7 Causes of Infertility
It can be a real challenge to determine the true source of fertility problems. This article does not include endometriosis nor is it all inclusive for the causes of infertility. To be properly diagnosed you need to consult with your medical care provider. However, this article will give you food for thought concerning multiple problems and possible underlying causes and solutions.
- Emotional Side Effects
- Abdominal Fat Storage
- Insulin Resistance
- Polycystic Ovarian Syndrome
- Miscarriages and Ketosis
- Gestational Diabetes
How many times have you been told, ‘just relax, it will happen’? Stress causes increased cortisol production, which promotes weight gain, which causes insulin resistance, which causes increased insulin in the blood stream, which causes multiple problems with fertility.
Fertility problems rank high on emotional issues. Husbands and wives have broken-up over fertility problems. (Berman PhD, 2014) Families have gone bankrupt over infertility treatment costs. (Berman PhD, 2014) Telling you to relax is much easier said than done. (Berman PhD, 2014)
An underlying problem is that schools don’t teach how to handle stress! People can go through their whole life and never learn how to adequately deal with their stress. They turn to smoking, drinking, drugs (prescription and non-prescription) and other addictions to avoid dealing with stress. Everyone could benefit from instructions on how to manage stress. Unfortunately, it is not as easy as taking a college course. Stress management is individualized.
Some people pray, some people meditate, and some people take long walks in the woods. No one can tell you what will work best for you. You have to do your own discovery work. I have a great post, First-Aid Box for Emotions, which talks about how to be prepared for emotional issues.
Uncontrolled stress can cause fertility problems. It triggers the release of adrenalin to feed your fight or flight mechanism. When you don’t fight or flight (which most of us can’t physically react to stress) then the adrenalin triggers the endocrine (hormone) system to produce cortisol. Cortisol has multiple effects on the body including infertility. Simply put; if you are fighting for your life, then you are not going to get pregnant. Another effect of cortisol is it increases fat storage.
Abdominal Fat Storage
How many times have you been told to lose weight to get pregnant? Abdominal fat can physically interfere with how the egg is delivered. (How can you lose the fat deposited around your ovaries?) Having a body mass index (BMI) over 32 is directly associated with problems of ovulation and conception as well as other challenges during the pregnancy. (Berman PhD, 2014) If you plan to get pregnant it is advisable to lose weight if your BMI is above 24. (BermanPhD, n.d.)
Abdominal fat can also interfere with the many other organs within the body cavity. Fatty liver disease is common with weight challenged individuals. The liver is the largest organ in the body and it has multiple functions. It is affected by the endocrine system. When stress triggers your fight or flight mechanism, the liver releases energy (blood sugar) to enable you to fight for your life or run a marathon. When you don’t use the extra energy, it triggers the pancreas to produce insulin to store the excess energy as fat. Over time, these increased fat stores cause insulin resistance which causes your pancreas to work harder to control your blood sugar.
Insulin resistance and the resulting increased blood insulin are key to many fertility problems. (Insulin resistance means your body loses the ability to use the energy needed in every cell of your body. Your pancreas compensates by producing more insulin.) Thousands of people have insulin resistance and have never been diagnosed. In these women, the required excess insulin also triggers increased levels of testosterone. (Campbell, 2015) The increased testosterone can completely shut down ovulation.
Increased blood insulin can also decrease Follicle Stimulating Hormones (FSH) and Luteinizing Hormones (LH). If ovulation does occur, the quality of the egg produced is reduced which results in difficulties maintaining the pregnancy (i.e. increased miscarriages). (Campbell, 2015) Increased blood insulin also increases the production of androgen from the ovaries. (Nutritionist, 2015) Sixty to eighty-five percent of fertility problems have been identified as having increased androgen or insulin resistance. (Marc A Fritz, 2011) Insulin resistance can be diagnosed using a hemoglobin A1C blood test. Changes in reproductive hormones can be identified with elevated hemoglobin A1C levels. (Nutritionist, 2015)
Additional tests are available but often not covered by insurance. Organic Acid Test (OAT) can measure the carbohydrate metabolism rate. An elevated L-Lactate indicates insulin resistance. (Brar, 2017) Also measuring the bacteria in the gut can indicate problem in digestion. To diagnose preventable diseases before symptoms develop, the standard blood tests are not adequate. Patients need to be proactive with their health care provider by inquiring about other tests to identify preventable diseases.
You can read more about this in my blog post, Pregnancy Diabetes and Insulin.
Polycystic Ovarian Syndrome
Insulin Resistance also promotes Polycystic Ovarian Syndrome (PCOS). Thirty percent of lean women with PCOS and 95% of overweight women with PCOS also have insulin resistance. (Nutritionist, 2015) In PCOS, the eggs are not released from the ovary and they form cysts (abscesses) on the ovaries.
This condition can start as early as puberty and be misdiagnosed as irregular periods. The common practice of placing women on birth-control pills to regulate their periods actually allows this condition to continue untreated. Many women are not diagnosed with PCOS until they are experiencing infertility. If diagnosed and treated early, infertility from PCOS can be prevented. Before the age of 40, 55% of women with PCOS will be diagnosed with type 2 diabetes or prediabetes.
If you want to read more on this topic, I have a post, PCOS and Insulin Resistance, which gives more details on the connection between PCOS, Insulin Resistance, and Infertility.
Miscarriages and Ketosis
An increased risk for miscarriages is associated with insulin resistance and undiagnosed prediabetes or type 2 diabetes. (Alkon, 2017) When your body has difficulty using blood sugars, your body will revert to burning protein and fats for energy. This process produced ketones. (Frise, 2010) As the pregnancy progresses, the woman’s body increases in insulin resistance. (Frise, 2010) The breakdown of fats puts you into a state of ketoacidosis (DKA). Typically, if you go more than ten hours between meals, your body will revert to proteins and fats for an alternative energy source. This can be quickly reversed by eating breakfast.
Today, many people with prediabetes are being encouraged to eat a low carbohydrate/high protein diet to “control” their prediabetes. This can be very dangerous to the developing embryo during early pregnancy. (Williams, 2018) (Frise, 2010) Elevated ketones can cause your body to quickly miscarriage. Ketoacidosis can also contribute to elevated blood pressure.
Elevated blood pressure during pregnancy is often defined as preeclampsia (Frise, 2010) It is associated with high protein diets. (CNS, 2017) Diagnosis of preeclampsia results from high protein levels in urine tests. (CNS, 2017) . In developing nations, Eclampsia is the leading cause of maternal-fetus mortality. (CNS, 2017) Fifty-one babies out of 1000 are stillbirths and high blood pressure is a major contributing factor in these births. (CNS, 2017) Insulin resistance coupled with high protein/low carb diets increase the risk for high blood pressure in expecting mothers. Women who are pregnant need to eat a well-balanced diet and get regular exercise and monitor their blood pressure.
Diabetes during pregnancy is not your fault. During pregnancy, your body produces growth hormones as well as other hormones to promote the pregnancy and the embryo’s growth and development. Around 26 weeks, those hormones start to rapidly increase. (Stoppler MD, 2016) Around 26-28 weeks, your doctor will check for gestational diabetes. Gestational diabetes is totally hormone driven. As the hormone produced during pregnancy increase, so does your chances of developing gestational diabetes. After delivery, gestational diabetes will go away. (Stoppler MD, 2016) Unfortunately, diabetes during pregnancy indicates your body has insulin resistance. (Stoppler MD, 2016) This diagnosis places you at greater risk for developing type 2 diabetes before the age of 40.
Pregnancy can be a beautiful thing. Many people view giving birth as a miracle. It is literally the gift of life. As many women delay pregnancy into their thirties, this also increases the chance of fertility problems and other health issues associated with pregnancy. Unfortunately, pregnancy places a lot of stress on a woman’s body. What happens during pregnancy can be an indicator of other health problems you will face. If you want to learn more about how you can avoid gestational diabetes, check out my post, 8 Tips to Avoid Gestational Diabetes.
My hope is that this article, 7 Causes of Infertility, gives you some ideas of what could be going on and what you can do about it if you’re facing infertility. If you want to learn more about my Gestational Diabetes course, I have a 30-day virtual course that you might be interested in. Follow this link to get more information. If you’re not sure what kind of help or support you need, schedule a discovery call with me and we’ll figure it out together.
Best of luck to you!
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Berman PhD, E. (2014, January 23). When Infertility Affects Your Marriage. Retrieved January 12, 2018, from Huffington Post: www.huffingtonpost.ca/erica-berman/infertility-and-depression_b_4251953.html
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Brar, R. (2017, December 1). Why Bloodwork is not enough. Retrieved January 15, 2018, from Living Proof Institute: https://thelivingproofinstitute.com/bloodwork-not-enough/
Campbell, L. (2015). Natural Fertility Info. Retrieved Jan 12, 2018, from natural-fertility-info/insulin-resistance.html: http://natural-fertility-into.com/insulin_resistance.html
CNS, J. A. (2017). 5 Ways to Help Prevent Preeclampsia for a Healthier Safer Pregnancy. Retrieved January 12, 2018, from Dr. Axe Food is Medicine: https://draxe.com/preeclampsia
Frise, C. M. (2010, March 15-18). Starvation ketoacidosis in pregnancy. Retrieved January 18, 2018, from Endocrine Connections Endocrine Abstracts (2010) 21 p143: http://www.endocrine-abstracts.org/ea/0021/ea0021p143.htm
Marc A Fritz, L. S. (2011). Clinical Gynecologic Endocrinology & Infertility 8th Ed. In L. S. Marc A Fritz, & S. Seigafuse (Ed.), Clinical Gynecologic Endocrinology & Infertility 8th Ed. Philadephia, PA, USA: Lippincott Williams & Wilkins Wolters Kluwer. Retrieved from Clinical Gynecologic Endrocrinology and Infertility 8th Edition.
Nutritionist, C. G. (2015, November 23). Infertility & Insulin REsistance Explained by a Fertilty Nutritionist. Retrieved January 12, 2018, from Path to Fertility: Https://fertility-news.rmact.com/path-to-fertility-blog/infertility-insulin-resistance-explained-by-a-fertilty-nutritionist
Stoppler MD, M. C. (2016, December 5). Gestational Diabetes. (C. Davis MD, Editor) Retrieved January 18, 2018, from Medicine Net.com: https://www.medicinenet.com/gestational_diabetes/article.htm
Williams, K. (2018). Is Ketosis Dangerous During Pregnancy? Retrieved January 12, 2018, from Pregnancy Week by Week Calendar: www.pregnancyweekbyweekcalendar.info/pregnancy-tips/is-ketosis-dangerous-during-pregnancy.html