Having children is something that many people aspire to at some point in their lives and for some, the act of procreation is a natural and easy process. For others, getting pregnant is something to be avoided at all costs. Yet, for about 17% of the population or 1 in 6 couples, the ability to have children is an elusive desire that brings with it frustration, heartache and loss. As both men and women postpone childbearing to focus on building careers, more and more couples and even single would-be parents are finding that it may not be that easy to conceive. While peak fertility for women is between age 22 to 26 it appears that women in developed countries on average are waiting until age 29 to have their first child and many are waiting until their mid-thirties or even forties to begin a family.
According to endocrinologists, a couple is considered to be infertile if the woman is under the age of 35 and they have not conceived after 12 months of contraceptive-free intercourse. Because of the declining egg quality of women as they age, for couples where the woman is 35 or older, infertility may be an issue after only 6 months of trying. Sperm quality also declines with age, and studies show that at age 37, a man may be half as fertile as he was when he was 25 or younger. Statistics show that in 35% of infertility cases the woman is infertile, while the man is responsible 35% of the time. The other 30% are cases where both the man and woman are infertile or the cause of infertility is unknown. The good news is that statistics show that 92 out of 100 women under age 38 and 77 out of 100 women who are older will get pregnant within 2 to 4 years of regular unprotected sex, while only 2% of the population is truly sterile. Yet for those couples having difficulty conceiving, many turn to medical intervention as their only hope.
Infertility is a $3 billion industry. Fertility drugs such as Clomid (clomiphene) can be taken by the woman to stimulate ovulation. IUI (intra-uterine insemination) is an option where the man’s semen is “washed” and placed inside the womb where it can be fertilized by the waiting egg. Increasing numbers of infertile couples are resorting to Assisted Reproductive Technology (ART) making it possible for couples who could not conceive naturally realize their dream of having a baby, though this can be an expensive (approximately $10,000) and arduous process. In Vitro Fertilization (IVF) is an ART procedure where the woman takes various fertility drugs to control her hormones and induce ovulation. At the appropriate time some of her eggs are surgically removed and combined in a laboratory with sperm donated by the man where conception takes place. One or more embryos are then placed back into the woman’s uterus where implantation can occur leading to pregnancy. If the woman’s eggs are not viable, eggs from a donor can be used. In other cases a surrogate mother may be obtained to carry the pregnancy of the couple’s embryo(s). About 57,000 infants are born each year in the U.S. as a result of IVF.
The success rate for IVF is about 30% and is not without risks. The fertility drugs stress the woman’s system and can cause hyperstimulation of her ovaries which can be very painful. The chance of multiple births, premature births, and miscarriage increases with IVF and recent studies show that children born this way have an increase in health problems including breathing difficulties, autism and childhood cancers compared to children conceived naturally. Researchers say that these issues are related to the genetics of the parents who turned to IVF due to their infertility. Most couples seeking ART infertility treatments are in their thirties or forties when the risk of genetic abnormalities in both eggs and sperm sharply increase sharply.
In both men and women, aging eggs and sperm, poor general health, nutritional deficiencies, environmental toxins, overwork, inadequate sleep and high levels of stress can interfere with healthy reproduction. Even too much exercise can upset hormonal balance and affect fertility.
Female infertility can be caused by hormonal imbalance involving a lack of estrogen, estrogen dominance or progesterone deficiency which affects ovulation and the ability to carry pregnancy to term. Hormonal imbalance can lead to irregular or absent menstrual periods, ovulation problems, endometriosis, uterine fibroids, ovarian cysts and polycystic ovarian syndrome (PCOS). Pelvic infections can cause scarring and blockage of the fallopian tubes. Poor quality or “hostile” cervical mucus can destroy or prevent the sperm from reaching the egg, and a tipped or prolapsed uterus can also interfere with conception and pregnancy.
Male infertility is most commonly caused by a low sperm count of less than 20 million per milliliter, poor sperm quality consisting of damaged or misshapen sperm and poor motility (movement) of sperm rendering it incapable of traveling through the uterus and fallopian tubes to fertilize the egg. Undescended testicles, prostate problems, low testosterone, testicular varioceles, and obstructions in the tubes leading sperm from the testicles to the penis can all contribute to infertility.
Environmental toxins such as synthetic chemicals and heavy metals are a huge factor in infertility. Petrochemicals found in pesticides, herbicides, cosmetics, detergents, shampoos, plastics, furniture, clothing, drugs and in our food and water supply act as endocrine disruptors which upset hormonal balance in adult men and women and children. Many of these chemicals are called xenoestrogens because they act like estrogens in the body which wreaks havoc on hormonal balance. Hormones deliberately put in our food also contribute to hormonal imbalance. A study published in August, 2010 in the Pediatrics journal showed that more American girls are reaching puberty earlier than previous generations at the average age of 10 or 11 and as early as 7 or 8. Reports of infants in China developing breasts have been linked to high estrogen levels found in cow’s milk. Genetically modified foods are also problematic. One study showed that the testicles of rats fed GM soy changed from normal pink to dark blue. Their sperm was damaged and their mates produced fewer and smaller babies with altered DNA. In India, buffalo fed GM cottonseed suffered from infertility, miscarriages and premature deliveries and many calves died. U.S. farmers reported that thousands of pigs, cows and bulls became sterile from certain GM corn varieties.
The American Journal of Industrial Medicine reported a study that showed the men working in the agriculture industry showed more than a ten-fold increased risk of infertility compared to other occupations. One interesting Danish study reported that organic farmers had higher counts of healthier sperm than farmers exposed to agricultural chemicals. Research on mice at Georgetown University Medical Center demonstrated that cancer risk attributable to junk food passed through two generations even if the direct offspring ate a healthy diet. Needless to say, an organic diet is essential for peak fertility and healthy children.
Smoking, alcohol, caffeine and marijuana are also detrimental to fertility. All of these substances adversely affect sperm quantity and quality. In women, smoking damages eggs, creates blockages in the fallopian tubes, increases the risk of ectopic pregnancy, alters the uterine lining making implantation of the fertilized egg difficult, damages the fetus, increases risk of cervical cancer, increases risk of miscarriage, and prematurely ages the ovaries by one to four years. Alcohol can cause menstrual irregularities and problems with ovulation. Prescription drugs can also interfere with fertility and affect libido including anabolic steroids, antidepressants, antibiotics, antifungal medication, and blood pressure medication to name a few.
Many cases of infertility can be resolved naturally without having to seek medical treatment or the extreme measures of ART. A holistic approach to fertility begins with achieving overall general health. A healthy individual is inherently fertile. For both men and women, when the body is struggling with disease or burdened with toxins, energy reserves are needed for detoxification and healing rather than reproduction. Physical or mental/emotional stress puts an increased burden on the adrenal glands which affects the thyroid and male and female sex hormones making conception difficult. Likewise, defective genes in the sperm or egg may be prevented from coming together by a protective natural selection process that occurs in the female reproductive tract.