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From Wikipedia, the free encyclopedia

Infertility
Specialty Urology, gynecology
Frequency 113 million (2015)[1]

Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult organism, except notably among certain eusocial species (mostly haplodiploid insects).

In humans, infertility may describe a woman who is unable to conceive as well as being unable to carry a pregnancy to full term. There are many biological and other causes of infertility, including some that medical intervention can treat.[2] Estimates from 1997 suggest that worldwide "between three and seven per cent of all [heterosexual] couples or women have an unresolved problem of infertility. Many more couples, however, experience involuntary childlessness for at least one year: estimates range from 12% to 28%." [3] 20-30% of infertility cases are due to male infertility, 20-35% are due to female infertility, and 25-40% are due to combined problems in both parts.[4] In 10-20% of cases, no cause is found.[4] The most common cause of female infertility is ovulatory problems which generally manifest themselves by sparse or absent menstrual periods.[5] Male infertility is most commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity.[6]

Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile during the rest of the menstrual cycle. Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature.

YouTube Encyclopedic

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  • Top 10 Solutions for Infertility with guest Dr. Patrick Flynn
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  • Hindi Mabuntis o Infertility – ni Dra. Ghe #3 (OB-Gynecologist)
  • 7 Signs Of Infertility In Men You Should Know About
  • #4 - Infertility - Reproductive Health - Dr. Rajeev Ranjan

Transcription

Dr. Axe: Hey, guys. Dr. Josh Axe here along with Dr. Patrick Flynn. We've got a great episode for you today and we are live here. We're going to be talking about the 10 natural solutions to help you overcome infertility and to naturally balance your hormones. I brought in the expert in infertility and all things hormones, Dr. Patrick Flynn. In fact, he's been labeled "The Hormone Whisperer" by people all over the world and all over the country. And he has people fly, again, from all over the world to come see him that are struggling with infertility, hormone imbalance issues such as PCOS, severe menopausal symptoms, PMS, and a number of other hormone-related issues related to the thyroid, the adrenal glands. Dr. Patrick, hey. Dr. Flynn: Thanks for having me. Dr. Axe: Awesome, great to have you here today. So, guys, we're going to be going over the top treatments and really what Dr. Patrick does with his patients in terms of the herbs, the essential oils, and the root causes of what actually causes infertility and hormonal issues like PCOS. And help us spread the message right now, there are millions of people, women and men, women especially, who are going to their doctor, getting medications, and they're not getting to the root cause of what's causing their problem. So take a minute right now, hey, punch your "share" button or "like" button or "love" button, help us spread this word. And also, hey, we love to start off the show by saying "hey" to you. Let us know the city you're from, the state you're from, the country you're from, and we'll give you a quick shout-out here on Facebook Live before we dive into the actual root causes of addressing hormone imbalance in the body, especially infertility. So, all right, let's see. We've got Shar Hull [SP] who just joined us from Malaysia. Hey, thanks for joining us here today. We've got Jeremy Roland from Louisville, Kentucky. We've got Assel T.G. [SP] watching from Puerto Rico. Marie Trema [SP] from beautiful California. Hey, Marie, thanks for joining us here today. We have Deb Bruckschen [SP] from Wisconsin. Dr. Flynn: Hey, Wisconsin. Dr. Axe: Hey, Deb. Good to see you, all right. I know you're from Green Bay. Dr. Flynn: Green Bay. Dr. Axe: The Green Bay area. So especially if you're in Minnesota, Wisconsin, Chicago, he's real close to you there. And also we have Brigitte Fazan [SP] watching from Cali. And I got to mention here someone saying, "Dr. Patrick is a healer." Awesome. Yeah, that's a great compliment there. And Diana Jefferies is saying "hey" from Adelanto, California. Awesome. Hey, guys, thanks for joining us today. And thanks for everybody, I see a lot of people sharing this video here right now. All right. So let's talk about this, Dr. Patrick. One of your key ways of addressing hormone imbalance is through testing. And here's the truth, a lot of doctors today aren't doing the right type of testing to find out what's causing infertility, what's causing hormone imbalance. Talk to us about the hormones you test for. And also you mentioned something about estrogen earlier. Dr. Flynn: Yeah. The sad part today is when people actually get their hormones tested, the key thing is it's incomplete. For example, I'll ask women, I'll say, "Have you ever heard of the hormone estrogen?" And, "Sure." And I respond, I go, "That's why you're sick. Estrogen is really a term of multiple hormones." And they give you that kind of deer in headlights look. And that's actually the hormone that dictates a woman's life. If you look when a woman, a young lady, has her cycle and develops into a woman, the only thing that really changes is her estrogen levels start to go at a much higher level. Dr. Axe: Yeah. Dr. Flynn: But there's so many of them. And most women have never even had them tested properly. Okay? And that's the biggest thing. So it's incomplete testing. Because people come in and say, "Doc, I've had some testing done." I'm like, "Really? Let me see it." And they maybe test one or two of them. And so you can't get a good complete picture of a woman's hormones unless you know of them. Okay? So that's a great place to start. Second, obviously, a little bit more known hormone is progesterone. Okay? It's really key, especially when you get down to mental stress, but progesterone is probably the most drained hormone that woman have. It's actually the number one cause, for example, of miscarriage when progesterone levels get low. Actually, if a woman actually gets pregnant and starts to bleed or, for example, they've had miscarriages in the past, they'll give them shots of synthetic progesterone that way. Dr. Axe: Wow. Dr. Flynn: But I will tell you, for example, one thing I think is key, especially for women, is cortisol. Okay? So there's more than these three hormones, because that would be an incomplete test if you just did those. But when women actually just start to research those three things when they're going through any hormonal change, from PMS to PCOS to infertility that way, it's got to start there. Now that's a really good start, but that's still incomplete. So just understand there's all the array of hormones that have got to be tested. But even just number one, estrogens dictate what a woman life is like. Dr. Axe: Well, talk to me about what are some of the different types of estrogens that people might get tested for. And then we have another question, somebody wants to know what they should be tested for if they are not losing weight like they should. That's a question here from Drace [SP]. Dr. Flynn: Well, actually that's a big key. When you look actually at weight loss, start with your cortisol. Because there is a tissue in our body that makes a significant amount of hormone, it's called adipose tissue. So when women's hormones drop, guess what happens. The body says, "I have to survive." And so what does it produce? Fat tissue. That's why when you get down to exercise women can actually exercise every day and if they're doing it wrong or doing it during the wrong times, guess what, hormone levels drop, and then fat tissue has to be produced for them to produce hormone. So cortisol is actually a wonderful one because if you drain your adrenals, if you drain your progesterones, your body has to survive. Your body does what it does to actually survive every situation, even produce fat. Dr. Axe: Yeah. And if you're a person out there and you're one of those people, especially a woman, and you're out there exercising and you're not losing weight or maybe you're even gaining weight in certain instances, it's because you're not exercising the right way during the right times of the month, which we're going to talk about when we talk about exercise here in just a minute. So again, as Dr. Patrick is talking about, you want to do a full-on hormone panel, and this is something he does with his company Wellness Way. And again, just Google search "The Hormone Whisperer Dr. Patrick Flynn" online, you'll find information there on Google. So again, you want to do a complete panel there. We know cortisol is one of those hormones we have to stay balanced. Now talk about this, it was really interesting. We know the American Health Association recently came out with this absurd recommendation that you got to get saturated fat out of your diet and then basing disease, or heart disease, on cholesterol. Talk about why women who want to balance their hormones and overcome infertility, why they actually need cholesterol. Dr. Flynn: Yeah. Well, I'll give you a clinical example. So the other day I had a 42-year-old woman come in and she lost her cycle and she thought she was actually going through menopause. Well, then I tested her proper hormones at LH and FSH and it still told that she still should be cycling. Well, anyways, so then I said, "Well, let's run your lipid panel." She had a cholesterol level at 98. And now she was so excited when it came back because even her OB said, "Listen, that's fantastic." And I just about had a seizure. Okay? Because every steroid hormone, let me say that again, every steroid hormone comes from cholesterol. So when the American Health Association said that coconut oil and things like that were bad for you, they're actually going to drive women and male hormones by teaching that. And I just about freaked. And we have a very good cardiovascular guy in our office, his name is Dr. Greg Abbott, and he put out a great article about that. And he said, "Hey, listen." He goes, "Listen, steroid hormones need, for example, cholesterol. And if we don't get cholesterol in our foods, guess what, it's going to be detrimental to hormone health that way. And do not lower your cholesterol." One of the worst things for female hormones is actually statin drugs. Statin drugs. Do you know when I started practice 18 years ago they never put women on statin drugs, they never did. In guys it was pretty common, that's why testosterone levels became so low. Dr. Axe: Yeah. Dr. Flynn: But women today, and even one of the major side effects of statin drugs is lower hormones. But it's detrimental to women's health that way, cholesterol is a key. So when you get a lipid panel done and your doctor is so excited that it's low, I'm freaking out. Dr. Axe: Oh, same here. Dr. Flynn: Big time. Dr. Axe: It's one of those things where, again, I don't know how the medical community doesn't understand this. Well, part of it is the pharmaceutical companies and their whole agenda. But, again, think about how important this is. Cholesterol and proteins together are a big part of those are your hormones you're producing. And, another point, 25% of your brain, your spinal cord, your nervous system is made up of cholesterol. So if you have low cholesterol levels as men, that's going to equal low testosterone. You being weaker, lower sex drive, lower energy levels. And for women very same thing. It's a lower sex drive, infertility, hormone imbalance. You've got to get your cholesterol levels healthy. And we're going to talk about that more with food, but let's mention what are a few foods that might support healthy levels of cholesterol or some fats there? Dr. Flynn: Well, two of my favorite, eggs and avocados. Dr. Axe: There you go. Dr. Flynn: It is. We have this fallacy about eggs. Remember, if you even go back, the American Heart Association saying, "Eggs are good, eggs are bad, eggs are good, eggs are bad." That's based on their pharmaceutical influence that way. And two wonderful things that way that actually are essential to health. Now there are people that say, "Doc, what if you're allergic to eggs?" Well, then, guess what, find other sources that way. You need cholesterol. And there's one thing I want to say about saturated fats. It's kind of interesting. People know a lot about polyunsaturated fats because of olive oil. But you understand that olive oil under room temperature is a liquid. Saturated fat under room temperature is actually a solid. If we were actually made up of polyunsaturated fats, we'd melt in room temperature. Do you see what I'm saying? Dr. Axe: Yes, yeah. Dr. Flynn: You never think of it that way. And then people start scratching their heads. Yes, saturated fats bind our cells together and keep us human. See what I'm saying? So a lot of people don't understand that. Dr. Axe: And I'm going to throw a few others up here. Getting a little bit of animal fat is good. Dr. Flynn: Yes, it is. Dr. Axe: Things like whether it's tallow or chicken fat, a lot of times I'll eat the organic chicken skin. And the reason is it's full of collagen and those healthy saturated fats, if it's a grass-fed wild animal. So getting things like this, we'll put a little bit of coconut oil in there down here. These are things that can really benefit the body. Now let jump into number three here. And by the way, hey, I know that for yourself, Dr. Flynn, again you have helped a lot of people with infertility, a lot of celebrities. So if you want to know more about Dr. Patrick, just search "The Hormone Whisperer" online, Dr. Patrick Flynn. You can find out more about him there. But we're going to talk about mental stress. And, by the way, there are millions of people that don't know this is true. I was shocked when I first opened my clinic, Dr. Patrick, and the number of women, young women, in their 20s and 30s coming in with infertility, PCOS, hypothyroidism, Hashimoto's disease, irritable bowel syndrome, just so many of these different health problems. I was absolutely shocked. And you know what the reason was? They don't know these key things that we're actually teaching about today. So, hey, take a minute right now, click the "share" button, the "like" button, help us spread this word. Because more men and women need to know the truth about how to naturally heal their bodies. So let's talk about mental stress. How important is this when it comes to balancing your hormones and overcoming infertility? Dr. Flynn: Out of all these things, I believe number three is actually the key. If you look at, for example, kind of a funny thing I always say, who stresses out more, men or women? Women. Who causes the women the most stress? Men. Okay? So, men, this is not a joke, you can be one of the biggest contributors to your wife's illness. Now that's going to get a huge one because women by nature, estrogen is a very bonding hormone. Okay? Testosterone is a very aggressive hormone. And what happens, and here's the big key and this is the big difference, our anabolic hormones, our hormones that come from our progesterone, estrogen, DHEA, all the ones that way, guess what, they're not connected to cortisol. But guess what, progesterone is. Progesterone converts into our stress hormones. So mental stress can deplete a woman's hormones faster than eating bad, faster than exercising too much, faster than doing anything. This by far is right now, I believe, and this is by lab testing, is the number one key to why women are sick today. Dr. Axe: Now let me ask you this, Dr. Patrick. When you have a patient come in and they're having major emotional stress, I know you've got a lot of different remedies, what is one of those things that maybe you have them become conscious of or start doing to deal with the stress and their husbands or significant others? Dr. Flynn: I'm going to use a funny example, one of my doctors is going to kill me on this. So we have Wellness Way clinics all over the country, we have great doctors and stuff like that. And the cool thing about this is our Montana office, Dr. Sampson and Alex. I went out to their wedding. I have a picture of Alex when she was in her wedding dress walking around with a bottle of California poppy because it's the most calming, relaxing, neurologically calming herb, helps us produce our very calming neurotransmitters very quickly. Dr. Axe: Yeah. Dr. Flynn: So California poppy actually leaves our office on a regular basis so often because why? Because even a wedding, which is one of the most beautiful things, it was a gorgeous wedding, we had a blast out there, but the idea is this: it's stressful. And so it does make the nervous system calm really quickly. So California poppy has always been one of the go-tos. We have some times when women come in they have such high anxiety. As people know, our motto is "we don't guess, we test." But there are sometimes clinically that . . . I had a woman come in just in tremors. And I put her back in my exam room and I gave her literally a tablespoon of California poppy every 15 minutes to calm down because doing a lab on her actually would have been clinically irrelevant at that time. Then we got her to calm down, then guess what, then we could continue our exam and our work on her. Dr. Axe: Great stuff. Dr. Flynn: Incredible thing. And actually the funny part is when people Google search it or look it up by WebMD, it's one of the most common and non-addictive herbs because, once again, you can't overdose on it. It's water-soluble. So if you took too much, you'd just pee it out. Dr. Axe: I love this, I'm going to write this down here. So we have California poppy. And then one other thing I want to mention, something I've done, Dr. Flynn, too, for patients is I've had them do what I call a healing bath. One cup of Epsom salts, 20 drops of lavender or chamomile oil, and just lay in the tub for 20 minutes soaking there. But I love it, that's a great natural, holistic remedy there. And also I see we got a lot of people sharing this. I think Marie I saw just share this. Hey, thanks so much for sharing this, liking this information. We're helping to spread the word about women's health and men's health here today, especially in regards to hormones. So let's talk about fatty acids here and the importance of. What are the most important fatty acids or fat-rich foods that we need to be getting in our diet on a daily basis? Dr. Flynn: Oils and nuts. Oils and nuts, by far. Because remember hormones are lipid-soluble, they need carrier proteins, they actually need the fatty acids. And so oils and nuts are one of the best foods on a regular basis that way. Macadamia nuts by far are one of the best that way. Cashews, walnuts, all high-based fatty acids that way that actually give the building blocks. We talk about building blocks of cholesterol, we need more than cholesterol, we also need the amino acid proteins, we also need the phospholipids to actually build that way. So oils and nuts to me, for example, have done a wonderful job of giving people, and giving women and men, the tools to be able to build those hormones. Dr. Axe: Cool, awesome. I just wrote down four down here, we got macadamia nuts, walnuts, flax seeds. Also doing things like salmon can be great here. But getting these fatty acids. And, of course, we put avocado up here earlier, but why is avocado so beneficial? Dr. Flynn: Well, it has multiple things. See, what happens when you actually look at the liver, and we're going to talk about this over here, but all hormones convert in the hormone. So therefore the glutathione that you get from the avocado helps the liver process everything and convert it, and also has methyl groups that change the estrogens from one form to the other. So those food groups are essential. That's why avocados should be a normal part of your diet on a regular basis. Dr. Axe: Yeah. And as I know we both have said before, an avocado a day will keep the endocrinologist away. Dr. Flynn: Yes. Dr. Axe: Okay? Which is something you want. Dr. Flynn: It's true. Dr. Axe: So anyway, so again you can see here some of these foods you want to be getting into your diet on a daily basis. And listen, these are delicious. Macadamia nuts, I love that vanilla-like flavor. Doing macadamia nut butter with some celery sticks is great. All right, let's talk about exercise here. Now this is one I think might surprise you guys a little bit. Let me actually jump back, did you hear everything he said about avocados? They help boost your glutathione levels, that's your body's master antioxidant, powerful for anti-aging. All right, exercise. So we're going to get some haters on this one. So we're going to talk about two types of exercise that are beneficial, weight training and burst training, and then things like yoga and walking. Or yoga, Pilates, bar walking, things that are in those categories. There are certain times of the month that women should be doing weight training or burst training and certain times they shouldn't be. Let's talk about when not to do those. Dr. Flynn: Well, let's set the stage first. For male hormones it's essential for guys to work out daily, and burst training is by far the best. I have some pro athletes come in and what happens is they're physically physiqued like crazy, but they push themselves beyond burst training and their testosterone levels drop down because they're causing so much disruption to their body. Okay? Now, Josh, it's kind of neat, you'll understand this a little bit more since you're married. Now the one thing about a woman when you look at exercise compared to a man, a man's testosterone levels are straight across all the time. Our testosterone levels will stay the same all month. When you got married, no one ever told you this, a woman's hormones change four times a month. That means it affects them physically, but it also affects them mentally four times a month. You really married four different women. Dr. Axe: Yeah. Dr. Flynn: You get what I'm saying? And, women, it's okay. It's okay that you're different, you don't have to be like a male. Any male that wants you to be like him, they don't understand you. Okay? So what happens is there's your four changes. So you're different every single week. But that means your exercise routine has to change every week. So the rough average days of a cycle, let's say, is 28. Yes, ladies, you can fluctuate from 26 to 32, but let's do this. Let's just stay on a 28 basis to make my point. Day one is when you menstruate. That first week, guess what, that's where you put in more of your non-burst training. Okay? Yoga, walking. Just stay active, you have to stay active. Movement is so important. But the idea is this, if you burst train, especially in that first week, you are going to deplete your hormones, your body is going to end up putting a ton of cortisol to compensate, and you could even gain weight. So when you menstruate, don't be putting your exercise at a high level. Because what happens is, yes, you can develop a great physique. This actually frustrates women, women are not supposed to have a six-pack. They're not. See, women actually get all excited and they look at these women and they show their six-pack and I look and I go, "That's a sick woman." Because she's actually depleted her layer of fat that's supposed to be there that produces hormone. And then eventually she's going to get very sick, very depressed, and actually there's going to be a lot of hormonal problems that stem from there. Okay? Now you move into week two, menstruation is done, hit it hard. And one of the best things that's actually high activity, and guys are going to love this part, that includes sex. Do you get what I'm saying? Burst training. Dr. Axe: Yeah. Dr. Flynn: So move into your burst training there on time. Week three, week three, guys, is where women actually make probably the most chronic illness they have. Because hormones have to be the highest, they have to be. And if they're mentally stressed out and they're pushing their body to high extremes, that third week they'll deplete their hormones, that will cause more illness in a woman than anything in history. Dr. Axe: So week three is when men should be buying their significant others spa packages and giving them foot massages . . . Dr. Flynn:Make the bath for them. Dr. Axe: . . . fanning them and feeding them grapes, the whole thing. Dr. Flynn: Well, and I always say this in my Hormone Connection seminar, week three we call that the woman zone. Guys, you have to understand this is where a woman has to have very little stress in her life. And if they do not, guess what, you can laugh, you can disagree, everything like that, but you know something? Infertility, PCOS, every hormonal problem, depression, all time high. Dr. Axe: Yeah, it is. Dr. Flynn: And if we don't change our thinking. And so that's why clinically what we started to do now is this, we started to test women during those times. And that's the big key. Ladies, each one of you guys are so different out there. We have beautiful women here like crazy, but each one of these women are different. So we got to test them to see what their body needs and how to do it. Dr. Axe: Yeah. So just understanding that your body is cyclical in nature, women, it's important, again. That first week of menstruation you should be doing yoga, walking and hiking outside, getting sun, just doing things that are very active and movement-oriented, but not super physically taxing. Doing that the first and third week of the month. And then the second and fourth, hey, going hard at it, doing burst training, doing some weight training, doing some things that are physically exerting. But really knowing your body is cyclical and exercising in such a way is really a key to naturally balancing your hormones. And we're going to dive in here and now talk about toxicity, this is a big topic. But, by the way, I see we got people joining from all over the world right now. I want to say "thanks" for everybody who's joining us live here on this live training. I'm talking here to Dr. Patrick Flynn, he's known as "The Hormone Whisperer." Hey, if you want to learn more about him, just do a Google search online, open a new tab now and look up "The Hormone Whisperer Dr. Patrick Flynn." You can learn about his clinic. Dr. Flynn: Yeah, "The Wellness Way clinics" is probably the easiest way to actually search us. Dr. Axe: Yeah, he has people fly in from all over the world to help them address hormone imbalance and infertility, some things we're talking about today. And men, actually deals with a lot of men with low testosterone levels, helping lay out plans for them, as well. All right, so let's talk about toxicity. How do toxins play a role? Let's also maybe talk about detoxification here. Let's talk about this whole area. Dr. Flynn: Well, you want to think about it this way, the whole endocrine system is a pattern that changes. As women know, they cycle. Men do cycle, too. Men cycle through the day, their testosterone level is higher in the morning than it is at night. Ladies, you know how you can find out? Tomorrow morning before your husband is awake lift up the sheet. You get what I'm saying? His hormones are high in the morning, it's out of his control. Okay? And I love that all the ladies laugh when I say that, but it's true. See, so we do have that cyclic pattern. That whole cyclic pattern can be disrupted by toxins. Let me give you a very sad female example. Once again, had a young lady come in, for example, that thought she was going through menopause in her 30s because what happened is she went to her doctor, she got a flu vaccine, and he cycle stopped. Do you see what I'm saying? Because heavy metals can disrupt the pituitary and disrupt the whole endocrine system, and of course she stopped menstruating that way. And then we start to detox her and stuff, and then once again her cycle started to come on. So there's a lot of things that cause massive toxins. Plastics, don't drink out of plastic. Use glass cookware. Don't store your food in things that actually can have BPA, all those endocrine disrupters. If you look at all the phytoestrogens that are out there today. You get what I'm saying? I know there's a big controversy because they don't test. What happens is this, people actually love soy. And I'm sitting there going, "Soy is an endocrine disrupter." Actually, even if you look at the breast cancer websites, they're even medical, they'll tell you stay away from soy. So be very careful with things that are endocrine disrupters because they're really toxins to the whole system to coordinate all this. Dr. Flynn: Yeah. And one of the tips I know you and I have both given people, Dr. Patrick, is one of the other big things for women is, hey, eat meat, but make sure it's organic and wild. Here's a big thing, conventional meat and dairy, we know they are packed with steroids and growth hormones. In fact, there's a study out of Spain that I had read saying the average glass of milk has 21 pharmaceuticals in it, from estradiol, other hormone mimickers, things that can really disrupt the hormones. So, again, women, only organic, wild, natural meats and dairy when you're consuming those. Stay away from the soy. We're not going to get into genetically modified foods because it would go for an hour, but stay away from GMOs, stay away from plastic containers, use glass, use stainless steel, use cast iron when you're cooking. Switch over there. Dr. Flynn: And I want to talk about this. Here's something that a lot of people don't know is an endocrine disrupter, but it's classified as one. Birth control pills. Dr. Axe: Oh, huge. Dr. Flynn: Birth control pills are known as an endocrine disrupter. But here's one thing, guys. This is what a lot of men don't understand. I can actually get a man to stop his wife taking birth control from a very easy thing. If you touch your wife or you have sex with her or you kiss her, guess what happens. You can transfer that birth control hormone to your husband. See what I'm saying? It's passive diffusion that way. And so therefore, guys, if your wife is taking this toxin, this endocrine disrupter, you're getting it. There's a lot of times that I will test guys and their levels will be very elevated. I'm like, "Are you taking any steroids or any illegal drugs?" They're like, "No." I'm like, "Then your wife is." He's like, "How do you know that?" "Because she's passed it to you." Dr. Axe: Yeah. Dr. Flynn: And so those are big disrupters and our number one source. This is well-documented and you can go read this on WebMD. The number one source, even if they don't take birth control, public water systems. Because there's no filtration to actually get it out. So in the city, a woman pees, it goes to the water treatment plant, it goes right back out to the water. So don't drink from a public water system. Dr. Axe: Dr. Patrick, these are huge tips, so this is public water here. Dr. Flynn: Yeah. Dr. Axe: Again, make sure you get a filter with either reverse osmosis or some type of filter in your house. I want to mention this, as well. I was leading a training yesterday and someone asked the question, "What are the side effects of birth control pills?" One of the things people also don't know is that it actually leaches vitamins and minerals from your body. In fact, it's probably the number one medication that robs your body of all of your B vitamins, including folate, which is critical for neural development of an infant, of a fetus. And so, again, the side effects of birth control. Also, I've had so many women I've taken care of with candida issues. Once they got off birth control, yeast and candida just grew like crazy. So this drug actually causes, within Chinese medicine it's called, dampness within your body. So, again, as Dr. Patrick is telling you, I can tell you as well from a clinical perspective these things are big. Now let's talk about some things people can do and be proactive with healing their hormones, balancing out their body. Dr. Patrick, what are some of the key nutrients people need to start to balance out their hormones? Dr. Flynn: This surprises people the most. Actually, I know it's so simple, but remember water, by far, is our number one nutrient. Dr. Axe: Yeah. Dr. Flynn: Number two, salt. Salt is key for hormonal development that way. Dr. Axe: Want to stick salt in there? Dr. Flynn: Yeah. And then number three, for example, magnesium. Magnesium is so important for the uterus, and that's why you'll see a lot of people use magnesium just to even calm menstrual cramps down that way. Magnesium is a very good part. Now there's actually another thing that surprises people when I talk about this because it's actually essential for actual implantation from the egg, development egg, onto the uterus. Cannabidiols, CBDs. Dr. Axe: Wow. Dr. Flynn: CBDs. And that's why, for example, CBDs are so important to our body. Actually, it's interesting because there's CBDs, cannabidiols, in breast milk. Okay? There's CBDs in a lot of food substances. There's CBDs, for example, in echinacea. Dr. Axe: Wow. Dr. Flynn: Yeah, a lot of people don't know that. Dr. Axe: Echinacea. Dr. Flynn: Echinacea is actually known as the poor man's marijuana. Dr. Axe: Okay. Dr. Flynn: Obviously the most known substance to actually produce CBD is actually marijuana. Hemp is fantastic, you can get CBDs from hemp that way. So yeah, these are key nutrients that are essential actually for not only fertility, but just even normal cycles. Dr. Axe: One of the things you and I were talking earlier, we talked about how great hemp seeds are for women to add into smoothies. So one of the ways to get several of these things, do two tablespoons every morning. We love bone broth, too. Do some bone broth, a protein powder that comes from bone broth, some health fats like coconut milk. But add a couple tablespoons of hemp seeds to your smoothie every single morning. They also contain the fatty acid GLA, which we know is great for hormones. Dr. Flynn: Yeah. Dr. Axe: Great tips there. I want to mention here B vitamins, too, making sure. And you're going to get those. We had one question for you, Dr. Patrick. "What do I do diet-wise if I'm a vegan?" Dr. Flynn: Okay. Well, actually that's not really that terrible because let's go back even to cholesterols and things like that. Dr. Axe: Yeah. Dr. Flynn: If you look at some of your best protein sources, obviously meat sources are very good that way. But hemp, spirulina are probably the two best protein sources that lead to there. And I love those things, so I actually do it. You don't need meat sources. Now that's one thing a lot of people freak out about that people don't realize. You can go without meat and be healthy, it's just much more difficult. Dr. Axe: It's tough. Dr. Flynn: And it becomes more management than it does anything. That's why having some wild game and things like that are much easier to get our sources that way. But there are wonderful superfoods. See, a lot of people don't realize a food gives you nutrients, but a superfood can actually create biochemical reactions. And, see, that's why we look at hemp, hemp is a superfood. Spirulina is a superfood that way. Cacao, chocolate is a superfood. Okay? Cacao actually has cannabidiols in there. So being a vegan, you can do this very easy that way. And just remember move towards the things, for example, that are easy to replace, and that's our superfoods. Dr. Axe: Love it, great advice. Let's talk about herbs now. We're going to talk about herbs, the best foods, and the best essential oils here. And if you're loving this live video as I am here with Dr. Patrick Flynn here, "The Hormone Whisperer," take a minute right now, punch the "share" button, click the "like" button, help us spread the word that food is medicine. And the real way is to get to the root cause of hormone imbalance, infertility, PCOS, and even low testosterone, these hormone issues. All right, thanks, everybody, for being on mission with us. I see everybody sharing this right now on my phone. All right, so let's talk about herbs. One we've talked about was schisandra, let's talk about that. Dr. Flynn: Well, schisandra is actually known as one of the most longevity herbs for a woman, but here's the big key. Herbs really, for example, once again help with support to the whole endocrine system that way. But going back to even cholesterol that way, all of your hormones, even though produced by the ovaries and adrenals that way, they go to the liver and they go through processes within the liver to actually convert from one form to another. To change estrogens, you need methyl groups. That's why methyl Bs do a wonderful job. Okay? And we're going to get to a couple of the foods that way, but schisandra is one of the very few herbs that change all functions of the liver that way. So that's why it's one of the most important things. Like you said, milk thistle you're writing down, milk thistle is essential. That's why detoxing for a woman is extremely important, even compared to a man. Ladies, does this frustrate you? Because I know you guys are like, you ever notice this, that your husband can actually stop drinking soda and he loses 20 pounds and actually you stop drinking soda and you gain 5 pounds? Okay? Because when that happens it comes down to the liver. And what happens is women need to actually start to clear that liver out, that's why detoxing is so essential for female hormone health. Dr. Axe: Wow. Dr. Flynn: It really is. And things like milk thistle, schisandra, and turmeric actually open up those pathways, allow things to convert. And, once again, this can be tested for. It's a wonderful thing to do. It's essential, women. If you haven't detoxed, guess what, you need to. Otherwise your hormones cannot convert into the forms they need to be. Dr. Axe: Yeah. So if you have never heard of schisandra, this is one of the sort of core herbs used within traditional Chinese medicine. We know milk thistle. I want to mention this was a huge point that Dr. Patrick just said. We tend to think of our liver as this just takes care of environmental toxins, it produces cholesterol, which we talked about how important that is for your body and for your hormones. We know your liver actually is probably the chief organ for balancing out estrogens and getting rid of phyto and xenoestrogens from those plastics and other chemicals you have in your body. So, again, taking care of your liver, women, is probably one of the most important organs in regards to your fertility that you can be taking care of. So we know milk thistle is great for that. There's actually another great Chinese herb, bupleurum tends to be great for that. So this is great advice here. We talked about some foods, what are a few more foods that are great for infertility and hormones? Dr. Flynn: Well, I'm going to actually, Doc, you didn't know I was going to do this today, I didn't tell him about this. It's not a joke. My favorite food right now, for example, is Dr. Josh's bone protein. Dr. Axe: Okay. Dr. Flynn: Okay? Now let me explain why. And, see, I've been saving this just for our video today. You always got to do a couple things that are kind of fun. So what happens is, as I could teach you right now, mental stress will drain a woman's hormones faster than anything. The second thing that actually makes women's hormones drought faster than anything is gut issues. Dr. Axe: Wow. Dr. Flynn: Gut issues. Dr. Axe: Yes. Dr. Flynn: Because any time there's an immediate reaction within the gut, the body searches for cortisone. Well, cortisol converts into our cortisone. Progesterone converts into our cortisone. So GI inflammation will damage it, leaky gut will damage it and it will cause so much inflammation. Ladies, it will drain your hormones. So, once again, and then the cool thing about his bone broth protein is not only is it going to help with leaky gut, but it's also going to give us the amino acids and all of the things that we need to actually support with the cholesterol to be able to do it. So it's one of our favorite foods, it's why we ask our patients take a scoop of it a day. See what I'm saying? Because then you're covering two aspects. You're causing one of the causal factors, but then you're giving the body the food it needs to actually build up the hormonal levels. I love beets, love beets. Okay? Beets use, for example, should be essential for actually hormone growth and development. A beet has a lot of methyl groups. Okay? Methyl groups are very important, especially in cancers. Because what happens is when the estrogens conform to one form or the other, if they don't convert properly, certain levels will start to rise. The methyl groups actually attach them and convert and rid them out of liver that way. And so that's why it's very key. I love beets that way. And then we get to the food again, spirulina and hemp. Spirulina and hemp, two essential foods that way. You can get these anywhere, it's actually fantastic. So those would be my four top foods, for example, for people to do it that way. But now obviously is there more? Yes. But those four, if you want to take a step actually making your hormones in the right direction, wonderful foods to implement in right away. Dr. Axe: I love it, great advice. One of the things people don't know about bone broth, which is one of the things you just mentioned and told everybody, is that it also contains an amino acid called glycine, which is critical for liver function, and contains proline and hydroxyproline, critical for gut repair. And one other thing I want to mention here, I was reading a study this week, Dr. Patrick, that said most us get actually probably too much muscle meat in our diet and not enough amino acids rich in glycine, and glycine actually increases life span. Just really incredible looking at its benefits. Let's talk now about essential oils. By the way, thanks, everybody, who's sharing this information on mission with us. We know that this information can help transform the lives of millions of men and women who are struggling with infertility, women with PCOS, men with low testosterone. And I'm here with Dr. Patrick Flynn, "The Hormone Whisperer." If you want to learn more about him, you can just do a Google search for "Hormone Whisperer Dr. Patrick Flynn." And he owns the clinics The Wellness Way and he's out of Wisconsin. Dr. Flynn: Green Bay, Wisconsin. Dr. Axe: And has people fly from all over the world to come see him to get help with hormones. All right, so let's talk about essential oils. What are your favorite essential oils for balancing hormones and fertility? Dr. Flynn: Patchouli, number one. Patchouli to me, for example, and even if you go back in its history, it's actually known as an endocrine increaser that way. And it's an adaptogen. So I love patchouli, for example. I love lemon. Lemon is one that we've lost because lemon is so prevalent in our culture that way, we lost the medicinal benefit of it that way and how amazing it is for us that way. And then thyme. Those three, for example, are probably my three favorite that way, and actually in that order. Dr. Axe: Love it. Patchouli, lemon and thyme, those three essential oils. And typically the way that you can use these oils, now do you recommend topically or internally? Dr. Flynn: Both. See, I'm a big proponent of actually orally. Dr. Axe: Yeah. Dr. Flynn: I am. I know a lot of people [Inaudible 00:36:04]. I like it being diffused. We have diffusers in our offices like crazy. You can actually rub them on your skin, no doubt. But actually the essential oil, if you're looking at an herb, for example, that comes from the root, okay? The oil also comes from a plant, it can be ingested. And the nice thing is, for example, it's much more absorbable here than it is on our skin. And it absorbs well through our skin, but orally, for example, you get a much quicker. Because there's neurological receptors in our oral cavity that way that can create an endocrine response quickly. That's why I like them to be done orally. Dr. Axe: I love it. One of the things I love here about thyme oil, as well, it's a pro-progesterone. Which, actually, men oftentimes are low in progesterone, too. So, again, great for that. So, guys, we've covered a lot of information here. Just to simplify, I want to walk through a few final things here, as well. By the way, if you're not subscribed here to our live feed, make sure you subscribe here to our channel. We got a lot more great content information coming out. But a few things just to run down here. As Dr. Patrick talked about, you want to test. In order for you to really find out some of the root causes of what's going on, it's really important to test not just estrogen, there are multiple types of estrogens that you want to get tested for. Cholesterol is critical for balancing your hormones. Listen, cholesterol is good. Cholesterol plus protein equals your hormones. If you have low cholesterol, it will harm or could harm your fertility and your hormones. Get, not conventional eggs, but go to your farmers' market. Those bright orange yokes, that's what you want. Eggs, avocados, tallow, coconut. Talked about, with mental stress, doing California poppy along with lavender and things like that to relax the body, some fatty acids. Here are some of the top foods to get: macadamia nuts, walnuts, flax seeds, and salmon. Exercise. Now this was something, I think, really eye-opening for a lot of people, Dr. Patrick. That first week of menstruation you want to do yoga and walking and hiking. You don't want to really physically exert yourself. So week one and three you want to rest or do more yoga and walking outside. Hey, weeks two and four, go for it. It's weight training, it's burst training, it's exerting yourself more. We talked about getting rid of the toxins, especially birth control in public water where some of the chemicals are hidden. We talked about all of these nutrients you need, herbs, foods, essential oils. I know this seems like a lot, but what I would do is take this information and just write down a plan. Number one piece of advice, change your breakfast, start doing that superfood smoothie with some bone broth and hemp seeds and spirulina, make that superfood smoothie every single morning, start incorporating just a few of these things at a time into your daily schedule. And if you want more help, we've got some great articles on draxe.com. You can look up "Dr. Axe PCOS," "Dr. Axe hypothyroidism," "Dr. Axe infertility." We have some articles that go in depth on some of these things. And also, hey, if you want to work with a practitioner, hey, check out Dr. Patrick Flynn, just Google search "Dr. Patrick Flynn Hormone Whisperer." He resides in Wisconsin, but sees people from all over the world. And, Dr. Patrick, this has been a great training on hormones. Dr. Flynn: Thanks, man. Appreciate it, doc. Dr. Axe: Loved you having you. And, hey, thanks, guys, for watching live. We'll be back again here later this week with some more live trainings.

Contents

Definition

"Demographers tend to define infertility as childlessness in a population of women of reproductive age," whereas "the epidemiological definition refers to "trying for" or "time to" a pregnancy, generally in a population of women exposed to" a probability of conception.[7] Currently, female fertility normally peaks at age 24 and diminishes after 30, with pregnancy occurring rarely after age 50.[8] A female is most fertile within 24 hours of ovulation.[8] Male fertility peaks usually at age 25 and declines after age 40.[8] The time needed to pass (during which the couple tries to conceive) for that couple to be diagnosed with infertility differs between different jurisdictions. Existing definitions of infertility lack uniformity, rendering comparisons in prevalence between countries or over time problematic. Therefore, data estimating the prevalence of infertility cited by various sources differs significantly.[7] A couple that tries unsuccessfully to have a child after a certain period of time (often a short period, but definitions vary) is sometimes said to be subfertile, meaning less fertile than a typical couple. Both infertility and subfertility are defined as the inability to conceive after a certain period of time (the length of which vary), so often the two terms overlap.

World Health Organization

The World Health Organization defines infertility as follows:[9]

United States

One definition of infertility that is frequently used in the United States by reproductive endocrinologists, doctors who specialize in infertility, to consider a couple eligible for treatment is:

  • a woman under 35 has not conceived after 12 months of contraceptive-free intercourse. Twelve months is the lower reference limit for Time to Pregnancy (TTP) by the World Health Organization.[6]
  • a woman over 35 has not conceived after 6 months of contraceptive-free sexual intercourse.

These time intervals would seem to be reversed; this is an area where public policy trumps science. The idea is that for women beyond age 35, every month counts and if made to wait another 6 months to prove the necessity of medical intervention, the problem could become worse. The corollary to this is that, by definition, failure to conceive in women under 35 isn't regarded with the same urgency as it is in those over 35.

United Kingdom

In the UK, previous NICE guidelines defined infertility as failure to conceive after regular unprotected sexual intercourse for 2 years in the absence of known reproductive pathology.[10] Updated NICE guidelines do not include a specific definition, but recommend that "A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner, with earlier referral to a specialist if the woman is over 36 years of age.[11]

Other definitions

Researchers commonly base demographic studies on infertility prevalence on a five-year period.[12] Practical measurement problems, however, exist for any definition, because it is difficult to measure continuous exposure to the risk of pregnancy over a period of years.

Primary vs. secondary infertility

Primary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives.[13] The World Health Organisation also adds that 'women whose pregnancy spontaneously miscarries, or whose pregnancy results in a still born child, without ever having had a live birth would present with primarily infertility'.[14]

Secondary infertility is defined as the absence of a live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives.[14]

Thus the distinguishing feature is whether or not the couple have ever had a pregnancy which led to a live birth.

Effects

Psychological impact

The consequences of infertility are manifold and can include societal repercussions and personal suffering. Advances in assisted reproductive technologies, such as IVF, can offer hope to many couples where treatment is available, although barriers exist in terms of medical coverage and affordability. The medicalization of infertility has unwittingly led to a disregard for the emotional responses that couples experience, which include distress, loss of control, stigmatization, and a disruption in the developmental trajectory of adulthood.[15]

Infertility may have profound psychological effects. Partners may become more anxious to conceive, increasing sexual dysfunction.[16] Marital discord often develops in infertile couples, especially when they are under pressure to make medical decisions. Women trying to conceive often have clinical depression rates similar to women who have heart disease or cancer.[17] Even couples undertaking IVF face considerable stress.[18]

The emotional losses created by infertility include the denial of motherhood as a rite of passage; the loss of one’s anticipated and imagined life; feeling a loss of control over one’s life; doubting one’s womanhood; changed and sometimes lost friendships; and, for many, the loss of one’s religious environment as a support system.[19]

Emotional stress and marital difficulties are greater in couples where the infertility lies with the man.[20]

Social impact

In many cultures, inability to conceive bears a stigma. In closed social groups, a degree of rejection (or a sense of being rejected by the couple) may cause considerable anxiety and disappointment. Some respond by actively avoiding the issue altogether; middle-class men are the most likely to respond in this way.[21]

In an effort to end the shame and secrecy of infertility, Redbook in October 2011 launched a video campaign, The Truth About Trying, to start an open conversation about infertility, which strikes one in eight women in the United States. In a survey of couples having difficulty conceiving, conducted by the pharmaceutical company Merck, 61 percent of respondents hid their infertility from family and friends.[22] Nearly half didn't even tell their mothers. The message of those speaking out: It's not always easy to get pregnant, and there's no shame in that.

There are legal ramifications as well. Infertility has begun to gain more exposure to legal domains. An estimated 4 million workers in the U.S. used the Family and Medical Leave Act (FMLA) in 2004 to care for a child, parent or spouse, or because of their own personal illness. Many treatments for infertility, including diagnostic tests, surgery and therapy for depression, can qualify one for FMLA leave. It has been suggested that infertility be classified as a form of disability.[23]

Causes

Sexually transmitted infections

Infections with the following sexually transmitted pathogens have a negative effect on fertility: Chlamydia trachomatis and Neisseria gonorrhoeae. There is a consistent association of Mycoplasma genitalium infection and female reproductive tract syndromes. M. genitalium infection is associated with increased risk of infertility.[24][25]

Genetic

A Robertsonian translocation in either partner may cause recurrent spontaneous abortions or complete infertility.[citation needed]

Other causes

Factors that can cause male as well as female infertility are:

German scientists have reported that a virus called Adeno-associated virus might have a role in male infertility,[44] though it is otherwise not harmful.[45] Other diseases such as chlamydia, and gonorrhea can also cause infertility, due to internal scarring (fallopian tube obstruction).[46][47][48]

Females

The following causes of infertility may only be found in females. For a woman to conceive, certain things have to happen: vaginal intercourse must take place around the time when an egg is released from her ovary; the system that produces eggs has to be working at optimum levels; and her hormones must be balanced.[49]

For women, problems with fertilisation arise mainly from either structural problems in the Fallopian tube or uterus or problems releasing eggs. Infertility may be caused by blockage of the Fallopian tube due to malformations, infections such as chlamydia and/or scar tissue. For example, endometriosis can cause infertility with the growth of endometrial tissue in the Fallopian tubes and/or around the ovaries. Endometriosis is usually more common in women in their mid-twenties and older, especially when postponed childbirth has taken place.[50]

Another major cause of infertility in women may be the inability to ovulate. Malformation of the eggs themselves may complicate conception. For example, polycystic ovarian syndrome is when the eggs only partially developed within the ovary and there is an excess of male hormones. Some women are infertile because their ovaries do not mature and release eggs. In this case synthetic FSH by injection or Clomid (Clomiphene citrate) via a pill can be given to stimulate follicles to mature in the ovaries.

Other factors that can affect a woman's chances of conceiving include being overweight or underweight,[51] or her age as female fertility declines after the age of 30.[52]

Sometimes it can be a combination of factors, and sometimes a clear cause is never established.

Common causes of infertility of females include:

Males

The main cause of male infertility is low semen quality. In men who have the necessary reproductive organs to procreate, infertility can be caused by low sperm count due to endocrine problems, drugs, radiation, or infection. There may be testicular malformations, hormone imbalance, or blockage of the man's duct system. Although many of these can be treated through surgery or hormonal substitutions, some may be indefinite.[54] Infertility associated with viable, but immotile sperm may be caused by primary ciliary dyskinesia. The sperm must provide the zygote with DNA, centrioles, and activation factor for the embryo to develop. A defect in any of these sperm structures may result in infertility that will not be detected by semen analysis.[55]

Combined infertility

In some cases, both the man and woman may be infertile or sub-fertile, and the couple's infertility arises from the combination of these conditions. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance.

Unexplained infertility

In the US, up to 20% of infertile couples have unexplained infertility.[56] In these cases abnormalities are likely to be present but not detected by current methods. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization. Also, polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility.[57] However, a growing body of evidence suggests that epigenetic modifications in sperm may be partially responsible.[58][59]

Diagnosis

If both partners are young and healthy and have been trying to conceive for one year without success, a visit to a physician or women's health nurse practitioner (WHNP) could help to highlight potential medical problems earlier rather than later. The doctor or WHNP may also be able to suggest lifestyle changes to increase the chances of conceiving.[60]

Women over the age of 35 should see their physician or WHNP after six months as fertility tests can take some time to complete, and age may affect the treatment options that are open in that case.

A doctor or WHNP takes a medical history and gives a physical examination. They can also carry out some basic tests on both partners to see if there is an identifiable reason for not having achieved a pregnancy. If necessary, they refer patients to a fertility clinic or local hospital for more specialized tests. The results of these tests help determine the best fertility treatment.

Treatment

Treatment depends on the cause of infertility, but may include counselling, fertility treatments, which include in vitro fertilization. According to ESHRE recommendations, couples with an estimated live birth rate of 40% or higher per year are encouraged to continue aiming for a spontaneous pregnancy.[61] Treatment methods for infertility may be grouped as medical or complementary and alternative treatments. Some methods may be used in concert with other methods. Drugs used for both women and men[62] include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogues, aromatase inhibitors, and metformin.

Medical treatments

Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of the following. If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), a course of ovarian stimulating medication maybe used. The physician or WHNP may also suggest using a conception cap cervical cap, which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, or intrauterine insemination (IUI), in which the doctor or WHNP introduces sperm into the uterus during ovulation, via a catheter. In these methods, fertilization occurs inside the body.

If conservative medical treatments fail to achieve a full term pregnancy, the physician or WHNP may suggest the patient undergo in vitro fertilization (IVF). IVF and related techniques (ICSI, ZIFT, GIFT) are called assisted reproductive technology (ART) techniques.

ART techniques generally start with stimulating the ovaries to increase egg production. After stimulation, the physician surgically extracts one or more eggs from the ovary, and unites them with sperm in a laboratory setting, with the intent of producing one or more embryos. Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman's reproductive tract, in a procedure called embryo transfer.

Other medical techniques are e.g. tuboplasty, assisted hatching, and Preimplantation genetic diagnosis.

In vitro fertilization

IVF is the most commonly used ART. It has been proven useful in overcoming infertility conditions, such as blocked or damaged tubes, endometriosis, repeated IUI failure, unexplained infertility, poor ovarian reserve, poor or even nil sperm count.

Intracytoplasmic sperm injection

ICSI technique is used in case of poor semen quality, low sperm count or failed fertilization attempts during prior IVF cycles. This technique involves an injection of a single healthy sperm directly injected into mature egg. The fertilized embryo is then transferred to womb.

Tourism

Fertility tourism is the practice of traveling to another country for fertility treatments.[63] It may be regarded as a form of medical tourism. The main reasons for fertility tourism are legal regulation of the sought procedure in the home country, or lower price. In-vitro fertilization and donor insemination are major procedures involved.

Epidemiology

Prevalence of infertility varies depending on the definition, i.e. on the time span involved in the failure to conceive.

  • Infertility rates have increased by 4% since the 1980s, mostly from problems with fecundity due to an increase in age.[64]
  • Fertility problems affect one in seven couples in the UK. Most couples (about 84%) who have regular sexual intercourse (that is, every two to three days) and who do not use contraception get pregnant within a year. About 92 out of 100 couples who are trying to get pregnant do so within two years.[65]
  • Women become less fertile as they get older. For women aged 35, about 94% who have regular unprotected sexual intercourse get pregnant after three years of trying. For women aged 38, however, only about 77%. The effect of age upon men's fertility is less clear.[65]
  • In people going forward for IVF in the UK, roughly half of fertility problems with a diagnosed cause are due to problems with the man, and about half due to problems with the woman. However, about one in five cases of infertility has no clear diagnosed cause.[66]
  • In Britain, male factor infertility accounts for 25% of infertile couples, while 25% remain unexplained. 50% are female causes with 25% being due to anovulation and 25% tubal problems/other.[67]
  • In Sweden, approximately 10% of couples wanting children are infertile.[68] In approximately one third of these cases the man is the factor, in one third the woman is the factor, and in the remaining third the infertility is a product of factors on both parts.

Society and culture

Perhaps except for infertility in science fiction, films and other fiction depicting emotional struggles of assisted reproductive technology have had an upswing first in the latter part of the 2000s decade, although the techniques have been available for decades.[69] Yet, the number of people that can relate to it by personal experience in one way or another is ever growing, and the variety of trials and struggles is huge.[69]

Pixar's Up contains a depiction of infertility in an extended life montage that lasts the first few minutes of the film.[70]

Other individual examples are referred to individual subarticles of assisted reproductive technology

Ethics

There are several ethical issues associated with infertility and its treatment.

  • High-cost treatments are out of financial reach for some couples.
  • Debate over whether health insurance companies (e.g. in the US) should be required to cover infertility treatment.
  • Allocation of medical resources that could be used elsewhere
  • The legal status of embryos fertilized in vitro and not transferred in vivo. (See also Beginning of pregnancy controversy).
  • Pro-life opposition to the destruction of embryos not transferred in vivo.
  • IVF and other fertility treatments have resulted in an increase in multiple births, provoking ethical analysis because of the link between multiple pregnancies, premature birth, and a host of health problems.
  • Religious leaders' opinions on fertility treatments; for example, the Roman Catholic Church views infertility as a calling to adopt or to use natural treatments (medication, surgery, and/or cycle charting) and members must reject assisted reproductive technologies.
  • Infertility caused by DNA defects on the Y chromosome is passed on from father to son. If natural selection is the primary error correction mechanism that prevents random mutations on the Y chromosome, then fertility treatments for men with abnormal sperm (in particular ICSI) only defer the underlying problem to the next male generation.

Many countries have special frameworks for dealing with the ethical and social issues around fertility treatment.

  • One of the best known is the HFEA – The UK's regulator for fertility treatment and embryo research. This was set up on 1 August 1991 following a detailed commission of enquiry led by Mary Warnock in the 1980s
  • A similar model to the HFEA has been adopted by the rest of the countries in the European Union. Each country has its own body or bodies responsible for the inspection and licensing of fertility treatment under the EU Tissues and Cells directive [71]
  • Regulatory bodies are also found in Canada [72] and in the state of Victoria in Australia [73]

Developing countries

Infertility is often not seen (by the West) as being an issue outside industrialized countries.[74] This is because of assumptions about overpopulation problems and hyper fertility in developing countries, and a perceived need for them to decrease their populations and birth rates.[75] The lack of health care and high rates of life-threatening illness (such as HIV/AIDS) in developing countries, such as those in Africa, are supporting reasons for the inadequate supply of fertility treatment options.[76] Fertility treatments, even simple ones such as treatment for STIs that cause infertility, are therefore not usually made available to individuals in these countries.[77]

Despite this, infertility has profound effects on individuals in developing countries, as the production of children is often highly socially valued and is vital for social security and health networks as well as for family income generation.[78] Infertility in these societies often leads to social stigmatization and abandonment by spouses.[79] Infertility is, in fact, common in sub-Saharan Africa. Unlike in the West, secondary infertility is more common than primary infertility, being most often the result of untreated STIs or complications from pregnancy/birth.[80]

Due to the assumptions surrounding issues of hyper-fertility in developing countries, ethical controversy surrounds the idea of whether or not access to assisted reproductive technologies should comprise a critical aspect of reproductive health or at least, whether or not the distribution and access of such technologies should be subject to greater equity.[81] However, as highlighted by Inhorn [82] the overarching conceptualisation of infertility, to a great extent, disguises important distinctions that can be made within a local context, both demographically and epidemiological and moreover, that these factors are highly significant in the ethics of reproduction. An important factor, argues Inhorn,[82] is the positioning of men within the paradigm of reproductive health, whereby because rates of general infertility mask differences between male and female infertility, men remain a largely invisible facet within the theorisation and discourse surrounding infertility, as well as the related treatments and biotechnologies. This is particularly significant given that male infertility accounts for more than half of all cases of infertility [83] and moreover, it is evident that the attitudes and behaviours of men have profound implications for the reproductive health of both individuals and couples.[84] For example, Inhorn [79] notes that when couples in Egypt are faced with seemingly intractable infertility problems - due to a range of family and societal pressures that centre around the place of children in constituting the gender identity of men and women - it is often the women who is forced to seek continued treatment; this continues to occur, even in known instances of male infertility and that the constant seeking of treatment frequently becomes iatrogenic for the women. Inhorn states that infertility often leads to “marital demise, physical violence, emotional abuse, social exclusion, community exile, ineffective and iatrogenic therapies, poverty, old age insecurity, increased risk of HIV/AIDS, and death”[76] Significantly, Inhorn demonstrates that this phenomenon can not simply be explained by a lack of knowledge, rather it occurs in a complex interaction between the centrality of children in the male gender identity as a symbol of maturity and the relative lack of power of women in Egyptian society, whereby they effectively become scapegoats for a culturally accepted narrative as a site of blame for the lack of childlessness. It should be emphasised that this is not simply an issue of “women oppressed by men” but rather, that men and women both share the burden of this narrative, but in different, unequal and highly complex ways. Therefore, while the notion that reproductive health is a ‘women’s issue’, may have powerful social currency, especially within popular discourse and indigenous systems of meaning, the reality of infertility suggests that medical and health paradigms have a significant part to play in challenging the validity of this entrenched belief . Moreover, the effectiveness of any therapeutic intervention, medical or otherwise will be contingent on such outcomes and has an important part to play in the alleviation of gendered suffering, especially the burden imposed on women, who continue to suffer disproportionately from the effects of infertility.

High costs may also be a factor and research by the Genk Institute for Fertility Technology, in Belgium, claimed a much lower cost methodology (about 90% reduction) with similar efficacy, which may be suitable for some fertility treatment.[85] At the 1994 United Nations International Conference on Population and Development (ICPD) in Cairo, the prevention and treatment of infertility was accepted into the program of action for reproductive healthcare. Infertility has shown to have a greater effect on developing nations than on birth rates or population control, but also on a social level as well. Reproduction is a large aspect of life for many cultures within developing nations, and infertility can lead to social and familial problems such as rejection or abandonment as well as personal psychological issues. Currently, fertility treatment options and programs are only available through private health sectors in developing nations and little-to-no treatment is available through public health sectors. The fertility treatment options offered through the private sectors are often costly or not easily accessible. Additionally, counseling is considered an essential aspect of fertility treatment, and due to lack of education and resources such forms of therapy remain scarce as well. While quality fertility care is not readily available in developing nations (such as sub-Saharan African countries), a standard procedure of care could be easily implemented for a low cost as a basic intervention. The lack of fertility treatment is problematic, and high birth and population rates are every reason to implement treatment options rather than reject them.[76]

See also

References

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