Fertility: Factors

Most articles on the internet focus on infertility factors that are directly part of fertility such as supply of eggs, sperm mobility, hormonal imbalances, and uterine health (for example).  However, other factors that have a direct impact on fertility are not as commonly talked about, even though there is research to support these factors. There are several environmental and lifestyle factors that can impact fertility and these factors are easily controlled. We are going to cover some of these factors, so you have a better understanding and can decide on whether or not to make any adjustments with these:

Hormonal Birth Control

Women use hormonal birth control for several years for a variety of reasons—one being to prevent pregnancy. There are controversial opinions on whether or not birth control affects fertility. However, the main mechanism of action for most hormonal birth control pills is to stop ovulation. It is thought by some that once you stop taking birth control, for some women, ovulation does not start happening again on it’s own.  Post-pill PCOS is the term coined for this but it has not been explored in the research yet.

One thing that has been shown in the research is that hormonal birth control can deplete your body of specific micronutrients. These are important for fertility. So it is recommended that you replenish these micronutrients after stopping hormonal birth control.

The depleted micronutrients are:

  • Folic acid - important for neural tube formation.
  • Vitamins B2, B6 and B12 - essential to reduce inflammation/homocysteine which is primarily a cardiovascular risk factor.
  • Vitamins C and E - antioxidants that decrease inflammation and may influence the environment for healthy sperm.
  • Magnesium, Selenium and Zinc - minerals that remove heavy metals, keep the uterus relaxed and protect the maternal thyroid perinatally. 

Environmental toxins

Environmental toxins can affect fertility (and decrease the success of fertility treatments) by damaging the reproductive system. They can also act as endocrine disruptors (Pizzorno 2018). Endocrine disruptors can impair the blood sugar control within our bodies and may even manifest as metabolic syndrome, diabetes, or PCOS.  

The most common endocrine disruptors are organochlorine compounds, bisphenol A (BPA, and organophosphate pesticides and herbicides).  Many other chemicals, metals, and air pollutants can also damage fertility. In fact, research has found that women exposed to pesticides had a 50% decrease in their ability to get pregnant (Pizzorno 2018).  

Mechanical Impairments

It is common to have scar tissue and/or fascial adhesions within the pelvic cavity and abdomen from any injury, surgery, infection, or inflammation. These restrictions can restrict the mobility of the pelvic organs and the blood flow to them.  

In addition, any impairments within the pelvic alignment can also have an impact on fertility. This is likely due to the fascial attachments and ligament attachments that are between the pelvic bones and pelvic organs.  Read more about how this affects fertility HERE.

Food Sensitivities

It is well-supported in the research that there is a link between Celiac’s disease and fertility issues. However, not as much is known about non-celiac’s gluten sensitivities (NCGS) and how it might impact fertility.  

In a case study of a woman undergoing IVF, she had success after the 6th round of IVF after going to a gluten-free diet (Bold 2015). There is some correlation with decreased inflammatory markers with a gluten-free diet, but there needs to be more research in order to have a better understanding of this. 

Ultimately though, we do know that gluten can have a big impact on fertility if you have Celiac’s and that it likely increases the systemic inflammation within our body. It also depends on your baseline gut health in regards to how sensitive your body will be to gluten (NCGS). If there is more “damage” to the gut lining, gluten can cause more inflammation. 

Gut Health

When we discuss gut health, there are several factors that impact it. Your digestion is the first step in good gut health! If food isn’t being broken down properly, there is more demand on the intestines to break food down. This results in food particles passing down through the lower gastrointestinal (GI) tract which can be damaging to the lining.

Second step is the ingredients you are consuming.  If your diet consists highly of processed foods, then you will be taking in more chemicals than if you ate primarily whole foods. These chemicals can create inflammation within the gut.  They can also make the gut lining more permeable. Permeability allows larger particles to pass through that shouldn’t normally pass through (such as chemicals). This can then increase inflammation within the body.

And then the last step is the gut bacteria, called the microbiota. These are the “good bacteria” that live inside of your gut. It’s not fully understood yet the degree that these influence body systems, but research suggests that they communicate to the brain through the vagus nerve (one of our cranial nerves) and can impact hormones and organ function.

Disruption of gut microbiota results in decreased circulating estrogens which can drive estrogen-mediated pathologies such as PCOS and fertility (Baker 2017).

Found that by altering the gut microbiota, they were able to decrease the symptoms of PCOS. In addition, it is thought that it helps decrease inflammation levels which can also affect fertility. (Mauro 2019)

Stress

If you are like most people, you probably downplay the impact of stress and just accept stress as part of life. However, stress can be a major factor in infertility and can be completely managed. When someone is experiencing a stressful situation, their body produces cortisol, the stress hormone. Cortisol is produced from the same compounds that make up our sex hormones, such as estrogen and progesterone. During stress, the body must prioritize one over the other so it prioritizes cortisol.

Think of it from an evolution standpoint.  If you were about to get eaten by a bear, your body would produce the hormones necessary to help you survive a bear attack rather than reproduce at that moment. In the short-term, this is helpful. However, if stress is long-term or chronic, this can significantly impact fertility.

Working on how well your body manages it’s stress responses and how it recovers from stress can help decrease the overall stress level. This will help restore better balance between your sex hormones and cortisol.  

The great news is that all of these factors can be addressed in order to help optimize your fertility. There are certain tests that you could do to test for some of these factors such as heavy metals testing, cortisol testing, and food sensitivity testing. Testing is not considered the gold standard as there is a sizable amount of error with testing. The gold standard is to remove the possible factors, and monitor symptoms, fertility and your menstrual cycle being one of them.

Resources:

Baker, JM, Al-Nakkash L, Herbst-Kralovetz MM. Estrogen-gut Microbiome Axis: Physiological and clinical implications. Maturitas. 2017; 103: 45-53.

Bold J, Rostami K. Non-coeliac gluten sensitivity and reproductive disorders. Gastroenterol Hepatol Bed Bench. 2015;8(4):294-297.

Mauro S.B. Silva, Paolo Giacobini. Don’t Trust Your Gut: When Gut Microbiota Disrupt Fertility. Cell Metabolism. 2019; 20(4): 616-618.

Pizzorno J. Environmental Toxins and Infertility. Integr Med (Encinitas). 2018;17(2):8-11.

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