Infertility, or the inability to conceive after trying for one year, is one of the least talked about, but most heartbreaking and utterly frustrating conditions for a couple to face. In fact, statistics show that infertility in women is at least as common as breast cancer, but with far less public awareness and support. Infertility is a condition that has an unfortunate tendency to lurk in the shadows and be hidden from the suffering couple's friends and family. Conventionally, conception tends to exist as a dichotomy between getting pregnant easily and naturally OR requiring extensive medical interventions like hormone therapy and IVF. This puts couples in a difficult position in which they are forced to choose between continuing to try to conceive naturally despite repeated disappointments, or face the prospect of spending hundreds to thousands of dollars on medical interventions that have wide ranging side effects and might not even work.

Naturopathic doctors don't view the body in terms of "healthy vs disease," or as "fertile vs infertile," but rather as a spectrum with optimum function at one end and very poor function or disease at the other. Most people don't fall on one end of the spectrum or the other, but rather somewhere in the middle, where optimizing fertility through lifestyle-based interventions can be amazingly effective. Some naturopathic doctors even specialize entirely in the field of fertility, because the safe and affordable modalities we use appeal to many couples who would prefer not to go the conventional route.

The key concept to note when it comes to infertility is that the body is focused on survival FIRST and reproduction SECOND. That is to say, if you are chronically inflamed, under a great deal of stress, have nutritional deficiencies, or hormonal imbalances, your cells will focus on their own survival at the expense of creating new life. Lifestyle-based changes like diet can have a profound impact on fertility because when the body gets what it needs, it is more willing to focus on making a baby.

These are the top five physiological factors that have been clinically shown to affect fertility, and ways to overcome them. Remember, nothing beats the individualized advice and recommendations you can receive by making an appointment with a naturopathic doctor!

1. Inflammation

Chronic inflammation is a factor in many, if not all, conditions that are affected by lifestyle choices. Chronic inflammation is the term we use to describe an overactive and hyper-vigilant immune system that is extremely reactive to environmental triggers and may even attack your cells! An inflamed cellular environment is not one that is hospital to a newly formed zygote. Inflammation is always best addressed through dietary changes. In my office I recommend an anti-inflammatory paleo diet that focuses on vegetables, lean meat, and fruit (in that order!) We remove grains, dairy, and refined sugar, and emphasize adequate calories, protein, and fat consumption. Two of my favorite supplements for decreasing inflammation include fish oil and vitamin D. For safety in pregnancy, aim for 2 grams of EPA/DHA daily and 2,000 IU of vitamin D daily. Don't forget to take the two supplements together for improved absorption!

2. Oxidative Stress

Many people are familiar with oxidative stress in the form of free radicals. Free radicals are molecules such as reactive oxygen species and hydrogen peroxide. They are created as a by-product during normal cellular metabolism and detoxification, and cause damage to cells and tissues if left unchecked. Molecules called "antioxidants" are responsible for "quenching" free radicals and include glutathione, vitamin C, and bioflavonoids found in fruits and vegetables. Having increased oxidative stress can prevent the occurence of a healthy, spontaneous pregnancy. Where is the best place to get these antioxidants? From the diet, of course! (Can you tell this is a theme in naturopathic medicine?) Check out this article for a list of foods high in antioxidants.

3. Methylation Status

Methyl groups are molecules that the body uses to turn other molecules (usually genes) on or off. They are like molecular light switches. Having an adequate population of methyl groups is absolutely essential for cellular function, especially for cells that are rapidly dividing (like those found in fetal tissue.) Having inadequate methyl donors has been shown to cause infertility, as well as a wide array of other symptoms, like anxiety & depression, brain fog, headaches, fatigue, and more. What kinds of molecules are methyl donors? SAM-E, methylfolate, methylcobalamine, methionine, and choline are some of the most essential, and typically come from a healthy diet. However, they can be safely supplemented through a high quality prenatal multivitamin.

4. Nutritional Deficiencies

Nutrient depletion is something that I see very frequently in my office. Of course, we aren't talking about nutritional deficiencies to the extent that someone has an overt disease, like scury or osteomalacia! Rather, the deficiency is "functional," which means that the person isn't getting enough of a certain vitamin or mineral from the diet, or have impaired absorption of it through the gut. This deficiency is just enough to cause decreased function of the molecular pathways that the nutrient supports. It bears repeating that if your own cellular processes are not functioning adequately, your body will not spare the resources to create and maintain the cells required to make a baby. Again, a good diet and a high quality prenatal vitamin goes a long way toward adequate nutritional status.

5. Hormonal Imbalances

Hormones are cellular messengers that are responsible for a wide array of functions in the body. Reproductive hormones are responsible for, you guessed it, reproduction! In females, estrogen and progesterone exist in a very finely tuned balance and correct interplay between these two hormones is absolutely essential to conceive and maintain a normal pregnancy. Progesterone is especially important, as it is responsible for preventing miscarriage and ensuring normal implantation and development. In our society, it is common for women to be "estrogen dominant," which means that the ratio of estrogen to progesterone is skewed, creating a cellular environment where there is too much estrogen and too little progesterone. Having low progesterone often means repeated miscarriages or the inability to conceive at all. Two processes that most negatively affect progesterone are environmental exposures/poor liver function and stress, causing a process called "the pregnenolone steal," which I will elaborate on in the next article. Avoidance of exposures to exogenous estrogens and a healthy stress management program can be incredibly effective at re-balancing your hormonal status.

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