After years of trying your best not to get yourself or someone else pregnant, it can come as a bit of a shock to find it more difficult to conceive that what you had anticipated. Most people are unaware of their fertility issues until they try to have children, others with hormone and reproductive health issues may already have an idea that conception will be difficult for them. In either case, the most important thing is to start looking for treatment as soon as possible so you can begin laying the foundations for your family.
What is infertility?
Infertility is defined as a sexually active individual or couple who have been trying to conceive without success for one year or more without contraception. This not only covers the inability to become pregnant, but also the inability to carry a pregnancy to full term (World Health Organization, n.d., para. 1).
In many infertility cases, the symptoms can also be the cause. A woman who has an irregular menstrual cycle may find that this issue is not only an indicator of infertility but also the driving force. In other cases, infertility is just yet another unwanted symptom of reproductive health issues such as Endometriosis (ENDO) and Polycystic Ovary Syndrome (PCOS).
What causes infertility?
There is a multitude of causes for infertility ranging from genetics and medical conditions to environmental factors and lifestyle choices; finding out which causes affect you is just a matter of narrowing down the list and eliminating any influences you can control.
Male genetic causes of infertility develop from chromosome or gene mutations that can cause blockages and defects in sperm production. Some genetic conditions that affect fertility in males include:
- Cystic Fibrosis: Most male sufferers of CF are infertile due to the vasa deferens – the part of the male reproductive system that carries the sperm from the testes to the penis – unsuccessfully developing (University of Maryland Medical, 2012, para. 12).
- Polycystic kidney Disease: Although the disease’s dominant area of obstruction is in the kidneys, PKD can also cause cysts to grow in other organs such as the reproductive system and had been known to cause blockages that prevent semen from being successfully ejaculated.
- Klinefelter syndrome: This condition occurs when a male is born with an extra X chromosome which causes a low or non-existent sperm count due to insufficient levels of testosterone produced.
- Kartagener syndrome: One of the rarer genetic disorders on the list, Kartagener syndrome affects the agility of the sperm and its swimming capabilities making it more difficult for the sperm to reach the egg.
For women, there are many conditions that can compromise fertility; these also stem from gene and chromosome mutations and deficiencies such as:
- Polycystic Ovary Syndrome: Women who suffer from PCOS have irregular or non-existent periods due to higher than normal levels of insulin and androgen – a hormone that controls the development of male traits. This excess of androgen prevents the ovaries from releasing eggs. As the name suggests, the syndrome also causes cysts to grow in the ovaries.
- Turner Syndrome: Defined by the partial or complete loss of the second sex chromosome, women with Turner Syndrome suffer from underdeveloped reproductive organs and high mortality rates that increase during pregnancy for both the individual and the foetus they carry (Lisal J. Folsom, M.D. and John S. Fuqua, M.D., (2015), para. 2).
- Endometriosis: A condition in which the endometrium – the tissue that lines the walls of the uterus – is found outside of the uterus causing scarring and sometimes blockage of the fallopian tubes.
- T shaped uterus: This condition can be genetic or developed from pelvic infections causing the uterus to narrow. Its “T” shape obstructs the eggs from reaching the uterus.
CHRONIC MEDICAL ILLNESSES AND TREATMENT:
For some patients, the cause of their illness is also the cause of their struggles with fertility. In other cases, the treatment some patients receive can interfere with conception and pregnancy.
- Chronic illnesses: When living with a chronic medical illness the human body will expend less energy on the reproductive system to focus on other areas of the body that need more attention; a wide range of illnesses “from heart disease to diabetes, can suppress both ovulation and sperm production, which can make it difficult to get pregnant…Thyroid disorders can also stop ovulation.” (Laurence A. Jacobs, MD, (n.d.), para 1).
- Sexually transmitted diseases: Silent STDs such as gonorrhoea and chlamydia can be extremely dangerous to a person’s general and reproductive health. As these diseases are centred around the reproductive system, this area is where the most damage is caused and if left untreated it can cause serious complications. The virus Hepatitis B is also known to cause difficulties with fertility.
- Dilation and Curettage: In rare cases a D&C can lead to Asherman’s syndrome – an illness that occurs when “trauma to the endometrial lining triggers the normal wound-healing process, which causes the damaged areas to fuse together.” The scar tissue and adhesions brought about by Asherman’s syndrome can create great difficulties with conception. (International Asherman’s Association, (n.d.), para. 4).
- Chemotherapy: For female cancer patients, chemotherapy and radiation therapy can be damaging to the patients eggs and ovaries and occasionally it can bring about early menopause. For male cancer patients, cancer treatment can cause testicles to produce defective sperm and in some cases no sperm at all.
An aspect of fertility treatment that is much more controllable through small changes are the lifestyle choices we make. Sometimes eating healthy and regular exercise is all your body needs to be able to support life.
- Diet: As our dominant source of nutrition, a healthy diet is key in making sure your body is in the perfect condition to make a baby. There are some foods considered to aid fertility such as whole grains, leafy greens and plant proteins like beans, nuts and seeds. Foods to avoid include things like sugary soft drinks, trans fats starches and red meat. (Nancy Gottesman, (n.d.), para. 4).
- Exercise: Although excessive exercise is known to prevent pregnancy, that doesn’t mean you have to give it up altogether! Moderate and regular exercise for those who are trying to conceive can actually help to prepare your body for pregnancy. Experts suggest light exercise like walking, swimming and short yoga sessions for no more than one hour a day. (Dalene Barton-Schuster, (n.d.), para. 12).
- Alcohol, drugs and cigarettes: Aside from being bad for your overall health, recreational drugs such as alcohol and cigarettes can have a heavy negative impact on a person’s fertility. For patients with a uterus, excessive alcohol consumption can cause “alterations in ovulation and menstrual cycle regularity” and for those with testicles, “studies on long-term, heavy alcohol use have reported decreased testosterone and sperm production”. (Kristin Van Heertum and Brooke Rossi, (2017), para. 13).
- Medications: Some medications can prohibit conception such as anti-depressants, cough medicine, antihistamines, ulcer medication and antibiotics. If you are trying to conceive, talk to your practitioner about the best alternatives to any of these medications. (Iva Keene MRMed. ND., (2017), para. 2).
- Environment: Heavy metal toxin pollutants such as fly spray, hair spray deodorant, tobacco smoke, coal fumes and paint not only harm our environment but also our bodies and their fertility, “because heavy metals cannot be degraded or destroyed they tend to bioaccumulate,” this means that the chemicals stay in your body for such a long time they begin to build up to the point where they can cause serious health issues. (Gabriela Rosa, (n.d.), para. 1).
As there are many myths and tales of what can help you get pregnant and what will prevent you from it, many will be surprised to learn that the following do not affect fertility:
- Miscarriages: Although devastating and emotionally gruelling, a miscarriage is not condemnation to infertility. Many women will have a miscarriage before they eventually conceive and go on to have happy and healthy babies. If you have experienced a miscarriage, don’t give up! Take good care of yourself, and try again. (Attain Fertility, (n.d.), para. 7).
- C-Sections: A caesarean delivery can be a daunting thought, though some mums swear by its effectiveness. The notion that a C-section will cause further implications when trying to conceive again is a misleading one, as it’s the “clinical and social circumstances leading to the Caesarean section have a greater effect on future fertility than the Caesarean section itself.” If you’ve previously had a caesarean section and you are looking to try for another baby, it would be in your best interest to talk to your practitioner and get to the bottom of why you needed the procedure in the first place and how or if it could potentially affect your fertility. (I. Gurol-Urganci, D.A Cromwell, T.A Mahmood, J.H van der Meulen, A. Templeton, (2014), para. 6).
- Emergency Contraceptive pills: There is a widespread belief that the ECP has negative side effects on general health and fertility and that the ECP will cause an abortion; this is simply not true. The hormone pill has been extensively studied and found to be “well tolerated… not a known allergen, leaves the body within a few days… not addictive and has demonstrated no toxic reactions” and that “use of hormonal contraception, including ECPs, has no effect on future fertility…ECPs leave the body within a few days and women who have used ECPs can become pregnant from any subsequent acts of sexual intercourse.” (World Health Organization, (2010, para. 2-7).
Figuring out what can and what can’t cause infertility is an important first step into exploring your own fertility issues and what aspects you can control yourself such as diet and exercise and the conditions you will need to talk to your doctor and practitioner about for further advice and treatment. In the next part of the series, we will go over how acupuncture and traditional Chinese medicine can treat many of these conditions and boost fertility.
- World Health Organization. (n.d.). Sexual and reproductive health. Retrieved from http://www.who.int/reproductivehealth/topics/infertility/definitions/en/
- University of Maryland Medical Centre. (2012). Infertility in men. Retrieved from http://www.umm.edu/health/medical/reports/articles/infertility-in-men
- Lisal J. Folsom, M.D. and John S. Fuqua, M.D. (2015). Reproductive Issues in Women with Turner Syndrome. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4807900/
- International Asherman’s Association. (n.d.). “It’s no longer a question of WHAT IF, but with knowledge it’s answering WHAT NOW”. Retrieved from http://www.ashermans.org/home/
- Laurence A. Jacobs, MD. (n.d.). How Does Chronic Illness Affect Fertility? Retrieved from https://www.thebump.com/a/chronic-illness-effect-on-pregnancy
- Nancy Gottesman. (n.d.), Get Healthy, Get Pregnant: The Fertility Diet. Retrieved from https://www.fitpregnancy.com/pregnancy/getting-pregnant/get-healthy-get-pregnant-fertility-diet
- Dalene Barton-Schuster. (n.d.). Is Exercise Good or Bad for Fertility? Retrieved from http://natural-fertility-info.com/exercise-good-or-bad-for-fertility.html
- Kristin Van Heertum and Brooke Rossi. (2017). Alcohol and fertility: how much is too much? Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504800/
- Iva Keene MRMed. ND., (2017), 9 Drugs Which May Affect Your Fertility. Retrieved from https://natural-fertility-prescription.com/drugs-which-affect-your-fertility/
- Gabriela Rosa. (n.d.). Sources of Heavy Metal in Your Home Environment. Retrieved from https://naturalfertilitybreakthrough.com/free-fertility-resources/sources-of-heavy-metal-in-your-home-environment/
- Attain Fertility. (n.d.). Facts About Fertility After Miscarriage. Retrieved from http://attainfertility.com/article/fertility-after-miscarriage
- Gurol-Urganci D.A Cromwell T.A Mahmood J.H van der Meulen A. Templeton. (2014). A population-based cohort study of the effect of Caesarean section on subsequent fertility. Retrieved from https://academic.oup.com/humrep/article/29/6/1320/626018/A-population-based-cohort-study-of-the-effect-of
- World Health Organization. (2010). Fact sheet on the safety of levonorgestrel-alone emergency contraceptive pills (LNG ECPs). Retrieved from http://apps.who.int/iris/bitstream/10665/70210/1/WHO_RHR_HRP_10.06_eng.pdf