Infertility
15% of American couples have infertility. The causes can vary from anatomical to hormonal in either the husband or wife. These include, low sperm count, poor sperm motility, failure to ovulate and damage to the Fallopian tubes from infection and even polycystic ovaries. Some disorders can be treated effectively and others do not respond to currently available treatments. Because infertility can be a complex problem, it is very important for couples to get a thorough evaluation to identify any abnormalities that can be treated medically or surgically.
Nutritional therapy for infertility can be effective too, but should be undertaken only with medical supervision and only after a thorough evaluation as mentioned above.
Over the past several decades, available research demonstrates a substantial decline in sperm concentration and quality among men living in industrialized countries. Environmental pollutants might be the culprit, possibly by exerting estrogenic or other endocrine disrupting effects. Chemicals of concern include pesticides, PCBs, dioxins, phthalates and estrogens present in cows milk just to name a few. A Danish study demonstrated that men who consumed at least 25% organic foods had a 43% higher sperm count compared to those who consumed less than 25% organic.
Observational studies in women have shown exposure to volatile organic compounds (VOCs), chemical dusts, pesticides, or video display terminal increased infertility risk. Further observational studies also found an association between cigarette smoke and decreased fertility in both men and women.
Other Potential Risk Factors For Infertility
Celiac disease and Food Allergy: Celiac disease can cause infertility in both men and women. This association raises the possibility that food allergies could also be involved.
Caffeine and Tannic Acid: Most, but not all observational studies found a connection with infertility with women especially in those consuming 4-7 cups a day. Tannic acid is present in coffee and tea and has been reported to cause decreased fertility when fed to mice and hens.
Alcohol: Chronic alcoholics commonly have oligospermia (decreased number of sperm) and infertility. Observational studies demonstrate that moderate alcohol consumption may impair fertility in women.
Vegetarian Diets: Available research demonstrates that well balanced and weight maintaining vegetarian diets, but not low calorie vegetarian diets, are adequate for supporting reproductive function in women.
Trans Fatty Acids: These are found in fast, fried, and junk foods. There is a definite connection with infertility in women. One study demonstrated that for each 2% increase in intake of energy from trans fatty acids, there was an associated 75% increase risk in ovulatory infertility.
Brominated Vegetable Oil: This is found in certain soft drinks such as Mountain Dew and some Gatorade flavors. Animal studies have demonstrated a connection with consumption of these oils and infertility in both men and women.
Nutritional Supplements: Sperm is highly sensitive to oxidative stress. If there is production of high amounts of free radicals in the body, this could potentially contribute to infertility by promoting sperm cell dysfunction. Various nutritional supplements including minerals, vitamins and antioxidants have been studied and found to be quite effective for infertility.
Hormonal Imbalances like thyroid have also been shown to contribute to infertility in both men and women.
At my clinic
The infertile couple that comes to me has already had a thorough evaluation of their infertility including a search for anatomical or hormonal abnormalities. From this point, with me they undergo various functional medicine tests including food allergies, celiac/gluten intolerance, nutritional deficiencies, oxidative stress and hormonal levels in either urine or blood. In addition, I also look for evidence of heavy metals, since searching for and treating this condition has also improved fertility for my patients (current observational studies are lacking though). The patient is counseled on caffeine and tea intake, alcohol intake. If the patient is vegetarian, I make sure they are getting adequate calories, and I am able to measure in my office their basal metabolic rate. The patient is told to cut out trans fatty acids, brominated vegetable oils and smoking as well.
Along with diet and lifestyle recommendations, the patient also goes home with a list of recommended supplements to start empirically based on available research for infertility. The follow up visit to review lab results will usually uncover certain areas that can be improved upon, and that’s where the treatment is customized for each patient. Some patients have had to undergo chelation to remove all the mercury from their bodies, while others just required correcting all their nutritional deficiencies and oxidative stress. Yet others just needed hormonal replacement like thyroid (please read my section on thyroid hormone replacement). Over the years, treating infertility in this way nutritionally has led to many positive outcomes.