Infertility and Optimal Naturopathic Fertility Care
When couples are excited by the prospect of starting a family, there are some very important aspects to take care of prior to conception. As a naturopathic doctor with over 15 years of experience, I have found several useful ways to improve fertility through a customized and detailed program. The common missing elements to improving fertility include optimizing custom nutrition, reducing chemical exposures based on your particular toxins you harbour, promoting circulation and balancing your individual hormone profile as well as your unique energy balance; I will discuss these factors below from the perspective of a naturopathic doctor.
Nutrition and Fertility
One of the most important factors to your fertility is your nutrition. The easy way to think of it is that the better the quality of food and nutrition you intake, the better the quality of your body (ie, your uterus, sperm number and motility, eggs, ovarian function, etc.). For instance, an Italian study published in the medical journal Reproductive Sciences compared the level of nutrition in fertile women to the nutrition of women experiencing infertility while awaiting in-vitro fertilization (IVF). The study concluded that there were significant discrepancies in nutrition between the two groups: the women experiencing unexplained infertility had either mild nutritional imbalance, or, severe micronutrient and macronutrient imbalance (sometimes associated with obesity) compared to the women with normal spontaneous fertility. The final conclusion was that a more thorough nutritional investigation and dietary and supplemental treatment can resolve unexplained infertility, improving IVF outcomes and possibly restoring spontaneous normal fertility. Even though this study was conducted amongst women only, imagine if the male counterpart’s nutrition was also optimized.
Toxicity and Fertility
Chemicals have good and bad aspects. However, when there is an overabundance of chemicals in the body, or if there is an over-sensitivity to them it can have a negative impact on fertility. An excellent research study that speaks to this examined the time-to-pregnancy (TTP = number of observed menstrual cycles until confirmed pregnancy) particularly with respect to the chemical load in the male partner. In this study, 501 couples were monitored for their chemical levels in their blood and urine as well as their TTP. It concluded that there were significant reductions in fertility (17-31% less fertile) for couples where the male had toxic lead (a relatively common toxic heavy metal element), as well as for the ultraviolet protective active chemical tetrahydroxybenzophenone (BP2) and two pthalates (monobenzyl and monomethyl pthalate). Seven PCB chemicals in men were also associated with reduced fertility (17-29% reduced). This study is a ground-breaking examination in the role of chemical-induced reduction in fertility for couples and in particular in men. Now imagine if there is also a reduced level of nutrition in these couples, this combination would likely reduce the fertility even further and may render such couples as having ‘unexplained infertility.’ As part of our naturopathic approach, we test for nutrition and chemical exposures and develop a fertility treatment program to re-balance the body by ridding the toxins and treating the deficiencies.
Another critical point to consider is that if the nutritional and toxic level is impacting the prospective parents, imagine the impact on a developing embryo/fetus/baby. Many studies have associated future health issues in infants (see page 12-13 of this World Health Organization study) with early chemical exposures to what are called hormone disrupting chemicals, or ‘endocrine disrupting chemicals,’ whether exposure happens before conception, during pregnancy or soon after. Note that there are several types of endocrine-disrupting chemicals (EDCs): pthalates, PCBs, bisphenol-A, mercury, lead, perchlorate, several pesticides, perfluoridated compounds (PFCs; found in non-stick and stain-resistant products) and more.
Circulation and Fertility
Exercise isn’t just for strong muscles and bones, it also can improve fertility. A recent study appearing in The Journal of Clinical Endocrinology and Metabolism found that a lifestyle and exercise program in infertile women with PCOS (polycystic ovarian syndrome) made a major difference in fertility. The researchers compared successful ovulation rate and live birth percent between two groups: those that underwent immediate infertility treatment, compared to those who started with a diet and exercise (lifestyle) program prior to infertility treatment. The difference in outcomes was significant: the ovulation rate was 45% vs. 62%, and the live birth rate was 10% vs. 25%. Note that excess weight and obesity is associated with approximately 30% of the known risk for infertility, so incorporating a successful diet and exercise routine can be crucially important for successful fertility.
Hormone balance and Fertility
There are several hormones and they work like a family but if one of the members is out-of-line, then it impacts the whole balance of the family of hormones. Take stress hormones for example, we know that trying to conceive in situations of stress will delay conception/fertility. It makes sense since stress hormones direct your blood and neurological stimulation: in a stressful environment, blood and nerve energy is directed to fighting and running and anxiousness, not reproduction. Other vitally important hormones in the hormone family that have a large impact on fertility are progesterone and thyroid hormone. Progesterone is necessary to promote receptivity in the endometrial lining of the uterus to best receive and allow implantation of the embryo; it is fundamental to the viability of early pregnancy. When progesterone is deficient it is often referred to as a ‘luteal phase deficiency’ so it can be useful to test to see if this is what is contributing to recurring miscarriages or failure to implant successfully, whether through regular spontaneous fertility attempts or through assisted fertility techniques. There are several strategies to balance progesterone in the body: herbs, several nutrients, hormone balancing with thyroid or progesterone supplementation, weight loss and improving insulin sensitivity. Next, the thyroid – this gland is incredibly important, in a way it is the master hormone that allows proper function of all the reproductive cells. Since it has such a wide-ranging effect on reproduction, it is very important for the thyroid to be functioning optimally. Note that thyroid dysfunction is the most common endocrine disorder in reproductive age women, associated with menstrual irregularities, anovulation and infertility. Thyroid testing must be done correctly. Typically, tests only look at TSH (thyroid stimulating hormone), however in the case of trying to optimize fertility, it is crucial to fully screen the thyroid with other related tests (eg: free T3, free T4, reverse T3, anti-TPO, anti-TG, 24-hour urine iodine and mercury, cortisol). Even the interpretation of what is thyroid imbalance is very controversial. In my naturopathic practice, I commonly diagnose people with subclinical hypothyroidism (or, borderline hypothyroidism). Often physicians wait for very high levels of TSH (>10) before prescribing thyroid hormone therapy, whereas so many couples suffer from under-treated hypothyroidism. Studies have found that keeping TSH under 3.0 can be beneficial for promoting fertility. Thyroid function tends to decline during pregnancy so it is important to track it every 2-3 months and treat it accordingly.
Energy balance and Fertility
This refers to the subtle yet vital energy that is associated with the body, referred to in Chinese medicine as “qi” (pronounced ‘chi’). There are several channels through which qi circulates in the body and when there is a blockage in flow, then symptoms and dysfunction ensues. In TCM, the Kidney, Liver, Conception and other channels can be blocked and may require acupuncture to promote better energy flow to facilitate reproduction. Several studies have demonstrated improvements in the time to achieve pregnancy with acupuncture as well as improving the pregnancy rate of women undergoing IVF.
Naturopathic fertility program
By addressing multiple factors that relate to fertility, a comprehensive customized naturopathic assessment and treatment program can help couples to conceive and to improve the chances of a healthier child. Contact the clinic to arrange an assessment – 905-597-7201.