Infertility

silhouettes of a man and woman embracing

There is an epidemic of infertility among both women and men in their thirties and older in this country. Infertility, the inability to conceive children, can be frustrating and heartbreaking. Infertility is defined as the failure to conceive after a year of unprotected intercourse. It is estimated that in the United States one in five couples suffer from infertility. 

The exact cause of infertility may be difficult to pin down. It is always best to be diagnosed by a physician.  The leading cause of female infertility is a blockage of the fallopian tubes. Such blockage may be due to birth injury in the woman, inflammatory conditions such as endometriosis (scarring of the fallopian tube), extreme stress on the adrenal glands, or a sexually-transmitted disease (STD). In women, difficulty in conceiving increases with age. Another possible reason that infertility may be on the rise is because women are waiting until later in life to have children.

In men, they likewise may have a blockage, deformed or low numbers of viable sperm, and other physical factors.

Although there can be a myriad of possible explanations to this disturbing phenomena, Dr. John Lee, author of What Your Doctor May Not Tell You About Premenopause speculates that high levels of environmental toxins may be the culprit. Toxic chemicals in the environment (called xenoestrogens and xenobiotics) affect the reproductive tracts of both men and women from conception on. Exposure to xenohormones in the womb can cause a lifetime of reproductive problems. Oral contraceptives, contraceptive implants and shots, and intrauterine devices (IUDs) also contribute to infertility.

Solid connections have been made between xenohormones (xenoestrogens) and infertility in birds, fish, reptiles and mammals. The doses necessary to cause reproductive abnormalities in an egg and infertility are extremely small. There is evidence that high levels of xenohormones are reducing the ability of the brain to send out hormone-stimulating substances that cause the manufacturing of hormones, as well as the ability of the ovaries and testicles to respond. These man-made chemicals may also be the culprit in world-wide falling sperm counts in men. 

DIAGNOSIS

Initially, a physician will measure certain hormone levels.  This should include the evaluation of the balance among follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone, estrogen, testosterone, prolactin, and thyroid and adrenal hormones.  

Mapping the timing of ovulation is the initial step in a program for tracking the possible reason(s) for infertility.  Ovulation usually occurs 14 days after the first day of her cycle; therefore attempts at conception should focus on that time frame.  A basal thermometer can be used to determine the exact time of ovulation. Upon ovulation, there is a decrease in temperature, followed by an increase of 1.0 to 1.5 degrees F. in the luteal phase.  This rise in temperature occurs in response to the thermogenic effect of progesterone secreted by the corpus luteum. This elevation in temperature will continue until 1 to 2 days or before her next menstrual cycle. Home ovulation-detection kits are available in pharmacies to measure LH.

TYPES

Primary infertility is the most common type.  It is the inability to conceive a child after one year of trying.

Secondary infertility is the inability to conceive or deliver a pregnancy to term after the birth of one or more biological children.  Many couples are unaware of this form of infertility because they were able to once conceive, and they tend to attribute the cause of not conceiving to stress or other factors.

Approximately 20 percent of infertile couples are diagnosed as unexplained infertility.

CAUSES

Infertility may be caused by a number of factors.  40 percent are contributed to “female” factors, while 40 percent are contributed to “male” factors. The other 20 percent are listed as unknown factors.  Factors may include:

  • Abnormality of the reproductive organs
  • Imbalance of hormone levels, especially estrogen and its relationship with progesterone.
  • Certain infections and (sexually transmitted) diseases may cause infertility.
  • In women, problems can arise from ovulation disorders, endometriosis, obstruction or damage to the fallopian tubes, and polycystic ovarian diseases (PCOS).
  • Abnormal sperm production in men.
  • Chemicals, xenoestrogens, and other environmental toxins, including certain occupational hazards.

DIET

A suggested diet for a woman wanting to get pregnant consists of healthy, whole foods that are easily digestible. Organic foods are always preferable. Testing for food allergies should always be considered. Eliminate or minimize refined sugar, processed and “junk” foods, and foods that may contain pesticides and insecticides. Try and eat more organic meat and eggs, and free-range chicken. Limit fish intake unless you are sure that the source of the fish is from non-polluted waters. 

free range eggs in a basket for sale

Researchers at the Chinese University of Hong Kong report that eating fish and shellfish, which often contains high levels of toxic mercury (especially tuna), could be linked to infertility in some women and men. Today, nearly all fish contain mercury, although larger species that live the longest, such as sharks and swordfish, concentrate the most mercury in their tissues. Mercury can cause permanent damage to the brain, nervous system, and kidneys and is especially dangerous for pregnant women.

SUPPLEMENT PROTOCOL

WOMEN

  1. PROGESTERONE CREAM
    When estrogen-dominant symptoms appear using natural topical progesterone cream can restore balance. Often, progesterone deficiency leads to elevated FSH (Follicle Stimulating Hormone) levels, which leads to increased estrogen production. If the follicles are unable to release and egg, no pregnancy results. Dosage: Apply one large dab at bedtime days 12-26 of cycle.  If unsuccessful after a few months, Dr. Lee recommends applying ¼ teaspoon up to twice a day (morning and bedtime) from days 5-26 of cycle for 3-4 months, then quit. If you become pregnant, keep using the progesterone every day in normal doses, stop in the second or third trimester. See a qualified health-care practitioner if you are using progesterone, and always follow the instructions of your OB/GYN. 
  2. CHASTEBERRY (AGNUS VITEX CASTUS)
    An herb long used to decrease heavy flow for women, but also helps to regulate progesterone levels. Dosage: Supplement daily with this herb every day, including during menses, for at least three months. If you become pregnant, stop taking the herb. Vitex has been used successfully with CHINESE ANGELICA (DANG QUAI), FALSE UNICORN and BLESSED THISTLE. Dosage: See a qualified health practitioner. 
  3. PRENATAL MULTIPLE VITAMIN/MINERAL FORMULA
    A multi-vitamin/mineral is important in supplying B vitamins including folic acid. B complex and vitamin B12 have been proven to improve both female and male fertility.  Dosage: As directed.
  4. B-COMPLEX VITAMINS
    B vitamins help to maintain a healthy nervous system and muscle tone of the intestinal tract, and are important in reproductive gland function. VITAMIN B6 (PYRIDOXINE) which is needed for the synthesis of RNA and DNA. VITAMIN B5 (PANTOTHENIC ACID) helps maintain sex hormone production and can help counterbalance stress, which can be a deterrent to pregnancy. Dosage: 50-150 mg daily, as directed.
  5. FOLIC ACID
    This B-vitamin is needed for successful conception and pregnancy. Low levels of folic acid in early stages of pregnancy have been linked to increased risk of neural tube defects in developing fetuses. Dosage: 400-1200 mcg/day.
  6. VITAMIN E (as MIXED TOCOPHEROLS with TOCOTRIENOLS)
    Known as the “anti-sterility” vitamin, vitamin E is essential for cellular respiration and absorption of fat soluble vitamins. Vitamin E’s antioxidant and anti-inflammatory ability enhances fertility.  Dosage: 400-800 IU daily.
  7. MAGNESIUM
    Magnesium (try to avoid magnesium oxide) helps to increase the absorption of B vitamins and aids the liver in eliminating both excessive and environmentally-acquired estrogen. The magnesium level in body fluids also supports the production of progesterone.  Dosage: 400-600 mg daily.
  8. MILK THISTLE
    An herb that helps to detoxify the liver (hepatic function) and aids in hormone conversion. Dosage: 80-200 mg daily. The herb should be standardized to 80% silymarin.
  9. ESSENTIAL FATTY ACIDS (FLAX SEED OIL and GLA)
    Flax seed can aid in bowel cleansing and detoxification. Gamma-linolenic acid (GLA) supports cervical mucous secretion, helps regulate blood pressure, and has an anti-inflammatory characteristic.  Dosage: 500-2,000 mg daily.
  10. SELENIUM
    A antioxidant mineral that prevents free radical induced cell and tissue damage. Dosage: 100-200 mcg daily.
  11. ACIDOPHILUS
    Supplementing with probiotics can help to restore bowel and intestinal flora, which enhances nutrient absorption in the body. Dosage: As directed.
  12. L-ARGININE
    Supplementation with oral arginine in poor responders to
    in vitro fertilization improved ovarian response and pregnancy rate in some studies. Dosage: 10-16 grams daily. NOTE: This is a controversial procedure and should only be done under the supervision of a qualified practitioner.

What to avoid if trying to get pregnant: Birth control pills, unopposed estrogen, pesticides of all types, excessive dairy products (hormone enhanced milk), caffeine, refined sugar, and junk food.

MEN

  1. B-COMPLEX VITAMINS
    These vitamins are very important in reproductive gland function and the maintenance of sex hormone production. Dosage: 50-150 mg daily. Additional VITAMIN B12 may be involved in cellular replication, and its deficiency reduces both sperm count and sperm motility. Dosage: 1,000-2,000 mcg a day. 
  2. L-ARGININE
    This amino acid is required for the replication of cells, making it essential for sperm formation and motility. Supplementing with Arginine can be beneficial in both preserving and restoring fertility. Dosage: 250-2,000 mg daily. 
  3. ESSENTIAL FATTY ACIDS (EFAs)
    It has been reported that eating saturated fats and low intake of EFAs may decrease the cells’ fluidity and interferes with sperm motility. EFAs also help normal glandular activity. Dosage: Of flaxseed, fish, and borage oils at 500-1,000mg 2-3 times a day. 
  4. ZINC
    Zinc is perhaps the most critical trace mineral for male reproduction function. It is involved in virtually every aspect of male reproduction. Dose: 30-60 mg daily. 
  5. SELENIUM
    An antioxidant that prevents free-radical damage, works with vitamin E, and preserves tissue elasticity. In men, half the body’s selenium stores are in the testicles. Some reports suggest that a decline in selenium intake may be a factor in men’s sub-fertility. Studies have shown that even low-dose selenium supplementation appears effective in increasing sperm motility. Dose: 50-200 mcg daily. 
  6. MACA ROOT
    In a recent study published in
    The Journal of the American Herbalist Guild men taking maca root had increased seminal volume. Sperm count per ejaculum, motile sperm count, and sperm motility. Maca appears to work without having any effect on the reproductive hormones. Dosage: 500-1,000 mg 3 times a day. 
  7. COENZYME Q10
    A potent antioxidant to decrease exposure to free-radicals and toxins that may decrease fertility.  Also, a small dose of 10 mg daily results in significant increases in sperm count and motility. Dosage: 10-100 mg daily.
  8. GINGER
    According to research done in Saudi Arabia, ginger significantly increased sperm counts and motility in animals. Ginger is safe and tasty. Dosage: As directed. 
  9. VITAMINS C and E
    Vitamin C plays and essential role in preventing damage to the DNA of sperm. Vitamin C is in high levels in the seminal fluid, and supplementation increases sperm count and improves sperm motility and viability. Dosage: 1,000-2,000mg a day. Vitamin E helps to normalize hormone production (enhancing fertility) and is essential for the absorption of fat-soluble vitamins and cellular respiration. Dosage: 200-400 IU daily. 
  10. GLUTATHIONE
    Glutathione is a key antioxidant that is used to improve sperm motility. N-acetyl-cysteine (NAC) is the precursor to glutathione in the liver. Dosage: As directed. 
  11. L-CARNITINE
    It has been reported that oral administration of L-carnitine (3 grams) for 4 months resulted in significant improvements in sperm number, quality, and motility in patients with inadequate sperm. One study suggested that antioxidant therapy with carnitines may represent a new non-hormonal option in treating men with certain mediated infertility. Dosage: 1-3 grams daily or as directed under supervision of a qualified practitioner.
  12. PANAX GINSENG, SCHISANDRA, ANDROGRAPHIS and SAW PALMETTO
    This specific herbal combination has been revered in Asia for centuries as a male potency and longevity tonic. Since these herbs are becoming more popular in the United States, reliability of Chinese herbs must be more recognized and researched. Dosage: See a qualified practitioner. 
  13. CANGZHU
    A Chinese herb widely prescribed in China for male infertility. Sometimes cangzhu is supplemented in combination with astragalus, ginseng and Chinese licorice. ASTRAGALUS has also been linked to increased sperm motility. Dosage: See a qualified practitioner. 

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Babal, K. Glutathione. Alive #247, May 2003. Pp. 80-81.

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Frieda, SB. Infertility: A Different Approach, Natural Pharmacy, March, 2001. 5(3): 1, 22.

Frieda, SB. Male Infertility. Natural Pharmacy, May, 2001. 5(5): 1, 20-21.

Kamhi, E.  Natural Techniques Against Infertility. Natural Pharmacy, October 2003. 7(5): 1, 23-24.

L-Carnitine- Monograph. Alternative Medicine Review, March 2005. 10(1): 42-47.

Lee, John R. What Your Doctor May Not Tell You About Premenopause. Warner Books, New  York, NY. 1999.

Mercury in Fish Linked to Infertility. Good Medicine, Spring, 2003. 12(2): 4.

Selenium (Monograph). Alternative Medicine Review, February, 2003. 8(1): 63-66.

Scott, R, MacPherson, A, Yates, RW, et al. The Effect of Oral Selenium Supplementation on Human Sperm Motility. British Jrl Urology, 1998. (82): 76-80.

Smith, E. Maca Root: Modern Rediscovery of an Ancient Andean Fertility Food. Journal of the American Herbalist Guild, Fall/Winter, 2003. 4(2): 15-21.

Terrie, YC. Coping With Infertility. Pharmacy Times, June 2006. 72(6): 80-82.

Up Next: Polycystic Ovary Syndrome (PCOS)

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