Infertility is a fear for most couples when attempting to conceive, but for some it is a shocking reality. For any couple wanting to bring a little one into the world there are the ups and downs both emotionally and physically when each month her menstrual cycle comes or the pregnancy test is negative. The initial excitement becomes wearing and turns into a stressful and sometimes emotionally unbearable task.
There are many things to consider when conception is challenging. When we assess fertility with our female patients we determine whether someone is ovulating regularly first by evaluating their cycle history and symptoms as well as hormone testing in individuals where this doesn’t seem likely. Initial labs that we consider running are based on the individual, but may include: FSH, estradiol, progesterone, testosterone, thyroid, prolactin, glucose and insulin. We may instruct our patients who have regular cycles to determine if they are ovulating by purchasing urine ovulation predictor kits by First Response. The kits can be picked up at any Target, Walmart, CVS, etc. This helps us determine when in the month they need to have intercourse if the test shows up positive.
We also like to evaluate the reproductive tract structure, meaning are the tubes open, do the ovaries have many follicles present and lack ovarian cysts and if there are any fibroids present (benign tumors in the uterus). Where the ultrasound can determine the quantity of eggs, checking the hormone levels like FSH, estradiol and Anti-mullerian hormone can help determined the quality of eggs.
Now with all that said the male partner must ALWAYS be evaluated. Men are truly 50% of the equation in more ways than one. We recommend having the male partner complete a semen analysis to check the quantity and quality of sperm. Our female patients are often pre-occupied with getting themselves healthy that they forget the other half of the equation is just as important. Having their partners evaluated can be of significant value because there are many natural solutions in improving sperm count and morphology.
Treatments are individualized and vary based on the findings from labs and imaging, but can include nutritional counseling, hormone balancing herbs, acupuncture, various vitamins and even nutrient IV therapy for both women and men.
When there are no clear answers from the labs and imaging than often couples are labeled as “unexplained infertility” and this can bring confusion and be heartbreaking news for many. Traditionally infertility specialists will recommend In Vitro Fertilization at this point. My goal when speaking with any infertile couple is to get my patient’s as healthy as possible by digging even deeper to determine other underlying causes to infertility. Other potential underlying causes are discussed in the Environmental Approach to Infertility section. Our philosophy is centered around having our patients as healthy as they can be so that they will be able to carry the pregnancy full term without any complications whether they go through with In Vitro or not. For patients who decide to go down the In Vitro Fertilization route we highly recommend combining it with acupuncture and IV therapy. We have seen in our practice that it greatly improves the success of conception and carrying the baby to full term without complications.
Environmental Approach to Infertility
Our approach with any couple trying to get pregnant is multi-dimensional. The intent of this material is to discuss the environmental impact and role that specific toxins can play on fertility specifically. By explaining which chemicals have been associated with impairing reproductive health, we are hopeful that you will be able to recognize if any of these are a part of your life and work on removing them.
The toxins that affect fertility have their own name in the literature known as endocrine-disrupting chemicals (EDCs). They have been shown to interfere with the production and regulation of our own hormones, primarily affecting reproductive function. Endocrine disrupting chemicals have been shown to manipulate the ovaries and alter binding of the hormone at the receptor level, sending mixed messages. Disruptions in the normal ovarian function by these EDCs can lead to irregular cycling preventing ovulation, infertility, causing estrogen deficiency, premature ovarian failure, and poor egg quality, among others. The deleterious effects of the EDCs are not gender specific. These endocrine disruptors have been linked to causing sperm abnormalities, including sterility.
The following chemicals have been tagged as EDCs: plasticizers (BPA and phthalates), pesticides (DDT and its metabolite DDE), polychlorinated biphenyls (PCBs) and herbicides (Roundup and 2,4- D).
PLASTICIZERS, BPA and PHTHALATES:
Bisphenol A (BPA) is a plasticizer found in reusable plastic containers, soup and beverage can liners, and dental sealants among others. Plasticizers are a problem as they will leach from the products into the food and beverages that we consume. Animal studies have shown that this chemical has been found in the follicles (eggs) in the ovaries. BPA specifically has been shown to inhibit the growth of the follicles and decrease production of progesterone, DHEA, estrogen, and testosterone.
The other popular chemical, phthalates, have been known to affect fertility for both women and men. Phthalates are ubiquitous. They are in most personal care and household products like: perfumes, cologne, nail polish, lotions, shampoos, make-up, household fresheners, dryer sheets and most cleaning products. Phthalates are chemicals that are used in fragrances to enhance the scent which when inhaled or applied topically to the skin get absorbed into the bloodstream. Any time fragrance is listed as an ingredient it is most likely a phthalate. Another common source of phthalate exposure is plastic water bottles and food storage containers, which when warmed, leach into your food and water.
The medical concerns associated with phthalates are many. We are only relaying the connection of phthalates to infertility in this article, but there are many other negative implications on health, including breast cancer and endometriosis. Animal studies have shown that when rats are exposed to phthalates fertility is impaired and there is an increase in mid-pregnancy miscarriages. Fish exposed to phthalates produced far fewer embryos, and have impaired ovulation. These studies are showing that not only are these phthalates disrupting the hormone production necessary for conception but it is also lowering the quality of the follicles (eggs).
To reduce phthalate exposure you must first be aware and then make a conscious effort to change over your current products. You can start evaluating your current beauty products by plugging them into www.cosmeticdatabase.org to determine how toxic they are. You can also peruse our website www.EVNDNaturals.com for hand selected non-toxic products. The best way to avoid BPA is to limit your canned products as it lines all canned products and even boxes of cartons of milk and soup. Ideally eat fresh, non-processed foods as much as possible. If fresh vegetables and fruits aren’t possible then frozen is the next best option.
Here is our list of alternatives to the everyday beauty and household products:
Switch from plastic to either a glass or steel water bottle. Whole Foods sells several types. Pyrex makes several glass container tupperware products which can be purchased anywhere.
For a great less toxic nail polish try the zoya nail polish brand. They have a great selection and they work amazingly well.
Be mindful of your cleaning products as well that usually contain synthetic fragrances. I use either a mixture of water and vinegar and have recently tried a new product I like called Nature’s Paradise multi-purpose cleaner or Extreme 18X Soap Nuts.
Deodorants are not only filled with phthalates but aluminum and other harsh chemicals. It can be difficult to find a less toxic effective deodorant but we like Aubrey’s E Plus High C roll on.
This all may seem overwhelming because it is. Our advice is to slowly change out some of your current products for safer ones. This will not only impact you but others around you.