Female Infertility

Natural Treatment of Infertility

Female infertility is defined as the inability to conceive or maintain a pregnancy after 12 months of unprotected intercourse. Many of of Perth clinic patients fall pregnant after addressing underlying causes of infertility such as MTHFR, methylation, gut health and hormone imbalance. Natural infertility treatment is an excellent option to try before considering IVF.

Conception and pregnancy depend on many factors including: the production of healthy eggs, unblocked Fallopian tubes, implantation of the fertilised egg, healthy embryo, and optimal hormonal balance.

There can be multiple factors that can cause infertility as well as multiple miscarriages.  Identifying underlying imbalances, assessing MTHFR genetic variations, hormonal imbalances, vitamin and mineral levels, thyroid function and bacterial and fungal overgrowth of the gut are vital prior to conception

Causes of Female Infertility

• Ovulatory disorders: the most common cause of functional infertility – present in 40% of infertile women and usually presents as menstrual abnormalities
• Tubal obstructions (e.g. scarring and adhesions from endometriosis or pelvic inflammatory disease)
• Structural abnormalities of uterus
• Uterine fibroids
• Endometriosis
• PCOS
• Cervical mucous problems
• Hormonal imbalances
  • High Estrogen to Progesterone ratio
  • Luteal phase defects
  • High levels of Prolactin
• Endocrine disorders e.g. hypothyroidism, poor adrenal function
• Sperm antibodies
• STD infections – chlamydia, gonorrhea

Risk factors

• Age: fertility decreases dramatically after age 35
• Stress: major factor in infertility; elevated cortisol inhibits production of and creates resistance to sex hormones
• MTHFR genetic variations
• Family history of infertility
• Obesity
• Smoking
• Alcohol and recreational drug use
• Sedentary lifestyle
• Nutritional deficiency
• Gut dysbiosis and/or leaky gut
• Insulin resistance / blood glucose dysregulation
• Hormonal contraception use
• Coeliac disease
• Exposure to environmental toxins

NATURAL TREATMENT STRATEGY FOR FEMALE INFERTILITY

It is essential that both partners are assessed and treated.  Medical testing is recommended to rule out underlying disorders.

• Identify / address underlying causes
• Detoxification / preconception care program (at least 3 months)
  • Preconception care involves ensuring that all the nutritional, lifestyle and environmental factors essential for healthy eggs, sperm, fertilisation and healthy pregnancy and fetus are present.
  • Preconception care should take place for at least 3 months prior to conception as the formation of mature sperm takes 2 months and maturation of eggs takes around 100 days prior to ovulation
  • It is recommended that couples practice non-pharmaceutical methods of contraception during the preconception care period.
• Support ovulation
• Optimise methylation
• Optimise gut health
• Support hormonal balance
• Reduce inflammation and oxidative stress
• Reduce stress and support nervous system / adrenal health
• Address any nutritional deficiencies
• Address any modifiable lifestyle factors
• Establish healthy weight
• Address any areas of sub-optimal health

Diet plan guidelines for Female Infertility

• Fresh, organic, whole food, low-GI diet, high in fruit and vegetables, whole grains, grass fed animal meat, fish and plant proteins, and healthy fats.
• Avoid sugars, refined grains, refined oils, trans fats, processed foods, alcohol, caffeine, excessive dairy and commercial animal fats.
  • Diets containing high amounts of carbohydrates (esp. high-GI), low-fat dairy products, and trans fats have been associated with increased ovulatory infertility
  • Alcohol and high levels of caffeine (> 6 cups/day) are both associated with reduced fertility
• Include foods rich in the following nutrients, deficiencies of which are associated with sub-optimal fertility:
  • Iron – lean red meat, seafood, eggs, green leafy vegetables, whole grains, legumes, sunflower seeds, nuts, tofu; consume vitamin-C rich foods with meals and avoid drinking tea close to meals
  • Zinc – lean red meat, poultry, seafood, eggs, nuts & seeds, legumes
  • Selenium – Brazil nuts (only a few are needed each day)
  • Antioxidants: needed to protect the egg cell and, in particular, sperm from oxidative damage. Colourful fruits and vegetables, red and black legumes, berries, turmeric, green tea, dark chocolate, etc.
• Weight-loss diet (if indicated): Overweight and obese women are less likely to conceive and have an increased risk of pregnancy complications and failed pregnancies than those of normal weight.
• Weight-gain diet (if indicated): Very underweight women can also have problems conceiving

Supplements that support Natural treatment of Female infertility

• Multivitamin and antioxidant formula – lowers the time to conception and improves pregnancy rates
• Folininc acid of methyl folate 400 ug/day – important in the first trimester to prevent neural tube defects and leukaemia development in the fetus. Supplementation should begin 3 months prior to conception for optimal benefit.
• Vitamin C – improves fertility outcomes in women with luteal phase defects
• Probiotic – ensure optimal gastrointestinal and immune function
• Vitamin B12 – status should be assessed and supplementation given if levels are low as deficiency is associated with a 3-fold risk of neural tube defects.  Also a key vitamin in the methylation process

Herbal considerations

NB Caution must be exercised when using herbs – it is essential that the patient be using contraception during the pre-conception care program, especially when using any herbs contraindicated in pregnancy. When the couple starts attempting conception, all herbs contraindicated in pregnancy must be stopped.

• Ovarian tonics: shatavari, false unicorn root, blue cohosh, peony
• Uterine tonics: black cohosh, blue cohosh, false unicorn root
• Oestrogen modulating: black cohosh, wild yam, false unicorn
• Female tonic: dong quai, false unicorn, peony
• Progesterogenic: chaste tree
• Nervine tonics: St John‘s wort, zizyphus, passionflower, oats, scullcap, vervain
• Anti-oxidants: St Mary‘s thistle, turmeric, green tea, rosemary
• Hepatics: dandelion root
• Hypoglycaemics: gymnema, goat‘s rue, cinnamon
• Adaptogens: withania, Siberian ginseng, codonopsis, rhodiola,
• Topical applications: aloe vera gel on a diaphragm if cervical cell damage

Lifestyle / Physical measures

• Cease any hormonal contraception; however, mechanical barriers are encouraged during the preconception period
• Moderate, regular physical activity: promotes fertility. Moderation is important, however – excessive physical exercise is associated with a range of reproductive dysfunctions.
• Regular exposure to sunlight: to ensure adequate vitamin D status
• Smoking: adversely affects fertility in both males and females. In females, smoking affects the follicular environment and hormone levels during the follicular phase.
• Stress, anxiety and depression: major risk factors for infertility (a major stressor in itself!). Increased cortisol down-regulates the Hypothalamus/Pituitary/Gonad) HPG axis. Stress management strategies include breathing, relaxation, yoga, massage, music, counselling and/or psychological support
• Environmental toxins:
  • Exposure to pesticides, PCBs, heavy metals, emissions from burnt furl sources is associated with decreased fertility, a higher risk of miscarriage and childhood disorders such as ADHD and autism spectrum disorder (ASD)
  • Couples planning to conceive and pregnant women should avoid sources of environmental toxins as much as possible
• Establishing window of fertility
  • Once baseline health issues have been addressed, it is important to establish the “window of fertility”, which is the 6 days leading up to ovulation
  • Fertilisation of the ovum is most likely to occur if intercourse takes place within the 3 days prior to ovulation. Having intercourse every 2-3 days leading up to ovulation is one of the best ways to increase the chance of conception.
  • Fertility charting, in which the intermenstrual interval, cervical mucous and basal body temperature (BBT) are assessed, is one of the best ways to detect ovulation or establish patter of ovulation (fertility charts are readily downloadable from the internet):
    • Cervical mucous is the best predictor of peak fertility – it should be slippery and clear.
    • BBT must be taken using a basal thermometer before getting out of bed or having anything to eat or drink. At ovulation, BBT rises by about 0.2ºC and stays elevated until the next menstrual period. Fertility is at its peak a few days before and on the day of the temperature spike.
  • Ovulation detector kits (urine or saliva) are also available – they detect the surge in LH that occurs on the day or so before ovulation. These are generally more accurate than charting but are relatively expensive.

FUNCTIONAL MEDICINE TREATMENT OF INFERTILITY

Infertility for couples can be very frustrating. It is important to assess and treat both the male and female.  Natural treatment of infertility through balancing dysfunctional areas of the body often allows pregnancy to naturally happen again.

Female infertility can be caused and contributed to by many factors, often there are a number of underlying issues that when treated, allow the female to conceive. 

Key areas to assess and treat include the production, balance and clearance of hormones, methylation and MTHFR imbalances, bacterial and fungal overgrowths of the gut, SIBO and diet and lifestyle measures.

At our Perth clinic of Advanced Functional medicine we have experience with females optimizing their health to improve the chances of healthy conception.  If you are struggling to conceive, we would love to hear from you. 

What measures have you taken to improve your chances of fertility?  Did you improve your health and have a healthy baby, if so, what measures did you take?  Have you investigated MTHFR and methylation?  Please leave a comment below.

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