Fertility: When "The Birds and the Bees" are Not Enough

Kim Oxbro, Naturopathic Doctor

The Birds and the Bees sometimes aren't enough to cut it as one in five North American couples are unable to conceive children (National Centre for Health Statistics, www.cdc.gov/nchs/fastats/fertile.htm). If you have been having difficulties conceiving, know that there are numerous options which are likely not to have been mentioned by your doctor or specialist. This article will briefly outline these options in the hope of improving your chances of conception.

The first step in fertility care is to figure out where the problem lies. Legitimate, medical tests to determine the actual cause of infertility are imperative before treatment begins, to help determine the underlying cause of the problem. While your specialist will conduct many of these, many more are not part of routine fertility screenings. The following will outline some of these important testing considerations.

Is there a hormone imbalance?

As an example, an under-active thyroid is a common cause of infertility. While blood work is routinely performed by doctors to test thyroid function in patients with fertility concerns, this testing is usually limited only to a hormone called TSH. This hormone is NOT the active thyroid hormone involved in weight control or fertility. A failure to check for the active thyroid hormone (called T3), let alone for other thyroid hormones, can result in a failure to diagnose a subtle thyroid disorder.

Likewise, expansive blood work also needs to be performed to determine the level of other hormones such as prolactin, estrogen, progesterone, luteinizing hormone, follicle stimulating hormone, testosterone, and DHEA levels. Testing for these hormones can determine if medical conditions such as 'polycystic ovarian syndrome (PCOS)' or 'amenorrhea' are the cause of infertility, and allow for treatment to be initiated accordingly.

While blood tests for hormones provide a helpful overview of hormone status, they only represent one moment in time. Moreover, hormones examined in the blood are not always an accurate analysis of a patient's true hormone status, as the blood tests measure both active and inactive hormones. Newer laboratory testing allows naturopathic and medical doctors to conduct salivary hormone testing. This testing will look at 11 samples over a full menstrual cycle to more accurately determine where a problem may exist. More importantly, these salivary tests only measure active hormones and, hence, only measure the hormones impacting fertility. As such, this more modern testing allows for a more precise diagnostic picture and individualized treatment.

Are there nutritional deficiencies?

Nutrition is a major factor in the fertility of an individual, but is rarely discussed with patients in detail. It is widely recognized that certain nutritional deficiencies, such as folic acid, iron, zinc, B vitamins, and iodine, can promote infertility (Br J Obstet Gynacol. 1982; 89:678-80). Having your individual diet reviewed by a doctor specifically trained in nutrition and having appropriate blood work performed to determine if levels of specific vitamins and nutrients are low, should always be one of the first steps in diagnosing the cause of infertility. Unfortunately this testing and investigation is rarely conducted.

Is ovulation occurring?

Although modern medicine offers us many advanced testing options to determine if a woman is ovulating (releasing an egg), a very simple, at home test called a basal body temperature test can also be a very useful in determining if ovulation is occurring. This involves taking your oral temperature at a specific time for the entire month. When a woman ovulates, her temperature will rise. By tracking the temperature over the month, the doctor and patient can determine when – and if – ovulation is occurring. This assists in the timing of planned conception, as well as being able to provide key diagnostic information.

Is there an elevated chemical or heavy metal body load?

Eliminating heavy metals and chemicals can improve fertility in previously infertile women. One study showed that urine heavy metal excretion is linked to gynaecological conditions (uterine fibroids, miscarriages, hormonal disorders) and found that reducing heavy metal body load improved spontaneous conception changes of infertile women (J Toxicol Environ Health, 1998; 54: 593-611).

Readers must be clear, however, on this topic. One can only determine if toxic metals or chemicals are potentially involved in fertility concerns by testing for them with 'real', accredited, medical laboratory testing. This can only be done by licensed naturopathic doctors or medical doctors. Testing for chemicals or metals can NOT be done by looking in the eye, 'live blood cell analysis' or various foot baths. To learn more, readers can go to www.millenniumhealthcentre.com and click on the 'links' page that connects to the websites of U.S. Biotek laboratory and Doctors Data laboratories.

While heavy metals and chemicals can be removed from the body, this requires therapies based on scientific research. One can not remove these using various 'detox' products sold in stores, some gyms or by individuals selling multi-level marketing products. Unfortunately, the public is often fooled into thinking otherwise by marketing and sales programs.

With Testing Done, How Do I Treat Infertility?? Start with Acupuncture !

Acupuncture can be very effective in helping a woman to conceive. One study showed that 39% of the non-ovulating, infertile women in the study conceived after acupuncture treatments over only a one-month period. More striking in these results was the fact that many of the women who conceived with the acupuncture had significant medical conditions causing their infertility including Polycystic Ovarian Syndrome, dysfunctional uterine bleeding (bleeding between periods), amenorrhea (the absence of a menstrual period) and anovulatory menstrual cycles whereby the woman fails to release an egg (Jilin Chinese Medicine & Medicinals, 5, 2004).

In another study, acupuncture was compared to the frequently used medication to induce ovulation - Clomiphene (Clomid). Results showed that after three menstrual cycles, acupuncture was equivalent to Clomid for inducing ovulation. Furthermore the acupuncture group showed higher rates of pregnancy than the group receiving Clomid (Zhongguo Zhen Jiu, 2008;28:21-23).

The most exciting scientific evidence behind acupuncture is that this traditional therapy improves the most modern of medical intervention for infertility, that being in vitro fertilization (IVF). A review of seven medical studies on acupuncture used with IVF published in the British Medical Journal (BMJ 2008;336:545–9) found that those who had acupuncture with IVF had 65% higher rate of pregnancies and nearly twice the rate of live births versus those who received IVF with no acupuncture.

Readers need to realize that while legislation has been passed to eventually regulate the use of acupuncture in Ontario, no current regulation exists to protect the public. While many health professional offer acupuncture for muscle pains and the like, they are not trained to offer acupuncture for conditions like infertility. Licensed Naturopathic Doctors are the only profession currently licensed and regulated in Ontario who have acupuncture as a specific part of their license, having studied it for four years. This will eventually change and the public will have greater certainty as to the skill of other health providers offering acupuncture.

As space prevents a more detailed examination of the many 'natural' therapies proven through medical science to improve fertility, know only that many other options exist. A detailed and individual consultation allows a doctor to describe which ones would be applicable to an individual patient.

Hoping you make your health your priority.