A Functional Medicine Approach to Addressing Female Infertility Pt. 1
So you’ve decided to start your fertility journey! In the context of functional medicine, a holistic view of the individual's health is taken and the aim is to optimize the body's natural functions to support reproductive health. Here are key aspects of fertility from a functional medicine perspective:
-Optimal nutritional status.
-Hormonal and endocrine balance.
-Addressing stress, environmental factors and gut microbiome.
-Detoxification, Blood Sugar Regulation and Inflammation.
-Working collaboratively with other fertility specialists.
If you have been trying to conceive for more than a year if you are under 35 or for more than 6 months if you are over 35, getting some testing may be helpful to help determine any causes of infertility and therefore give you the tools and resources needed to address them. Below is a brief description of the types of testing, both diagnostic imaging and blood work that can help support your fertility journey:
Diagnostic Imaging
Trans-Vaginal Ultrasound: In the context of fertility in women, this procedure is often used to evaluate the uterus, ovaries, and fallopian tubes. It helps to identify abnormalities such as ovarian cysts, fibroids, or structural issues in the uterus that may affect fertility. Additionally, transvaginal ultrasound is used to monitor the development of follicles in the ovaries and to track the thickness of the uterine lining during fertility treatments.
Hysterosalpingogram: A hysterosalpingogram (HSG) is a diagnostic imaging procedure that is often used in the evaluation of female fertility. The purpose of an HSG is to assess the condition of the uterus and fallopian tubes by injecting a contrast material into the uterine cavity and monitoring its flow through the reproductive organs. The procedure helps identify any syabnormalities or blockages that may affect a woman's ability to conceive. Along with an ultrasound, this is a first line diagnostic tool.
Laboratory Testing
This standard panel not only accesses baseline hormones, it also gives an indicative of ovarian reserve, or the number and quality of eggs remaining in a women’s ovaries.
“Day 3” Labs: FSH, estradiol, LH, prolactin, AMH, and Full Thyroid panel (TSH, FT3, FT4, TPO, TG antibodies).
“Day 21” Labs: Progesterone Labs, taken 7 days after ovulation, i.e., on or around day 21 of cycle
Other Essential labs include: CBC, CMP, GGT, HbA1C, Insulin, Homocysteine, hsCRP, DHEA-S, testosterone, SHBG, Iron profile, Ferritin, Lipid Panel, 25-OH vitamin D, RBC Folate, Vitamin B12. These tests help determine hormonal function, nutrient status and whether or not there is any inflammation or blood sugar imbalances that may be impacting fertility.
Other Helpful Tests
DUTCH Complete Hormone Testing: In addition to testing baseline reproductive hormones such as Estradiol, Progesterone, Testosterone and DHEA, other factors that contribute to fertility such as adrenal function and hormone detoxification are investigated. It is a urine test and is conducted between days 19-21 of one’s cycle,
DUTCH Cycle Mapping: This is a urine test that follows levels of Estradiol and Progesterone throughout an entire menstrual cycle. Levels of Estradiol (the type of Estrogen that is produced by the ovaries) and Progesterone should rise and fall at specific times during a cycle, allowing for an optimal environment for ovulation and implantation of a fertilized egg into the uterine wall.
Cervical Mucus and BBT Charting: An inexpensive and alternative way to assess Estrogen and Progesterone levels throughout a woman’s menstrual cycle, based on observations made of a gel like discharge that appears during a woman’s fertile window, as well as changes in her resting temperature.
Sperm Count and Analysis: Sperm count and analysis are crucial components of male fertility assessments. Understanding the quality and quantity of sperm is essential in evaluating a man's reproductive health and his potential to father a child. Measurements include sperm count, concentration, motility (movement) and quality.
The above functional tests and charting systems help identify underlying causes to one’s inability conceive, and treatment is focused on working with a woman’s body rather and supporting her overall health. The use of nutraceuticals, micronutrients, acupuncture and botanical medicine, along with addressing lifestyle factors such as stress, sleep, improper nutrition and the over or under usage of exercise can greatly enhance chances of conception. Naturopathic physicians are able additionally able to work collaboratively with other medical providers and physicians to leave no stone unturned in one’s fertility journey.
