Infertility - a common problem usually badly treated
This is an extremely common problem and it is now estimated that about one in ten couples are sub-fertile. Infertility is defined by the medical profession as inability to conceive after 2 years of trying. I must say I would want to investigate if there was no result after 6 months! I am always shocked by the lack of logical thinking which goes into the treatment of infertility because the mechanics of conceiving are very simple and straightforward. Quite simply one needs
a healthy egg
a healthy sperm (actually at least 20 million of them! It takes 20 million males to do the job that one female can do!)
which must come together in the right environment for implantation and then stay there for 9 months
A healthy egg
A regular period is a good sign that a healthy egg is being produced on a regular basis. Indeed, the US National Research Council, in its report "Biological Markers in Reproductive Toxicology" concluded that "menstrual cycles constitute the most accessible and non-invasive biological markers of female reproductive function in humans. Any aspect that disrupts normal cyclic menstrual function may be described as causing reproductive toxicity."
If the nutrition is not right, the hormones will not be right.
If you are not seeing a regular period then this should be investigated from the nutritional point of view and a careful look should be taken at the diet with respect to:
protein and calorie content - are you eating enough good quality food?
allergies and malabsorption - do you have any gut symptoms?
and, most importantly, micro-nutrient status - tests of nutritional status
It is not good enough just to do a sperm count. There must be enough normal sperm (a high percentage may be abnormal), they must be able to move normally and they must be able to release their genetic material (sperm decondensation) at the right time. All these things can be tested for at Biolab by doing a sperm chromatin decondensation test.
If there are any abnormalities in this department, then they need investigating by looking at:
1. tests of nutritional status - zinc, selenium and magnesium are the commonest deficiencies
2. infectious diseases screening
3. possibly pesticide screening and heavy metals screening with hair analysis.
Tests to ensure healthy eggs and sperm
Macro-nutrients: Protein, fats and carbohydrates - one cannot make healthy eggs and sperm from junk food. Being very under weight will cause infertility through inability to produce an egg. This is Nature's way of telling you that there are not the necessary reserves to have a baby. You should be eating protein twice daily, 5 helpings of fresh fruit and/or vegetables and avoiding all processed foods. Do the Paleo Ketogenic Diet.
Micro-nutrients: (vitamins, minerals, essential fatty acids) status - micronutrients are the raw materials necessary for growth and repair. These cannot be made in the body, they have to be consumed. They are the basic building blocks. Without these the body cannot make healthy babies. Micronutrient deficiencies are extremely common in Western society in people who do not take micronutrient supplements regularly. I usually prescribe vitamins, minerals and essential fatty acids routinely but actually measure the minerals because deficiencies are common and difficult to correct. Increasingly I measure the function of enzymes that depend on vitamins and minerals as co-factors.
Toxic stress - alcohol, caffeine, tobacco, drugs of addiction and prescription drugs are all toxic to the egg and sperm and should be avoided. Hair analysis for heavy metal poisoning and pesticide screening may be indicated.
Foresight Infectious Diseases screening. Low grade undiagnosed infections are a major cause of infertility. See article on Vaginal infections and pelvic inflammatory diseases
Thyroid problems are extremely common - you need to do a free T4, free T3 and TSH.
Must come together
The sperm must arrive in the right place and the cervical mucus must be receptive to sperm. This can be tested for by doing a post-coital test, in which a sample of cervical mucus is examined microscopically 6-20 hours after intercourse at mid-cycle. The number of sperms, migration rate, decondensation of chromatin, abnormal behaviour of sperms can all be observed.
Anti-sperm antibodies in the woman may destroy the sperm.
If the sperms arrive in the right place and function normally then one has to ask the question: are the tubes patent? This needs a hystero-salpingogram, which is a hospital procedure where some dye is placed into the uterine cavity to see if the tube between the ovary and the womb is open. Blockages are commonly caused by infections.
In the right environment for implantation
In order for the fertilised egg to implant there must be a receptive environment in the womb. The commonest problem here is low grade infection of the womb and mineral imbalances. Infections need to be investigated by the Foresight Infectious Diseases screening and micronutrient imbalances through nutritional testing.
If deficiencies have been identified, they can be corrected. Nutritional deficiencies may take several months to correct depending on how severe they are. They should be checked before attempting conception. This is because improving nutrition may create an environment which is good enough to conceive but not good enough to maintain a pregnancy or guarantee a perfect baby.
Recurrent miscarriage may be caused by Hugh's syndrome. This occurs when there is an increased tendency to clot due to abnormal antibodies being present. This can be tested for with the anti-phospholipid antibody test.
What not to do
Be very wary about going in for sex hormone treatments before the nutritional side has been sorted out completely (in fact the hormone treatments should not be necessary once the nutrition is right). If the nutrition is inadequate, the hormones will be inadequate. By "forcing" the issue through using hormones, one is forcing a conception which Nature does not approve of. This increases the risk of malformations in the baby (something the infertility clinics do not tell you). Furthermore the hormones used are extremely powerful chemical messengers which may have direct effects on the baby. The example I always use is that of stilboestrol. This was a synthetic oestrogen widely used during pregnancy post 2nd World War which caused vaginal cancer in the female babies which did not appear until their teenage years.
If hormones are to be used, then it is doubly important that nutritional supplements are taken as well. Good nutrition is highly protective against toxic stress.
And then stay there for 9 months
See miscarriage. Common causes of include poor nutrition, infection, anti-phospholipid antibodies, cervical incompetence.
Vaginal infections and pelvic inflammatory diseases
Genito-urinary tract infections in men
Nutritional supplements - what everyone should take
Foresight "Preparation for Pregnancy" available from Argyll Publishing, Glendaruel Argyll PA22 3AE 01369 820 229 cost 12.99 plus £2 p and p.
Tests of nutritional status - serum minerals, red cell magnesium and selenium full vitamin profile, essential fatty acid profile.
Post coital test (at Biolab)
Sperm chromatin decondensation test
Foresight infectious diseases screening
Pesticides and related substances
Hair analysis (for toxic metals)
Pelvic inflammatory diseases screening (at the London Clinic)
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