Treating Infertility Information for Couples

Infertility affects one in six couples. It is even more common in fibromyalgia because of the hypothyroidism, nutritional deficiencies, and PCOS. These numbers are continuing to rise as sperm counts drop worldwide and undiagnosed thyroid problems increase—so you are not alone.

Fortunately, it is often quite reversible, and we have seen many people with infertility who have been able to conceive. Please though…don't go telling people it's Dr. Teitelbaum's baby!

This information will have a lot of tips that can be very helpful, and are scientifically proven.

Various factors may be responsible for the inability to achieve a successful pregnancy. Despite research showing that fertility declines after age 30, women are delaying having children. Infertility may be caused by ovulatory, anatomic, immunologic, infectious, nutritional or hormonal factors on the woman's side. In men, abnormalities of semen parameters are the most common contributors. Treatments that improve cellular energy production may dramatically increase sperm motility (see below). In all couples, both the man and woman should be treated to optimize fertility.

After a thorough standard medical work-up, the cause of the infertility often remains unexplained. In this setting, the only option many couples are given is IVF (In Vitro Fertilization). IVF is given attention because it costs ~ $30,000+, while research on inexpensive natural options has been ignored (not because doctors don't care, but simply because no one will pay to publicize the information).

The good news is there are many natural ways to improve all steps of the reproductive process. A large number of studies have successfully explored the use of individual nutritional and hormonal therapies, resulting in women with unexplained/ untreatable infertility often getting pregnant!

Treatment: FOR THE WOMAN Life Style Education

These are important things to avoid from now until after you are three months pregnant, as they can cause infertility. Just do the best you can with these guidelines—OK to not be "perfect" with them.

1. Avoid Coffee and sodas¹ (Tea is OK). Coffee and sodas inhibit fertility-often markedly. Especially avoid caffeine if your Prolactin blood test is LOW as it can lower it further.
2. Avoid melatonin (which is sometimes used to treat insomnia) as it can affect reproductive hormones.²
3. Avoid taking over 900 mg of supplemental vitamin C (causes reversible infertility). Taking 750 mg a day of vitamin C however helps infertility.³ Do not take over 7000 units of supplemental vitamin A (causes birth defects-beta carotene is OK) daily. The recommended supplement below has 3500 IU of vitamin A (the other 3500 IU it contains is beta carotene).
4. Avoid hot tubbing (it increases birth defect risks). A hot bath, which is not over 100 degrees in temperature, is a safer way to relax. In a bath much of your upper body will remain out of the water, making you less likely to overheat. Additionally, the water in a bath begins to cool off, as opposed to a hot tub, further reducing any risk of overheating.⁴ A hot tub is usually set at 102–104 degrees, which can overheat your body and can harm the baby.
5. Avoid a high protein/Atkins' diet⁵(an Atkins like diet in a rat study decreased fertility over 50 percent).
6. No alcohol if Prolactin levels are higher than 10 (and avoid in general as is convenient).⁶
7. Avoid vaginal lubricants such as FemGlide, Replens, and Astroglide, which can damage sperm. Pre-seed brand is OK.⁷
8. If you smoke, stop till after the baby is born. Smoking contributes to infertility in many ways.⁸

Lifestyle things to do to help get pregnant

1. It works best to have intercourse on the day you ovulate and up to four days before (otherwise "ad lib" whenever you feel like it). It is OK to have intercourse multiple times during this period. For purposes of getting pregnant, intercourse even one day after ovulation is unlikely to result in pregnancy—but OK to do anyway for its other benefits.
2. Use whole milk instead of low fat or fat free milk products. In a Harvard study, high intake of low-fat dairy foods was associated with an increased risk of infertility, while an increased intake of high-fat dairy foods was associated with a lower risk of infertility. Women consuming at least two servings of low-fat dairy foods per day showed an 85 percent increased risk of infertility. On the other hand, women consuming at least one serving of high-fat dairy foods per day showed a 27 percent reduced risk of infertility.⁹ Whole milk products (instead of low fat ) also taste better!

Treatments To Optimize Fertility

1. Supply overall nutritional support with the "Energy Revitalization System" by Enzymatic Therapy, and a healthy, well-balanced diet.^10,11,12,13 As noted above, dieting and high protein/low carbohydrate diets are to be avoided.^14,15 Stay on these when you get pregnant and through breast feeding.
2. Add prescription Armour thyroid 30 mg adjusted to dose that feels best (to a maximum of 90 mg) or Synthroid 25–75 mcg^16,17 while keeping Free T4 < 75 percent of the upper limit of normal. This can be helpful even if your blood tests are normal. DO NOT TAKE IRON OR CALCIUM SUPPLEMENTS WITHIN SIX HOURS OF THE THYROID DOSE, OR THE THYROID WILL NOT BE ABSORBED. Take your calcium at dinner and bedtime. If you get shaky or hyper or racing heart, lower the thyroid dose (or stop it). Stay on the thyroid through your pregnancy (it supports a healthy pregnancy).
3. Optimize iron levels. If the ferritin blood test is under 80 or iron percent saturation under 25 percent, treat with an iron tablet; one a day after 2 pm on an empty stomach.^18,19 Continue the iron through your pregnancy. Do this even if your doctor says that your blood tests are "normal." Get the actual ferritin test result.
4. If PCOS (Poly Cystic Ovary Syndrome) is present (suspect if there is acne, overweight, and/or excess facial hair—often present when testosterone or DHEA-S levels are elevated), research shows that treatment with the medication metformin 1500–2000 mg/day not only increased fertility, but also decreased the risk of serious birth defects considerably.^{20,21,22,23,24}
5. If the Prolactin level is over 10, alcohol and melatonin (which can raise Prolactin) are to be strictly avoided. Vitamin B6 100 mg or as needed to bring Prolactin within the normal range (but not greater than 200 mg of B6) can be added. Stop the extra B6 (except for what is in the multivitamin) around seven months into the pregnancy (otherwise it can suppress breast milk).
6. If folic acid levels are low (lowest 20 percent of normal range) a blood test looking for wheat allergies is recommended and a gluten free diet instituted if positive. Also Folic Acid 5 mg twice daily should then be added.²⁵

Treatment: FOR THE MAN Life Style Education

These are important things to avoid from now until after your partner gets pregnant, as they can cause infertility. Just do the best you can with these guidelines—OK to not be "perfect" with them.

1. When convenient, avoid meat with Estrogen (i.e., get your meat from a natural foods store).
2. Avoid Soy based foods (e.g., tofu, tempeh, soy cheese and milk, etc). Even modest intakes drop sperm counts by 40 percent.²⁶
3. Avoid Melatonin, Testosterone, Verapamil and Nifedipine (latter two are heart/blood pressure medications), which can cause reversible infertility.
4. Avoid alcohol when convenient²⁷ and tobacco.²⁸
5. Sperm do poorly at temperatures over 96 (which is why the testes hang below the rest of the body to stay cooler). Avoid elevated scrotal temperatures by wearing boxer shorts. Do NOT wear briefs, tight fitting underwear or jeans. Avoid hot tubs. Avoid rowing/ski machines, treadmills or jogging unless the testes can hang free.
6. Avoid aspirin, Motrin or similar medications, which block the hormone prostaglandin (Prostaglandins in the seminal fluid may assist sperm ). Tylenol is OK in moderation.
7. Increase liquid vegetable oils and avoid cottonseed (may contain gossypol which inhibit sperm function)²⁹ palm or coconut oils or trans, hydrogenated or saturated fats as comfortably able.

Treatments To Optimize Fertility
All of these can be taken together in the morning (or split up or taken any time of day)

1. Supply overall nutritional support with the "Energy Revitalization System" vitamin powder. This contains over 50 nutrients including 750 mg of Vitamin C and 100 iu of vitamin E.^30,31,32,33 It also supplies folic acid34, 35 and antioxidants. ³⁶
2. CoEnzyme Q10 at 200 mg/day. Take it with food that contains some fats to enhance absorption.36
3. L-Arginine 4 gm/day.³⁷
4. Acetyl-l-carnitine 1000 mg/day and Carnitine 1000 mg/day markedly improves sperm motility and the sperm's defenses against attack.³⁸
5. Zinc 15 mg/day (present in the vitamin powder).³⁹
6. Ribose 5 gm twice a day (can use like sugar and mix in food or drinks or use the chewable tablets). In many studies this increases energy production, which may also help sperm motility. The second dose can be taken any time during the day.

References/Footnotes:

1. National Center for Health Statistics. Infertility. http://www.cdc.gov/nchs/fastats/fertile.htm. Accessed April 26,2006.
2. Resolve. National survey results reveal startling lack of awareness of infertility even as numbers climb to 7.3 million. October 27, 2005. http://www.resolve.org/site/PageServer?pagename=fmed_mcpr20051027. Accessed December 8, 2005.
3. Carlson et al. Evidence for decreasing quality of semen over the last 50 years. Br Med J 1992;305:609-613
4. (Weight and pregnancy) http://abcnews.go.com/Health/wireStory?id=1141274
5. Wilcox AJ, Weinberg CR. Lancet 337:1159-1160,1991;Williams MA, et al. Coffee and delayed conception. Lancet 335:1603, 1990
6. Partonen T. Short note: melatonin-dependent infertility. Med Hypotheses. 1999;52(5):487-488.
7. Henmi H, Endo T, Kitajima Y, et al. Effects of ascorbic acid supplementation on serum progesterone levels in patients with a luteal phase defect. Fertil Steril 2003;80:459-61.
8. http://www.americanpregnancy.org/pregnancyhealth/hottubs.htm for more information
9. Atkins like diet in a rat study at the Colorado Center for Reproductive medicine decreased fertility over 50%- study presented at [?2004] European Society of Human Reproduction and Embryology Conference
10. Psychiatry Letter 4(7): 35-38,1986.
11. http://my.webmd.com/content/Article/114/111034.htm
12. http://www.medscape.com/viewarticle/572258 Maternal Tobacco Use and Its Preimplantation Effects on Fertility: More Reasons to Stop Smoking
13. A prospective study of dairy foods intake and anovulatory infertility," Chavarro JE, Willett WC, et al, Human Reproduction, 2007 Feb 28; [Epub ahead of print]. )
14. Czeizel AE, Metneki J, Dudas I. The effect of preconceptional multivitamin supplementation on fertility. Int J Vitam Nutr Res 1996;66:55-8.
15. Thiessen DD, Ondrusek G, Coleman RV. Vitamin E and sex behavior in mice. Nutr Metab 1975;18:116-9.
16. Bayer R. Treatment of infertility with vitamin E. Int J Fertil 1960;5:70-8.
17. Sieve BF. The clinical effects of a new B-complex factor, para-aminobenzoic acid, on pigmentation and fertility. South Med Surg 1942;104:135-9.
18. Wynn A,Wynn M. The need for nutritional assessment of the infertile patient. J Nutr Med 1:315-324,1990.
19. Green BB et al. Risk of ovulatory infertility in relation to [high or low] body weight. Fertil Steril 50(9); 621-6,1988)
    19a- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136077/
    19b. http://www.ncbi.nlm.nih.gov/pubmed/20350920
20. Rushton DH et al. Ferritin and Fertility. Letter. Lancet 337:1554, 1991.
21. http://www.ncbi.nlm.nih.gov/pubmed/17077236
22. Costello MF, Eden JA. A systematic review of the reproductive system effects of metformin in patients with polycystic ovary syndrome. Fertil Steril. 2003;79:1-13
23. Glueck CJ, Wang P, Kobayashi S, et al Metformin therapy throughout pregnancy reduces the development of gestational diabetes in women with polycystic ovary syndrome. Fertil Steril. 2002;77:520-525
24. Glueck CJ, Phillips H, Cameron D, et al. Continuing metformin throughout pregnancy in women with polycystic ovary syndrome appears to safely reduce first-trimester abortion: a pilot study. Fertil Steril. 2001;75:46-52.

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