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Fertility

What Is Fertility And How It Works?

Mar 19, 2021

Fertility is defined as the human body’s natural capacity to conceive a baby. And honestly, most of us take it for granted.

You have your monthly period, so assume that you can get pregnant easily. Right? Sadly, fertility doesn’t come easily to many of us. Infertility is the inability to naturally conceive a baby after a year of unprotected sex. And there are several, very varied factors that could be the cause behind this infertility. Global research shows that infertility affects 11% of couples worldwide and research shows that the pattern of infertility in some parts of India is the same as in other parts of the world, except that infertile couples report late for evaluation.

This comes as quite a surprise to some of us who have always taken fertility for granted. And with good reason! After all, we are a country where fertility was rarely an issue few decades ago. Our parents and grandparents seemed to be “naturally fertile”. So much so; we have a population problem in our country!

So what really changed? The answer – our modern lifestyle. Our parents and grandparents lived a generally healthier lifestyle. They ate good, home cooked food that was locally sourced, they understood the importance of moderation and everyday walks, they had a less stressful lifestyle and jobs, and they placed importance in a good night’s sleep. So, the reason their generation was naturally fertile is because they had better overall health because of their lifestyle choices.

And that’s the easiest way to understand how fertility works. Fertility is just a result of great health. Reproduction is a natural human function, but it can only happen when the person is in great health themselves.

How Fertility Works?

Let’s begin with Fertility 101. Every month, a woman’s reproductive system produces a cascade of hormones that cause ovulation. Ovulation occurs sometime mid of the menstrual cycle, and a healthy ovum is produced from either of the ovaries. This ovum or egg descends via fallopian tubes into the uterus. When the timing is right, the ovum is fertilized through sperm. Sperm is produced in the testes of men, and healthy sperm can survive for up to 2-3 days inside the uterus. The best time for conception is 2 days before ovulation and during ovulation, so that the sperm can fertilize the ovum. If for some reason, the ovum is not fertilized by sperm within 24 hours of being produced, it dissolves and results in your period.

This is how fertility works. And there are many factors that could be the cause behind infertility, in both men and women. It’s very important to understand that infertility is not just a female health issue. Infertility can affect both men and women, and both partners can take steps to improve their fertility.

What Can Affect Fertility In Women?

Most couples first notice fertility issues only when they have been unable to conceive naturally after having trying for about a year. However, it’s important to note that many causes of infertility started years ago and have been ‘silent’ until now, or ignored, until you wilfully want to want have baby.

Several factors can affect fertility for women.

  1. Age

Your age can affect your fertility. With advancing age, female fertility reduces, especially if you are suffering from lifestyle diseases like insulin resistance, diabetes type 2 or hypertension. Fertility for over 40 becomes particularly tricky as it comes with added risk factors.

2. Chronic Diseases

Many chronic, lifestyle diseases can also affect the reproductive system. Even if a disease and its treatment are not directly linked to the reproductive system, it can impact fertility. Some examples are diabetes, hypothyroidism, untreated celiac disease and periodontal disease.

3. Hormonal Imbalances

PCOS is extremely common today. And is one of the primary reasons for infertility. Many young women ignore the early warning signs and try to fix their problems through mere medication. Studies show that PCOS is the commonest endocrine disorder in women of a reproductive age, occurring in approximately one in seven women. Of these women approximately two-thirds will not ovulate on a regular basis and consequently may therefore seek treatment for infertility.

Some early warning signs that women ignore as “normal” are hormonal imbalances that can greatly affect fertility. Estrogen dominance and low progesterone levels don’t just make your period uncomfortable, they also drastically impact fertility.  Many of us ignore the early warning signs of these fertility issues, like:

  • Irregular menstrual cycle
  • Painful periods
  • Breast tenderness
  • PMS pain and symptoms
  • Heavy or irregular menstrual bleeding
  • Uterine Polyps
  • Fibroids
  • Pain during sexual intercourse
  • Sexual dysfunction or low libido
  • Blackening of the skin around areas like the neck, the armpits, groin
  • Male pattern body hair

Left unchecked, estrogen dominance can result in autoimmune diseases, hypothyroidism and you guessed it – infertility. When hormones are out of whack, this imbalance makes it difficult for a healthy ovum to leave the ovary, which means it cannot be fertilized by sperm for you to get pregnant.

4. Infection and Abnormalities of Reproductive Tract

Any infections of the reproductive tract like recurrent UTIs and STDs can also contribute towards infertility. Blockages and/or abnormalities of the reproductive system also make it harder for you to get pregnant naturally.

5. Lifestyle Problems

Often the most ignored, unhealthy lifestyle habits like being overweight, eating a poor diet that lacks in proteins and essential vitamins, lack of sleep, sedentary lifestyle, and stressful work hours can all contribute towards infertility, and this holds true for both men and women.

Factors Affecting Fertility In Men

Just like in women, several factors impact fertility for men. Truth be told, infertility in men is a less talked about subject, but is one of great importance for any couple wishing to conceive a baby. When it comes to the male reproductive system, infertility is usually related to

  • effective sperm production,
  • the number of sperm or sperm count,
  • shape of the sperm, and
  • movement of sperm (meaning, its ability to swim towards a healthy ovum for impregnation)

So what factors affect fertility for you if you are a man?

  1. Metabolic Syndrome

This one is often the most neglected culprits contributing to male infertility. Most fertility doctors will concentrate on sperm and its quality, not trying to understand WHAT is affecting your sperm quality in the first place. The answer is metabolic syndrome – a compilation of symptoms that include obesity, insulin resistance, hypertension and dyslipidemia.  Growing evidence has linked metabolic syndrome and its individual symptoms to the increasing prevalence of male infertility

2. Poor Lifestyle Choices

Just like in women, bad lifestyle habits can impact your fertility. Poor nutrition that lacks in sufficient proteins, eating a diet that is too rich in oily and junk foods, and not consuming a wide variety of foods for optimal vitamin and mineral levels all play a role. Increased stress, lack of sleep, smoking and excessive drinking, and poor fitness levels – all contribute towards metabolic syndrome – hence towards poor fertility.

3. Hormonal Imbalances

Yes, you read that right. Women are not the only ones who have to worry about hormonal imbalances. Low testosterone levels can lead to male infertility. Measurements of FSH, LH, and prolactin are useful tests in the management of male infertility.  Testosterone injections and other steroid supplements can also impact sperm production and its quality.

4. Infections

STDs and UTIs also have an impact on male fertility. Pus cells in semen, commonly seen in those suffering from gonorrhoea, can decrease sperm count, motility and capability of fertilization.

5. Age

Most people wrongly assume that paternal age doesn’t affect fertility. Studies show that age does impact the male reproductive system as well, particularly for outcomes of assisted reproductive techniques for fertility for over 40.

So, as you can see, fertility is not just a ‘women’s issue’. “Optimising physical, mental and emotional health of both partners, as a couple, is crucial to get the best fertility outcomes. In an ideal scenario, you want the best genetics from both parents to go to the baby; and this does not happen if the father has several metabolic issues. The process of having a healthy pregnancy starts well before conception. Work as a couple; understand your health, fix the very foundations of your health, get in alignment with each other emotionally, and in tune with Nature…and your baby will get the best start in life”, says Dr.Kalpana Mahabalesh, an OBGYN with more than two decades experience.

If you are dealing with the stress of infertility, it’s very important for you to not lose hope. Today, reproductive medicine and endocrinology are rapidly growing fields. With the right guidance and support, it is possible to overcome fertility issues to get pregnant and carry a healthy baby to term. At Sepalika, we are here to help you with healthier alternatives to IUI and IVF by correcting the very foundations of your health so you can enjoy all the joys of parenthood to the utmost.

Mahesh Jayaraman
Mahesh is a hormone health counsellor & holistic health expert. He has a Mastery Certification in Functional Blood Chemistry Analysis from the US, is certified in Functional Nutrition from Washington State University and uses a wide array of healing modalities to guide his clients to vibrant health and well-being.