The Functional Approach to Infertility
I am always so happy to hear from friends and patients when they come to me with excited eyes to tell me they are pregnant. On the other hand, I have also met countless patients who are struggling to get pregnant, have experienced pregnancy losses, and are confused with what to do with egg freezing, infertility treatments and countless hormone injections. My heart goes out to you and hopefully this article will shine some light on to how to navigate your health and improve your fertility chances. I myself have been so fortunate to have experienced pregnancy and motherhood. I wish that motherhood journey on anyone who longs to have children and I would want to set them up for success by using a functional approach to improve fertility chances in every way they can.
In Functional Medicine, we always look at the underlying root causes of imbalances in the body. We try first of all, to use nutrition, lifestyle changes, and supplementation to boost the hormonal balance in the body and optimize egg and sperm health.
1. Full Body Evaluation
As a practitioner, I would always start with an initial evaluation of the whole body’s system, including hormonal health, to rule out underlying diseases like thyroid dysfunction which can be the cause of irregular periods and infertility. The initial evaluation also checks for imbalances or deficiency in the sex hormones like progesterone which can affect the uterine lining and reduce the chances of pregnancy. Testing for sexually transmitted diseases helps to rule out infections like Chlamydia which can cause pelvic inflammatory diseases and affect fertility. I would also check for metabolic disturbances in the body like Insulin Resistance and rule out underlying causes like polycystic ovary syndrome (PCOS), which can lead to infertility. Gynecological issues like endometriosis and uterine fibroids should also be ruled out with a pelvic scan.
2. Stress Reduction and Proper Sleep
Lifestyle is an important aspect to improve fertility. Today, many young women are in high-stress jobs working long hours. I have seen many young women’s blood results showing low progesterone and high cortisol, which can lead to unnecessary weight gain and problems getting pregnant.
Take the first steps to incorporate stress-reduction techniques like meditation or breathing exercises to help relieve stress. Ensure proper rest and at least 6-8hours of sleep to enable the liver proper time for detoxification and allowing the adrenals to rest. Acupuncture is helpful to reduce stress, improve the circulation of “qi” of the body, and boost the “kidney qi” essence to improve fertility.
It’s also important to not put additional stress on the body by overexercising and undereating. Many young women are going to the gym 6-7 times a week doing intense exercises to maintain their figure. Too much exercise can instead have negative consequences on fertility. Instead, make sure to balance the exercise between intense and relaxing exercises.
3. Check for Toxicity
At least 6 months before planning pregnancy, work to support detoxification. Especially if you have symptoms of toxicity like chronic fatigue, brain fog, body pains, chronic allergies etc. Check for heavy metal toxicity and organic pollutant toxicity – things like BPA, phthalates, parabens, and lead and mercury toxicity, which can affect fertility. Work with your functional practitioner to help detoxify the body of excess toxins if they are present and best to start half a year before planning for pregnancy to allow your body time to detoxify.
4. Look Out for Nutrient Deficiencies
With today’s culture of fast, convenient food, it is not surprising to find many women have nutrient deficiencies that may be preventing the body from getting pregnant. Oftentimes, women go on a low-fat diet to stay slim, but fats are needed to produce hormones and maintain the health of their eggs. Some women have difficulty getting pregnant due to inflammation in the body from multiple food allergies or intolerances. It is useful to do a food allergy and intolerance test to know which foods could be causing inflammation in the body.
Dietary advice: Eat a diet low in saturated or trans fats but load up on good monounsaturated fats – eat nuts and seeds and cut down on vegetable oils. Load up on antioxidants and polyphenols in the diet to reduce oxidative stress on the eggs and sperm.
5. Balance the Gut
A healthy gut is essential to maintain a good immune system and help the body eliminate toxins. Eat a diet high in fiber and drink enough water to prevent constipation. Increase your intake of cruciferous vegetables to help support detoxification in the body.
Dietary advice: Fermented foods like sauerkraut, kimchi, kefir, or taking pre and probiotics are useful to help maintain a healthy gut microbiome and a healthy immune system.
6. Supplementation to Boost Egg and Sperm Health
As we go into our 30’s and 40’s, our fertility rate drops as the quantity and quality of our eggs start to decline. Also, the remaining eggs start to accumulate more oxidative stress and may be at risk of abnormal chromosomes. IVF doesn’t help improve the quality of the eggs. It is essential to protect the health of the eggs with a high antioxidant supplement. Also, studies have found that the loss of egg quality is associated with declining levels of the metabolic cofactor nicotinamide adenine dinucleotide (NAD). Treatment with NAD+ was found to help rejuvenate the declining egg quality in aged animals leading to restoration in fertility. (Ref: Michael J. Bertoldo, Dave R. Listijono, Wing-Hong Jonathan Ho, NAD+ Repletion Rescues Female Fertility during Reproductive Aging, Cell Reports, Volume 30, Issue 6, 2020)
Although in recent years due to our food and lifestyle changes, the fertility rates of women have been found to be declining at a rapid pace, the good news is that there are now ways that you can find out the root causes of infertility, reverse and even regain fertility. If you are struggling with issues of infertility and not sure where to start, I would recommend you start with a trained Functional Medicine practitioner to understand the root cause of your problem and help you with a targeted approach to improve your fertility.
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Dr See Yunn Ho
Dr Ho See Yunn is a Physician with more than 15 years experience. She is board certified in both Singapore and Hong Kong and received her specialization in Family Medicine from Singapore. She also received her Advanced Fellowship in Functional and Nutritional Medicine and Peptide certification from the American Academy of Anti-Ageing and Regenerative Medicine. Dr Ho is trained and certified under Dr. Walsh’s advanced nutrient therapy protocols that use personalized nutrient treatment strategies to treat patients with behavior disorders, ADHD, autism, depression, anxiety, bipolar disorders, schizophrenia and Alzheimer’s Disease.