What you will learn:
- Infertility is the failure or inability to conceive naturally after 12 months of regular unprotected sexual intercourse without contraception in women under 35 years of age.
- Infertility is not only a heavy private matter but also a public health issue.
- Besides emotional distress, there are also financial costs to be considered while going through the infertility journey.
- Infertility is a complex matter. There are several factors that can affect a couple’s chances of getting pregnant: female factors, male factors, combination, unexplained infertility
- Fertility is a reflection of health – it is important that both partners’ health be thoroughly assessed in order to address underlying causes of infertility
- You are not alone. There are many invaluable resources that aim to educate and connect people to professionals who can help.
- Naturopathic medicine is a comprehensive approach that can improve fertility-related outcomes as well as overall health.
What is Infertility?
Infertility is defined as the failure or inability to conceive naturally after 12 months of regular unprotected sexual intercourse without contraception in women under 35 years of age. For women over the age of 35, it is the failure to conceive after 6 months of intercourse. The current definition of infertility does not take into account the 2SLGBTQ+ population as well as single parents pursuing biological family building. For most medical purposes (i.e. treatments, insurance matters), infertility is when reproductive cells or gametes (sperm and egg) are exposed to one another for a year without conception.
The definition of infertility also stretches to those who have had regular, recurrent spontaneous abortions. This is usually determined after 3 consecutive miscarriages or 2 if over 35 years of age.
Infertility affects around 8 to 12% of couples of reproductive age worldwide. Between one in six to one in eight couples are deemed to be infertile. [Side note: hence the advent of #1in6, a twitter hashtag used to promote infertility awareness]
What does infertility mean to people diagnosed with it?
“I feel like my body has failed me.”
“It feels like a piece of me is missing”
“Every negative pregnancy test is devastating.”
“It’s hard for me to attend baby showers.”
Infertility is a HEAVY word. It is not only a diagnosis, but also a financial burden and an emotional sentence.
The road to a successful pregnancy can be an expensive trek. There are numerous costs to be taken into consideration, such as: treatment, drugs, parking, travel for accommodations, opportunity cost of time missed at work, professional fees, assisted reproductive technology (ART) fees (IUI, IVF, ICSI), storage fees, cryopreservation, etc.
Not to mention, being told you are infertile is disheartening especially if it is a burden that you bear. It causes so much heartache, distress, and disappointment. The burden of infertility can also be isolating for many people because of its social and cultural consequences. Being childless and infertile can be a determinant for people’s social support system and their stigmatization from their community.
Why should I care about infertility?
Infertility is a global public health issue. It is a disease that largely involves the reproductive system, but reflects a much larger social issue especially in areas with less educational and health resources, e.g. fertility awareness method, facilities that conduct ART, access to collaborative healthcare practitioners.
While infertility is often viewed as a private matter, it should be considered that public health initiatives and accessible services can have a profound impact on our knowledge about fertility. Having a deeper understanding of reproductive health can also lead to the development of effective and rational public policies for prevention of disease (not just reproductive issues), health care access, and regulation of new technologies and medical innovations.
What you should know about infertility
Infertility can be traced to either the male partner, female partner, or a combination of both.
Female factor infertility
Infertility in women, also known as female factor infertility, accounts for approximately 40% of cases. Some factors that are associated with infertility in women may include:
- Age – the likelihood of getting pregnant decreases as we age.
- Egg quality/production problems – this may come up as having issues with your periods/menstrual cycles.
- Having a history of sexually transmitted infections (STIs) – having complications from STIs can lead to blockages in the fallopian tubes.
- Problems in the uterus (your womb) – a history of fibroids or polyps may affect your fertility. This may show up as very heavy bleeding and/or long periods.
- Problems in the fallopian tubes – any blockages or missing tubes.
- Endometriosis – this is when tissues that are normally [supposed to be only] in the uterus are found outside of the uterus (like your ovaries, intestines, even your lungs!). This can cause pelvic pain and stubborn bloating that are typically associated with your periods.
- Hormonal imbalances
- Early menopause (before age 40) – this may be due to your ovaries starting to fail.
Male factor infertility
Infertility in men, also known as male factor infertility, accounts for approximately 30-40% of cases. Some factors that are associated with infertility in men may include:
- Poor sperm count and quality (low sperm count, sperm that have non-progressive motility, abnormally shaped sperm, or combination of aforementioned factors)
- History of STIs – e.g. Chlamydia
- Hormonal imbalances
Combination of male factors and female factors
Infertility cases that are deemed to be caused by both male factors and female factors and account for approximately 20% of cases. These cases may be associated with:
- Cancer history, past treatments for cancer – chemotherapy, radiation, and/or oncological-related surgeries can affect fertility.
- Chronic illnesses (e.g. diabetes) and their treatments – certain medications are known to affect fertility.
- Alcohol consumption
- Smoking (tobacco, electronic cigarette, vaping)
- Being underweight or overweight
Unexplained Infertility
Around 20% of infertility cases are categorized as Unexplained Infertility. This simply means the cause for infertility is undiagnosed. There is no obvious cause or concrete explanation for where the problem lies. Unexplained infertility may imply:
- You or your partner’s health may be under-assessed – i.e. lack of adequate indicated testing – salivary hormone tests, DNA fragmentation, egg reserves, etc.
- You may have an underlying medical conditions that has not been detected and/or generally under-diagnosed (e.g. subclinical hypothyroidism, endometriosis, adrenal PCOS)
- You may have not worked on other body systems that could affect your fertility. It is not uncommon for people to underestimate the impact of stress and compromised immune system on fertility outcomes. Sometimes, working on improving your immune system can be the game-changer for a successful pregnancy.
Your fertility is a reflection of your health. Infertility is therefore a culmination of many different factors that have developed into an inability to conceive. If you are thinking about starting a family, then it is imperative that you work with your healthcare team in initiating thorough assessments. But don’t forget…
It takes two! Infertility is almost always complex, so it is important that both partners should get thorough work-ups. Remember both female factors and male factors almost equally account for infertility.
Is infertility getting in the way of your dreams? Are you trying to conceive? Thinking about trying?
Getting a diagnosis like infertility can be difficult. It is understandable to feel confused, frustrated, and upset.
Remember that you are not alone. Infertility affects millions of people worldwide every year, and it is severely under-reported. Do not hesitate to reach out to your family and friends. You may never know who else has been inflicted by infertility until you open up about your own experience.
Reach out to support groups – counsellors, psychotherapists, fertility communities, Planned Parenthood, etc. There are resources out there that can help demystify the complexities of infertility.
- Infertility Network is a Toronto-based support network that provides information and resources online to the public as well as hosts local events. They also have a database of counsellors
- Infertility Awareness Association of Canada, now known as Fertility Matters Canada is Canada’s national organization that aims to provide support, awareness, information and education, and promoting equal access to fertility treatments.
- FertilityFriend provides patient-friendly resources that can help you with charting your cycle
- Kindara is a fertility awareness app for smartphones. Similar to Fertility Friend, it aims to help monitor your cycles and fertility. Kindara also hosts a great community for its users and is home to invaluable resources for those curious.
- Resolve (The National Infertility Association) is a non-profit patient advocacy association based in the United States.
Seeing a Naturopathic Doctor can help you reach your fertility goals.
What is Naturopathic Medicine? Check out my FAQ page to learn more about what we do. Naturopathic medicine is a system of health care that uses a combination of modern scientific knowledge and traditional forms of natural medicine. The grounds of naturopathic medicine arise from the thoughtful intention of preventing illness, promoting wellness, and encouraging the body’s natural ability to heal.
Naturopathic doctors (ND) employ a comprehensive approach in improving fertility for men and women from the ground up. NDs seek to uncover what is preventing a couple from conceiving and address the underlying causes of infertility. The principle by which NDs are driven by is bringing the couple’s health back in balance.
Your fertility work-up may be based on:
- Improving the quality of your eggs or sperm cells
- Improving circulation to the reproductive organs
- Improving implantation rates
- Preventing miscarriage and/or recurrent miscarriages
- Reducing stress and improve your physiological stress response
- Improving and achieve hormonal regulation
- Improving success rates of IVF or IUI procedures
- Improving chances of pregnancy
- Improving any medical conditions that may be primarily affecting your fertility
What’s next for you?
Whether you are thinking about starting a family, starting out your pre-conception plan, or already pregnant or have been given a diagnosis, you are not alone on your journey. Seek community and support. Start getting in tune with your body. Get thorough assessments. Reach out to your integrative healthcare team. You are not alone.