Infertility in the United States is on the rise. The use of assisted reproductive technology (ART) by infertile couples is increasing by 5% to 10% annually. Although this may be partially due to societal factors such as advanced education and career opportunities for women, later marriage, and delayed childbearing, there is likely more to this issue. In fact, recent studies show that after a year of having unprotected sex, 15% of couples are unable to conceive a child. Moreover, after two years, 10% of couples had still not achieved a successful pregnancy.

Given the increased prevalence of this issue, more research is investigating potential causes of infertility. Below are some of the most common causes of infertility:

Environmental Toxins

Our modern society is filled with environmental toxins. From the air we breathe to the food we eat to the products we use; we are exposed to toxic chemicals on a daily basis. In fact, on average, we are exposed to over 700,000 toxic chemicals every day in the United States.

Lead is a well-known toxin that remains high in today’s environment due to its use in the paint used in old housing and pipelines, some metal jewelry, and some children’s toys. As a documented endocrine disruptor, lead has been shown to cause reproductive and fertility problems in both men and women. Moreover, lead is particularly harmful during the fetal development process and can lead to problems such as IQ, hyperactivity, and hearing problems. For both children and adults, lead can cause cardiovascular problems (increased blood pressure and hypertension), impaired kidney function, and thyroid disease.

More generally speaking, environmental toxins have the potential to damage sperm, eggs, and the developing fetus. Exposure to common substances like alcohol, tobacco, cannabis, caffeine, and plastics, for example, have all been linked to fertility and fetal development issues.

Learn more about the harm of environmental toxins.

Hormone Imbalances

Hormone dysfunction is often at the core numerous health issues including infertility. As chemical messengers, hormones are necessary in cellular communication and function. When hormone function is disrupted bodily systems such as reproductive health can be severely compromised.

Hormone production begins to decline after the age of 30 and continues to worsen if left unaddressed. In fact, both men and women are genetically programmed to stop producing testosterone after the age of 30. It is also prevalent for women to suffer from suboptimal levels of hormones such as estrogen and progesterone that are vital when it comes to fertility. For pregnancy to occur, hormones in the body must signal and regulate the growth of an egg within the ovary, release the egg, and then prepare the uterus for the implantation of a fertilized egg. An absence or irregular quantity of just one of the hormones involved in this process can delay or prevent a successful pregnancy.

Hormonal conditions such as PCOS and Endometriosis are becoming increasingly prevalent in the United States as well. Both of these conditions can make it incredibly difficult to conceive. PCOS can result in infrequent or absent ovulation while the cause of Endometriosis fertility issues is less understood. Although it is not fully understood, experts hypothesize that this is due to the condition’s ability to damage the fallopian tubes and/or ovaries. However, most women with endometriosis are likely to be able to conceive, especially when receiving support and treatment.

Learn about the benefits of progesterone for endometriosis here

Nutrient Deficiencies

Approximately 90% of Americans are deficient in at least one essential vitamin or mineral. Such nutrients are the building blocks of health, a severe deficiency can result in a variety of issues such as fatigue, brain fog, inflammation, joint pain, hair loss, low libido, and potentially, fertility problems.

For example, according to Ceko, a selenium deficiency has been linked to potential fertility issues: Selenium is an essential trace element found in protein-rich foods like red meat, seafood, and nuts. It is important for many biological functions, such as immune response, thyroid hormone production, and acts as an antioxidant, helping to detoxify damaging chemicals in the body. We’ve known for some time that selenium is important to men’s fertility, but until now no-one has researched how this element could be involved in healthy reproduction in women.

Our findings are important because they show that selenium and selenoproteins are at elevated levels in large, healthy ovarian follicles. We suspect they play a critical role as an antioxidant during the late stages of follicle development, helping to lead to a healthy environment for the egg, We found that gene expression of GPX1 was significantly higher – in some cases double – in egg cells that yielded a pregnancy.

The researchers cautioned that more research is needed to understand how to optimize selenium for fertility and that it’s not just a matter of taking more selenium supplementation.

Thyroid Health

Similar to a hormone imbalance, thyroid dysfunction is becoming an increasingly prevalent issue that results in systemic problems. In fact, of the 750 million people estimated to be living with thyroid disease globally, 60% remain undiagnosed.

In recent surveys of thyroid research, it was stated that the thyroid has a notable influence over various aspects of fertility in both men and women. Thyroid dysfunction has been implicated in contributing to a wide range of fertility issues including but not limited to anovulatory cycles, sex hormone imbalances, low sperm density, and abnormal sexual development. The critical role of the thyroid in these and other areas makes it imperative that we understand the influence of the thyroid on both female and male fertility.

​​Studies suggest that any form of thyroid dysfunction may impede female fertility. However, decreased thyroid activity, or hypothyroidism, appears to be the primary concern. A decline in thyroid function slows many bodily processes which can contribute to fertility issues such as luteal phase defects, hyperprolactinemia, and sex hormone balance. In addition to hypothyroidism, studies suggest that the more common subclinical hypothyroidism, which is not easily detectable through standard testing, can also cause serious fertility issues. Women are approximately three times more likely than men to have thyroid issues but sadly many of these cases go undiagnosed.

During pregnancy, the thyroid gains even greater importance regarding female fertility. It is widely agreed that maintaining healthy thyroid function and appropriate thyroid hormone values during pregnancy is critical for positive outcomes.

Thyroid Stimulating Hormone or TSH is one of the primary metrics used to assess thyroid function. Increased TSH values during pregnancy, indicative of thyroid dysfunction, is associated with a variety of issues including miscarriage.

A study evaluating over 50,000 hypothyroid women further defines the connection between TSH values and the risk of miscarriage. During the first trimester, nearly 63% of the participants had TSH values above 2.5 mU/L. 7% of the study population had TSH levels above 10 mU/L, far above the recommended value. Women who maintained TSH values above 4.51 had a higher incidence of miscarriage when compared to women with TSH values between 0.2 and 2.5 mU/L. Another study presented similar results. 202 of the nearly 4,600 participants presented elevated TSH during weeks 11-13 of gestation. Each of these cases resulted in miscarriage. This contrasts with the other 4,318 pregnant participants with no history of thyroid disease, all of which resulted in live births after 34 weeks.

Solving Fertility Issues

Although there are conditions that result in patients being infertile, oftentimes fertility issues can be resolved with a trusted endocrinologist. Holtorf Medical Group’s team of board-certified physicians is experienced in empowering men and women to resolve fertility, thyroid, and hormonal issues. If you or a loved one are dealing with fertility issues, contact us to book your appointment today.

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