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Sunday, July 1, 2007

Overcoming Obstacles to Infertility

Conventional treatments for infertility often involve high costs and low success rates: approximately 5 to 30 percent, depending on the procedure, age of the female partner, quality of the egg and sperm and skill of the treatment team. The procedures that are successful are not without side effects. In-Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ISCI) increase the risk of multiple pregnancies, low birth weight, birth defects and disability in surviving infants. Although necessary and rewarding for some couples, assisted reproductive technology may not be essential for everyone.

In 2002, a joint study from the National Institute of Environmental Health Sciences in North Carolina and the University of Padua in Italy analyzed the fertility of 782 couples from seven European cities. Researchers concluded that most of the women with no known reasons for not conceiving naturally who did not achieve pregnancy during the first year of trying became pregnant the second year, unassisted. Lead investigator Dr. David Dunson recommended delaying assisted fertility treatments for healthy couples until they have tried to get pregnant on their own for 18 to 24 months. Focusing on optimal wellness and removing obstacles to infertility may eliminate the need for high-tech treatments.

Medical Assessment

Couples have the best chance of conceiving when both partners are in ideal health. There are a number of medical conditions that can interfere with fertility including celiac disease, inflammatory bowel disease and infections of the urinary tract and reproductive organs. Health problems specific to women include polycystic ovarian syndrome, fallopian tube blockage or damage and uterine abnormalities such as fibroids and endometriosis. For men, conditions associated with reduced fertility include abnormal sperm, undescended testes, varicocele (enlargement of veins in the spermatic cord) and obstructions of the reproductive system from scarring after injury, surgery or infection.

Before a couple starts trying to conceive, each partner should have a complete health check-up and address any abnormalities. The check-up should include a thorough physical exam and laboratory tests to screen for infection, nutritional deficiencies and diabetes, and to evaluate liver, kidney, thyroid and cardiovascular function. If sperm abnormalities are suspected, a semen analysis will measure the volume of semen, sperm count, sperm mobility and percentage of abnormal sperm.

Body Mass Index

A healthy weight is important for optimum wellness and critical for achieving a pregnancy, especially in women. Responding to primitive survival mechanisms, the body perceives limited food intake and weight loss as signs of starvation. It shuts down non-essential systems, like reproduction, and ovulation stops until fat stores are sufficient.

When the amount of fat tissue increases, so do estrogen levels, but sometimes too much. Overweight women also have lower rates of fertility. Fortunately, weight loss as little as ten percent can improve hormone imbalance and restore ovulation, increasing chances of pregnancy.

Body mass index (BMI) is a ratio of weight to height that provides a better estimate of fat distribution than weight alone. Individuals with a BMI below 20 are considered underweight, while those with a BMI above 24 are overweight. To achieve an ideal BMI, regular exercise and a healthy diet are essential.

Good Nutrition

For optimum health, eat a varied diet high in fiber, vegetables, fruit, whole grains, legumes and healthy fats like olive oil, avocado, raw nuts and seeds, and wild coldwater fish including salmon, halibut, herring, sardines and anchovies. Avoid tap water, refined carbohydrates like sugar and white flour, processed foods, deep fried foods, caffeine, alcohol, unnecessary medicines and foods that contain potentially harmful pesticides, ripening agents, waxes, hormones, antibiotics and genetically modified organisms.

Sometimes people don’t get all of the nutrients they need from their diet, so a multiple vitamin-mineral supplement is good insurance. Certain nutrients are especially important for reproductive processes, including omega-3 fatty acids, zinc, selenium, manganese, iron, folate and vitamins C, E, A, B6 and B12. Amino acids arginine and carnitine can improve the production and function of sperm. Some nutrients can be harmful when taken incorrectly, so see a qualified practitioner before starting supplementation.

Exercise and Stress Management

Wellness of body, mind and spirit is not possible without exercise and stress management. A regular fitness routine should incorporate aerobic, strengthening and stretching exercises. Make it a priority and schedule time for physical activity six days each week. Talk to your doctor before starting a new exercise regimen; she or he can provide individual recommendations for intensity, duration and target heart rate.

Exercise is one way to manage stress. Basic breathing exercises and progressive muscle relaxation work well too. Some activities exercise both the body and mind, like yoga and qi gong.

According to Chinese medicine philosophy, illness results from congestion and stagnation. When qi (energy) flows freely and evenly through the body, healing can take place. Qi gong is a movement technique that embodies this ancient wisdom and is quickly gaining popularity in the Western world.

Environmental Awareness

The Third National Report on Human Exposure to Environmental Chemicals from the Centers for Disease Control recently confirmed that certain toxins in our environment affect hormone balance and fertility. Potentially harmful chemicals are found in insecticides, herbicides, fungicides, solvents, plastics, heavy metals, household cleaners, fragrances, nail polish and construction materials. Couples who want to conceive should avoid unnecessary exposure.

Non-toxic building materials are essential for parents-to-be who plan to remodel a room for a baby or move into a new home. Potential parents should avoid carpet, particleboard furniture, vinyl and linoleum flooring. Good choices include “no-VOC” (volatile organic compounds) paint and sealant, and inert building materials, such as ceramic, stone, slate, bamboo, porcelain and stainless steel. A non-toxic home is not only good for conception, it will create a healthy environment for raising children.

Alternative Approaches

Couples who are in optimal health but unable to conceive after two years should seek medical advice, especially when the female partner is above the age of 35. Whether or not conventional therapies are part of the picture, alternative options such as botanical (plant) medicines, homeopathy and acupuncture can be helpful. These couples should find a qualified practitioner experienced in treating infertility and inform everyone on their treatment team of all the therapies they are using.