Struggling With Infertility? The Top 6 Ways To Support Fertility + The Functional Medicine Labs You Need To Know About

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Infertility is one of the biggest problems I see facing women today. In fact, according to the World Health Organization, (1) upwards of 17.5% of the world’s population struggles with infertility at some point in their lives, leading to years of frustration and heartache. As a functional medicine practitioner, it is my job to help women take back control of their health by uncovering the underlying hormone imbalances and other problems holding them back from getting pregnant. Just know that if you struggle with infertility, you are not alone and there is hope. Read on to learn more about fertility, the best labs you can run, and my favorite remedies for boosting fertility, naturally.

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Infertility causes and symptoms

The CDC (2) defines infertility as not being able to get pregnant after at least one year or longer of having unprotected sex. While there is no single cause of infertility, many factors can contribute to people not being able to conceive, including:

  • Chronic health problems: Conditions like polycystic ovary syndrome (PCOS) that can inhibit ovulation.
  • Uterine or cervical abnormalities: Structural issues in the uterus or cervix can hinder conception or implantation.
  • Fallopian tube damage or blockage: Scar tissue, infections, or endometriosis can obstruct the fallopian tubes, preventing the egg from meeting the sperm.
  • Hormone imbalances: Imbalances in sex hormones in both men and women can inhibit ovulation and sperm quality.

Functional medicine fertility labs

In functional medicine, we understand that everyone’s biochemistry is unique and just because you have the same symptoms and health problem as someone else, doesn’t mean the underlying cause is the same. For anyone struggling with infertility these are the foundational labs that we start with in my telehealth clinic before moving on to more extensive testing based on your specific case.

1. Cortisol

We all know that stress isn’t good for your health, but it is especially harmful to your fertility since chronically high cortisol levels can mess with your hypothalamic-pituitary-gonadal (HPG) axis, responsible for controlling reproductive hormone production. When this happens, it can inhibit the release of gonadotropin-releasing hormone from your hypothalamus (responsible for producing sex hormones like testosterone, estrogen, and progesterone) and the production of luteinizing-hormone (necessary for ovulation) and follicle-stimulating hormones (ensures optimal function of the ovaries and testes).

To determine just how much stress is impacting your fertility, I typically run The 24-Hour Adrenal Stress Index. This salivary test tracks your cortisol throughout a whole day to get the most accurate look at your overall cortisol levels.

2. Sex hormones

Your body relies on a specific balance of sex hormones - estrogen, progesterone, and testosterone - to facilitate various aspects of fertility including sperm production, ovulation, and conception. Hormone imbalances in any one of these hormones can throw off this delicate system and contribute to infertility. Hormone labs give us a look at whether or not a hormonal imbalance in one or all of these hormones is a factor in your infertility struggles.

For estrogen and progesterone I like to run a full blood and salivary hormone panel, including all estrogen isomers, and for testosterone I like to run a blood and saliva testosterone and DHEA panel.

3. Insulin

Blood sugar levels have been linked to a variety of different hormone problems, including PCOS which is the most common cause of female infertility. In fact, women with PCOS are often insulin resistant (3) and have an increased risk for Type 2 diabetes. Therefore, I always make sure to assess blood sugar levels with a combination of tests including serum insulin, c-peptide, fasting blood sugar, and HgbA1c.

4. Toxin labs

It’s no secret that we live in a toxic world. Xenoestrogens are synthetic compounds that are found in many everyday products including pesticides, plastics, and personal care products. They are actually classified as an endocrine disruptor (4) as they can “mimic” estrogen and bind to estrogen receptor sites in your body, leading to a cascade of hormone imbalances that end up affecting your fertility. 

Multiple studies are also pointing to mold exposure as another potential contributing factor for infertility. In fact, two studies published in Toxins, found that certain mycotoxins - the toxic compounds produced by certain types of mold - actually impacted (5) male fertility and contributed (6) to female infertility, PCOS, and pregnancy loss.

For all of my patients struggling with infertility, I will start with ​​mycotoxin labs to look for the presence of mycotoxins in your urine and antibody production against mycotoxins in your blood as well as heavy metal and other toxin labs to determine if you have any consistent exposure to certain toxins.

For a complete guide to mold testing, check out my article here.

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Natural ways to improve fertility

Again, since everyone’s case is unique, your specific recommendations for improving fertility can vary. But with that said, these are some of my favorite tools for boosting fertility that are also some of the most well-researched at this time.

1. Manage your blood sugar

Knowing that high blood sugar is so closely tied with PCOS and other hormone imbalances, stabilizing your blood sugar should be a priority. In functional medicine, we understand that food is an integral piece of this blood sugar puzzle, and can be managed with a diet focused on reduced sugar consumption and clean, whole foods that are high in fat and protein. To learn more about the best foods to eat for PCOS and hormone imbalance, check out my article here

2. Try acupuncture

Acupuncture, a staple in TCM, has long been used as a natural fertility treatment and has been shown in many studies to significantly increase (7) pregnancy rates in women with unexplained fertility. A systematic review published in the Chinese Journal Of Integrated Medicine (8) found that the reason acupuncture was so successful in boosting fertility was because of its ability to improve ovulation through balancing the endocrine system, metabolism, and ovarian blood flow.

3. Correct any nutritional deficiencies

Multiple studies have found links between infertility and deficiencies in essential nutrients like Vitamin D, (9) Vitamin B12, (10) and micronutrients (11) like zinc. (12) In addition to the labs above, nutrient labs can help determine if you have any deficiencies that you need to correct through dietary changes and supplements. My supplements The D3-K2 and The Methylator provide highly bioavailable forms of both Vitamin D and Vitamin B12 for maximum absorption.

4. Go non-toxic

Making the switch to non-toxic beauty and cleaning products is one of the easiest things you can do to naturally boost your fertility. By eliminating as many endocrine disrupting chemicals as possible, you are giving your body a break from constantly having to be on the defense against these chemicals. You can also support your liver - your body’s main detox organ - with supplements like milk thistle to enhance your body’s natural detoxification process.

5. Try natural supplements

Certain natural supplements have been used for years around the world for female reproductive health and have shown a lot of promise in recent clinical studies for boosting fertility.

  • Bee pollen: A nutritional powerhouse, one study found (13) that regular supplementation of bee pollen was able to boost women’s chances of getting pregnant by 40% after just 9 months.
  • Chaste Tree berry: Often used as a treatment for severe PMS and PMDD, studies also show that it can be beneficial (14) for both male and female infertility.
  • Myo-inositol: A common supplement for PCOS, myo-inositol is so effective that in one controlled trial, researchers found that women taking myo-inositol supplements achieved a natural pregnancy rate of 30% over a 6-month period (15) compared to just 18% on metformin - a diabetes drug that has become the go-to treatment for PCOS in the conventional medicine world.
  • Black cohosh: Studies have linked this herb to a significant improvement (16) in pregnancy rates for those struggling with PCOS-related infertility. 

6. Alleviate stress

This is often easier said than done, but it is probably one of the best things you can do to boost your fertility. Since chronic stress leads to sky high cortisol levels that can throw all of your sex hormones out of whack and drive up inflammation, it’s imperative to start alleviating stress as much as possible. Make JOMO (the joy of missing out) a regular practice, reevaluate unhealthy relationships, and start implementing mindfulness practices like breathwork, yoga, journaling, or meditation and start to feel the stress melt away.

Seeking help from a functional medicine expert

Ultimately, everyone’s journey with fertility is unique. As a functional medicine expert, my job is to help you uncover the underlying causes behind your fertility struggles and put you on a path toward healing. From extensive lab testing to a comprehensive health history, my telehealth functional medicine team and I specialize in personalized functional medicine care for your entire health - mental and physical. If you are struggling with infertility, schedule a telehealth consultation today to learn more about how we can help you with functional medicine.

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References:

  1. World Health Organization "1 in 6 people globally affected by infertility: WHO" Accessed December 2023. https://www.who.int/news/item/04-04-2023-1-in-6-people-globally-affected-by-infertility
  2. Centers for Disease Control and Prevention "Infertility FAQs" Accessed December 2023. https://www.cdc.gov/reproductivehealth/infertility/index.htm
  3. Centers for Disease Control and Prevention "PCOS (PCOS (Polycystic Ovary Syndrome) and Diabetes)" Accessed December 2023. https://www.cdc.gov/diabetes/basics/pcos.html#:~:text=Women%20with%20PCOS%20are%20often,risk%20for%20type%202%20diabetes.
  4. ScienceDirect "Xenoestrogen" Accessed December 2023. https://www.sciencedirect.com/topics/neuroscience/xenoestrogen
  5. El Khoury, Diala et al. “Updates on the Effect of Mycotoxins on Male Reproductive Efficiency in Mammals.” Toxins vol. 11,9 515. 3 Sep. 2019, doi:10.3390/toxins11090515
  6. Kinkade, Carolyn W et al. “Impact of Fusarium-Derived Mycoestrogens on Female Reproduction: A Systematic Review.” Toxins vol. 13,6 373. 24 May. 2021, doi:10.3390/toxins13060373
  7. Guven, Pinar Gursoy et al. “Effectiveness of acupuncture on pregnancy success rates for women undergoing in vitro fertilization: A randomized controlled trial.” Taiwanese journal of obstetrics & gynecology vol. 59,2 (2020): 282-286. doi:10.1016/j.tjog.2020.01.018
  8. Huang, Dong-mei et al. “Acupuncture for infertility: is it an effective therapy?.” Chinese journal of integrative medicine vol. 17,5 (2011): 386-95. doi:10.1007/s11655-011-0611-8
  9. Berry, Sinéad et al. “Vitamin D deficiency and female infertility: A mechanism review examining the role of vitamin D in ovulatory dysfunction as a symptom of polycystic ovary syndrome.” Journal of reproductive immunology vol. 151 (2022): 103633. doi:10.1016/j.jri.2022.103633
  10. Bennett, M. “Vitamin B12 deficiency, infertility and recurrent fetal loss.” The Journal of reproductive medicine vol. 46,3 (2001): 209-12.
  11. Cetin, I et al. “Role of micronutrients in the periconceptional period.” Human reproduction update vol. 16,1 (2010): 80-95. doi:10.1093/humupd/dmp025
  12. Osadchuk, L V et al. Urologiia (Moscow, Russia : 1999) ,5 (2021): 84-93.
  13. Ali F.M. Ali, A. Awadallah “Bee propolis versus placebo in the treatment of infertility associated with minimal or mild endometriosis: A pilot randomized controlled trial. A modern trend“ VOLUME 80, SUPPLEMENT 3, 32, SEPTEMBER 2003 DOI:https://doi.org/10.1016/S0015-0282(03)01886-7
  14. Rafieian-Kopaei, Mahmoud, and Mino Movahedi. “Systematic Review of Premenstrual, Postmenstrual and Infertility Disorders of Vitex Agnus Castus.” Electronic physician vol. 9,1 3685-3689. 25 Jan. 2017, doi:10.19082/3685
  15. Raffone, Emanuela et al. “Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women.” Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology vol. 26,4 (2010): 275-80. doi:10.3109/09513590903366996
  16. Fan, Chi Wai et al. “Systematic Review of Black Cohosh (Cimicifuga racemosa) for Management of Polycystic Ovary Syndrome-Related Infertility.” Journal of pharmacy practice vol. 35,6 (2022): 991-999. doi:10.1177/08971900211012244

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Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is the host of the popular The Art Of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, The Inflammation Spectrum and the brand new book Gut Feelings: Healing the Shame-Fueled Relationship Between What You Eat and How You Feel.

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