FAQ #20: How do naturopathic doctors help address fertility and infertility? 
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The AANP and the INM would like to acknowledge Jaclyn Chasse, ND, for her contributions to the content of this FAQ. 

If you and your partner are struggling to have a baby, you are not alone. One in eight couples in the United States have difficulty getting pregnant or staying pregnant. Infertility, defined as trying to conceive for one year (or six months after age 35) with no success, affects both men and women ages 15 to 44. And new data suggests that infertility is on the rise.

Fertility challenges often take physical, emotional and financial tolls on a couple. Between repeated visits to reproductive endocrinologists, prescription medications, hormone injections and labs, trying to have a baby can feel like an exhausting, mechanical series of procedures. Some couples will consider reproductive technology (ART) such as artificial insemination, intrauterine insemination (IUI), and in-vitro fertilization (IVF) to achieve pregnancy. While these approaches can be effective, they are financially out of reach for numerous families. Given that success rates of treatments like IVF are between 13 percent and 36 percent for women over 35, couples want to optimize their health first to maximize their outcome. They may also be concerned about long-term risks of ART for the health of the baby. With all of these variables, patients often wonder if they have other options.

Trained to treat the whole person, naturopathic doctors (NDs) have helped countless men and women resolve fertility challenges and conceive easily, safely, and cost-effectively. With a focus on uncovering what is preventing a couple from conceiving, naturopathic doctors address underlying causes of infertility whenever possible. NDs look at each patient as a unique individual. They guide couples in improving fertility with a goal of conceiving naturally and avoiding interventions when possible. Addressing health beyond conception, NDs also focus on helping you achieve a healthy pregnancy and baby.

Identifying Underlying Causes
Naturopathic doctors begin by assessing the whole couple. Initial appointments generally last one hour or more, and include a detailed family history, medical history, discussion of diet, physical activity, environmental exposures, sleep patterns, and psycho-emotional stressors for both partners. You can expect a conversation about your lifestyle, menstrual cycle, and what you’ve been doing to try to conceive. Your ND may order blood work, imaging, and nutritional labs. They will dig deeper if tests uncover red flags.

There are a wide variety of reasons a couple may have difficulty conceiving. Although some receive a diagnosis from conventional doctors, many have “unexplained infertility.” Fertility challenges can be caused by poor sperm health (for men), poor egg quality, hormonal imbalances including cycle abnormalities (for women), obesity, and more. A number of root causes are linked to lifestyle and environmental factors, and NDs are trained to look for and uncover these underlying issues.

There are many safe, natural, and effective lifestyle modifications and therapies that can address these problems, strengthen your overall health, and improve your chances of getting pregnant. Because of their rigorous training in clinical nutrition, lifestyle counseling, botanical medicine and more, licensed naturopathic doctors are experts at engaging and empowering patients to make lifestyle changes, proven to improve health outcomes.

Pre-Conception Care
Proper preconception care has been shown to enhance fertility and lead to healthier outcomes, both for couples who are conceiving naturally and for those who are using assisted reproductive technology (ART). Naturopathic doctors work to help you cultivate a healthy body first to maximize pregnancy success and nourish the growth of a healthy baby. NDs encourage couples to take a few months of time to prepare for conception. In this period, NDs work with couples to:

  • treat underlying health conditions, such as obesity in both men and women
  • optimize diet and nutrition
  • manage stress
  • incorporate comprehensive micro-nutrient support
  • optimize intercourse timing through education about the menstrual cycle

Poor Egg Quality  
While fertility obstacles and treatments are highly individual, for women, poor egg quality is a common underlying cause. Egg quality can decline naturally with age or prematurely. In both cases, finding out the ‘why’ of the decline is essential. Causes can be nutritional and hormonal. Research has demonstrated that for nutritional causes, supplementation with antioxidants such as melatonin, vitamins such as DHEA, and other plant-based antioxidants can be helpful to improve egg quality. Hormonal irregularities affecting egg quality and ovulation include endometriosis and Polycystic Ovarian Syndrome (PCOS). Naturopathic medicine has many different remedies to help women address these imbalances, including the use of botanical therapies.

Poor Sperm Health
For men, sperm production, quality, and motility are often at the heart of fertility challenges. While individual recommendations are tailored, naturopathic doctors help support sperm health through: 1) optimizing lifestyle choices such as quitting smoking and limiting alcohol consumption; and 2) optimizing diet and nutrition, including supplementation with micronutrients such as zincL-CarniteneCoQ10, and antioxidants such as selenium.

Enhancing Clinical Care with Tender Loving Care (TLC)
The journey to pregnancy can feel like a physical and emotional rollercoaster. Naturopathic doctors provide patients with a high level of emotional and psychological support from start to finish. Adding psychological support and sympathetic counseling to clinical care not only feels better, but also has been shown to improve pregnancy success rates.

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