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Updated 06 November 2015

Fertility - get the timing right

An estimated 10-15% of couples experience ‘unexplained infertility’ which cannot be put down to a specific medical diagnosis. Read about possible causes and solutions.

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Unexplained infertility is one of the most stressful experiences a couple can go through. It is estimated that between 10-15% of couples experience ‘unexplained infertility’, which is when doctors cannot put it down to a specific medical cause.

Nutrition, alcohol, smoking, levels of other toxic metals, pesticides, food additives, stress and other hazards of modern day living can all affect the health of both sperm and egg. It is important therefore for the man and woman to address their individual health so that when they try to conceive, their chances are maximized.

Pregnancy is a very personal and beautiful journey, and like love, it mostly happens within a relationship with the decision to start a family. It is a process that has the power to transform a couple’s life in a way that cannot be anticipated.

As human beings we are designed with functionally perfect, wonderfully complex bodies. However, in today’s world people no longer function optimally and in harmony with nature or themselves.

This change has led to greatly increased stress, and primarily, hormonal imbalances. Our bodies are constantly being bombarded with pressure from countless sources such as pesticides, hormones, antibiotics, chemicals, and on top of it all, we have stressful emotions to deal with.

Hormones play a vital role in the functioning of our bodies.  Because we're becoming more aware of how environmental influences adversely affect us, we're making personal efforts to regain our connection with what is natural and supportive of a healthy and balanced lifestyle.

We are becoming more in touch with what our bodies need on a physical, mental and emotional level. There is no doubt that the stress we burden ourselves with only causes more disharmony in our lives, and that having control over our thoughts and focusing on positive change helps us to overcome obstacles.

Cape Town fertility specialist, Dr Sascha Edelstein, recommends that couples with conception difficulties address their relative infertile state naturally before considering fertility treatment. Dr Edelstein says: “When we are younger, we are concerned that every time we have sex this will lead to pregnancy. There is some validity to this concern, as women in their late teens and early twenties do have increased fecundity (chance of conceiving each month).

However, already in our late 20s to early 30s the chance of conceiving each month for a healthy couple having regular unprotected intercourse is only about 22%. After one year of unprotected intercourse, 80% of couples will have conceived. By definition, a couple is only considered be infertile if they have failed to conceive after one year.

For this reason, we do not advocate performing investigations or commencing treatment unless a couple has been trying to conceive for a year. But for the individuals who are trying to conceive (say for 6 months) this may be very frustrating.

Getting the timing right

One factor that couples can address prior to work-up and/or starting fertility treatment is the timing of intercourse around a woman’s fertile period. In the past, we have advocated using basal temperature charts to establish when a woman ovulates: we look for a small increase in basal body temperature that coincides with ovulation. However, this is not always accurately measured.

There are automated fertility devices now on the market which offer greater ease, more precision and better record-keeping than manual temperature charting, with the ability to detect anovulation (failure to ovulate), and can also detect pregnancy earlier than any other tests).

Both methods aim to establish when a woman is ovulating and will be successful if there are no underlying factors causing infertility, such as an ovulation, tubal pathology (due to pelvic infection or endometriosis); or male factor.Dr Edelstein continued to mention that in cases of couples with known infertility, or for women who are older than 35, it is not appropriate to advocate using timed intercourse.

These patients should not be advised to wait for a year before being fully assessed and given a treatment plan.”

Although infertility causes can include irregular ovulation, hostile mucus, endometriosis or other reproductive abnormalities, low sperm count or poor quality of sperm, there are many ways in which couples can increase their chances of getting pregnant naturally.

Certainly, after a few months of healthy living, sperm counts and menstrual cycles should correct themselves and provide an optimal environment for fertilisation.

A few biological facts underlying the female monthly cycle:

- Every woman ovulates one day in each cycle. An egg will mature in the right ovary one month and in the left ovary the next month, always alternating.

- After ovulation, the egg can be fertilized for a maximum of 18 hours.

- The same is true for the time before ovulation. After intercourse male sperm will remain active and fertile in the female body for a maximum of 120 hours (five days).

- This means that there are six days in every cycle when a woman can get pregnant: five days before ovulation and on the day she ovulates.

Risk factors associated with infertility:

Nutrition

Difficulty to conceive is one of the first signs of nutritional imbalance. Studies have shown that good nutrition is vital and that any form of drastic dieting should be avoided, as this can cause added stress to the body and mind.

Refined carbohydrates, excess sugar, processed foods, caffeine, saturated fats and mercury-containing foods should be avoided.

An enriched and varied eating plan of unprocessed, fresh, whole and raw foods, along with a good vitamin and mineral supplement is recommended. Hormones are dependent on the presence of essential nutrients including unsaturated oils and zinc. 

Drugs

Smoking and alcohol have been found to reduce sperm count and overall health and motility of the sperm. Drinking any alcohol at all can reduce your fertility by half, and one study showed that women who have a drink every day have a 2,5 times higher risk of miscarriage than those who abstain.

During the months prior to conception, both partners should avoid smoking and alcohol and any other unnecessary drugs. Any pharmaceutical medication must be checked by a medical professional or pharmacist before use and should be reduced to a minimum. 

Environmental pollution:

Certain pollutants and chemicals in the environment can affect both male and female fertility. Making efforts to reduce exposure to these toxins can make a big difference to your ability to conceive.

The following substances must be noted: Xenoestrogens – synthetic oestrogens in the form of pesticides and plastics. These chemicals can affect our food and our environment, and it is therefore important to introduce more natural, organic and freshly prepared foods into your diet for maximum benefit.

Be aware of the possibly harmful chemicals in your immediate environment and make the effort to reduce your exposure to them. 

Contraception

The contraceptive pill has been shown to lower levels of zinc (a key nutrient for fertility), manganese, vitamin A and some of the B complex vitamins, and to raise levels of copper. The copper IUD has been found to raise levels of copper and thus will lower the levels of zinc and usually manganese and selenium.

Mineral balancing is often necessary after the use of hormonal forms of contraception.

It is most advisable to use more natural methods of contraception such as the barrier method (without the use of spermicides), or to use a natural family planning method such as the rhythm method/temperature method, where you can predict your most fertile time around ovulation, and avoid intercourse, or use a barrier method during this short fertile phase.

This knowledge will then be invaluable to couples who are having trouble conceiving (knowing more accurately when they are ovulating). Some women get pregnant son after stopping the pill but in many cases women find that it takes longer to return to their natural balance. It is therefore recommended that women avoid the use of hormones prior to planning a baby. 

Stress

Stress has an impact on blood sugar and therefore hormone balance; it is also associated with decreased serotonin levels, which can prevent ovulation. Stress can also impact on the immune system, leading to fertility-related antibody problems.

It is important that you address any issues that may be causing you to feel pressure, and make an effort to adopt stress management and relaxation techniques. 

Restoration of health and a few tips for a healthy start…

The treatment of infertility must start primarily with optimising the health of the couple, and should be holistic. The individual physical, emotional, psychological health of both partners is of utmost importance. A healthy lifestyle is advised for up to 6 months prior to conception.

Tips:

- Daily exercise done together is a great way to unwind and chat.

- Yoga is a wonderful way to de-stress and maintain a more balanced lifestyle, and is known to address fertility in a positive way.

- Getting out of the city is a great way to find some peace and relaxation.

- Therapies such as massage and reflexology are known to help the body’s functions return to balance.

- Homeopathy helps in restoring an individual to his or her true potential and is known to address fertility problems effectively.

- Nutritional therapy helps one get back on track with what to eat and what supplements to take to support your general health and fertility.

There is so much information out there, and it is important for you to take control of your own health, seek advice from qualified professionals, get back to the foundations of health, make positive changes, empower yourself with knowledge and treat yourself with love.

More info:

Send questions to the Fertility Expert

Find more Fertility articles here

For more information on ovulation prediction and basal body temperature devices, visit: www.ecobabe.co.za

References:

  1. Barlow SM, Sullivan F. Reproductive Hazards of Industrial Chemicals. An Evaluation of Animal and Human Data. Academic Press, 1982.
  2. Barnes B, Bradley SG. Planning for a Healthy Baby. Vermillion, 1999.
  3. Naish F, Roberts J. Healthy Parents, Better Babies. Newleaf, 2000.
  4. Balch PA, Balch JF, Prescription for Nutritional Healing
  5. Bloch R, Lewis B. Homeopathy Help in the Home. Cape Town: Struik, 2003
  6. Holford P. New Optimum Nutrition Bible. London: Piatkus 2004
  7. Dr Hubertus Rechberg: VE Valley Electronics, GmbH.
  8. Institute of Obstetrics and Gynaecology, University of Sassari. Porto Cervo - Costa Smeralda - Sardinia, Italy - June 11-14 1997
  9. Dr Sascha Edelstein, MBChB FCOC Mmed MPhil; Cert Reproductive Medicine – Obstetrician and Gynaecologist, Christiaan Bernard Memorial Hospital
 
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