction
- Consider supplements such as berberine, n-acetyl cysteine, or a prenatal.
Browse high-quality Women’s Health supplements here.
Integrative Medicine Approach to Men’s Fertility
Keeping sperm healthy is just as important as healthy eggs inside the ovary.
Sperm have a difficult job of not only finding an egg but then being robust enough to penetrate and fertilize the egg.
Eat a diet rich in antioxidants to ensure healthy sperm. There’s a significant correlation with oxidative stress and poor sperm quality (6). To support motility and quality in sperm, get plenty of antioxidants in the diet from deeply-colored veggies, and quality proteins.
Zinc also improves sperm quality, count, and motility (7). Pumpkin seeds are one of the highest sources of dietary zinc.
Supplements for male fertility:
- Carnitine
- CoQ10
- Fish oil or omega 3
- N-acetyl cysteine (NAC)
Integrative Medicine Puts You in Control of Your Fertility
The question of infertility is one wrought with emotions and frustration, but with integrative medicine you have more control over your health and wellness with root-cause solutions.
Improve fertility by optimizing diet, correcting hormone imbalances, and reducing environmental toxin exposure with a safe, supportive, and stress-free functional plan.
Resources
- https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0046544
- https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2366795/
- https://journals.lww.com/obgynsurvey/Abstract/2014/02000/Definition_and_Epidemiology_of_Unexplained.17.aspx
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527168/
- https://onlinelibrary.wiley.com/doi/full/10.1002/rmb2.12353
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773819/
