Maximizing Fertility: A Helpful Guide

Published on June 06, 2018 by Randall Heilik

It is undeniable that infertility has become a much more prominent health problem in our society. The Centers for Disease Control (CDC) reports that approximately 10 percent of women, between 15–44 years old have experienced difficulties with infertility. Furthermore, male infertility currently accounts for roughly 30–40% of all cases. There are many medical conditions that contribute to, or may be the primary cause of infertility. If you have been struggling with infertility or if you are ready to take the plunge into attempting a pregnancy, there are several simple and inexpensive steps you can take to maximize your chance of achieving a healthy, enjoyable pregnancy.

The World Health Organization (WHO) defines “infertility” as: “an inability to become pregnant after one year of trying” (9). Our bodies are naturally fertile, so when fertility is compromised, there is often an underlying condition. Infertility is one way our bodies communicate that something “just isn’t right”.  Although many conventional fertility treatments work well for most people, dietary and lifestyle changes are simple steps you can take now to improve your fertility.

Multiple factors contribute to infertility, and there is no magic pill that works for everyone. The common physiological causes of infertility in women include: hormonal disorders that impede or prevent ovulation, polycystic ovary syndrome (PCOS), cervical abnormalities, fallopian tube blockage, endometriosis, primary ovarian insufficiency (early menopause), and physical restrictions in the pelvis. Furthermore, thyroid problems—either too much or too little thyroid hormone—can interrupt the menstrual cycle, making it more difficult to conceive. About 40% of infertility cases are actually attributed to the male partner, with problems including low sperm count and suboptimal movement.

While most couples generally believe that physiological problems are the cause of infertility, lifestyle and environmental factors are often overlooked. Stress is thought to play a role here, affecting the hypothalamic pituitary axis. Nutritional deficiencies, body weight, emotional distress, cigarettes, alcohol, and environmental pollutants—including heavy metals—also all have an effect on a couple's ability to conceive and for the woman to carry a baby to full term.

Each couple needs to address the underlying issues contributing to infertility, and ensure that all the necessary building blocks are in place for a healthy pregnancy. Check with your doctor or fertility specialist to rule out underlying medical conditions, and in the meantime take a lens to your lifestyle and environmental habits which you can control and modify in favour of fertility.

Harvard researchers have also found a clear link between diet and lifestyle habits and fertility1. Frustrated couples that are unable to conceive may consider ART (Assisted Reproductive Technology) such as IVF (in-vitro fertilization) or IUI (intra-uterine insemination), which aim to increase the odds of success by increasing the number of eggs produced. However, the technique does not aim to affect the quality of the egg, and it pays little attention to the general health of the woman trying to conceive. As the above research indicates, IVF alone only yields a 30% pregnancy rate.

A study conducted at the University of Surrey followed the progress of 367 couples that followed a health improvement program2. The program included appropriate supplements, removing heavy metals, improving diet by increasing the amount of organic food, resolving infections, and correcting lifestyle issues. By the end of the study, 89% of the couples had given birth. Within the group, 37% had a history of infertility, and of these, 81% had a healthy child by following the natural health program.

In addition, 38% of the couples in the group had experienced miscarriage in the past, and of these, 83% gave birth with no miscarriages.

Nutrition for Fertility

Essential fatty acids, particularly linoleic acid (Omega-6) and alpha-linolenic acid (Omega-3) are essential to every living cell in the body. They are also key in ovulation, specifically in the process of follicular rupture (releasing the egg) and collapse (allowing the development of the corpus luteum). Good sources of essential fatty acids include: fish, fish oil, microalgae, non-hydrogenated cold-pressed oils such as flaxseed and pumpkin-seed oils, eggs, raw nuts and seeds, and dark-green and winter vegetables like broccoli, cauliflower, beets, carrots, kale, collards, cabbage, turnips, rutabaga, and brussel sprouts. Due to low efficiency of converting the omega-3 fatty acid, alpha-linolenic acid (ALA) to the longer chain derivatives eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), it is recommended to obtain EPA and DHA from dietary supplements, preferably from a microalgae such as Schizochytrium Oil which already contains the active, converted forms of EPA and DHA for optimal efficacy. Non-algae based omega-3 sources such as chia, or flax seeds, risk exposure to trans fatty acids from poor processing or storage as well as exposure to lignans and other anti-nutrients such as cyanogenic glycosides which can interfere with inflammation control and mineral absorption. 

Omega-3 fatty acids have been found to clean the blood of fat deposits, reduce clotting, and encourage blood flow to the tissues, including the uterus. Omega-3 fatty acids also boost the immune system and have been found to reduce certain immune cells (NK, or natural killer, cells) which prevent the embryo's implantation in the uterus. The omega-3 fatty acids EPA and DHA are also essential in fetal brain development.

Be aware that with long-term exposure to light, heat, and oxygen, essential fatty acids found in vegetable oils may become rancid, or convert into trans fatty acids, which are toxic. Trans fatty acids can impair the proper functioning of the immune and reproductive systems. Other sources of trans fatty acids include: shortening, margarine, and hydrogenated vegetable oils, which are found in many processed foods. Try to refrain from consuming trans fatty acids in your diet, and always store your oils in a cool, dry place, away from light, heat, and oxygen.

A high-potency multivitamin and mineral complex with iron, folic acid, and B vitamins would be advantageous to supplement the diet with to help correct any potential nutrient deficiencies and boost fertility potential. The vitamins and minerals important for reproductive health (vitamins A, C, E, B complex, zinc, and selenium) enhance fertility but are often lacking in the standard Western diet of highly processed foods.

Vitamin B6 helps the body metabolize excess estrogen, produce adequate progesterone, and lower elevated prolactin levels. A Harvard study treated women with galactorrhea (lactation not associated with childbirth or nursing)/amenorrhea syndrome with 200 to 600 milligrams of vitamin B6 daily. Within three months all of the women in the study had normal menstrual cycles and had stopped lactating.

Coenzyme Q10 (CoQ10) is a vitamin-like supplement that is suggested to enhance both male and female fertility. Found in every cell of the body, CoQ10 is a part of the electron transport chain, which is responsible for generating energy in our cells. Functioning as an antioxidant, it decreases the damaging effects of free radicals on the reproductive system.

It is believed that as we age, our naturally occurring levels of CoQ10 diminish. As a result, the processes that require high energy, such as those associated with fertilization and embryo development, are unable to work as hard – resulting in lower efficiency within those systems. With less energy available for the “machinery” of the dividing cells, more errors can be made with the division of genetic information, leading to a higher rate of genetically abnormal embryos or inabilities to carry to full term. A recent study in mice found an improvement in the egg quality later in their reproductive years suggesting that supplementation of CoQ10 may be able to help overcome the natural decline of a woman’s fertility as she ages.

Folic acid is extremely important in cellular division, and can be found in foods like dark-green leafy vegetables and natural orange foods -- oranges, cantaloupe, yams, and sweet potatoes. Regardless of dietary intake, infertility challenges or not, it is highly suggested to supplement with methylated folic acid (L-Methylfolate; 5-MTHF) the biologically active form of vitamin B9 before and during conception.  Furthermore 30-50% of people have a MTHFR (Methylenetetrahydrofolate Reductase) gene defect which can increase risk for infertility, miscarriages, health issues, high homocysteine levels (involved with PCOS) and pregnancy complications. Those who carry this gene defect should not only supplement with a methylated B-complex, but avoid foods and supplements which are fortified with the synthetic folic acid (folate).

It is possible that Arginine and Carnitine may also be helpful for increasing a woman's fertility. An article in the July 1999 Human Reproduction Journal described an Italian study in which numerous women classified as "poor responders" to ovarian stimulation were given oral L-arginine, an amino acid and dietary supplement that tonifies the Kidneys. In the L-arginine-treated group, a lower cancellation rate and an increased number of eggs collected and embryos transferred were observed. The study concluded that "oral L-arginine supplementation in poor responder patients may improve ovarian response, endometrial receptivity and pregnancy rates8.” These two amino acids are also associated with enhancing sperm production. (Chinese medicine classifies arginine as a Kidney Yang tonic, while carnitine nourishes the Yin and Blood.)

Superfoods for Fertility

Bee pollen and/or royal jelly are often used in TCM (Traditional Chinese Medicine) for fertility support which are both regenerative and tonifying. A Japanese study demonstrated that women who were given bee pollen with royal jelly showed improvement or disappearance of their menstrual problems, while there was no change in the placebo group6. Another study showed bee pollen significantly improved sperm production in men. Bee pollen, which is worker bee food, is rich in vitamins, minerals, nucleic acids, and steroid hormones, and improves health, endurance, and immunity4. Royal jelly is modified pollen fed only to the reproducing queen bee, whose job it is to produce more infant bees. This nutritive tonic might be considered the bee equivalent of fertility drugs. Rich in amino acids, vitamins, and enzymes, royal jelly helps the queen lay millions of eggs and live longer than the worker bee.

Add more cruciferous vegetables like cabbage, broccoli, brussel sprouts, and cauliflower to your diet. Cruciferous vegetables contain di-indolylmethane (DIM), a compound that stimulates more efficient use of estrogen by increasing the metabolism of estradiol (one form of estrogen produced by the body). Excess estradiol is associated with breast pain, weight gain, breast and uterine cancer, moodiness, and low libido. Adding DIM sources to your diet allows the estradiol to break down into the beneficial 2-hydroxy estrogens, which don't have estradiol's negative effects. There are also dietary supplements available which contain phytonutrient, Indole-3-carbinol (I-3-C found in Brassica family of vegetables mentioned above.

A Special Note for Men

Men who are having fertility problems should make similar dietary and lifestyle adjustments. Avoid environmental estrogens and dietary sources of free radicals including: poor quality saturated fats, hydrogenated oils, and trans fatty acids. Where possible, reduce all unnecessary medications, especially antihypertensives, antineoplastics, and anti-inflammatory drugs, which can impair sperm production.

Other Considerations

Research suggests that Acupuncture is twice as effective as conventional drug therapies to help women conceive due to its ability to improve the quality of a women’s menstrual cycle.

A study published in the December 2011 issue of the journal Complementary Therapies in Medicine showed that women who received Acupuncture treatments had been twice as likely to get pregnant than women who received conventional drug treatments for infertility or IVF3.

“Acupuncture and herbal medicine can increase the chance of getting pregnant by improving the function of these organs, which in turn promotes qi (energy) and blood flow to critical areas of the body.”

The aim of TCM therapies is to reestablish balance in the body. It can also be used alone or in combination with IVF or IUI treatment to increase fertility.

 

Randall Heilik, CHNC, Functional Genomic Analyst 

References

1. Chavarro, J.E. et al., 2007. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstetrics & Gynecology, 110(5), 1052-3.

2. Ward, N., 1995. Journal of Nutritional & Environmental Medicine, 5, 205-208.

3. Ried K, Stuart K, 2011: Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: A systematic review; Complementary Therapies in Medicine, Vol 19 Issue 6, 2011; 319-31

4. Townsend, G. F., Lucas, C.C. (1940). The chemical nature of royal jelly. Biochem J. Sep; 34(8-9): 1155–1162. Retrieved online from: http://www.ncbi.nlm.nih.gov/pm...

5. Hellner, M., Winter, D., von Georgi, R., and Mu ̈nstedt, K. (2008). Apitherapy: Usage And Experience In German Beekeepers. eCAM; 5(4)475–479. doi:10.1093/ecam/nem052. Retrieved online from: downloads.hindawi.com/journals/ecam/2008/827582.pdf

6. Suzuki, Kazu-Michi, et al. (2008). Estrogenic Activities of Fatty Acids and a Sterol Isolated from Royal Jelly. eCAM;5(3)295–302 doi:10.1093/ecam/nem036. Retrieved online from: http://downloads.hindawi.com/j...

7. Food and Agriculture Organization of the United Nations. (n.d.) Royal Jelly. Chapter 6. Retrieved online from: http://www.fao.org/docrep/w0076e/w0076e16.htm

8. Adjuvant L-arginine treatment for in-vitro fertilization in poor responder patients Cesare Battaglia  Michela Salvatori  Nicoletta Maxia  Felice Petraglia  Fabio Facchinetti Annibale Volpe Human Reproduction, Volume 14, Issue 7, 1 July 1999, Pages 1690–1697,

9. WHO 2018 Infertility Clinical Definitions & Statistics: http://www.who.int/reproductivehealth/topics/infertility/definitions/en/