It is estimated that over 12% of reproductive age women struggle with infertility. Infertility is defined as the inability to conceive after 1 year of trying, or after 6 months if over the age of 35. While the emphasis is often placed on causes pertaining to the women, male causes of infertility contribute equally. Reasons why couples struggle with conception vary greatly and are due to unknown causes in up to 20% of situations. Hormones, body composition, structural abnormalities, metabolic conditions and lifestyles factors all play a part for both men and women. Because each situation is unique, a proper workup is essential for being able to correct the underlying cause. Treating the underlying cause can help a couple get pregnant naturally and can also increase success rates of various reproductive therapies such as in vitro fertilization.
First steps of pregnancy
While pregnancy is one of the most natural processes on earth, there are a surprising number of steps that need to take place in order for it to happen successfully. The first step is that a women needs to ovulate, or release an egg. The egg needs to be met and penetrated by a sperm and then travel down the fallopian tube to the uterus. Next, the fertilized egg must successfully implant within the uterine lining before it can begin to grow. From here hormones, genetics, the immune system, and nutrition all affect whether or not the pregnancy can be maintained. Interference in any of these steps can lead to infertility or loss of pregnancy.
With the first step of pregnancy being that a woman must ovulate, lack of ovulation is a major cause for infertility. Typically if a woman does not get her menstrual cycle or is having fewer than normal cycles, it is likely she is not ovulating. Some of the most common causes for this include: polycystic ovarian syndrome (PCOS), hypothyroidism, and functional hypothalamic amenorrhea.
Polycystic ovarian syndrome and ovulation
PCOS is a common endocrine condition in which a woman’s hormonal balance is off, leading to excess androgen hormones such as testosterone. The overall hormonal effects lead to eggs not fully maturing and releasing from the ovary. Additionally there are impairments in the body’s insulin sensitivity, oftentimes contributing to the development of elevated blood sugar or diabetes. Women who have PCOS typically present with irregular menstrual cycles, ovarian cysts, male pattern hair growth, obesity, and impaired insulin levels. However it should be noted that a person could have PCOS without presenting with all of these characteristics.
Having polycystic ovarian syndrome doesn’t mean that a woman cannot get pregnant, however it can pose difficulties. In these situations the goals of treatment are focused on balancing hormones and managing weight and blood sugar in order to promote regular ovulation. This can be done naturally through the use of certain herbal medicines, nutrition, and lifestyle habits. If you have PCOS and are planning on getting pregnant in the future, it is best to start these natural treatments sooner than later to give the body enough time to create favorable changes.
Hypothyroidism in women
Hypothyroidism is another common condition that can affect female fertility. When not functioning at the proper rate, an imbalanced thyroid can disrupt a number of hormones necessary for conception. Not only can this prevent ovulation, but it can also lead to miscarriages or difficulties for the growing fetus. It should be noted that the thyroid could contribute to infertility even at sub-clinical levels, meaning levels in which treatment is not normally required. Luckily abnormal thyroid levels are relativity easy to correct, which can greatly improve the likelihood of becoming pregnant. While this is often done through the use of medications, combining natural therapies promotes proper functioning of the thyroid as well. This is done through monitoring and supplementing with nutrients required for thyroid hormone production as well as following dietary guidelines that decrease damage and autoimmune attack to the gland. As with treating PCOS, the sooner the condition is addressed the greater the results will be.
Effects of physical and emotional stress on ovulation
The term functional hypothalamic amenorrhea refers to a few different situations in which lack of ovulation is the end result of stress placed on our bodies. This stress can be emotional or physical, and results in a disruption in the normal balance of sex hormones. Physical stress encompasses being over or underweight as well as partaking in excessive exercise. Because functional hypothalamic amenorrhea is typically the results of lifestyle habits, the effects on the body are reversible assuming the stressor can be removed or lessened. Treatment for this situation is different case-by-case depending on the particular stressor. Maintaining a healthy weight and adequate nutrition is essential in any situation. If the stressors are primarily emotional, there are numerous options to help the body cope including craniosacral therapy, acupuncture, herbal medicine, hypnotherapy and counseling. Your practitioner can help you sort through the various treatments to find what would work best for you and your body.
Structural blockages that interfere with pregnancy
In addition to anovulation (lack of ovulation), women can also experience infertility due to structural abnormities. As mentioned earlier, the fertilized egg must be able to travel down the fallopian tube and then be implanted within the uterine lining. Any blockage in this pathway can inhibit pregnancy from progressing. Common causes for a blockage include past surgeries, pelvic infections, ruptured appendix, sexually transmitted diseases, fibroids and even endometriosis. If the structure of the reproductive organs is in question there are various types of imaging that can be done for assessment including an ultrasound or x-ray, which is referred to as a hysterosalpingogram.
In the case of endometriosis, it is best to be preventative and implement hormone-balancing treatments as soon as possible to prevent structural changes. While oral contraceptives are often used for this, there are a number of vitamins, botanicals, and foods that can help balance hormones without using oral contraceptives. Additionally it is important to become educated on how to avoid toxins such as those in our food and cosmetic products that can worsen hormonal imbalances that contribute to the condition.
Infertility is similar amongst males and females. Because there are more steps taking place within a woman’s body there are more chances of things going wrong along the way. For men, the main problem area boils down to the health of the sperm. When analyzing sperm there are three factors to consider; concentration, morphology, and motility. So, males need to produce a high number of correctly shaped sperm that have the ability to reach the egg. An issue with any one of these factors can contribute to infertility due to the fact that the sperm will not reach the egg for fertilization. When a couple is worked up for infertility, it is common for the male to get a semen analysis to assess the viability of the sperm. A number of factors influence semen quality including thyroid health, obesity, environmental toxin exposure, and lifestyle habits such as smoking, drinking, and drug use.
Hypothyroidism in men
In males the thyroid is necessary for sperm development and an underactive thyroid also contributes to abnormal weight gain and obesity. Obesity itself is an additional risk factor for male infertility. Therefore, correcting the health of this gland will help restore reproductive health in more than one way. Other avenues can also be explored with your physician to help determine the best path to getting back to a healthy BMI. Switching to a Mediterranean diet not only helps with weight management but has also been shown to enhance fertility, so it can be a great starting point for overall health.
Lifestyle factors that affect fertility
If factors such as smoking, drinking or medication use are the cause of infertility, there are many avenues of support to help overcome habits or addictions. These include counseling, herbal medicines, acupuncture and even hypnosis. In some instances the cause of poor sperm quality cannot be treated directly, however there are great natural remedies to promote healthier sperm production. Since sperm have such a short life span it is important that they have a healthy environment to exist in. Antioxidants are an effective treatment for increasing sperm function and viability by mitigating the damage done through such factors.
Steps towards restoring reproductive health
It is currently estimated that infertility rates affect over 12% of women, a number that is consistently rising. While there are many factors that can contribute to this, it can be difficult to determine where the issue lies. If you find yourself having trouble getting pregnant, begin by having both partners receive a thorough workup and address any issues that are found. Naturally supplying your body with the extra nutrients it needs during pregnancy can greatly improve fertility. Beginning this as soon as possible will give your body the best chance at restoring reproductive health.