Fertility in the Age of the ‘Super Woman’

In Dr. Karen M. Pendleton, Health and Beautyby Lola Magazine

As my partner Dr. Jack Ward and I embarked on the establishment of our Lifestyle Medicine practice, PairO’Docs Bio-Rejuvenis, we initially concentrated on what is now one of our 10 tenets, tenet #8, Hormonal Balance. 

In the dawn of our practice, the organic draw was women in some spectrum of menopause…pre, peri, and/or full-blown menopause. Soon after, younger women were seeking us for proactive measures dealing with their fertility. That has been so heartwarming for me to be able to guide a woman in laying the groundwork for a healthy and fertile field.

About the same time, one of my family members was dealing with her own fertility challenges. She, like me, had pursued her medical education and career, only to discover her biological clock ticking away. When asked when she and her husband were going to start their family, her answer resonated with me. “We will start our family when we can fully love, nurture and enjoyed them.”

As her time approached (mid 30s) for targeting pregnancy, challenges emerged. Finally, after a decision to seek the recommendations of a fertility specialist, these were the recommendations presented: Intrauterine Insemination (IUI), In Vitro Fertilization (IVF), Donor Eggs / Embryo Adoption.

Infertility is defined as the inability to become pregnant after one year of unprotected intercourse in women under 35. Women aged 35 and older should seek care from a fertility specialist after six months of regular intercourse without conception.

Infertility affects more than ten percent of couples at some time during their reproductive lives. This means that one couple out of every ten will experience infertility, making it a relatively common condition.

While infertility was once considered a “female problem,” we now know that up to half of all couples have a male infertility component. This makes thorough testing of the male a necessity before beginning any female treatments.

One misconception is that most infertile couples will require In Vitro Fertilization (IVF). Studies show that only 8 to 15 percent of couples will eventually require IVF; and most become pregnant using procedures such as Intrauterine Insemination (IUI).

Intrauterine Insemination (IUI) is a medical procedure and, specifically, a type of artificial insemination that assists sperm reaching the egg more easily. Further, the sperm is placed into the uterus directly during ovulation to minimize the sperm’s travel time to improve the chances for fertilization.

Reported in the journal Facts, Views and Visions in OBGYN, the first documented case occurred in London, England, in the late 1700s. That procedure was the brainchild of a Scottish surgeon, Dr. John Hunter. 

Success rates vary depending on the age of the woman and other factors like sperm, fallopian tube status and cervical mucus conditions.

In Vitro Fertilization is a type of assisted reproductive technology, whereby an egg is fertilized by sperm in a test tube or elsewhere outside the body. The process involves monitoring and stimulating a woman’s ovulatory process, removing the ovum or ova (egg or eggs) from a woman’s ovaries and letting sperm fertilize them in a liquid medium in a laboratory. After the fertilized egg undergoes embryo culture for about two to six days, it is implanted into the uterus (mother or surrogate) with the intention of establishing a successful pregnancy.

Donor Eggs / Embryo Adoption is a process in which a fertile woman donates an egg, which undergoes fertilization in the laboratory. Then, the fertilized egg or eggs (now termed embryos) is/are transferred to the recipient’s uterus.

FYI: Donor sperm is the oldest form of assisted reproduction. Donated sperm can be used for Intracervical Insemination, IUI or IVF.

Surrogacy

With a surrogate, also known as a gestational carrier, a woman other than the intended mother carries the baby until birth. Sometimes donor eggs or sperm are used; other times, the parents’ own genetic material is.

Fast forward to my family member’s fertility decision: In Vitro Fertilization. The IVF yielded 10 embryos. Six were used for the procedure and the other four were frozen (officially known as Oocyte Cryopreservation). The first procedure with the above stated yielded one healthy baby boy. Fifteen months later, as the mother of that baby boy was making her hospital rounds, she ran into her fertility specialist. That doctor asked “What are you and your husband going to do with the other frozen embryos?” Her answer was, “Let’s schedule the next IVF procedure.” And, within days she was pregnant. Thus, in her case the IVF was a 100% effective. Oh, and did I mention, a healthy baby girl was born!

My family member’s fertility story truly inspired me to be of service to our community of “super women.” Who are these “super women?” These are women who are mothers, daughters, sisters, friends, and well, me, who are determined to set goals and achieve them. This dedication to our goals in many instances has required a lot of hard work and sacrifice. For me, I made a conscious decision to be child-free but have been labeled unintentionally (I hope) as childless. That’s okay because in the last 20 years, I’ve been instrumental in the conception of five babies, with the fifth to be born before the end of this year 2019. That success is based on my golden 10 tenets.

Americans are having fewer and fewer babies these days.

In 2018, there were nearly 3.8 million children born in the U.S. That may sound like a lot, but that’s the lowest number in more than three decades, according to statistics from the Centers for Disease Control and Prevention. There are many factors that have led to this decline. But it’s mainly driven by changes in our society. 

Here are the top reasons why fertility and birth rates are falling:

  1. People are having children later in life. 
  2. The cost of having children is rising.
  3. The number of unplanned pregnancies has dropped. 
  4. Environmental factors may play a role, i.e., hormone disruptors found in chemicals like pesticides and plastics.

In my evaluation of both women and men, I definitely target possible root causes and address them accordingly. 

In women these causes include:

  • Hormone Issues, i.e., sex (ovarian), pituitary, adrenal & thyroid hormones
  • Primary Ovarian Insufficiency / Failure
  • Polycystic Ovarian Syndrome (PCOS)
  • Pelvic Inflammatory Disease (PID)
  • Endometriosis
  • Uterine Fibroids
  • Abnormal Cervical Mucus
  • Obesity and the obesity-related diseases (Diabetes, Hypertension, Heart Disease)

In men these causes include:

  • Hormone Issues, i.e., sex (testicular), pituitary, adrenal and thyroid hormones
  • Testicular Abnormalities, i.e., undescended testes, varicocele
  • Tubular Defects (involves the network of tubes from the testes to the penis)

In both women and men these causes include:

  • Food Sensitivities
  • Autoimmune Diseases
  • Infections, i.e., Sexually Transmitted Diseases (STDs)
  • Medications, i.e. Anabolic Steroids (bodybuilding), Antifungal, Chemotherapeutics
  • Genetics, i.e. Genetic Carrier Screening

Once possible causes are identified and managed, other practices are so very important to incorporate. Again, many of these strategies are rooted in our practice’s 10 tenets. For example:

Tenet #7  | Nutrition and Gut Health:

Nourish your fertility with a healthy dietary lifestyle. In general, I am a proponent of the Mediterranean diet. Drink Electrolyzed Reduced Water. Compliment your diet with clean, food-grade, nutrient-dense, physician-directed supplements. 

Tenet #9  | Body Movement:

Engage in a balanced regimen of daily exercise 

Tenet #5  | Stress Management (anxiety)

Just breathe and press pause. Practice self-care with the laying on of healing hands. Love yourself and don’t forget your partner. Go out and play / dance. Do your homework… you don’t know what you don’t know until you know. Surround yourself with a supportive tribe that emphasizes a mind-body-spirit connection.

In addition, there are so many complimentary practices that I feel can be beneficial to those folks addressing their fertility. These include yoga, acupuncture, herbal medicine, hypnosis, biofeedback, Chiropractic care and Cannabis sativa (CBD and/or THC) – controversial.

And finally, let’s not forget about good old intimacy. Think about “bringing sexy back”! 

What are the newest advances available or on the horizon for fertility?

Just to name a few:

  • In Vitro Maturation (IVM)
  • Uterine Transplantation
  • Pre-Implantation Genetic Testing
  • Genetic Editing
  • Creation of egg and sperm, i.e., In Vitro Gametogenesis (IVG)

Just remember this quote from 

Georgia Witkin, PhD: 

“With today’s advanced technology, every woman is really just ‘pre-pregnant’; not infertile.”

If you are interested in being proactive in your wellness and/or fertility journey, I invite you to reach out to our practice.  Do so by going to www.AskiDrKaren.com and complete the Healthspan Quiz. 

DISCLAIMER:

All of the information found in this article is based on the opinion of the author Karen M. Pendleton, M.D.  The information is meant to motivate readers to make their own health decisions after consulting with their own health care providers.  All readers should consult a doctor before making a health change, especially those that are related to a specific diagnosis or health condition.  No information in this article should be relied on in determining a diet, making a medical diagnosis or determining a treatment for a medical condition. The information in this article is not intended to replace a relationship with a qualified healthcare practitioner and is not intended as medical advice. No information in this article should be used to diagnose, treat, prevent or cure any disease or condition.