Infertility
CAUSE
This is not straight forward nor universally the same. However, many women with infertility issues have low thyroid, low progesterone or other significant health issues that need to be fixed. BUT, the issue might not be with the woman. Men have had a serious decrease in sperm counts over the last 40-50 years. One example: habitually carrying one’s cell phone in the front pockets of his pants can remarkably decrease sperm counts.
TREATMENT
The foundational treatment is to be sure that the mother is healthy, and this especially requires that the thyroid system is working well.
Thyroid: Routine thyroid testing is often inadequate, in my opinion. Most frequently, a single test is done, the TSH or Thyroid Stimulating Hormone, and that is not actually a thyroid hormone. It’s the hormone/message from the boss of the thyroid which is the pituitary gland. Normally, if you have too little thyroid hormone, the pituitary is supposed to begin “shouting” at the thyroid to wake up and get to work. Thus, the TSH is elevated above the lab normal range. A high TSH is interpreted as being THE way to diagnose low thyroid function. Many doctors in integrative/functional medicine would argue that this test is only one of the several factors that need to be evaluated in deciding on whether the thyroid function is low or not. This evaluation would include a more comprehensive panel of blood tests including TSH, the relatively inactive thyroid hormone T4, the active thyroid hormone T3, the “anti-thyroid hormone” Reverse T3, and testing for autoimmune thyroid disease; and one should seriously consider the history, the story of the patient as that tells us a lot about the possibility of thyroid dysfunction; and the physical exam can give several clues as to whether one is in fact hypothyroid. A thorough evaluation for possible low thyroid function thus includes at least a complete panel of lab tests, the physical exam, and the history. Making the diagnosis only based on the TSH is not adequate in my view. Treatment is fairly easy once we are clear on whether this is an issue or not.
Progesterone is the “Pro” or “for” gestation hormone, pro-gestation or pro-pregnancy, hormone. If the progesterone production of a woman is inadequate, she can have a difficult time with getting pregnant or maintaining a pregnancy. Women with low progesterone often have signs or symptoms of low progesterone which can include: PMS, painful periods, heavy periods or other manifestations of less than ideal menstrual cycles.
In addition, it’s important for the husband to be in good health for the optimal chance of a good pregnancy.