Solving infertility

Hatching healthy eggs
Unlike men – who produce a regular supply of fresh sperm after puberty – women are born with all their eggs (or ova) in place. Your ovaries contain about two million eggs at birth, but as you age, they gradually disintegrate. By puberty, there’s about 750,000 left, and by age 45, only 10,000 can be left. Your fertility is dependent on the health of these eggs and your reproductive organs, plus your body’s ability to produce the right balance of hormones to ‘mature’ your eggs ready for ovulation with each monthly cycle. Getting the right mix of supporting nutrients is key to this. In this section, we identify specific vitamins, minerals and fats that can make you more fertile. However, no nutrient works in isolation. Eating a well balanced diet enhanced with supplements that boost levels of all essential nutrients is the best route to achieving good health and maximising your fertility.

Tune up your sex hormones
The mineral zincWhat it does: Component of over 200 enzymes in the body, essential for growth, important for healing, controls hormones, aids ability to cope with stress… is absolutely vital for reproductive health. Infertility, low sex drive and period problems have all been linked to inadequate levels. Together with vitamin B6, zinc affects every part of the female sexual cycle. Working in partnership, these two nutrients ensure that adequate levels of sex hormones are produced. For example, one hormone called LHRH (luteinising hormone releasing hormone) causes your pituitary gland to stimulate the development of an egg (or ovum) that causes ovulation. A deficiency in either zinc or B6 causes a deficiency in LHRH, so your fertility decreases. Adequate levels of zinc and B6 also increase your desire for sex (which is why zinc-rich oysters are called an aphrodisiac) and alleviate pre-menstrual problems – women who suffer from premenstrual syndrome (PMS) are often zinc deficient (1).

After conception, zinc and B6 ease pregnancy sickness and post natal depression, as well as increasing the chances of having a healthy baby. Oysters, lamb, nuts, egg yolks, rye and oats are all rich in zinc, while B6 is found in cauliflower, watercress, bananas and broccoli. The optimum intake is 20mg of zinc and 60mg of B6, which you can achieve with a diet that includes these foods plus a good multivitamin and mineral supplement.

Why the right fats are essential
FatThere are many different types of fats; polyunsaturated, monounsaturated, hydrogenated, saturated and trans fat. The body requires good fats (polyunsaturated and monounsaturated) in order to… is an essential part of our diet. But while the wrong kinds of saturated fats – found in processed foods, meat and dairy products – are rich in most people’s diets, the right kinds of fats are normally lacking. Oily fish such as mackerel, herring, sardines and salmon are rich sources of one kind of essential fat called Omega 3. Nuts and seeds are rich in the other kind – Omega 6. Like zinc and B6, Omega 3 and 6 fats are needed for healthy hormone functioning, so a deficiency is likely to effect your menstrual cycle and therefore your fertility.

To make sure you get enough essential fats, aim to have a portion of oily fish two to three times a week and eat a handful of fresh, unsalted seeds every day. Seeds are also rich sources of minerals (including zinc) and proteinProteins are large molecules consisting of chains of amino acids. Proteins are essential nutrients for the human body – they are a building block of…, so they make a perfect snack. But because of their fat content, they are prone to damage when they come into contact with oxygen (a process called oxidation – see below). For best results, follow our magic formula: keep a mixture (50 per cent flax and 50 per cent pumpkin, sunflower and sesame) in a screw-top jar in the fridge, then grind a heaped tablespoon in a coffee or food grinder each day to sprinkle on cereals, yoghurt or soups. Grinding releases their oils and makes it easier for your body to absorb the nutrients.

Limit the impact of ageing
Although oxygen is essential to life, it also causes damage – and reproductive organs are particularly sensitive. When oxygen is broken down in our bodies, highly reactive molecules called free radicalsFree radicals are molecules produced when the body breaks down food or by environmental exposure to things like cigarette smoke, pollution and radiation. Free radicals… are formed, and these harm, or oxidise, other molecules which can start a chain reaction of damage. For example when an apple is cut and comes into contact with oxygen in the air, it gradually turns brown on the outside then begins to rot. The same would happen inside our bodies were it not for a complex repair system that minimises damage. However, this system is dependent on a good source of ‘anti-oxidant’ nutrients from our diet. If these are lacking, then we age faster, are more prone to developing disease and can become less fertile.

So to keep your body young, you need a good intake of antioxidants. The main antioxidantAntioxidants are substances that protect cells within the body from damage caused by free radicals. They help to strengthen the body’s ability to fight infection… nutrients are vitamins A (both the animal form retinol and the plant form beta-carotene), C, and E, plus the minerals zinc and seleniumWhat it does: Antioxidant properties help to protect against free radicals and carcinogens, reduces inflammation, stimulates immune system to fight infections, promotes a healthy heart,…. Phytonutrients are a recently discovered class of antioxidants – bioflavonoidsBioflavonoids are sometimes referred to as vitamin P. Flavonoids are widely distributed in plants and are known for their antioxidant activity…. and lypocene are two you may have heard of. These enhance our absorption and utilisation of other antioxidant nutrients as well as having protective qualities themselves, and are often responsible for giving a plant its colour, which is why eating a ‘rainbow’ selection of fruit and vegetables ensures you get a good variety of phytonutrients. Essentially, they all work together to project your body and especially your reproductive organs. Studies have shown that both vitamin CWhat it does: Strengthens immune system – fights infections. Makes collagen, keeping bones, skin and joints firm and strong. Antioxidant, detoxifying pollutants and protecting against… and vitamin EWhat it does: Acts as an antioxidant, protecting cells from damage, including against cancer. Helps body use oxygen, preventing blood clots, thrombosis, atherosclerosis. Improves wound… boost fertility in women and men (2), while vitamin A is needed for your ova to grow and develop before ovulation. However, a word of caution. While the betacarotene version of vitamin A is perfectly safe, too much of the animal form, retinol (found in fish and animal liver), can cause problems, so get the lion’s share of your intake from vegetable sources.

Protect yourself from ‘anti’ nutrients
Anti-nutrients are substances that deplete your body of vital resources while contributing nothing nutritionally themselves. Refined sugar can be classed as such because it contains no nutrients of its own yet uses up stores of vitamins and minerals as your body processes (or metabolises) it. But anti-nutrients that have a greater impact on your fertility are those that actually damage your body – alcohol, cigarettes, drugs and environmental toxins.

Alcohol – When you are preparing to conceive, drinking any alcohol at all can reduce your fertility by half – and the more you drink, the less likely you are to conceive (3). One study showed that women who drank less than five units of alcohol (ie fewer than five glasses of wine or 2.5 pints of beer) a week were twice as likely to conceive within six months compared with those who drank more (4).

Tobacco – Unsurprisingly, smoking hampers fertility too. In a study at the Institute for Reproductive Medicine in Germany, researchers have found that smoking damages the quality of eggs in ovaries, reducing the number capable of producing a baby.

Coffee – Sadly, you can’t even seek solace with a cup of coffee. Research has shown that caffeine – also found in tea, chocolate and cola drinks – decreases fertility. Just one cup of coffee a day can halve your chances of conceiving (5). The increased number of chemicals and pollutants in the environment is also a factor. And toxic metals such as lead and mercury can play havoc with your fertility as well as damaging a developing baby. These are outlined in more detail in our book Optimum Nutrition Before, During and After Pregnancy.

Weight matters
Fertility decreases in both obese and skinny women Infertility rates go up in times of food shortage – because without sufficient nutrients, a women’s menstrual cycle will stop. But in our resource-rich Western world, thankfully this doesn’t happen – unless the food shortage is self-imposed. Slimmers and underweight women run the risk of becoming infertile if they don’t eat enough to maintain a regular menstrual cycle. Swedish research has revealed that the ‘average’ woman (ie 5’ 4” of medium build) will stop having periods at 8st 3lb (52 kg) (6). But even if you are underweight and still have periods, your diet can affect your fertility. We’ve seen women who’ve become infertile as the result of combining a low-fat diet with constant exercise – even though they are having regular periods and ‘appear’ perfectly healthy. As a result of extensive research, fertility expert and Harvard professor Rose Frisch maintains that only 10% of women are fertile with a body mass index of 18. (To work out your BMI, follow this formula: your weight in kilograms ÷ the square of your height in meters, eg 62kg ÷ (1.7 x 1.7) = 21.5) Frisch says: “Many women who maintain body shape made popular on the catwalks throughout the world are completely infertile”. This is because your body needs a sufficient intake of fat (albeit the right kind) to produce the hormones required for ovulation. Likewise, if you are overweight, your fertility can be reduced. Even moderate obesity – classified as a body mass index of 25-30 – reduces your chances of conception and increases the risk of miscarriage (7).

So for maximum fertility, you need to eat enough of the right kind of fats and be neither under nor over weight. As each of us has individual bone structures and body shapes, there is no definitive answer to what your normal weight should be, but the body mass index is a useful guide.

Is too much stress reducing your fertility?
Stress is an everyday fact of life in the twenty-first century. But when you’re trying to conceive, too much can reduce your fertility and play havoc with your health. Our reaction to stressful situations is the same today as it was in early stages of our evolution, when we had to be primed to ‘fight or flight’ to ensure survival. If we came face to face with a fierce predator, all our energies would be diverted into running away or protecting ourselves rather than producing reproductive hormones or digesting the food in our gut. Although we are unlikely to face such dangers today, we still respond in the same way when we have a pressing work deadline, get stuck in traffic or have to juggle too many responsibilities. And as these sorts of events occur daily, sometimes hourly, bodily systems like reproduction and digestion can become neglected.

Stress also uses up stores of nutrients – especially B vitamins – which are crucial for a multitude of functions including fertility. We know that being relaxed boosts fertility because holidays are a common time to conceive. But for most of us, taking time off is limited to a few times a year. The rest of the time, if you find it hard to relax, get irritable, are unable to ‘shut off’ from the events of the day or have trouble sleeping, stress is having a negative effect on your health – and this could reduce your fertility. Shakespeare had a point when he wrote: ‘There is nothing good or bad but thinking makes it so’ (Hamlet, Act 2, Scene 2). Unless your house burns down or someone dies, most stresses are not disasters. Thinking they are, however, can easily overwhelm you. So if you feel you need help to address the way you react to stress, there are many options open to you. Learn to meditate, take up T’ai Chi or Yoga, create some ‘me time’, have a regular massage, learn positive thinking – whatever will help you to relax and get on top of stress.

Eating a wholefood diet and supplementing a good multi will also provide all the nutrients you need to help your body cope better with stress.

Maximise your fertility by lowering Your homocysteineHomocysteine is an amino acid found in the blood. Elevated levels of homocysteine have been associated with narrowing and hardening of the arteries, an increased…
Homocysteine is a protein-like substance naturally found in our blood. However, a diet lacking in sufficient nutrients or a genetic impairment can mean that levels of homocysteine are higher than they should be, and this can contribute to all sorts of health problems, including infertility. So significant is homocysteine that we advise you test yourself before you get pregnant and, if necessary, reduce a high level (below 6 is optimum) with the right supplements and dietary measures before you conceive. Not only can it boost your fertility, it will also help you avoid many of the problems that can occur during pregnancy. See Optimum Nutrition Before, During and After Pregnancy for more information or visit www.thehfactor.com.

Reducing your homocysteine may also benefit other disorders that can reduce fertility. For example, researchers from Italy have found that women suffering with PCOS are much more likely to have high homocysteine levels (8). Getting your partner tested may also increase his fertility. In men, high homocysteine is strongly associated with low sperm motility. Motility is the ‘swimming power’ of sperm, which determines whether they can make it to the egg and penetrate it, or run out of puff. In one study, high homocysteine was associated with 57 per cent less motility! (9) This may be because the chemical process our bodies use to convert homocysteine to beneficial substances – a process called ‘methylation’ – is absolutely vital for healthy sperm production.

Wannabe parents over 30
More women are deciding to have babies later than ever before – in the past 25 years, the percentage giving birth age 30 and over in England and Wales has doubled. Men too are leaving it later. And while there are many psychological advantages to being an older parent, physically it can be much more demanding. To begin with, getting pregnant is more difficult – after the age of 30, the viability of your eggs starts to decline and you are likely to have fewer cycles in which you ovulate. A 35-year old woman takes, on average, twice as long to conceive than a 25 year old.

Male fertility – previously thought to be unaffected by age – also starts to reduce after the age of 24. Researchers at the University Division of Obstetrics and Gynaecology at St Michael’s Hospital in Bristol studied 8,500 couples and found that the older a man is, the longer it is likely to take his partner to conceive, irrespective of her age. The odds of conceiving within six months of trying decrease by 2% for every year that the man is over the age of 24. “It tells us that to some degree men as well as women have a biological clock that starts ticking as they get into their thirties,” says Dr Chris Ford, who led the study. Older parents also have a greater risk of conceiving a baby with genetic abnormalities such as Down’s Syndrome. For example, the risk of a chromosomal abnormality in a woman age 20 years is 1/500, increasing to 1/20 by age 45. But this is partly because your body has had more exposure to an unhealthy lifestyle (nutrient-deficient diet, smoking, drinking etc), stress and pollutants.

So taking care pre-conceptually and throughout your pregnancy can greatly increase your chances of having a healthy baby. In fact, research has shown that under ideal conditions – ie if you are in good health with perfect nutrition, good antioxidant protection and limited exposure to pollutants (ie the programme outlined in this book) – the effect of age on the chance of achieving a successful pregnancy may be less than previous studies show (10). Certainly, we are finding many older couples have healthy babies after adopting the optimum nutrition approach we prescribe.

Know when to try
During your cycle – which can vary from 23 to 35 days – there is only one day in which an egg is available for fertilisation. However, sperm usually live for three days and under excellent conditions can survive for five. Therefore, if you know when you ovulate, having frequent sex in this five-day window dramatically increases your chances of conception.

So, how do you find out when ovulation occurs? The discovery that a different type of mucus is produced just before ovulation led to the development of the simplest and safest method of birth control. Unlike normal vaginal mucus, fertile mucus is sticky and thread-like – a bit like egg white. It’s designed to both nourish and protect the sperm, providing it with channels to move along, thereby greatly increasing its chances of reaching the egg. In a World Health Organisation study, 90% of women could identify their fertile mucus within the first month of learning what to look for. Another way to tell is by monitoring your resting temperature (ie as you wake up in the morning) – this will drop then rise very slightly as you ovulate. There are also ovulation predicator kits that you can buy without prescription from chemists and large supermarkets. For more details, read the book The Manual of Natural Family Planning by Anna Flynn and Melissa Brooks (Thorsons/HarperCollins). Once you’re ready to get pregnant, being in good health at the expected time and shortly after conception is especially important. Catching the flu or a virus in the early stages of pregnancy can harm your baby and increase your risk of miscarriage, so if you become unwell while trying to conceive, abstain until you have fully recovered. You can reduce the risk of getting ill in the first place by supporting your immune system. For more on this, read Optimum Nutrition Before During and After Pregnancy or Boost Your Immune System.

Still having problems conceiving? If, after following this advice, you still have problems conceiving, we recommend you see a nutritional therapist specialising in fertility. These specialists can work with you and your partner to identify and try to correct any underlying problems such as polycystic ovarian syndrome (PCOS), hormonal insufficiency, parasite or bacterial infections, heavy metal toxicity or food allergies. And if you’re planning to try conventional fertility treatment such as IVF, they can also help you maximise the chances of it working successfully. However, research from preconceptual care charity Foresight shows that a more holistic treatment gets the best results. While just 21% of IVF treatments result in a birth, following a nutritional protocol achieves around a 78% success rate. Optimum Nutrition Before, During and After Pregnancy provides more information, and also looks in more detail at what men can do to increase their fertility.

In summary, if you want to boost your fertility, start to adopt the following measures three months before you want to conceive:

• Eat regular sources of the key fertility nutrients – in particular zinc (oysters, lamb, nuts, egg yolks, rye and oats), B6 (cauliflower, watercress, bananas and broccoli) and essential fats (oily fish and fresh, unsalted seeds).
• Also boost antioxidant nutrients – aim to eat at least five portions of different coloured fruits and vegetables a day, plus a handful of fresh nuts and seeds.
• Supplement a good diet with a daily multivitamin and mineral formula.
• Reduce sources of ‘anti-nutrients’ such as refined foods (anything made with white flour or sugar), alcohol, tobacco and caffeine, and limit exposure to or use of industrial chemicals and pharmaceutical drugs.
• Learn relaxation techniques if you’re frequently feeling stressed.
• Test your homocysteine and reduce high levels before conceiving.
• Learn natural family planning techniques that will help you know when you’re at your most fertile.

References

1. C. J. Chuong and E. B. Dawson, ‘Zinc and copper levels in premenstrual syndrome’, Fertility and Sterility, vol. 62 (1994), pp. 313-21.

2. R. Bayer, ‘Treatment of infertility with vitamin E’, International Journal of Infertility, vol. 5 (1960), pp. 430-4.

3. R. Hakim et al., ‘Alcohol and caffeine consumption and decreased fertility’, Fertility and Sterility, vol. 70, no. 4 (1988), pp. 632-7.

4. T. Jensen et al., ‘Does moderate alcohol consumption affect fertility? Follow-up study among couples planning first pregnancy’, British Medical Journal, vol. 317 (1998), pp. 505-10.

5. A. Wilcox et al., ‘Caffeinated beverages and decreased fertility’, Lancet, vol. 2 (1988), pp.1453-5.

6. N. Holmberg, Acta Obstetricica & Gynecologica, Scandinavica, vol. 50 (1971), pp. 241-6.

7. D. Hamilton-Fairley et al., ‘Association of moderate obesity with a poor pregnancy outcome in women with polycystic ovary syndrome treated with low dose gonadotrophin’, British Journal of Obstetic Gynaecology, vol. 99 (1992), pp. 128-131.

8. G. Loverro, ‘The plasma homocysteine levels are increased in polycystic ovary syndrome’, Gynecology & Obstetrics Investigation, vol. 53 (2002), pp. 157-162.

9. B. V. Sastry and V. E. Janson, ‘Depression of human sperm motility by inhibition of enzymatic methylation’, Biochemical Pharmacology, vol. 32 (1983), pp. 1423-1432.

10. C. P. West, ‘Age and infertility’, British Medical Journal 294: 853 (1987).