Fertility, the ability to conceive a biological child, is influenced by several factors due to our health status, nutrition, lifestyle, age, and genetics. While some factors are certainly out of our control, the good news is we can exert a significant influence over our fertility by being empowered by this knowledge. This article will discuss fertility, functional testing to help get to the root causes of infertility, and functional medicine treatments to boost fertility naturally.

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How Common is Infertility?

Infertility is the inability to conceive a baby after one year of trying. It is estimated that 186 million individuals and 48 million couples worldwide live with infertility. The reasons for infertility include medical factors, hormonal imbalances, poor nutrition statuses, genetic variants, and environmental factors, such as our relationship with stress and our daily lifestyle.

When Are You Most Fertile?

While a number of factors influence fertility, women have been suggested to be the most fertile in their twenties, whereas men are by the age of thirty. Research also suggests that fertility begins to decline at age 27 for women and at 35 for males. There are, however, numerous factors that influence fertility other than chronological age.

Signs of High Fertility in a Woman

Signs of high fertility in women include certain physical signs as well as the lack of certain symptoms. For example, healthy balanced hormones may look like a regular menstrual cycle with no hormonal imbalance symptoms such as low energy and libido, mood fluctuations, weight issues, acne, or changes in hair growth or texture.  

High fertility also indicates plentiful ovarian reserves, meaning there are still many healthy eggs that can potentially mature, ovulate, and await conception. Healthy metabolic function, such as a healthy weight and good blood sugar regulation, is also a good sign for healthy fertility since poor metabolic function is a cause of infertility. Gut health and sufficient immunity are also indirect indicators of high fertility since a robust gut microbiome and immune system support healthy reproduction.

Possible Causes of Infertility

While increased age can be a contributing factor to infertility, other possible causes include:

Hormonal Imbalances

Hormonal Imbalances can occur when we have too little or too much of a particular hormone, as they exist in a delicate balance. When hormones are imbalanced, irregularities and changes in the menstrual cycle can occur, affecting ovulation. Polycystic Ovarian Syndrome (PCOS) is an example of a hormonal imbalance disorder and is a common reason of female infertility. Additionally, thyroid dysfunction can contribute to infertility since thyroid hormones are in constant communication with other sex hormones.

Chronic Stress

Chronic stress can cause elevations in cortisol that can affect hormonal balance and fertility by causing dysregulation in sex hormones important for regular menstrual cycles. Prolonged stress can also affect several processes in the body that can influence fertility, like compromised metabolism, poor digestion, and poor immune health.

While stress affects us all differently, there appears to be a link between stress and the ability to conceive. For instance, a study that looked at women trying to conceive found those with the highest levels of alpha-amylase, an enzyme indicative of stress, took 29% longer to get pregnant than those with lower levels. Stress can also affect methylation pathways which may also impede fertility.

Compromised Methylation

Methylation is a process that readily occurs in the body and underlies many important bodily functions relative to reproduction and fertility, such as DNA expression and embryo development. Among other factors, methylation aids in the appropriate detoxification of harmful substances in the body, protecting it against oxidative damage and possible genetic mutations. Many of these processes can be compromised without proper methylation and affect fertility.

Oxidative Stress and Inflammation

Oxidative stress can cause inflammation and damage to the body. For instance, Oxidative stress can interfere with the process of methylation, which is significant for fertility. Oxidative stress and inflammation can also affect digestive, hormonal, and metabolic health.

Metabolic Factors

Metabolic health also influences fertility. Being overweight or obese can affect fertility, and being significantly underweight or having an eating disorder can also impact fertility. Concerning obesity, excess adipose tissue can cause hormonal dysregulation and inflammation and may cause changes in egg quality. In terms of eating disorders or those being very much underweight, this can cause disruptions in sex hormones and menstruation which may make it more difficult to get pregnant. Insufficient nutrient reserves and low body weight can also make fertility challenging for this population.

Insufficient Nutrient Reserves

Sufficient nutrient reserves are imperative for fertility. Among many functions, adequate nutritional reserves such as the B vitamins provide substances called methyl donors, required for methylation to occur and are vital for increasing fertility. In addition to B vitamins, folate, Choline, Vitamin D, and Iron are all important and required for fertility.

Medical and Genetic Factors

Many medical and genetic factors can affect fertility, such as fibroids, fallopian tube blockage, endometriosis, history of a sexually transmitted disease or infection, and pelvic inflammatory disease (PID). The genetic causes of infertility remain unexplained for most males and females.

Substance Abuse

Substance abuse can cause oxidative stress in the body, nutritional deficiencies, compromise liver function and alter the gut microbiome and hormonal balance, all of which can affect fertility. Substance abuse can also impede methylation, which is significant to fertility.

Microbiome Imbalances

Microbiome imbalance is when the ratio of beneficial bacteria in the gut is altered, in addition to a lack of diversity of beneficial strains. This can cause a further imbalance in the body as it is foundational in regulating many aspects of health, such as hormones, inflammation, immunity, and metabolic health. Some research suggests that dysbiosis, an altered microbiome, can contribute to hormonal and metabolic imbalances that hinder fertility. There is also research to support the vaginal microbiome playing a role in fertility, highlighting the importance of our whole body microbiome.

Functional Medicine Labs to Test for Root Cause of Infertility

The following functional medicine labs may be utilized for determining the root cause of infertility.

Weight Management/Wellness Metrics Profile

This test assesses for imbalances in hormones, including reproductive hormones and cortisol (our stress hormone), that could be contributing to obesity, weight gain, and difficulty losing or sustaining a healthy weight which is important for fertility. Additionally, this thyroid panel can be added-on, which evaluates an individual's overall metabolic health relative to thyroid issues that could be contributing to infertility.  

Methylation Panel

This test assesses the body’s ability to methylate, providing valuable insights into the biochemical pathways of the body that could be compromised due to genetic variants or insufficient nutrient intake. If methylation is discovered to be an issue, certain vitamins, and supplements can help support this process, leading to healthy detoxification and DNA synthesis important for fertility.

Organic Acids

This test assesses the different biological processes in the body that could be compromised relative to fertility. It is a thorough test that evaluates many root causes of infertility, including micronutrient status and imbalances in the gut microbiome. It can also show markers of oxidative stress and inflammation.

Vaginal BiomeFx

This test evaluates the numerous microorganisms in the vaginal microbiome for levels of beneficial bacteria, as this has been suggested to be a supportive factor in fertility. Additionally, this test provides individualized nutrition, supplement, and lifestyle recommendations based on one’s results.

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Conventional Treatment for Infertility

Conventional treatment would initially involve a thorough physical and pelvic exam to rule out any physical reproductive issues involved in fertility struggles. Invitro fertilization (IVF) is a conventional treatment for infertility and may be a promising treatment for couples who have struggled with fertility. IVF occurs in a laboratory setting and includes collecting mature eggs from the ovaries and then fertilizing them with sperm. The fertilized egg(s) or embryo(s) are then transferred to the uterus.

Natural Ways to Increase Fertility With Functional Medicine

The most natural way to increase fertility is to take optimal care of yourself, your body, and your mind. This includes making lifestyle changes that promote optimal wellness, such as getting enough rest, enough movement, decreasing alcohol, and reducing stress in healthy ways such as yoga or meditation. This helps to prepare the body for the demands early on in pregnancy. The following nutrition, supplement, and integrative therapies are also important for boosting fertility naturally.

Fertility Diet for Women

Sufficient nutrition support plays a significant role in supporting fertility by enhancing reproductive efficiency or ovarian reserves. This refers to one’s fertility capacity and depends on both the number and quality of one’s eggs. A nutrient-dense, anti-inflammatory diet rich in vegetables, seafood, poultry, and fruit has been suggested to improve fertility in women and males. The Mediterranean diet, in particular, has been found to be supportive of fertility as it supports egg quality. This diet is also helpful for maintaining metabolic health or restoring weight which is important for fertility.

The following nutrients have also been found to be supportive of fertility for women. Folate, Vitamin B12, and Vitamin B6 are necessary for a number of biochemical functions involved in methylation. Folate has a key role in methylation and in reducing levels of homocysteine (a marker of poor methylation) and inflammation. Folate is also required for cell division due to its role in DNA and RNA synthesis, having important implications for fertility, development, and the reduction of birth defects. Dark leafy greens are rich sources of folate. Vitamin B12 is vital for methylation, gene expression, and cell differentiation regarding fertility. Sources of B12 include grass-fed beef, pork, poultry, eggs, and dairy. Vitamin B6 is also important for methylation, among other factors such as the nervous system and metabolic health. Sources include chicken, fish, bananas, starchy vegetables, nuts, and beans. Overall, supporting methylation is also essential for the healthy detoxification and metabolism of estrogen in the liver.

Other key nutrients involved in fertility include Zinc, Iron, and Vitamin D. Zinc helps to maintain healthy metabolic, gut, and immune system health. Sufficient amounts of Zinc also support cell growth and repair. Oysters, eggs, poultry, wheat germ, beans, and nuts are rich sources of Zinc. Iron helps to deliver oxygen throughout the body and plays a role in fertility and overall development. Good sources of iron include oysters, dark leafy greens, lean meat, nuts, and beans. Vitamin D and K have been found to have a role in fertility as they help produce sex hormones and regulate cell growth. Sources of Vitamin D include salmon, mushrooms, eggs, milk, and sardines. Sources of Vitamin K include dark leafy greens such as spinach and kale, cabbage, broccoli, and pumpkin.

Selenium is a necessary mineral that supports thyroid health, specifically for healthy thyroid hormone production. Since healthy thyroid function is essential for fertility, selenium can be quite helpful. Brazil nuts have the most selenium content of any food.

Fertility Supplements for Women

While nutrition and lifestyle factors far precede supplements, there are a number of supplements that one may choose for improving their fertility health. Keep in mind that supplements may vary depending on one’s individual needs. It is also essential to consider the quality and purity of supplements.

Research suggests the following micronutrients: Vitamins C, E, A, Zinc, Vitamin D, and B Vitamins may be supportive in fertility as ​​supplementation can help restore micronutrient and antioxidant status to optimal levels for conception and reduce oxidative stress.

DHEA supplementation has been suggested to support ovarian reserves, helping to improve egg quality and overall fertility. DHEA can also convert into other necessary reproductive hormones, such as testosterone and estrogen. So it is, therefore, a helpful supplement for overall hormone balancing.

CoQ10 is a potent antioxidant that helps to support the regeneration of cells and has been found to be beneficial in supporting fertility by improving egg quality.

There is some research to suggest that NAC supplementation may be helpful in women trying to conceive, particularly for women going through IVF. NAC has strong antioxidant properties that may support reducing markers of oxidative stress while supporting the health of mitochondria and their role in egg development and reproduction.

Probiotics have also been found to have a role in supporting fertility. Among many factors, they help to modulate our microbiome, helping to support all aspects of our health. Supporting one’s digestive health and microbiome balance has been suggested to be important in terms of fertility. Certain strains, such as Lactobacillus crispatus and Lactobacillus rhamnosus have been shown to help ensure a healthy vaginal microbiome.

Omega 3 fatty acids have been suggested to be supportive for fertility in females as they reduce inflammation as well as support egg quality. DHA is a specific omega-3 fatty acid that has been suggested to have a role in fertility and reproductive health as it is involved in neural development.

Male Fertility Supplements

While there are no supplements to replace nutrition and lifestyle factors, there are a few supplements that have been suggested to support fertility in males.

Zinc plays an essential role in the stability of cell membranes and cell division, among many other factors in the body, and has been suggested to support male fertility.

There is evidence to support that Omega-3 supplementation is supportive of fertility in males by improving sperm quality.

Antioxidant support has been found to be supportive in males for improving fertility, such as Vitamin C shown to improve adrenal and hormonal health as well as Vitamin E. Antioxidants have been found to be supportive for fertility and reproductive health due to their protective properties relative to sperm health.

Complementary and Integrative Medicine for Fertility

The prevalence of integrating complementary and integrative medicine (CIM) for improving fertility has been on the rise. This speaks to the impact that the mind-body relationship has on influencing our health, as problems with fertility can contribute to stress.

Acupuncture has been found to be a supportive treatment in terms of fertility, as well as for those undergoing IVF. Acupuncture increases blood flow and has also been found to reduce markers of stress.

Meditation and yoga have been found to be effective in improving fertility in males. The proposed mechanism is improving sperm and DNA health and reducing oxidative stress.

Biofeedback is a tool to gain information about the physiological processes in the body, such as the nervous system, and has also been suggested to be effective in terms of supporting fertility as it helps to reduce biomarkers of stress.

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Summary

Fertility is certainly complex and warrants a holistic approach encompassing lifestyle, nutrition support as well as determining underlying etiology. Ensuring we are taking care of ourselves in optimal ways - body and mind - is significant for improved fertility for women and men. Addressing imbalances in the body in conjunction with mind-body approaches for combating stress and engaging in relaxation are all ways to support fertility.