A Holistic Approach to Infertility in the 21st Century
By Cristina McMullen, ND, Certified Wellness Coach, Bio-Energetic Practitioner
Infertility has been and remains to be one of the most significant medical and even social problems of our modern times. It is a phenomenon that affects around 50-80 million people worldwide, classifying 8-10% of couples as infertile. In the United States alone, 19% of women aged between 15-49 years old are unable to get pregnant after a solid year of trying to conceive.
And this statistic is sadly on a steady incline. So much so that the use of assisted reproductive technology by infertile couples is increasing by about 5-10% per year! Yes, in vitro fertilization (IVF) therapy has come a long, long way and has a much better success rate, but the drastic increase for its need makes you wonder why infertility rates are increasing so rapidly, and if there are more holistic measures couples could try before resorting to IVF and other fertility treatments.
Let’s break down some of the most common causes of infertility as well as some nutritional, herbal, and therapeutic options that can help someone improve endocrine function and make it more likely for couples to be able to conceive naturally.
What Exactly is Infertility and What Causes It?
Infertility is defined as the inability to conceive after intentionally trying to for at least one full year. This inability to conceive can be caused by a whole host of underlying conditions that can be affecting either the woman or the man. In fact, roughly 30% of infertility is attributed solely to the female, another 30% is attributed solely to the male, 30% can be attributed to a combination of both partners, and another 10% seems to have an unknown cause. So, infertility indeed is a two-way street, but for today’s purposes, we are going to be focusing on female infertility.
Some of the more common causes of infertility in women include Polycystic Ovarian Syndrome (PCOS), endometriosis, diminished or low ovarian reserve, poor egg quality, thin endometrial lining,inflammatory disease of the uterus, and uterine fibroids.
Endometriosis is a very complex disease that is becoming a major cause of infertility in women. Up to 30-50% of women with endometriosis suffer from infertility and a whopping 30-50% of infertile women have endometriosis. Though the medical community is not quite sure exactly what causes this disease, women who suffer from it usually have higher levels of estrogen than other women and is most likely at least part of what causes endometrial tissue to grow outside of the uterus and in the abdominal cavity. This build up of tissue outside of the uterus can cause a distorted anatomy of the pelvis, adhesions, scarred fallopian tubes, inflammation of the pelvic structures, changes to the hormonal environment of the eggs and altered egg quality, as well as impaired implantation of pregnancy.
PCOS is another major cause of infertility, affecting roughly 5- 10% of women. It is caused by an overproduction of estrogen and increased testosterone levels that can affect egg quality and inhibit proper ovulation. Most, if not all, of the other causes of infertility also have some form of hormonal imbalance that may not be quite as severe but still affect the reproductive organs enough to inhibit a woman’s ability to conceive.
While hormonal imbalances are the major player in female infertility, there are still other factors that can play a rather significant role. Blood sugar imbalances, poor dietary choices, smoking and excessive alcohol consumption, exposure to toxic environmental chemicals, chronic infections, and even extremely high levels of stress can all affect a woman’s body in a way that would inhibit her from being able to become pregnant.
Whatever the cause of infertility, at the root of all cases there is an imbalance or disruption in the body that needs to be corrected. According to the philosophies of Traditional Chinese Medicine (TCM), infertility occurs because of a disrupted vital balance and blockage of Qi energy. In other words, a woman’s natural balanced state, from the time she begins menstruating to the time she begins menopause, is a state of “potentially conceiving” and any deviation from that state does not necessarily imply “infertility,” but means a shift from one’s optimum reproductive health.
So the answer to infertility does not always have to rely on medical interventions like IVF, but rather can be resolved by figuring out what is causing her body to be out of balance and bringing it back into homeostasis.
Disruptions in the Body
There is no denying that in today’s world we are constantly being bombarded by chemicals and other environmental toxins. These chemicals build up in our bodies and can cause a whole slew of health issues. When it
comes to women and their reproductive health, a category of chemicals called endocrine disruptors are
of major concern. When these specific types of chemicals enter the bloodstream, they have the ability to mimic the body’s natural hormones and end up blocking or binding to hormone receptors.
A specific subcategory of endocrine disrupting chemicals, called xenoestrogens, specifically have an estrogen-like effect. When these chemicals are in a woman’s body, they increase total estrogen, causing estrogen dominance. Since these chemicals are not biodegradable, they are also stored in fat cells and contribute to a host of endocrine disorders like endometriosis and PCOS, making them major underlying factors in infertility. Some of the more common xenoestrogens in our environment include parabens found in skincare products, BPA, phthalates, and PCBs found in plastics, and others found in insecticides, herbicides, glues, paints, and grocery store receipt paper. Certain foods that we eat even contain xenoestrogens from either the chemicals that were sprayed on them while growing or the fact that they are heavily processed and full of chemicals themselves.
Genetics and mutations to certain genes can also play a major role in a woman’s fertility. MTHFR mutations are alterations to certain genes that affect the body’s methylation pathways. Now,methylation is very intricate and complex, but in the case of infertility, you just need to know that methylation is involved in the breakdown of hormones and is also important for tissue growth and cellular development. This includes the growth of the endometrium and egg during the menstrual cycle. Since endometrial growth prepares a fertilized egg to implant into its lining, a disruption in methylation may affect early stages of pregnancy and even lead to miscarriages.
Certain mutations can also cause follicles in women to make less estrogen, which then makes the ovaries less responsive to follicle stimulating hormones and can affect overall egg health and ovulation. High homocysteine levels are also associated with MTHFR mutations and high homocysteine levels have been correlated with a
lack of ovulation both in healthy women and those with PCOS. Homocysteine can also increase a woman’s risk of blood clots because it irritates blood vessels. In terms of pregnancy, this can interfere with implantation and embryonic development and can explain why some women end up needing to take blood thinners in order to successfully conceive.
Underlying chronic microbial infections can also put such a burden on the body that it is unable to conceive. For example, chronic yeast or fungal infections within the body can lead to a poor vaginal microbiome and can dramatically impact a woman’s ability to get pregnant. Other underlying viral infections such as Epstein Barr Virus and a heavy metal burden can tax the thyroid and affect its ability to produce other hormones needed for fertility.
High levels of stress can exhaust the adrenal glands and also have a major impact on hormone production and overall fertility. There is a reason why we hear stories of couples who tried for years to get pregnant, only to finally find themselves pregnant after they gave up and stopped stressing out about the intricacies of the process. The body can become too stressed to take on anything else and once that main stressor was removed, it can finally prioritize conception.
What Holistic Steps Can Be Taken To Improve Fertility Chances?
Like the famous saying goes, “knowledge is power.” And now that we have a better understanding about some of the things that can cause imbalances in a woman’s body, we can figure out how bring the body back into harmony.
Detoxification and Supplementation
Before even considering pregnancy, a woman needs to make sure that the microbial and environmental toxins that are burdening her body are removed from her system. While there are some general suggestions on how to go about this, the toxic slew within each person is unique to them and is best handled on an individual basis so that supplements and protocols can be customized to each person.
Bioenergetic testing can help pinpoint exactly what needs to be detoxed from the body and a knowledgeable practitioner can find the best remedies to do the job. After individual burdens have been eliminated from the body, I believe that any couple that wants to get pregnant should do a general total body cleanse together. Like stated before, our environment is full of toxins these days that can not only affect our ability to get pregnant, but once pregnant these chemicals can cross the placental wall and enter the baby’s bloodstream. Studies have shown up to 287 different chemicals in the blood of umbilical cords, many of which are carcinogenic. It is very wise for both partners to eliminate as many of these harmful toxins from their bodies before they try to conceive.
My personal favorite cleanse that we carry is called the Core Restore Kit by Ortho Molecular. It is a comprehensive cleanse that lasts either 7 or 14 days (you can choose) and focuses on maximizing liver detoxification. It also follows more of a paleo/whole 30 diet so the elimination of sugar and caffeine will nourish the adrenal glands and help to kill off any yeast or fungal overgrowth.
Now that each partner’s bodies are cleansed from environmental and microbial toxins, it is time to address nutritional support and potential genetic mutations. The standard recommendations include a prenatal multivitamin and fish oil supplement. Folate in particular is a major focus when it comes to supplements as studies have shown that folate helps to prevent neural tube birth defects.
When it comes to the matter of MTHFR mutations, however, not every form of folate is created equal. Folate is actually a collective term that refers to all types of B9, including folic acid and methylfolate. Folic acid is the synthetic, inactive form that has to be made active (methylated) by enzymes in the methylation pathway. Methylfolate, however, is already in its active form. Those with MTHFR mutations need to make sure their prenatal multivitamin contains methylfolate and not folic acid. This is because those with the gene mutation
cannot properly convert folic acid into methylfolate. Instead, they need to take the form of B9 that does not need to run through the methylation pathways in order to become usable by the body. The general recommendation for folate is 400-600 mcg daily. If someone has suffered multiple miscarriages, OBGYNs may recommend up to 4 mg (4,000 mcg) daily. The main prenatal multivitamin we carry in our Nutrition Shop is a complete multivitamin and fish oil combo that contains 1,700 mcg of methylfolate.
Remember also that people with MTHFR mutations also tend to have higher histamine levels. Trimethylglycine (TMG) is another nutrient that can significantly help bring down high homocysteine levels in the body. While we have some B complex vitamins that contain TMG, I usually recommend adding a product called Homocysteine Supreme by Designs for Health. This product contains a hefty dose of TMG (900 mg) along with extra B vitamins, including an extra 3,400 mcg of methylfolate. But don’t worry about combining the prenatal with the Homocysteine Supreme. Higher serum folate levels are associated with higher luteal phase progesterone levels, which is ideal for fertility and even pregnancy.
Another supplement that I find to be very important both while trying to conceive and during pregnancy is a probiotic. The one I recommend to these women, however, is not your run of the mill probiotic. My favorite for conception and pregnancy is Ortho Biotic Women’s. This is because it contains only strains of bacteria that are found to colonize a healthy vaginal microbiome.
Why is this important? Well, the microbiome of any part of our bodies impacts the pH of that part of the body. When it comes to trying to conceive, an imbalanced pH level of the cervix or vagina can damage sperm enough to prevent it from fertilizing an egg. By making sure the vaginal microbiome is what it should be will ensure an ideal pH for sperm to start their journey. Pregnant women should also stay on this probiotic, or at least get back on it towards the end of the pregnancy, so that the vaginal microbiome is again ideal for when the baby makes his or her way down the birthing canal and gets covered in all those immune boosting, jumpstarting bacteria.
Women who suffer from PCOS, endometriosis and other hormonal imbalances should also be taking a few other supplements to target the estrogen dominance and potential blood sugar irregularities. DIM is a phytoestrogen that actually binds to the xenoestrogens in the bloodstream and flushes them out of the body. We have a few different DIM products that you and your practitioner can choose from and decide which is the best for you.
Inositol improves insulin resistance and is recommended for those with PCOS in particular. Sensitol is the product we carry and it contains two forms of insositol (myo- and d-chiro-) along with alpha lipoic acid to support normal insulin function and cellular metabolism. If your blood sugars are extremely high, and bordering diabetes, berberine is an herb that has actually been shown to be just as effective as metformin in regulating blood sugar levels. Women with PCOS who have very high testosterone levels need to also get that balanced out before conceiving. This is where a product by Douglas Labs called TestoQuench for Women would come into play because it moderate androgen activity in the body.
Last, but not least, is probably my favorite fertility product. I love to recommend this one whenever we have done all of the detoxifying and supporting nutritionally, and are yet to get a positive pregnancy test. Fertile Garden by Health Concerns is a Chinese Herbal blend that helps to regulate the menstrual cycle and nourishes the reproductive system. In TCM terms it does this by replenishing yin and regulating the flow of Qi and blood. It is also especially helpful for women trying to conceive in their mid-30s and 40s, and can even help men with normal erectile function and sperm count.
Acupuncture is probably most well-known to help increase fertility. It has proven itself so much so that a lot of fertility clinics work with acupuncturists in order to increase their client’s chances of a successful embryo transfer. It does this by bringing the body back into balance, which increases the chances of conception. What is it balancing mainly? In more TCM lingo, acupuncture mainly works to balance a woman’s “kidney essence” or “heavenly qi” when it comes to fertility.
The other supporting therapy that we have seen amazing results with is vaginal ozone therapy. Ozone is O3 and
stimulates the production of immunoglobulins in the blood, increases resistance of microorganisms to
microbes, improves oxygen transport mechanisms, and destroys viruses. When administered vaginally, it stimulates hormone balance (which is great for PCOS, endometriosis, and fibroids), helps balance vaginal pH, boost womb health, and eliminate inflammation. All of this makes it much easier for sperm to make it to the fallopian tubes and pass through them. Our HOCATT therapy contains ozone that can be personally administered through a vaginal catheter.
Nutrition is also vital for optimum fertility. If you have ever heard me talk, you know I am a huge advocate for using food as medicine, and this is especially important in terms of our reproductive system health. While trying to conceive, you want to focus on real food. Load up on foods from the perimeter of the grocery store and
avoid as many packaged, processed foods as possible. Since conventionally grown fruits and vegetables are heavily sprayed with xenoestrogen containing pesticides and herbicides, buy organic whenever possible.
You can also visit www.ewg.org and look up their Dirty Dozen list. This lets you know the 12 common produce items that contain the highest pesticide/herbicide residual on them that you want to fork up the extra money to buy organic. And that goes for the products that are made from these ingredients too (think ketchup and tomato sauce since tomatoes are on the list).
Since we want high levels of folate in the bloodstream, try to get at least one green leafy vegetable in each day. This includes broccoli, cauliflower, and brussels sprouts. Other sources of folate include legumes, meat, and
nut butters. The leafy greens and cruciferous vegetables pack an extra punch because they are full of
the phytochemicals that flush out xenoestrogens from the body. So, feel free to go over that one serving a day.
Fruits, though we want to watch the kinds we eat to regulate blood sugar levels, such as cantaloupe, grapefruits, and other citrus fruits will give you a natural source of inositol. Lastly, a big forkful of sauerkraut or some other fermented vegetable will help balance pH and nourish the microbiome.
In our many years of practice at Longevity, we’ve seen so many couples who were labeled as infertile find hope and healing, and to finally see their prayer for a baby be answered! Before jumping right to expensive fertility treatments, we urge you to do some detective work to get to the root cause of the issue. And remember that only 30% of infertility is the sole cause of the female. Don’t carry that burden without first making sure your husband’s health isn’t also playing a role in your inability to conceive. Wherever you are in your fertility journey, our knowledgeable practitioners and staff are here to partner with you to find answers, and support your body every step of the way.