I am proud to share that this article/ case study was published in a Naturopathic journal. To view the original, published article please visit:
https://ndnr.com/endocrinology/infertility-case-study-its-usually-never-just-1-thing/
Introduction
Infertility affects 1 out of 8 couples1 and can be a sign of other imbalances and deficiencies in the body.
When HG presented to my office, she was a 38-year-old woman who
had been trying to get pregnant for 12 years. She had already suffered through
11 failed in-vitro fertilization (IVF) cycles and 2 failed intrauterine
insemination (IUI) cycles. She was told that an egg donor was her only option
if she wanted to get pregnant; however, one of those failed IVF cycles had used
an egg donor. She had lost hope in herself and her body, and she felt defeated.
Although a donated egg was the option given to her, she desperately wanted to
have her own biological child if possible.
During her initial consult with me, it became evident that HG
had not been thoroughly evaluated and that none of her underlying health issues
had been addressed.
She had been diagnosed with endometriosis, past human papilloma
virus (HPV) infections, and Hashimoto’s thyroiditis. It was clear to me that
inflammation was likely present as well. She also suffered with gas and bloating
on a continuous basis. For each of these conditions, she had been given no
treatment options, and was told to manage the pain from endometriosis with pain
relievers.
Endometriosis
It is estimated that about 11% of women (6.5 million)
in the United States suffer with endometriosis.2 At least 30% of
women with endometriosis are infertile.3 A hallmark symptom of
endometriosis is pain – pain with sex, pain with bowel movements, chronic
pelvic pain, and back pain. Heavy bleeding during menses and/or bleeding
between periods is also common. HG definitely experienced intense pain due to
endometriosis. She was diagnosed with Stage 4 endometriosis, and she suffered
with heavy periods and pain with sexual intercourse. For almost 10 years she
took birth control pills continuously, which suppressed her menses and managed
her pain symptoms. She also had 1 fallopian tube removed due to extensive
scarring from the endometriosis. After this surgery, HG was told that her
uterus “was cemented to her lower back.” Well, no wonder she was in so much
pain.
Past HPV Infections
HG had also been diagnosed with cervical squamous
intraepithelial lesion, high-grade (CIN II/CIN III), which had been treated
with the LEEP procedure. Five years later, she was reevaluated and again found
to have dysplasia, this time low-grade squamous intraepithelial lesion (LSIL), and
she was positive for HPV. Cervical cancer and its precursor, cervical
intraepithelial neoplasia (CIN), are caused by strains of HPV.4
Our bodies are composed of 50% bacteria, so it makes sense that
the various types of bacteria can influence our health and fertility. In
general, high microbial diversity is considered beneficial for health; however,
when it comes to the vaginal microbiome, this is not the case. Low bacterial
diversity that is dominated by a few species of Lactobacillus in the vaginal microbiome is associated with a
reduced risk of both HPV and bacterial vaginosis (BV).4 However,
when the vaginal microbiota shift, such that Lactobacillus spp decreases and anaerobic species increase, the
risk of BV increases.4 Some studies have found correlations between BV
and increased incidence, prevalence, and persistence of HPV infection and CIN.4
Bacterial vaginosis is the most common vaginal disorder in
women of reproductive age.5 BV is significantly higher in women with
tubal infertility, as compared to non-tubal infertility,6 and BV increases
the risk for preterm delivery and spontaneous abortion.7
Hashimoto’s Thyroiditis
HG was told by her doctors that she had a thyroid issue
called Hashimoto’s thyroiditis. No treatments were offered, so she didn’t think
much of it. She periodically went in for thyroid scans to monitor the nodules,
but beyond that, nothing was done.
Thyroid function is intimately related to health, fertility,
pregnancy health, baby’s neurodevelopment, and baby’s long-term health. Oocyte
maturation (the process of egg development within the ovary) depends on normal
levels of thyroid hormone.8 Hypothyroidism is associated with
menstrual irregularities, menorrhagia, and ovulatory dysfunction.8 Hashimoto’s thyroiditis, aka thyroid autoimmunity (TAI), refers to an
autoimmune condition in which the immune system produces antibodies that attack
the thyroid gland. TAI is the most frequent cause of low thyroid function in
women of childbearing age.8 Hypothyroidism occurring during the
first half of pregnancy poses a risk of poor neurodevelopmental outcomes in the
baby.8 Moreover, the rate of miscarriage is increased in women with
TAI.8
Because thyroid function is so critical for mother’s
reproductive health and baby’s neurodevelopment, it makes sense to screen for
thyroid dysfunction in women trying to get pregnant, who are already struggling
with infertility, and who have a history of miscarriage or pre-term
delivery.
Inflammation & Oxidative Stress
Not only did HG have signs of inflammation, including
her endometriosis diagnosis and pain in her feet, HG’s blood work also revealed
elevated inflammatory markers. Markers of inflammation and oxidative stress
have been found associated with endometriosis.9 Low egg and embryo
quality may be due to higher oxidative stress.9 Unexplained
infertility impacts 15% of US couples, and studies indicate a possible
correlation between infertility and higher levels of reactive oxygen species.9 Increased levels of oxidative stress contribute to spontaneous abortion,
recurrent pregnancy loss, preeclampsia, intrauterine growth restriction, and
preterm labor.9
The Process
When HG contacted me, she knew she had to do something
different because what she had been trying for the past 12 years was not
working. She was also concerned of the
long-term impact of the numerous hormonal medications she had taken or injected
over the years. These concerns led her
to make the decision to take a step back and focus on her health so she could increase
the chance of having her own biological child.
She was motivated and ready to address her health in general, and
specifically, to address all these areas of imbalance that were identified
during the initial intake, from the functional analysis of her blood work, and the
review of her past lab work.
She dedicated herself and improved her diet, healed her
gut, and
decreased the inflammation. She also incorporated a mind-body routine.
For almost 11 months, HG dedicated herself to her health. And
it paid off. The pain related to her endometriosis reduced drastically. Her
periods were no longer a nightmare. Her thyroid antibodies were restored to
normal range. Her Pap smear revealed no more HPV infection. Her pain and
inflammatory markers all decreased.
A Happy Outcome
Overall, she felt great and was ready to “try again.” Because of scarring and only having 1 fallopian tube, HG opted to try IVF one last time. She was just about to turn 39 and her insurance company pretty much told her, “It’s now or never.” So she went ahead. HG completed the cycle, and 3 eggs were obtained. One egg fertilized immediately. She started the IVF cycle, and 2 weeks later the embryo was implanted. For the first time in 13 years, HG got pregnant. She went on to have a healthy pregnancy and delivered a beautiful baby girl….. Her own biological child.
About Dr. Reena Singh, ND
Reena Singh, ND, has been in practice for over 10 years. Her journey into naturopathic medicine started when was 19 when she was diagnosed with ulcerative colitis and told that she would suffer with this disease for her entire life, that she would likely get cancer in her 30s, and that having her own children was unlikely. She reversed the disease process using naturopathic medicine and has 2 healthy children. She works with couples who want to optimize their health so that they can get pregnant and have a healthy baby. For more information, please visit www.zamawellness.com. Facebook: https://www.facebook.com/ZamaWellness/
To view the references please go to: https://ndnr.com/endocrinology/infertility-case-study-its-usually-never-just-1-thing/
Next Steps
Are you ready to take the next step? Do you need help “connecting the dots” and want to address the root cause of your fertility issues? Contact me and let’s talk about how to get you from wishing to holding your baby.
Schedule a free phone consult with me. https://www.zamawellness.com/calendar/
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