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| Female Infertility |
Last updated: Nov 19, 2009 |
Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Other conditions that may be present | Recommendations
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More women are waiting to bear children later in life. However, waiting beyond your thirties leads to decreasing fertility and an increased risk of birth defects. It may not be possible to prevent infertility, but there are measures that you can take to minimize the possibility. If you have any suspicion that you may have contracted a sexually-transmitted disease, see your doctor promptly so that treatment, if necessary, can begin in a timely fashion.
A woman should have regular gynecological examinations starting at age eighteen or within six months of becoming sexually active, whichever comes first, so that any developing problems can be detected and corrected early.
Adopt a healthy lifestyle that includes a wholesome diet, regular exercise, avoidance of toxins of all kinds (including recreational drugs), and measures to reduce stress. If you consume alcohol, do so in moderation only.
Here are some things to try other than the remedies listed later in this report: - Don't have intercourse more than three times per week. More frequent intercourse may reduce the number of viable sperm in the male partner's semen.
- Time intercourse to coincide with ovulation, which usually occurs midway between menstrual periods. Some women can tell when they are ovulating. Signs of ovulation include bloating and breast tenderness and, for some women, a slight cramping pain. Unfortunately, many women experience no telltale signs. There are over-the-counter tests that can help you pinpoint the time of ovulation.
- After intercourse, spend ten to fifteen minutes quietly in each other's arms before getting up. If a woman stays in a prone position for fifteen minutes or so following intercourse, this allows the sperm sufficient time to reach the egg.
- If it has been determined that your body is producing antibodies that are damaging or destroying sperm, your partner should use a condom for six months. Following no contact with the sperm, your antibodies may be lulled into inactivity. After this rest period, time intercourse (without a condom) to coincide with ovulation.
- Avoid vigorous exercise, hot tubs and saunas, as they may lead to changes in ovulation.
- Do not take any drugs except those prescribed by your physician.
A woman who suffers from premenstrual symptoms such as bloating and breast tenderness is probably ovulating, so if she is having difficulty becoming pregnant, the cause probably lies elsewhere.
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Signs, symptoms & indicators of Female Infertility: | |  | | | | Symptoms - Reproductive - General | Difficulty conceiving/being unable to have children |
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Conditions that suggest Female Infertility: | |  | | | | Symptoms - Reproductive - Female Cycle | Counter-indicators:
Being/being post/being peri menopausal |
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Risk factors for Female Infertility: | |  | | | | Environment / Toxicity | Mercury Toxicity / Amalgam Illness | Researchers in Hong Kong compared mercury levels in fertile and infertile couples. The results were as follows:
Fertile men 15% with high mercury, Infertile men 35% with high mercury Fertile women 3.8% with high mercury, Infertile women 23% with high mercury
So for infertile men, the chance of mercury toxicity over fertile men was 2.3 times higher and for women, 6 times higher. They recorded how much seafood the couples consumed and found that those eating more seafood tended to have higher blood mercury levels. [Fertility and Sterility, 78: 2, August 2002, pp. 426-428] |
General Detoxification Requirement | Many cases have been reported by fasting centers where couples who had been childless for many years, due to infertility, were able to concieve after a few therapeutic fasts combined with colon cleansing. |
| Habits |
Overtraining, Effects | Infections |
Pelvic Inflammatory Disease (PID) | The most worrying complication of PID is infertility. Scars that damage the fallopian tubes make it difficult for a fertilised egg to pass along the tube to the womb. After one infection, more than 10% of women will suffer from infertility. PID also increases the risk of ectopic pregnancy, when the fertilised egg implants in the fallopian tube because it cannot reach the womb. This is a dangerous condition and the tube will probably need to be removed during an operation. |
STD Gonorrhea | Gonorrhea can spread into the womb and fallopian tubes, resulting in pelvic inflammatory disease (PID). PID affects more than 1 million women in the United States every year and can cause infertility and tubal pregnancy. |
STD Syphilis
STD Chlamydia | As many as 40% of women with untreated chlamydia will develop pelvic inflammatory disease (PID). Undiagnosed PID caused by chlamydia is common, resulting in a 20% infertility rate. |
Mycoplasma Infection | Lab Values |
Elevated Cortisol Levels | Chronically elevated cortisol levels can stop a woman from ovulating and may lead to infertility. |
| Lab Values - Hormones |
Marginal/poor ovarian reserve
Counter-indicators:
Normal ovarian reserve | Metabolic |
Problem Caused By Being Underweight
Anorexia / Starvation Tendency | Anorexia or starvation causes difficulties in conceiving and carrying a baby to term. |
Cystic Fibrosis | Fertility problems in women with CF may be due to thicker mucus making fertilization difficult. |
Problem Caused By Being Overweight | Nutrients |
Manganese Requirement
Vitamin A Requirement | Symptoms - Reproductive - Female Cycle | Counter-indicators:
Partial/total/radical hysterectomy or hysterectomy with both ovaries or hysterectomy with one ovary | Symptoms - Reproductive - General |
(Several) past abortions | Tumors, Benign |
Fibroids | See link between Anemia and Fibroids. |
| Uro-Genital |
Polycystic Ovary Syndrome (PCOS) | Impaired fertility is a prominent feature of PCOS. This is believed to result from elevated insulin levels that stimulate excess androgen production by the ovaries. The androgens cause premature follicular wasting which causes inconsistent or absent ovulation, which is associated with infertility. |
Endometriosis | It has been estimated that some 25-50% of infertile women suffer from endometriosis. The cause of infertility is believed to result from the scarring and adhesions that form in the reproductive tract as a result of inflammation. Scar tissue and adhesions may reduce fertility by either obstructing or distorting the shape of the fallopian tubes, which in turn impedes the passage of sperm to the egg. In the event that sperm do reach the egg, they may encounter a hostile environment unfavorable to fertilization. Finally, scarring from endometriosis may obstruct the fallopian tubes so that if an egg is fertilized, it may be unable to travel to the uterus for implantation.
Women with endometriosis conceive at lower rates than women without endometriosis and miscarriages are more common in endometriosis patients than in those who do not have the disease.
Women with ASRM stage I-II disease have pregnancy rates which are significantly lower than patients without disease. These rates are improved with surgical therapy and are optimized with a combination of good excisional therapy and medical suppressive therapy if there is any suspected residual disease.
Women with ASRM (formerly AFS) stage III-IV disease have pregnancy rates which are 50-60% lower than others who do not have the disease. Medical or surgical therapy does not strongly change these rates. |
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Female Infertility suggests the following may be present: | |  | | | | Environment / Toxicity | General Detoxification Requirement | Many cases have been reported by fasting centers where couples who had been childless for many years, due to infertility, were able to concieve after a few therapeutic fasts combined with colon cleansing. |
| Infections |
STD Gonorrhea | Gonorrhea can spread into the womb and fallopian tubes, resulting in pelvic inflammatory disease (PID). PID affects more than 1 million women in the United States every year and can cause infertility and tubal pregnancy. |
STD Syphilis | Metabolic |
Anorexia / Starvation Tendency | Anorexia or starvation causes difficulties in conceiving and carrying a baby to term. |
Problem Caused By Being Underweight | Uro-Genital |
Polycystic Ovary Syndrome (PCOS) | Impaired fertility is a prominent feature of PCOS. This is believed to result from elevated insulin levels that stimulate excess androgen production by the ovaries. The androgens cause premature follicular wasting which causes inconsistent or absent ovulation, which is associated with infertility. |
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Recommendations for Female Infertility: | |  | | | | Animal-based | Glandular / Live Cell Therapy | Although hard evidence is still lacking, many natural doctors use glandular extracts to promote reproductive health. These are usually extracts from several different organs including ovaries, uterus and others. These combination products may contain selected homeopathic remedies as well. |
Propolis / Bee Products | Forty women with primary infertility of at least 2 years' duration, and mild or minimal endometriosis, were randomly assigned to receive bee propolis (500mg BID) or placebo for 9 months. Twelve (60%) of 20 women in the active-treatment group became pregnant, compared with 4 (20%) of 20 in the placebo group. No side effects were reported. [Fertil Steril 2003;80(Suppl 3): p.S32] |
| Botanical |
Red Clover (Trifolium pratense) | Red clover blossom may act as a female fertility enhancer. It contains several estrogen-like compounds which may promote fertility in estrogen-deficient women. [Duke, J. A. Handbook of Medicinal Herbs: 489. Boca Raton, FL: CRC Press, 1985] |
Vitex | Vitex is often used to help infertility caused by a luteal phase defect (a shortening of the post-ovulatory part of the menstrual cycle): women taking vitex for three months appear to have more success at becoming pregnant. |
| Detoxification |
Heavy Metal Detoxification / Avoidance | Investigate the possibility of heavy metal intoxication, which may affect ovulation. A hair analysis can reveal heavy metal poisoning. |
| Diet |
Gluten-free Diet | Strict adherence to a gluten-free diet has enabled many women who were previously unable to conceive to become pregnant. |
Fried Foods Avoidance
Caffeine/Coffee Avoidance | Research has indicated that women who drank more than one cup of coffee a day reduced their likelihood of conceiving by 50%, and men who drank two to three cups of coffee a day had an increased incidence of abnormally formed sperm. Having five cups a day appears to make sperm sluggish as well. |
High/Increased Fiber Diet
Pumpkin Seeds
Animal/Saturated Fats Avoidance
High/Increased Protein Diet
Increased Water Consumption | To flush toxins from your system, drink eight 8-ounce glasses of pure water daily. |
Sugars Avoidance / Reduction
Alcohol Avoidance | Alcohol consumption can prevent implantation of a fertilized egg. |
Processed Foods Avoidance
Not recommended:
Soy Isoflavones (genistein, daidzein) | Women who are trying to conceive may want to heed the following: Avoid eating too much soy. According to a study involving humans, a compound found in soy known as genistein has been found to impair sperm as they swim toward the egg. Even tiny doses of the compound in the female tract could destroy sperm. Genistein can be found in all soy-containing products.
Researchers further explained that avoiding soy around a woman's more fertile days of the month might actually aid conception.
Based on the findings, a spokeswoman for the Vegetarian Society said that for anyone trying to become pregnant, avoiding soy products for a few days a month is worth a try ... even if there is a slim chance it will aid in fertility. [BBC News June 21, 2005] |
| Drug |
Conventional Drugs / Information | Fertility drugs such as clomiphene (Clomid, Serophene), gonadorelin (Factrel, Lutrepulse), human chorionic gonadotropin - HCG (A.P.L., Fullutein, Humegon, Pregnyl, Profasi), and human menopausal gonadotropins - HMG (Metrodin, Pergonal, Repronal) are commonly prescribed. |
| Habits |
Tobacco Avoidance | Cigarette smoking is associated with female infertility due to tubal and cervical causes. In animal studies, nicotine has not only been shown to decrease tubal motility and blood flow, but appears to decrease estrogen levels as well. Cotinine, a byproduct of nicotine, is found in the cervical mucus of female smokers, and may be toxic to sperm. |
Aerobic Exercise | Exercise regularly but moderately. Maintaining a high level of physical fitness increases the possibility of conception. For both men and women, the ability to reproduce is dependent on a healthy body. Stressing your body with intensive exercise can cause a decrease in fertility. |
| Hormone |
Progesterone | Progesterone is an important hormone in preventing miscarriage. Without adequate progesterone, the lining of the uterus will remain rigid making pregnancy difficult to achieve. The lack of normal progesterone production by the ovaries in the second half of the menstrual cycle is called luteal phase defect. Women who have this defect are either unable to have their fertilized eggs implant in their uterine lining or, if the egg is implanted, it is so weak that miscarriage is a certain outcome.
To lessen the possibility of miscarriage, women who have a luteal phase defect use progesterone supplements after ovulation to help maximize the chance of carrying a pregnancy to full term. Progesterone supplements are also prescribed to women who are undergoing in-vitro fertilization (IVF) and other methods of assisted reproductive technology (ART). Progesterone supplements are given to women following an egg transfer in certain types of fertilization methods. Treatment for all women using progesterone supplements continues for at least fourteen days following ovulation. If pregnancy occurs in a woman who is taking progesterone supplements, her doctor may decide to continue the treatment for another 8 to 10 weeks until placental production of progesterone can carry the pregnancy successfully. |
| Lab Tests/Rule-Outs |
Test / Monitor Hormone levels | Because male infertility is related to approximately 50% of all infertility cases, it is important to conduct a semen analysis to make sure that this is not the cause of the problem.
Ideally, you will have already begun tracking your ovulation through fertility awareness or a fertility monitor. This will provide your doctor with valuable information about your ovulation. Usually the first question regarding female fertility is whether you are ovulating or not.
The first tests performed by your doctor involves measuring your follicle stimulating hormone (FSH) and luteinizing hormone (LH) to establish a baseline. This is performed on the third day of your cycle. A second test for LH may occur on the day of the LH surge, which is before ovulation in most cases.
Additional tests may include:- Cervical mucus tests: This involves a postcoital test (PCT) which determines if the sperm is able to penetrate and survive in the cervical mucus. It also involves a bacterial screening.
- Ultrasound tests: This is used to assess the thickness of the lining of the uterus (endometrium), monitor follicle development, and check the condition of the uterus and ovaries. An ultrasound may be conducted two to three days later to confirm that an egg has been released.
- Hormone tests: These tests are done to assess the various hormone levels that contribute to the reproductive process.
These hormone tests include the following:- Luteinizing Hormone (LH)
- Follicle Stimulating Hormone (FSH)
- Estradiol
- Progesterone
- Prolactin
- Free T3
- Total Testosterone
- Free Testosterone
- DHEAS
- Androstenedione
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Tests, General Diagnostic | If both the semen analysis and hormone tests are normal, there is also additional testing that your fertility specialist may recommend. These tests include any of the following:- Hysterosalpingogram (HSG): This is simply an x-ray of your uterus and fallopian tubes. A blue dye is injected through the cervix into the uterus and fallopian tubes. The dye enables the radiologist to see if there is blockage or any other problems.
- Hysteroscopy: A procedure that may be used if the HSG indicates that there may be problems. The hysteroscope is inserted through the cervix into the uterus, which allows your fertility specialist to see any abnormalities, growths or scarring in the uterus. The hysteroscope allows your physician to take pictures which may be used for future reference.
- Laparoscopy: A procedure which uses a narrow fiber optic telescope. The laparoscope is inserted through a woman’s abdomen to look at the uterus, fallopian tubes, and ovaries. Your physician will be checking for endometriosis, scar tissue, or other adhesions. It is important to confirm that you are not pregnant before this test is performed.
- Endometrial biopsy: This is a procedure which involves scraping a small amount of tissue from the endometrium just prior to menstruation. This biopsy is performed to assess whether there is a hormonal imbalance or not. It is important to confirm that you are not pregnant before this test is performed.
These tests are not mandatory and your fertility specialist will know which tests best fit your situation. |
| Mineral |
Selenium | A deficiency of selenium can lead to infertility in women. |
| Physical Medicine |
Hydrotherapy | Alternating hot and cold sitz baths are useful in improving pelvic circulation. These may be helpful in promoting fertility. Please use at times other than when attempting conception. |
| Psychological |
Stress Management | Mental and emotional stress can impact fertility. Try to eliminate the stress in your life as much as possible. Infertility itself can be extremely stressful. |
| Surgery/Invasive |
Surgery | Artificial insemination can be used to place sperm directly in the cervix or uterus. In vitro fertilization involves combining an egg with sperm in a laboratory, and then implanting the fertilized egg into the uterus. |
| Vitamins |
Vitamin Paba | Para-aminobenzoic acid (PABA) stimulates the pituitary gland and sometimes restores fertility to some women who cannot conceive. |
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KEY |  | Weak or unproven link |  |  | Strong or generally accepted link |  |  | Proven definite or direct link |  |  | Weakly counter-indicative |  |  | Very strongly or absolutely counter-indicative |  |  | May do some good |  |  | Likely to help |  |  | Highly recommended |  |  | Reasonably likely to cause problems |
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