For individuals and couples who have had the misfortune of being labeled as “infertile,” or for those struggling with getting pregnant, naturopathic medicine has a lot to offer. Conventional medicine offers the gold standard in diagnostics, but the only treatment offered by conventional docs is typically uses expensive drugs and surgical procedures to aide in conception. In Los Angeles one round of IVF (in-vitro fertilization) is likely to cost a couple $24,000, with a success rate of only 4-18% per treatment!
In my office I utilize similar fertility diagnostics, to conventional MD’s, but I also offer treatment options that are less invasive and holistic. These treatments can be applied prior to utilizing treatments like IVF, often eliminating the need for this costly and invasive therapeutics/procedures. My treatments, and those of most naturopathic doctors, are individually tailored using natural medicines (western botanicals and supplements) and dietary & lifestyle changes. I incorporate the beneficial aspects of modern medicinal practices to complement a natural therapeutic approach to achieve a healthy conception, pregnancy and birth. In this article we’ll cover steps towards achieving optimal fertility, tests that should be ordered by your doctor (or naturopathic doctor), and an ideal supplement regiment for fertility and pregnancy.
The first, and most important step in optimizing fertility is ensuring that you are trying around the right time of the month. Here are some simple things to do to enhance timing:
- Look for signs of ovulation: signs of ovulation include change in cervical mucus (stretchy), twinges/cramps near the ovaries (lower sides of your abdomen), mild increase in PMS for 24 hours, increased libido, and a dip then a steady rise in temperature
- Not everyone ovulates on day 14, best to find your rhythm either by charting basal body temperatures or via other signs of ovulation
- A positive ovulation predictor kit (OPK) means ovulation within the next 24 hours
- Once released, the egg lives only about 12-24 hours depending on age/quality
- Sperm can live in fertile mucus for 2-5 days
- Best to have sex just before ovulation and the day of ovulation
If proper timing has already been established and a conception is not achieved in 6-12 months, both partners should have a thorough work-up to make sure there aren’t any particular blockades that are affecting their fertility. Although females are more likely to explore the cause of the infertility, up to 24% of infertility is due to male factors and 28% remains unknown, so it really is important to have both partners evaluated.
When couples, or individuals, come to me for fertility healthcare they typically have already had a work-up from their primary care practitioner. I look for any health concerns that may have been undiscovered by these practitioners. These additional steps can be through further laboratory testing or by gathering important information regarding diet, stress, sleep, exercise, etc all which affect fertility.
In my practice I would say that approximately 30% of infertility comes from stress and “trying too hard.” Stress plays a role in reproduction because reproductive hormones are inhibited by stress. This is an important point so let me repeat this again. Reproductive hormones are inhibited by stress. Not only can the stress hormone, cortisol, suppress ovulation and reduce sperm count, but it can also interfere with implantation of the embryo and if high enough can by the cause of a miscarriage.
Further lifestyle factors are also highly important, such as maintaining a healthy weight, consuming a whole foods diet, moderate exercise, and drinking at least 8 glasses of water a day.
Finally let’s give an overview of labs that should be covered for both individuals. For the female factor we want to look at:
- Baseline labs: liver, kidney, electrolytes, immune function, anemia panel, thyroid panel, and Vitamin D levels
- Baseline: uterine and ovary health (via blood work and imaging), including measuring levels of estrogen and progesterone at the appropriate time in their cycle
- Adrenal health (if there has been prolonged stress)
- Undiscovered Autoimmunity
- Food allergy testing
- Potentially heavy metal testing, if there is a concern over increased exposure
Supplements I recommend for women include:
- Essential Fatty Acids
- Multi-Vitamin with folate (Pure, Thorne, Rainbow)
- The list of supplements recommended online (by other practitioners and bloggers) can be quite long and cumbersome, and not all are necessary, safe, or needed for everyone. Since my doctorate is in conventional and alternative medicine I am well educated on what each individual needs, or more importantly (sometimes) what they don’t need.
For the Male Factor:
- Baseline labs: liver, kidney, electrolytes, immune function, sperm analysis
- If the sperm analysis comes back less than ideal a hormone panel should be ordered as well
Additional lifestyle factors that are important to consider for men are:
- Stop smoking – damages sperm, decreases count, decreases libido, worsens morphology, slows motility
- Decrease alcohol – more than 2 drinks/day can decrease count and decrease libido
- No drugs/marijuana/steroids – decreases everything
- Keep a healthy weight – excess fat increases estrogen and decreases testosterone which decreases sperm count
- Avoid heat on the boys – no hot tubs/baths/saunas, no laptops on the lap, no cell phones in the front pocket, no biking, no tight underwear
- No lubricants for sex unless specifically for making babies such as pre-seed. KY and other petroleum based lubricants stop/slow motility and change a healthy pH for sperm.
Supplements for men:
- Fish oil
- Vitamin C
- Same advice for men in this category: The list of supplements recommended online (by other practitioners and bloggers) can be quite long and cumbersome, and not all are necessary, safe, or needed for everyone. Since my doctorate is in conventional and alternative medicine I am well educated on what each individual needs, or more importantly (sometimes) what they don’t need.
So in general I am looking for areas of concern that should be addressed, treating to relieve these symptoms (or lab values), and building foundational health habits. Ideally I will work with someone for 3-6 months before they want to conceive, since both the eggs and sperm are made close to 3 months before they are “utilized” for fertility. It’s important to know that there are additional answers and treatment options for fertility, but equally just as important to relax and be calm about this process. I can treat a lot of the causes of infertility, with enough time and commitment, but the only person who can decrease that detrimental stress hormone is you.