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Many couples eagerly look forward to the day when they can welcome a new baby to their family. Unfortunately, this dream is becoming more and more difficult for couples around the world with 2015 data showing infertility affecting 15% of couples globally1.
Over the past several decades, infertility rates have risen as reproductive health issues become more common. In fact, it is estimated that over 16% of women aged 15-49 struggle to get or stay pregnant.
Why are modern couples struggling to grow their families? The increase in the prevalence of infertility in men and women may be due to the increased unhealthy dietary and lifestyle habits as well as increased age. It is estimated that over 60% of women undertaking Assisted Fertility Treatment are over 35 years of age.
The good news is that we have power over our reproductive health, and we can make changes to our lifestyles to support our fertility, rather than sabotage it. The first step is knowing what is causing our fertility challenges. Then, we can take the proper steps to restore our fertility and make way for a baby.
Let’s take a look at the potential causes of infertility and learn how we can improve our chances of conceiving with natural integrative and functional medicine approaches.
Infertility defined
Simply speaking, infertility is the inability to get pregnant. Doctors typically diagnose infertility after a couple has actively tried to conceive with unprotected sex for at least one year.
In reality, infertility is not so cut and dry. There are many different reasons why a woman may not be getting pregnant despite her best efforts. Infertility may also refer to women who can get pregnant, but are not able to stay pregnant and experience recurrent miscarriages.
What is Unexplained Infertility?
In some cases, doctors are able to tell why someone isn’t conceiving, such as blocked tubes or uterine fibroids. In other cases, there is no clear explanation. If you are given the diagnosis of “unexplained infertility,” this simply means there is no obvious allopathic reason why you aren’t getting pregnant.
Unexplained infertility is relatively common (up to 25% of couples) but no less frustrating. In some cases, this diagnosis is even more stressful, because there is no clear solution or next step suggested by doctors.
Functional medicine and other holistic therapies can be particularly helpful for couples with unexplained infertility, because these methods seek to restore your overall balance and can correct issues that traditional fertility tests don’t account for.
Male vs. Female Infertility
Many people assume that infertility occurs due to issues or abnormalities in the female partner. However, infertility is just as often due to poor sperm quality or quantity, or issues with both male and female health.
- What is Male Infertility?
An adequate number of healthy and motile sperms in the male partner is essential for healthy conception. These sperm are needed to fertilise the egg released from the ovaries of the female partner.
When there are not enough healthy sperm, the sperm do not swim properly, or the sperm are misshapen, infertility can occur.
Male infertility issues can include signs and symptoms like: 
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- Low sperm count
- Abnormal sperm morphology
- Abnormal sperm motility
- Erectile disfunction or ejaculation issues
- Testicular swelling or pain
- Abnormal hormone levels
- Poor quality seminal fluid or pH
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- What is Female Infertility?
For pregnancy to occur, a woman must release a healthy egg from the ovary, have the egg successfully travel from the ovary through the fallopian tube, and into the uterus where it meets the sperm. Once fertilised by a healthy sperm, the egg must implant into the uterine lining and start growing into an embryo.
As you can see, there are many potential obstacles for a healthy pregnancy to occur! When hormone or structural issues get in the way, it can make pregnancy even more difficult.
Female infertility issues can include signs and symptoms like:
- Hormone imbalances
- Irregular menstrual cycles
- Irregular or absent ovulation
- Uterine fibroids or ovarian cysts
- Blocked fallopian tubes
- Poor egg quality
- Poor uterine lining or impaired circulation
- Thyroid issues
- Anti-sperm antibodies
Any issues that can adversely affect the process of fertilization of an egg and a sperm can reduce the chances of conception.
Hence, it is important to examine and assess the health of both the female and the male to detect the possible cause of infertility in the couple.
How Does Infertility Affect Couples?
The diagnosis of infertility is often devastating for couples. It’s normal to experience high mental stress due to constantly tracking menstrual cycles, various doctors appointments, and the uncertainty that surrounds infertility. Many couples also feel guilty for being unable to let their partner enjoy parenthood. Others may feel ashamed or angry with their body, or regret not trying to conceive earlier in life.
Underlying Contributors to Infertility
Let’s look at some of the common causes of infertility and the therapies that have been found to be helpful for healing or correcting them.
- Irregular ovulation, insulin resistance and PCOS
Ovulation issues are often at the root of infertility. Hormonal disruption such as insulin resistance and polycystic ovary syndrome (PCOS) can increase the risk of infertility in women by affecting ovulation.
When the delicate network of communication between the glands of the body such as the pituitary gland, ovaries, and follicles does not work efficiently, ovulation may not happen. Without ovulation, there is no egg to fertilise and conception does not occur.
Women with PCOS often also have insulin resistance. Insulin resistance increases the risk of infertility further. According to fertility specialist Carolyn Gundell, MS, “women and men with elevated blood sugar and insulin resistance are at greater risk for fertility challenges. Changes in reproductive function and hormones can occur with higher hemoglobin A1c (blood sugar) levels and may cause longer time to pregnancy or higher chance of miscarriage.”
Thankfully, you can reduce the effects of PCOS and insulin resistance by regulating your hormones and encouraging regular ovulation with functional medicine.
- Luteal phase deficiency/defect
The luteal phase is the second half of the menstrual cycle in which the body prepares for pregnancy. Progesterone rises and the uterine lining grows to support the future growing baby.
In women with a luteal phase defect, however, the lining does not grow sufficiently to support a growing embryo. If the egg is successfully fertilized, it has nowhere to implant and thrive. As a result, pregnancy does not occur.
- Hypothyroidism
Hypothyroidism is a common thyroid condition that occurs when the thyroid gland does not produce an adequate amount of thyroid hormones. This results in symptoms like severe fatigue, slow heart rate, dry skin, irritability, hair loss, and infertility.
Low levels of thyroid hormone can prevent the release of the egg from the ovary and delay or stop ovulation.
- Poor gut function and microbiome
Trying to conceive? Check your gut health.
Infertility has been linked to the lack of a healthy and diverse microbiome in the gut. How? The gut’s microbiome directly impacts the immune system. With poor gut health, the immune cells may produce auto-antibodies against sperm, eggs, or reproductive tissue. This mounts an immune response which causes inflammation and prevents conception. A poor gut function or dysbiosis of the gut can impact absorption of nutrients resulting in nutrient deficiencies – which also impacts fertility.
- Chronic inflammation, Infections, and Autoimmunity
Chronic inflammation is often the root cause of most chronic health conditions including infertility.
Inflammation and autoimmune conditions can also worsen the risk of infertility by interfering with the normal immune system functions and creating hormonal imbalances.
Chronic infections impact fertility by increasing your risk of inflammation and gut microbiome imbalances. H. pylori infections in particular could impact the follicular fluids, cervical mucus, and sperm motility and increase the risk of infertility in both men and women.
- Endometriosis
Endometriosis is a chronic inflammatory condition in which the uterine tissue grows outside of the uterus. It can show up in places like the ovaries, fallopian tubes, or intestines. This not only causes pain and inflammation, but can contribute to infertility.
Early diagnosis and treatment of endometriosis could help to restore healthy ovulatory cycles and help women conceive normally. However, it is important to combine the treatment with appropriate measures to reduce inflammation and autoimmunity to derive the expected results.
- Chronic stress, the HPA Axis, and Poor Sleep
Chronic stress is a common issue in our modern lives, and is only made worse by fertility challenges.
Unfortunately, chronic stress floods the body with cortisol and throws hormones off balance. Studies show that chronic activation of the hypothalamus-pituitary-adrenal axis (HPA Axis) could prevent fertility. This is due to the simple fact that our bodies are trained to preserve energy. When we are stressed or burned out, getting pregnant only robs us of more vital energy that we may need. So, the body changes our hormone balance (specifically the ratio of follicle stimulating hormone to luteinizing hormone) to prevent possible pregnancy, even though getting pregnant is our main goal.
Stress also affects the quality and duration of your sleep. Since most of the healing and repair mechanisms of the body occur at night during sleep, the lack of sleep can deprive the body of the chance to heal the damage caused due to exposure to toxins and pollutants.
- Environmental Toxin Exposure and Mould
Exposure to mould and environmental toxins such as allergens and irritants can increase your risk of infertility. Other toxins, like parabens, phthalates, and BPA as well as electromagnetic frequencies (EMF) are known endocrine disruptors that can reduce your fertility and cause other health issues.
Toxicity could compromise your microbiome health, worsen inflammation, and disrupt hormonal balance thus causing infertility.
Reducing your exposure to these factors is the key to maintaining optimum health and preventing infertility.
- Poor Diet and Nutrient deficiencies
Your body needs quality food to fuel your fertility. Unfortunately, our modern diets full of processed foods and sugar sabotage our fertility. They create inflammation in the body and lack the nutrients we need (like iron, B vitamins, zinc, and vitamin D) for sperm and egg development. These deficiencies hamper the efficient functioning of the immune system and reproductive organs.
- MTHFR & other gene mutations
Mutations in the MTHFR gene (Methylenetetrahydrofolate reductase) have been linked to both female and male infertility. In women, an MTHFR mutation can prevent a healthy pregnancy. It has been linked to issues like miscarriage, pre-eclampsia, and birth defects.
In men, these mutations can alter the structure and functions of the organs involved in sperm production at the cellular level. The hormonal imbalances caused due to these mutations can also affect the sperm production processes. This may cause a low sperm count thus reducing the chances of pregnancy.
Functional Medicine Solutions to Infertility
The functional medicine approach to fertility takes all of these causes of disease into account to help you find the right solutions for your body. Whether you know the root cause of your fertility challenges or you have unexplained infertility, functional medicine can help you find balance and restore your reproductive health so you have the best chances of getting pregnant.
Here are just a few solutions that functional medicine offers for couples trying to conceive.
- Eat a Diet that Supports Your Fertility
Functional medicine offers an individualized approach to improving your fertility. Through testing, functional medicine provides a comprehensive view of nutritional deficiencies enabling a tailored approach to supplementation.
Dietary and lifestyle changes have been shown to reverse issues like insulin resistance and PCOS. Cutting back on processed foods and refined sugars, for instance, can increase your insulin sensitivity, aid with weight loss, and correct other hormonal imbalances.
It is also essential to restore your gut health. Supporting healthy gut tissue and eating a wide variety of fresh, whole foods helps to balance and maintain your microbiome and reduce inflammation.
- Complete a Proper Detox
Functional medicine/clinical detoxes do more than your average cleanse. They are tailored to you and your needs to provide the best fresh start while you’re trying to conceive.
It is strongly recommended that you seek to undertake clinically guided detoxification at least six months before trying to conceive.
- Manage Your Stress
Chronic stress is one of the main root causes of hormone imbalance and infertility in both men and women. As such, it is essential that you make time for stress management along your fertility journey!
Make time for rest, hobbies, and quality time enjoying your partner’s company. Practice self-care routines and de-stress through exercise and meditation.
Source: article by Deborah Freudenmann
- https://rbej.biomedcentral.com/articles/10.1186/s12958-015-0032-1