Treatment Protocol to improve Fertility

Infertility in women is defined as the inability to conceive after 12 months of unprotected intercourse, and/or the inability to maintain a pregnancy. Conception and pregnancy depend upon many factors, including:

  • The production of healthy sperm by the man
  • Healthy eggs produced by the woman
  • Unblocked fallopian tubes that allow the sperm to reach the egg
  • The sperm's ability to fertilise the egg when they meet
  • The ability of the fertilised egg (embryo) to become implanted in the woman's uterus
  • The embryo must be healthy
  • The woman's hormonal environment must be adequate for foetal development

The most common female infertility factor is an ovulation disorder. Other causes of female infertility include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis. Congenital anomalies involving the structure of the uterus and uterine fibroids are associated with repeated miscarriages. Ageing is also an important factor in female infertility. The ability for ovaries to produce eggs declines with age, especially after age 35. Primary infertility is infertility occurring in patients who have never conceived. Secondary infertility is infertility that occurs when a woman is unable to get pregnant or carry a pregnancy to term after already having had a child.

Major factors that can contribute to female infertility include:

  • Stress—extended periods of stress lead to an elevation of glucocorticoids, which inhibit ovarian hormone production and render target tissues (such as the endometrium) resistant to the actions of sex hormones
  • Structural reproductive disturbances
  • Functional reproductive disturbances, such as:
    - high oestrogen: progesterone ratio
    - luteal phase defects
    - cervical mucous problems
    - endometriosis
    - hyper-prolactinaemia
    - fibroids
  • Endocrine disturbances—e.g., hypothyroidism, hyper-adrenalism, hypo-adrenalism
  • Immune dysregulation (leading to sperm antibody production)
  • Age—fertility decreases as women age
  • Family history of infertility and/or reproductive disturbances
  • Abnormal bowel flora and/or increased gut permeability
  • Increased toxic load—e.g., smoking, alcohol, recreational drugs, pharmaceutical drugs
  • Insulin resistance and BGL dysregulation
  • Nutritional deficiencies
  • Genitourinary infection (e.g., Chlamydia, Mycoplasma)

Common signs and symptoms of female infertility include:

  • Inability to conceive after unprotected sexual intercourse
  • Recurrent miscarriage
  • Menstrual cycle disturbances (i.e., irregular cycles, PMS, amenorrhoea, dysmenorrhoea, menorrhagia, and metrorrhagia)
  • Pain with sexual intercourse


Treatment to improve Fertility

With so many factors potentially contributing to infertility (as detailed in the list above), effective treatment involves:

  • Supporting progesterone levels and function (if with PMS, irregular cycles, premenstrual mastalgia and/or premenstrual cravings)
  • Promoting oestrogen clearance and metabolism (if with heavy, painful and/or clotting periods, fibroids, endometriosis and/or xeno-oestrogen toxicity)
  • If with premenstrual IBS, dietary sensitivities or environmental toxicity needs to be considered
  • Correcting dysbiosis (gut flora imbalance)
  • Supporting health of the thyroid gland (if hypothyroid)

Herbal Medicines, Diet, Specific Nutrients and LIfestyle factors play an important role:

  • Herbal Medicines: Chaste Tree, Wild Yam, Dong Quai, Turmeric, St Mary's Thistle, Barberry, Phellodendron, Peonia, Shatavari, False Unicorn, Black Cohosh and others
  • Nutrients: Iodine, Zinc, Pyridoxal-5-phosphate (B6), Activated B Vitamins, Magnesium, EPA & DHA, Calcium D-Glucarate, Idole-3-Carbinol and others
  • Probiotics (if dysbiosis present): Lactobacillus rhamnosus GG (LGG), L. plantarum (299v) and others
  • Diet and Lifestyle: see list below

Dietary and lifestyle guidelines that may promote female fertility:

  • Smoking cessation is the highest priority in currently smoking patients
  • Stress management techniques, such as yoga, meditation and exercise are advised
  • A diet high in fresh vegetables, essential fatty acids and quality protein sources provides essential phytonutrients, antioxidants and magnesium is essential
  • Minimise intake of sugars, processed food, caffeine, and alcohol
  • Eliminate foods that increase oestrogen levels in the body and the liver's ability to metabolise it. These include non-organic poultry, sugar, white flour and refined foods, and methylxanthines (coffee, tea, chocolate, colas)
  • Cruciferous vegetables (broccoli, cabbage, cauliflower, etc.) enhance glutathione activity which is important for the detoxification of hormones
  • Organically grown and raised foods to avoid hormone-potentiating pesticide residues is recommended
  • Include detoxifying foods such as beets, carrots, yams, garlic, dark leafy greens, lemons, and apples
  • Fibre can facilitate the excretion of metabolised hormones and toxins
  • Minimise refined foods, as they deplete the body of magnesium and other essential nutrients which are needed for normal hormone production