There might be nothing tougher on a marriage than infertility—the onslaught of hormone treatments, the sex on demand (sounds fun, but it really isn’t) and the expensive, invasive (and, some fear, even cancer-causing) in vitro fertilization (IVF) treatments have many couples looking for a blend of holistic and medical solutions. “Nope,” they say, mournfully placing another Clearblue into the trash, “not this month.”
It’s like this for one in eight couples in the United States today: Blame pesticides in food or hormone-disrupting stress or blocked fallopian tubes—experts point to a host of medical, environmental and social factors, although a 2013 report from the National Center for Health Statistics says rates are stable or possibly declining.
Chief among the fertility-zappers is age. According to the Centers for Disease Control and Prevention, 20% of American women now have their first child after age 35. Unfortunately, about one-third of them will have a hard time, thanks to diminished egg reserves or a heightened risk of other reproductive challenges. But while one-third of infertility problems can be traced to the female partner, the same number can be attributed to the man (see “Sperm Zappers”). Both partners have issues 10% of the time, and 20% of cases are frustratingly labeled “unexplained.”
So let’s look instead at the causes.
Most female infertility stems from ovulatory issues, including hormone imbalances or polycystic ovarian syndrome (PCOS), a hormonal disorder characterized by irregular periods, excess hair growth and acne. Others face infections or thyroid disease; mechanical issues like blocked fallopian tubes; or endometriosis, a painful disorder in which the uterine lining grows outside the uterus. Certain culprits, including blocked tubes, require surgery or assisted reproductive techniques like in vitro fertilization (IVF). Some experts believe that IVF cases are on the rise in the U.S. and worldwide because techniques are becoming more high-tech, and the perception (purely anecdotal) is that they are more successful.
But some fertility specialists say a quick-fix mentality on the part of both patients and physicians has contributed to an overreliance on IVF, which costs about $12,000 per cycle and can be exceptionally taxing on a woman’s body and emotions.
“Approximately 50% of women who are undergoing IVF don’t need it,” says Sami S. David, M.D., assistant professor of reproductive medicine at Mount Sinai Medical Center in New York City and author of Making Babies: A Proven 3-Month Program for Maximum Fertility. “Lifestyle is a huge factor,” adds David, one of a growing number of practitioners who are advocating a blend of holistic care with mainstream reproductive endocrinology.
While you can’t change your age, you can control the foods you eat, the way you handle stress and your environment. We asked the experts—many of whom used a combination of traditional and complementary approaches to surmount their own fertility challenges—for their top recommendations. Choose the methods that suit your physical or emotional needs; if after three months you’ve seen no improvement, consult a reproductive endocrinologist.
Many experts believe chronic stress has hijacked our primitive fight-or-flight response, causing the pituitary gland to unnecessarily release endorphins that suppress reproductive hormones. A landmark Harvard Medical School study found that women who participated in a 10-week mind-body program, including relaxation and yoga, were nearly three times more likely to conceive than women who didn’t take part. The research was lead by Alice Domar, Ph.D., executive director of the Domar Center for Mind/Body Health at Boston IVF and author of Conquering Infertility.
“Yoga reduces the stress hormone cortisol and induces the relaxation response,” explains Tami Quinn, a registered yoga teacher and cofounder of the Chicago-based holistic fertility center Pulling Down the Moon. Specific poses, such as Viparita Karani (Legs up the Wall), can also increase blood flow to the ovaries and uterus, potentially thickening the uterine lining; this can aid with embryo implantation. Stick with gentle hatha or restorative yoga and avoid breaking a sweat—this is not the time for Bikram yoga.
Guided imagery is a therapeutic technique that allows you to enter a deeply relaxed state of mind, then focuses your attention on specific images that work to calm you. Mind-body expert Bernie Siegel, M.D., author of Love, Medicine & Miracles, suggests tailoring this brain game to your conception goals: “Like rehearsing for a performance, when you visualize your egg being fertilized, your chemistry changes and the body responds as if fertilization is happening.”
A 2008 British Medical Journal study found that women who underwent IVF and acupuncture together were 65% more likely to conceive than women who only underwent IVF. According to acupuncturist-herbalist Jill Blakeway L.Ac., it works by promoting uterine blood flow. It can also quiet post-IVF uterine contractions, encouraging implantation and decrease levels of cortisol (a “stress hormone”) and prolactin, both of which are known to disrupt reproductive function.
Jorge E. Chavarro, M.D., Sc.D., an assistant professor of nutrition and epidemiology at the Harvard School of Public Health and author of The Fertility Diet, followed 18,000 participants in the long-running Harvard Nurses’ Health Study who were trying to get pregnant. Among his findings:
Foods that elevate insulin levels contribute to fertility-zapping ovulatory disorders. “Not all proteins are digested the same,” Chavarro explains. “Animal proteins require more insulin to be secreted.” Beef and poultry, specifically, were associated with infertility. The good news: Replacing 25 grams of animal protein with 25 grams of plant protein (beans, peas, nuts) was related to a 50% lower risk of ovulatory infertility.
Found primarily in packaged baked and fried foods, trans fats elevate insulin levels. Monounsaturated fats, like those found in avocados, nuts and olive oil, are associated with a decreased risk of infertility.
Quickly digested carbs, such as white bread, potatoes and soda, spike your blood sugar, promoting insulin secretion. Carolyn Dean, M.D., N.D., dislikes “white” carbs for another reason: They encourage yeast overgrowth. “Yeast toxins can cross-react with hormones necessary for pregnancy, blocking their receptor sites,” she says. Dean recommends eliminating sugar and white flour, eating fiber-rich, slowly digested complex carbohydrates and incorporating plain yogurt or probiotic supplements to encourage the growth of healthy gastrointestinal bacteria, which favorably compete with yeast toxins for space.
TRY: Culturelle Probiotics ($15 for 30 capsules; vitacost.com) or Life-way plain organic kefir ($5 for 32 ounces; lifeway.net)
Chavarro’s research found that low-fat dairy foods appear to heighten the risk of infertility, while women who consumed one daily serving of whole milk or full-fat ice cream were 27% less likely to experience infertility.
A study published in the American Journal of Public Health found that tea drinkers doubled their odds of conceiving, perhaps because of their antioxidant content. Note: Blakeway advises avoiding red raspberry leaf tea because it is linked to miscarriage.
Certain supplements and herbs may help you on your conception quest.
The mineral is thought to keep the fallopian tubes relaxed, facilitating the travel of sperm to meet egg. In IVF, it can calm the uterus to encourage implantation; during pregnancy, it may help prevent miscarriage. Dean, who is the medical director of the Nutritional Magnesium Association, suggests 750 milligrams daily. The mineral is also found in seaweed, cacao, leafy greens, nuts and seeds.
TRY: Natural Calm Magnesium Citrate ($23 for 16 ounces; calmnatural.com)
Holistic nutritionist Sally Kravich, M.S., CNHP, recommends fish oil (800-plus milligrams EPA and 500-plus milligrams DHA per day) to balance your hormones and encourage healthy fetal brain development.
TRY: Nordic Naturals Ultimate Omega ($60 for 180 softgels; vitaminshoppe.com)
Chinese herbs are often used in conjunction with acupuncture to address elevated follicle stimulating hormone (FSH) levels, repeat miscarriage, unexplained infertility and PCOS, says Oakland, Calif.-based acupuncturist and herbalist Zoe Cohen, L.Ac. Single herbs are rarely prescribed; instead, multicomponent formulas are tailored for each patient based on her diagnosis. Herbs traditionally sold raw, dry or as powder are available in pill or tincture form. Cohen explains that herbs can be deceptively powerful and may interact with fertility drugs, so it is crucial to work with a licensed herbalist experienced in treating infertility.
Not ready to jump head-first into Chinese herbs? Stanford University School of Medicine researchers found that FertilityBlend, a combination of prenatal vitamins and fertility-enhancing herbs, increases your chances of conceiving. (FertilityBlend for Men boosts sperm count.)
TRY: FertilityBlend for Women ($30 for 90; fertilityblend.com)
Every day, we’re exposed to hundreds of chemicals, from our shampoo to our water bottles to car exhaust. Research has found that many of these products contain endocrine-disrupting compounds called xenoestrogens (bisphenol-A, or BPA, and phthalates are two examples), which mimic estrogen in the body, meddling with the body’s sensitive hormonal milieu by blocking real estrogen from doing its work. High blood levels of the chemicals used in nonstick cookware and waterproof clothing have been shown to significantly increase a woman’s risk of infertility.
David suggests eating organic foods and keeping your home as green as possible: Avoid microwaving food in plastic containers, steer clear of cosmetics containing phthalates or parabens and include dietary phytoestrogens, such as flax seed or soy, in your diet; they’ll bind to the estrogen receptor sites before xenoestrogens get the chance.
According to the American Society for Reproductive Medicine, 12% of female infertility cases are a result of a woman weighing too little or too much. That’s because estrogen is produced in fat cells. Too little body fat and the body can’t produce enough estrogen to fuel ovulation; too much and the body reacts as if it were on birth control. Gaining just six to eight pounds (if underweight) or losing 10 to 14 pounds (if overweight) may be enough to boost your baby-making odds.
Similarly, it’s important to strike a balance between overdoing it and not doing enough on the exercise front. David says gentle exercises like walking, swimming and yoga promote blood supply to the pelvic region and reduce stress. But he recommends avoiding “workout intensities that elicit an endorphin rush, as this can suppress egg and ovarian hormone production.” A landmark study in Obstetrics & Gynecology found that IVF patients who reported exercising four hours or more per week for one to nine years were 40% less likely to have a live birth than women who did not exercise. Women are advised not to work out while undergoing IVF treatment because doing so could harm the ovaries, but a study that followed 118 IVF patients from June 2009 to March 2010 found that 12% of them were ignoring the exercise warnings from their doctors.