Upcoming Issue Highlights

Conceiving Naturally

Nautral approaches to increase fertility, when used alone or with conventional techniques, may help couples improve their chances of conceiving.

One in eight, or 15 percent, of trying-to-conceive couples in the U.S. experiences fertility issues, according to the Centers for Disease Control and Prevention. “The prevalence of American women wrestling with fertility issues is enormous and, in my opinion, only going to get worse,” said Deborah Waddell, Dipl, Ac, Lac, who has been counseling patients on reproductive health for more than 13 years.

The number of couples seeking reproductive therapy is growing, and there are several reasons for this, according to Waddell. “First and foremost, couples are waiting until they are both in advanced maternal and paternal age,” she said. “[Also,] the amount of processed food laden with chemicals and genetically modified organisms (GMOs) is increasing at an alarming rate. And the amount of chemicals and pesticides, all of which are known endocrine disruptors, are not only in food and plastics, but in most cleaning products.” 

The endocrine system is made up of glands that secrete hormones in order to deliver messages to the body, so any disruptions can lead to a host of fertility issues. “Each endocrine gland communicates with the other in an amazing design,” Waddell explained. “If one of the endocrine glands is not functioning properly, it may cause a broken link in communication with the other endocrine glands or actions of the body, which may greatly impair fertility.” 

Jaclyn Chasse, ND, co-founder of Northeast Integrative Medicine in Bedford, NH and medical educator for Emerson Ecologics, agreed. “Hormone disruption can cause menstrual cycles to be irregular or to hinder a woman’s ability to ovulate, and proper hormone balance is required in order to thicken the lining of the uterus and support early pregnancy,” she said.

Traditional Treatments 

When couples fail to conceive naturally, they often turn to conventional fertility treatments to aid them in the process. Unfortunately, these treatments can be expensive, exhausting and possibly even dangerous. “With Western reproductive fertility treatments, women’s cycles are pre-arranged to fit the schedules of the clinic they go to,” Waddell said. “This is done with the use of, in many cases, huge amounts of hormones to regulate a woman’s cycle so the clinic can optimize ovulation on their schedule.” 

Fertility treatments often begin with oral medications that enhance ovulation, such as Clomid and Letrozole. “If those don’t work, the next steps are intrauterine insemination (IUI) and in-vitro fertilization (IVF),” Dr. Chasse said.

Many insurance companies require up to three IUIs before moving onto IVF, said Waddell, who added that IUIs have a much lower success rate than IVF, and the cost of IVF is almost triple the cost of an IUI.

A Natural Approach

In order to increase their chances of conceiving, and to lower medical costs, many couples turn to natural approaches to improve their fertility. Natural fertility treatments aim to regulate a woman’s cycle using techniques such as acupuncture and stress-reduction, and by incorporating healthy foods and supplements into the diet.

Waddell offers her patients Eastern reproductive therapy, which includes acupuncture, Chinese herbal medicine, and dietary and lifestyle modifications. Some of her patients have combined Eastern reproductive therapy with the Western approach, while others have utilized acupuncture and Chinese herbal formulas as a standalone treatment for their inability to conceive.

When beginning with a new fertility patient, Waddell will spend several hours explaining how acupuncture works. “I stress to my patients that the Eastern approach may take a bit longer, but the women start noticing changes in their cycles and how they feel very quickly, so they continue their treatments,” she said. “That being said, as their health care provider, I am also right there for them emotionally as well. Going through reproductive treatments is stressful, although acupuncture helps to relieve their stress as well.” 

Waddell uses patented Chinese formulas for reproduction to help normalize a woman’s cycle. “In Chinese medicine, yin represents estrogen and yang represents progesterone. Utilizing these formulas is based on if a woman is lacking one or the other, if her FSH (follicle-stimulating hormone) levels are high or low, etc. ” Waddell explained. “I also recommend my patient and her husband take maca to help normalize hormones and increase libido.” 

Waddell also requires the couple to meet with her to discuss their diet. She recommends they steer clear of the standard American diet (SAD), which is teeming with chemicals and pesticides. “Many of the pesticides and herbicides in food in the grocery stores today are loaded with these endocrinedisrupting chemicals,” she said. “Hence, I always recommend to my patients that they eat organic whenever possible and always give them the Environmental Working Group’s (EWG) list of the Dirty Dozen and the Clean 15 product chart.”

The EWG’s Dirty Dozen is a list of foods that, when tested, were shown to contain a number of different pesticide residues and high concentrations of pesticides relative to other produce items. The Dirty Dozen list includes apples, strawberries, grapes, celery, peaches, spinach, sweet bell peppers, imported nectarines, cucumbers, cherry tomatoes, imported snap peas and potatoes. “If they can’t afford to purchase everything organic, then I strongly urge them to only buy organic when purchasing the Dirty Dozen,” Waddell said. Conversely, the EWG’s Clean 15 is a list of produce least likely to hold pesticide residues, and includes avocados, sweet corn, pineapples, cabbage, frozen sweet peas, onions, asparagus, mangoes, papayas, kiwis, eggplant, grapefruit, cantaloupe, cauliflower and sweet potatoes.

Dr. Chasse also recommends dietary changes to her patients, favoring the Mediterranean diet for its well-known health benefits. “This diet, rich in plant foods and sparing meats and sweets, is rich in nutrients and healthy fats from nuts, seeds and fish. Every couple should be on a Mediterranean diet when trying to conceive,” she said. “It is also important to ensure both partners are a healthy weight. Finally, looking at overall health, including sleep and stress, are vital to support optimal fertility.” 

Other ways patients can clean up their acts includes ridding their homes of plastics. “BPA (bisphenol A), which is in all plastics, has the potential to alter our hormones levels, which can lead to infertility,” Waddell said. “When these disruptors invade our body, they begin to mimic and alter hormone levels. These disruptors fit into our endocrine receptors like a lock and key, [therefore] our body does not try to attack or destroy them.” Estrogens (female sex hormones), androgens (male sex hormones) and thyroid hormones are all at risk.

Waddell suggests using all-natural cleaning products, since harsh chemical sprays and cleaners also contain endocrine disruptors. “I recommend [couples] reduce their exposure by purchasing chemical-free natural alternatives to the following: cleaning products, medications, beauty products, pesticides, plastic containers and bottles, linings of metal food cans, and toys for infants and children.” 

Encouraging patients to incorporate these techniques into their lifestyles can lead to success stories. “Many couples come to me when nothing else worked for them,” Waddell said. “For example, I had a 43- year-old woman come to me because she was told her eggs were too old … After three months of acupuncture, herbs, dietary and lifestyle changes, she was pregnant and delivered a nine pound, 13- oz. Healthy boy. This is just one of so many cases where a woman was told she would never conceives with her own eggs.”

Supplementation

Supplements are often a necessary way to make up for what is lacking in the diet. “After addressing diet, supplements can play a big part in restoring fertility,” 

Dr. Chasse said. “It can be difficult to obtain enough nutrients from food to meet the needs of a couple trying to conceive.” Dr. Chasse recommends couples go on a good prenatal multivitamin, as well as fish oil, since both have been demonstrated to improve pregnancy outcomes. “Finally, additional antioxidants can be fertility-promoting in many individuals. Some with great research include n-acetyl cysteine, CoQ10 and melatonin,” she said.

Connecticut-based Vital Nutrients has been supplying practitioners with professional grade supplements for 15 years. According to Beth Baldwin-Lien, ND, the company’s director of medical affairs and education, optimizing nutrition has been shown to dramatically increase pregnancy rates.

The company offers PreNatal Multi, UltraPure Fish Oils, and antioxidants such as vitamin C, as well as melatonin, which may be considered as part of a protocol for poor egg quality, Dr. Baldwin-Lien said. In addition, Dr. Baldwin-Lien suggested Antioxidant 2.0, Zinc, 200-300 mg/day of CoQ10 and UltraPure Fish Oil, which may be of benefit in supporting normal sperm count and morphology. Similarly, l-carnitine 2 g/day along with acetyl-l-carnitine 1g/day has been used to support normal sperm motility, she added.

According to Dr. Baldwin-Lien, studies have demonstrated significant improvement in pregnancy rates in women on multiple micronutrient supplements, compared to folic acid alone. Also, melatonin has been associated with increased egg maturation in women undergoing IVF, and improved progesterone levels through the luteal phase.

Other studies have provided preliminary evidence that suggests taking vitex agnuscastus orally can increase the chance of pregnancy in women who are infertile due to relative progesterone deficiency.

Further, Dr. Baldwin-Lien noted that studies have demonstrated a role for myoinositol (as in Vital Nutrient’s Inositol Powder) in sensitizing cells to insulin, restoring ovulation and decreasing serum androgens in women with PCOS (polycystic ovary syndrome). Myo-inositol may also improve oocyte quality and maturation, she added.

Vital Nutrients provides product sheets and educational brochures, many of which are available on the company’s website (www.vitalnutrients.net). “We recommend practitioners take the time to educate themselves on any natural products that may help their patients gain a full understanding of product uses and possible contraindications,” Dr. Baldwin-Lien said. “Additionally, Vital Nutrients offers practitioners opportunities to resell directly in their office, setup a patient direct program, or their own practitioner website featuring their choice of Vital Nutrients products.” 

Another company offering nutritional supplements for reproductive health is Minnesota-based Socialvite. As a practitioner, and the company’s CEO, Rebecca Bush, ND, recommends her patients avoid foods that may contain high levels of hormones or heavy metals. “I’ve seen the removal of foods that elicit an IgE immune response and supporting a healthy gut as a cornerstone of supporting fertility,” she said, noting her company’s L-glutamine powder that supports a healthy gastrointestinal tract. “Many patients with fertility issues present with multiple food sensitivities, a leaky gut and stress … Since leaky gut is such an issue, l-glutamine powder is part of just about all my fertility treatment plans.”

If her patient needs additional phase II support, Bush uses a combination of naceyl cysteine (NAC), methylsulfonylmethane (MSM), trimethlyglycine (TMG) and calcium d-glucarate.

Socialvite also offers high potency B-vitamins that contain active forms of B2, B6, B12 and folic acid, as well as magnesium. “It has been shown that for men, vitamin C, zinc, selenium, vitamin E, folic acid, vitamin B12, l-carnitine and beta carotene may improve sperm count or quality,” Dr. Bush said. “For women, supplementation with vitamin C, vitamin D, folic acid, iron and vitamin B6 is useful.” 

The company’s goal is to support the growth of natural medicine, so it offers a built-in charitable arm that donates 15 percent of every purchase to the natural organization of the practitioner’s choice. “One of those causes are the patients seen by practitioners at reduced prices,” Dr. Bush said. “Socialvite provides generous free products for these patients when practitioners order at modest levels. This is in addition to our automatic 15 percent donation…”

Addressing PCOS 

PCOS affects five to 10 percent of women of reproductive age, according to the National Institute of Health, and is one of the most common endocrine disorders among females. Since it disrupts the menstrual cycle, it can make it difficult for a woman to get pregnant. “Because this syndrome is not well known or understood, many of these women remain undiagnosed or are told that there are few treatment options, none of which are natural,” said Mark Stewart, national sales manager for Texas-based Chiral Balance, a company that aims to make PCOS no longer equal “infertility.”

More women are becoming aware of alternative treatments for this condition. “And this information is not coming from their allopaths—it is coming from peerto- peer supports groups like PCOSChallenge.com, from PCOS-oriented websites like PCOSDiva.com, and, increasingly, from naturopaths, acupuncturists, and others who understand the value of nutritional therapies.”

According to Stewart, the first-line allopathic therapies for PCOS are metformin and birth control. “Metformin does work to control blood sugar, but is very hard on the digestive tract and has a number of other unpleasant side effects. Birth control is able to level out a woman’s hormones somewhat, but it is obviously a poor choice for women who are trying to conceive,” he said. “Many people are looking to natural therapies like DCI (D-chiro-inositol) to control their insulin and androgen levels by treating the underlying cause of the imbalances, rather than the symptoms. DCI helps women with PCOS to control their blood sugar, insulin and androgen levels to restore ovulation.” 

DCI is effective in many women with PCOS because it addresses a nutritional deficiency, Stewart explained. “In clinical trials, the study authors compared DCI’s efficacy to metformin and noted that it had none of the accompanying side effects,” he said.

Chiral Balance offers Dchiro- inositol, vitex agnus-castus and Tri Sense (a collection of insulin sensitizers: vitamin D3; ECGC from green tea extract; chromium; cinnamon; saw palmetto/ milk thistle; and a prenatal multivitamin formula).

Since women can develop PCOS for a variety of reasons, Stewart recommended that practitioners assess whether a patient has insulin resistance issues before prescribing DCI. “If a patient’s PCOS is related to another underlying issue (such as hypothyroidism), it is unlikely that an insulin sensitizer will alleviate the situation,” he said. “We suggest that practitioners look closely at a patient’s blood work to determine if they are a good candidate for DCI therapy.”

Healthy Take Aways

One in eight trying-to-conceive couples in the U.S. experiences infertility.

Advanced age and a chemicalladen diet can lead to problems with fertility.

Eliminating endocrine disruptors, such as pesticides and plastics, can increase fertility.

Adding a multivitamin, fish oil and antioxidants to the diet has proven fertility benefits.

FOR MORE INFORMATION:

■ Chiral Balance, (866) 942-9800 www.chiralbalance.com

■ Socialvite, (866) 290-9694, www.mysocialvite.com/products

■ Vital Nutrients, (888) 328-9992, www.vitalnutrients.net

More on Male Reproductive Health

Men are often overlooked when it comes to fertility issues, so it’s important to assess their health as part of a fertility plan. According to Adam Killpartrick, DC, member of Natural Practitioner’s Advisory Board, the most common problem he sees in his patients at his New Hampshirebased practice is estrogen dominance and a tendency toward elevated dihydrotestosterone. These imbalances can manifest in a number of issues such as increased size of the prostate, hair loss and aggression. But estrogen dominance can also decrease fertility due to low sperm count, and may cause other sexual problems like erectile dysfunction.

Dr. Killpartrick’s strategy for optimizing estrogen levels includes reducing aromatase enzyme with zinc (if levels are low), and adding quercetin, grape seed extract, chamomile extract, and turmeric to the diet. If estrogen is dominant, he suggests considering supporting the liver’s ability to clear excess estrogen by including cruciferous vegetables, DIM (diindolymethane) and indo-3-carbinol.

For more information, call (603) 435-6600 or visit www.suncookvalleychiropractic.com.