FERTILITY AND PREGNANCY
Naturopath Cherie Caut, observes that when your health is supported before you conceive, healthy pregnancies and births are more likely to happen. Cherie brings a unique combination of conventional medicine understanding of fertility and assisted reproductive technologies to complementary medicine practice. Cherie's approach is to integrate core naturopathic principles with the latest evidence-based natural medicine and fertility research. Cherie has experience providing IVF support for IVF patients in Adelaide.
Pre-conception care involves an integrated approach to health that considers multiple aspects in regards to their known impact on fertility. We refer to these aspects as fertility factors; nutrition, lifestyle, female fertility awareness, female reproductive health, male reproductive health and environmental factors.
Cherie can directly refer for initial fertility investigations such as your ovarian reserve testing (AMH) or semen analysis and refers to several pathology laboratories in Adelaide for other relevant investigations frequently considered important when assessing fertility issues such as nutritional deficiencies, hormonal function or environmental and heavy metal toxicity.
+ PREPARING TO MAKE A BABY
The most crucial time for men and women to have an impact on their fertility is before and during the 3 months prior to when conception occurs. The pre-conception period is the time during which the developing sperm and egg (oocyte) are incredibly susceptible to your state of health.
+ A HEALTHY EGG AND SPERM
The pre-conception window is typically 3 months as this is how long it takes for a sperm and egg (oocyte) to go through their growth and development prior to becoming the sperm and egg (oocyte) that are able to result in a pregnancy. It takes approximately 70 days for sperm to develop and mature and then another 12-21 days to have arrived in the ejaculatory duct at the time a couple attempts to conceive. Additionally it takes approximately 85 days for the primary follicle inside the ovary to mature and be ready at the time of ovulation.
There are factors that may negatively or positively impact on the health and quality of the developing egg (oocyte) and sperm during this time.
+ THE TOP 5 FERTILITY FACTORS
Age - Fertility declines with age in both women (>35 years) and men (>45 years). Consider planning your pregnancy sooner rather than later.
Weight - Being overweight or obese decreases fertility in both men and women. Pregnancy and birth complications are increased in overweight or obese women. Being underweight can also reduce fertility in women.
Smoking - Smoking decreases fertility in both men and women. Smoking by the father or both parents increases the risk of childhood leukaemia in their children. Women who smoke in pregnancy increase the risk of miscarriage, birth defects and having a low birth weight baby. Cigarette smoke can harm a developing female foetus' ovaries if her mother is exposed in pregnancy.
Alcohol - Alcohol decreases fertility in both men and women. Alcohol can harm the foetus. Heavy or binge drinking in men is associated with impotence, reduced libido and reduced sperm quality.
Timing - Conception is mostly likely to occur in the 5 days before ovulation and the day of ovulation. This is known as the 'fertile window'. Learning to know your fertile window is important for timing of conception attempts.
+ OTHER FACTORS THAT CAN AFFECT FERTILITY
STI's - Sexually transmitted infections can affect fertility in both men and women. The most common STIs are chlamydia and gonorrhoea however there are other STIs and genitourinary infections. Some may impact fertility, pregnancy and the infant.
PCOS/ENDOMETRIOSIS - Both conditions may cause female infertility, however with the correct diagnosis, treatments are available to aid in the return of fertility.
DIABETES - Undiagnosed diabetes may reduce fertility and managing diabetes is important to prevent pregnancy complications and reduce the risk of miscarriage. PCOS is a risk factor for diabetes.
THYROID DISORDERS - Severe hypothyroidism can be a cause of infertility and the risk of pregnancy loss is increased in women with uncorrected overt or subclinical hypothyroidism. Hyperthyroidism can cause menstrual irregularities leading to fertility issues. Untreated significant or subclinical hypothyroidism or thyrotoxicosis in pregnancy can lead to preeclampsia, heart failure, intrauterine growth retardation, preterm birth and still birth.
HEAT - Testicles need to be a couple degrees cooler than normal body temperature. If testicles become too hot such as in a spa, sauna, hot bath, prolonged sitting, or some sports (cycling), sperm production can be compromised. Some men may have an enlargement of the blood vessels of the testicles reducing sperm production. Recent illness and fever can also reduce sperm production. Mobile phones in trouser pockets and laptop computers are habits to consider changing.
MEDICATIONS/DRUGS - Some medications can affect fertility. Surgery with anaesthetic may reduce sperm production temporarily. Anti- depressants and sedatives may also affect sexual function in men. Anabolic steroids can cause infertility and illegal drugs may reduce testosterone, reduce sperm production and cause sperm damage.
CAFFEINE - Women who consume large amounts of caffeine take longer to conceive and may have a higher risk of miscarriage. Caffeine is present in coffee, tea, energy drinks, some soft drinks, and chocolate.
ENVIRONMENTAL TOXINS - Environmental exposure to toxic chemicals, plastics, pesticides, heavy metals (lead, arsenic, mercury) may affect fertility. Some chemicals interfere with the normal functioning of male and female reproductive systems and are known as Endocrine-Distrupting Chemicals (EDCs).
EXERCISE - Exercise is important for maintaining a healthy weight and increasing fertility in both men and women. Regular moderate intensity exercise is recommended for 30 minutes most days of the week. Excessive exercise, such as high intensity and high frequency may negatively impact on fertility.
NUTRITION - A healthy diet prior to conception increases fertility. Ensuring adequate folate may prevent neural tube defects (NTD) such as spina bifida. The South Australian guidelines recommend women who plan to conceive should supplement their diet with 500 micrograms folic acid daily from at least one month before conception and for the first 12 weeks. Vitamin B12, Iodine, vitamin D, calcium, iron, zinc, selenium and omega-3 DHA are also important for a healthy pregnancy. Antioxidants such as folate, zinc and selenium are important for healthy sperm development.
GENETICS - There are some genetic and chromosomal conditions in men and women that can reduce fertility or cause infertility. Genetic and chromosomal screening tests are important in cases of low testosterone or severely low/absent sperm production in men or reduced ovarian reserve in women.
There are some further considerations in the assessment of infertility or recurrent miscarriage. Please ask our Naturopath for more information about these factors.
In addition to optimising your health by supporting or resolving your current health concerns you will be supporting healthy ovulatory and uterine function, sperm development and maturation and optimising your chances of a successful pregnancy with a decreased risk of gestational diabetes, pre-eclampsia, pregnancy complications, post-natal depression, pre-term or low birth weight baby.
Success is more likley when both members of a couple participate in pre-conception care and all appropriate pre-pregnancy screening tests are completed and medically diagnosed conditions such as STIs/genitourinary infections have been treated. Following recommendations as closely as possible for at least 3-4 months prior to conceiving is also important to success.
+ PRE-CONCEPTION CARE & ASSISTED REPRODUCTIVE TREATMENTS
Pre-conception care can be an important complementary approach to Assisted Reproductive Technology (ART) treatments such as ovulation induction (OI), intra uterine insemination (IUI) or in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) and may improve your chances of success by supporting your own health. Prior to commencing your assisted treatment cycle optimising your health may have an impact on pregnancy outcomes through addressing known barriers to fertility such as dietary, nutritional, lifestyle and environmental factors. For both men and women it is important to become aware of what factors are vital in supporting a healthy conception and ongoing pregnancy. Our Naturopath is experienced at tailoring treatment approaches before and during your treatment cycles and working collaboratively with fertility specialists.
Nutritional reserves are at risk of depletion after pregnancy and during breastfeeding. Post-natal care is important for recovery and optimal health. Some women require additional support during breastfeeding or for eventually the return of regular menstrual cycles and hormonal balance. Natural medicine can also support conditions such as post-natal depression, recurrent cystitis, prolapse, haemorrhoids and surgical recovery.