A Womb with a View

Across Canada, one out of six couples is infertile, using the official definition of not being able to conceive after 12 months of regular intimate relations without birth control. This number appears to be increasing, possibly because of aging-related difficulties; many women now choose to delay starting a family until they're older. As many as one million Canadians are affected.

In about 20 per cent of the cases, both partners have problems that cause the infertility. The rest are evenly divided between the sexes and include such problems as men with low sperm count and women with pelvic inflammatory disease. Conditions such as endometriosis, hormonal imbalances and polycystic ovaries can also make it difficult to conceive.

The only way to know what's causing the problem is to undergo an infertility workup. Following diagnosis, conventional medicine has a truckload of low- and high-tech methods available to help you. Some have names straight out of science fiction: in vitro fertilization (IVF the test tube procedure); gamete intrafallopian transfer (GIFT the egg is mixed with sperm in a Petri dish and transferred to the woman's fallopian tubes where fertilization occurs) and zygote intrafallopian transfer (ZIFT an embryo in its earliest stages after fertilization in the laboratory is transferred to the fallopian tube by laparoscopy). All of the methods are time-consuming, invasive and costly (a minimum $10,000 per high-tech procedure) and only 50 percent are successful.

According to Alice Domar, PhD, author and director of Harvard Medical School's Mind-Body Program for Infertility at Boston's Deaconess Hospital, infertility is a stressful condition. It causes depression, anxiety and fatigue similar to that seen in women with cancer, heart and autoimmune diseases. Stress hormones over a prolonged period can disrupt hormone balances and the reproductive system, contributing to PMS, menopausal symptoms, breast and uterine cancers and infertility.

Serafina Corsello, MD, medical director of the Corsello Centers for Nutritional Medicine in New York City, sees many women in their 20s and 30s with infertility problems related to hormone imbalances. The women have the estrogen in their bodies needed in the first phase of the menstrual cycle for the development of the egg and preparation of the uterus. But the hormones needed in the second half of the cycle for release and implantation of the egg, luteinizing hormone (LH) and progesterone, are low or lacking. Corsello blames the problem on too much estrogen not only what's made in the body but what comes into the body in the form of food and environmental chemicals such as polychlorinated biphenyls (PCBs).

Pre-Pregnancy Program

Corsello's natural fertility program includes: bowel cleansing; a "super-nutrition diet"; tonics; herbs; antioxidant supplements and something she calls "the harmony of healing." She requires patients to follow a bowel cleansing regimen for one or two weeks to rid their body of most biochemical imbalances caused by food malabsorption.

"Most people's intestines don't function properly due to stress-related accumulation of toxins. By cleaning out the intestines and adding back helpful bacteria (such as Lactobacillus acidophilus), you restore your intestinal ecology," she says.

The nutrition program features an all-organic diet consisting of 40 percent complex carbohydrates, 30 percent protein and 30 percent fat. Corsello advises daily consumption of organic soy products, eggs, three generous servings of vegetables, three fruits and six servings of whole grains, beans, seeds and nuts. She recommends that patients avoid non-organic milk products, sugar, sweets, stimulants and refined wheat products. She emphasizes essential fatty acids (EFAs), needed for numerous metabolic functions that rely on EFA derivatives, including anti-inflammatory activity and hormonal balance.

The daily supplement program includes 400 mg in capsules, once or twice a day, of the herb vitex (Agnus castus) or chasteberry. The active ingredients are unknown but extracts have been shown to have a progesterone-like effect. It's a traditional herbal for numerous female problems associated with menstruation, endometriosis and birth process and is safely used during pregnancy.

Dr Corsello prescribes antioxidants like folic acid (two mg); B12 (1,000 mcg daily); a B-complex supplement; zinc (20 to 50 mg daily); omega-3 fatty acids (as needed); vitamin C with bioflavonoids (500 to 1,000 mg daily) and vitamin E from mixed tocopherols (400 IU twice a day). Some patients' diets require supplementation with fatty acids, others get enough from their diet through eating fish and juicing.

The remainder of the program are tools that allow for relaxation: aromatherapy (lavender and rose), romantic music, candles and aesthetic surroundings. Corsello says, "It's amazing how this helps to regulate hormone functions!"

Infertility on the Rise

It's generally agreed that fertility is declining. In 1992, Niels Skakkebaek of the University of Copenhagen reported that sperm counts had dropped by about 50 percent worldwide between 1938 and 1991. Experts are still debating whether there really has been a global fall in sperm count or whether the apparent decline is more a reflection of geographical variations.

Harry Fisch, director of the male reproductive centre at the Columbia-Presbyterian Medical Center in New York City, resists the idea that estrogenic chemicals alone are behind the overall pattern. He points to lifestyle factors rather than a general decline in fertility. It might be possible to improve fertility by avoiding smoking, maintaining normal weight to avoid excessive heat to the testicles, drinking less alcohol and caffeine and avoiding DHEA and other supplements which may be converted to testosterone, thus limiting the body's own production of this hormone.

In complementary medicine practice, the primary tools are nutrition, natural hormones and stress management.