Nutritional Influences on Illness: Female Infertility


Nutritional Influences on Illness: Female Infertility

Infertility, defined as the failure to become pregnant after one year of unprotected intercourse, affects approximately 10 to 15% of couples. In about 60% of infertile couples, infertility is due to a gynecologic problem.

Dietary Factors

Excessive weight and insufficient weight are each the cause of primary infertility in about 6% of women with ovulatory dysfunction.( 1) In some studies, over half of all women seeking treatment for infertility were amenorrheic (did not have menstrual periods) following a period of weight loss.( 2)

There is reason to believe that both caffeine and alcohol can impair female fertility. Excessive alcohol ingestion causes serum prolactin to rise, and hyperprolactinemia is associated with infertility.( 3) Caffeine has the opposite effect; it reduces the concentration of serum prolactin, and hypoprolactinemia is also associated with infertility.( 4) Moreover, epidemiologic studies have found that women who drink four or more cups of regular coffee daily are consistently less likely to become pregnant than non-coffee drinkers.( 5)

Caffeinated soft drinks may, for unknown reasons, be even more harmful than coffee. In one study, a single caffeinated soft drink daily reduced the monthly chance of conception by one-half after coffee consumption, frequency of intercourse, and age were controlled for.( 6)

Nutritional Factors

As with other body systems, deficiencies of essential nutrients may adversely affect the functioning of the female reproductive system and cause infertility. Specifically, when deficiencies of folic acid, vitamin B12 or iron have been diagnosed and treated fertility has been restored - even when patients had been infertile for several years.

Some, but not all, studies of supplementation with vitamin B6 have found supplementation with the vitamin to be effective, at least occasionally. Unfortunately, these studies generally failed to investigate whether the women were B6-deficient and they lacked placebo control groups. One of these studies was of a group of 14 women, ages 23 to 31, with premenstrual syndrome who had been infertile for 18 months to 7 years. Following supplementation with adequate pyridoxine, to relieve their menstrual symptoms for at least 6 months, 12 of them (86%) were able to conceive, an 11 of the pregnancies were within the 6 months following the start of supplementation.( 7)

Most of the other studies have concerned women with amenorrhea and/or galactorrhea (inappropriate discharge of breast milk). An initial report on 3 women was encouraging.( 8) Later studies, however, generally failed to find resumption of ovulation following pyridoxine supplementation, although sometimes menses was resumed.( 9, 10)

Finally, exposure to heavy metals, such as lead, cadmium or mercury, can impair fertility, principally through their effect on sex hormones.( 11)

A nutritional approach to treating female infertility should thus seek to correct any major weight disturbance if your patient fails to ovulate regularly. Caffeine and alcohol ingestion should be avoided. Laboratory studies, in addition to a complete blood count and measurements of hormone levels, should look for evidence of a folic acid, vitamin B6, vitamin B12 or iron deficiency, and the possibility of heavy metal exposure should be evaluated. If everything appears normal, consider a trial of perhaps 50 mg daily of vitamin B6 for a few months -- especially if your patient has premenstrual syndrome.

Doctor Werbach cautions that the nutritional treatment of illness should be supervised by physicians or practitioners whose training prepares them to recognize serious illness and to integrate nutritional interventions safely into the treatment plan.

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(1.) Green BB et al. Risk of ovulatory infertility in relation to body weight. Fertil Steril 50(9):621-6, 1988.

(2.) Wynn A. Wynn M. The need for nutritional assessment in the treatment of the infertile patient. J Nutr Med 1:915-24, 1990.

(3.) Mendleson JH. Alcohol effects of reproductive function in women. Psychiatry Letter 4(7):35-8, 1986.

(4.) Casas M. et al. Dopaminergic mechanism for caffeine induced decrease in fertility? Lancet i:731, 1989.

(5.) Williams MA et al. Coffee and delayed conception. Letter. Lancet 335:1603, 1990.

(6.) Wilcox AJ, Weinberg CR. Tea and infertility. Letter. Lancet 337:1159-60, 1991.

(7.) Abraham GE, Hargrove JT - reported in Medical World News March 19, 1979.

(8.) McIntosh EN. Treatment of women with the galactorrhea-amenorrhea syndrome with pyridoxine (vitamin B6). J Clin Endocrinol Metab 42(6):1192-5, 1976.

(9.) Kidd GS et al. The effects of pyridoxine on pituitary hormone secretion in amenorrhea-galactorrhea syndromes. J Clin Endocrinol Metab 54(4):872-5, 1982.

(10.) Lehtovirta P, Ranta T, Seppala M. Pyridoxine treatment of galactorrhoea-amenorrhoea syndromes. Acta Endocrinol (Copenh) 87(4):682-6, 1978.

(11.) Gerhard I, Runnebaum B. [Environmental pollutants and fertility disorders. Heavy metals and minerals.] Geburtshilfe Frauenheikd 62(7):383-96, 1992.

Reprinted with permission from the International Journal of Alternative and Complementary Medicine, Green Library, 9 Rickett St., Fulham, London SW6 1RU, United Kingdom.

Townsend Letter for Doctors & Patients.


By Melvyn R. Werbach

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