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  • Dr. Susan Caldwell

The Upside of Infertility



As Infertility Awareness Week 2021 comes to a close, I would like to offer some encouragement to those dealing with the pain of infertility. On the surface, the diagnosis of infertility seems like a heavy, hopeless label that leads couples to get stuck in painful emotions. While this can happen, it is also true that sometimes the recognition of infertility can be a blessing in disguise for many women. Remember that infertility is only a symptom that invites us to dig deeper to discover the underlying cause of the symptom of infertility. When we do the work of investigating the symptom of infertility, we often find that women are simply not healthy enough to conceive and to sustain a pregnancy for nine months. And she needs to know this truth.


Infertility is often a sign that a woman needs help to restore her health and the restoration of her health will naturally lead to a restoration of fertility. Infertility can be a type of warning sign that there might be trouble ahead in the same way that a “check engine” light on the dashboard is a warning sign that tells a driver that their engine needs attention before attempting to drive any distance in their car.


So....what is the upside?


I see women every day in my clinic who are no longer trying to conceive but who are sick and feel terrible with complaints such as fatigue, hair loss, weight gain/obesity, low libido, diabetes, high blood pressure, etc. When I listen to their stories, many times they’ve had infertility or miscarriages that were never investigated. They were prescribed various birth control methods to “treat” the problems with their cycles such as heavy/painful/irregular periods, premenstrual syndrome (PMS), polycystic ovarian syndrome (PCOS), insulin resistance, and ovarian cysts. I explain to them that birth control did nothing to treat these problems but then has led to further disturbances in ovulation (leading to inability to make estrogen and progesterone), vitamin deficiencies, often permanent loss of libido and insulin resistance/obesity.


There have been some important advances in women’s health in the past few decades but the widespread use of hormonal birth control is a reminder than in many ways we are still living in the dark ages when it comes to helping women to get and stay healthy during their reproductive years. Countless women present to their doctors’ office where they complain of not feeling well physically or emotionally and they are given a “one-size-fits-all” prescription that promises to make them well but ends up causing more disease and dysfunction.


Women are seriously complex and beautiful creatures who are unique in that their bodies attempt to run the equivalent of a marathon every month when after they ovulate they create a functional cyst on the ovary known as the corpus luteum that is in charge of making enormous amounts of progesterone (and much less estrogen) over two weeks in preparation for a healthy period or a healthy pregnancy. It is quite an exhausting process that takes much energy. One researcher put it this way:

When you think about it there isn't anywhere else in the body where you have to develop a tissue from scratch in such a short period of time and get a blood supply in so fast. Dr. Sarah Robertson.

The work of ovulation and corpus luteum production requires that women are REALLY healthy. Just like any elite athlete, ovulating women need great sleep, nutrition, hydration and exercise. Infertility is often the first subtle sign that a woman is depleted and needs more to be able to nurture a new life for nine months.


The Snowball Effect


Just like a snowball is easier to manage than is an avalanche, minor health problems are easier to manage when they are identified and dealt with earlier than later. As soon as a woman hears the diagnosis of fertility, it means that there is much work to be done in order to uncover the problems that are causing infertility.


Here are a few examples:


Insulin Resistance


Insulin resistance is often found in women with infertility who have been diagnosed with PCOS and obesity. When insulin resistance is not identified and treated (usually with diet and lifestyle changes), it can eventually lead to diabetes and the many complications that can result from diabetes such as: heart attacks, strokes, kidney disease, eye disease and dementia. Excess insulin is a major reproductive toxin that increases the risk of infertility and miscarriage. Women who are diagnosed early are very fortunate to be able to make the changes necessary to not only have a healthy pregnancy but also to avoid major health challenges in later years.


Thyroid Disorders


A fertile woman’s thyroid needs to be working very well in order to be able to ovulate regularly and then to conceive a new life when she is ready. Hypothyroidism is a common cause of period problems as well as infertility. Thyroid function should be assessed in women with these problems, including thyroid stimulating hormone (TSH), free T4, total T3 and free T3. When this is not assessed early when a woman detects problems with the cycle, thyroid function can worsen leading to infertility and miscarriage. A common cause of poor thyroid function is autoimmune thyroiditis. In this case, a woman’s own immune system is at war with her thyroid gland. When this is found, she should make changes in her diet because foods such as gluten, dairy and refined sugars can act as a trigger that negatively effects not only her thyroid but other organ systems as well. As with many diseases, this should be found and treated sooner rather than later in a woman’s life because of the crucial role of thyroid function in many facets of a woman’s overall health.


Vitamin Deficiencies – Iron and D3


Many women are generally deficient in iron and vitamin D. Since women lose blood by menstruating every month, they are prone to be iron deficient. It is very important that when labs are done that ferritin is checked rather than a simple CBC (complete blood count). Ferritin becomes low long before there is an abnormal CBC. A normal ferritin level is above 50 but many women will have symptoms of low iron when levels are below 100. Every woman is different!! I advise women of reproductive age to take a daily multivitamin (or prenatal) that contains iron for this reason.


Most people (men and women) are deficient in vitamin D3. This vitamin is important for proper ovulation and is beneficial in pregnancy. When deficiency in vitamin D is found and treated during the reproductive years and beyond, women are less likely to have bone loss (osteopenia and osteoporosis) in the post-menopausal years.


It is well known that birth control pills cause vitamin deficiencies. And because so many women are given birth control pills prior to their first pregnancy, many women are deficient in a number of important vitamins at this critical time and struggle to be healthy before, during and after pregnancy.




Most women who are diagnosed with infertility have several minor diseases or deficiencies that add up to cause infertility. Women with infertility don’t always feel unhealthy yet infertility is a sign that health is lacking. This is where the digging begins. Using an individualized approach, we must dig beneath the surface to find the underlying causes of infertility. In the practice of NaProTechnology, the process starts by giving the woman the tools to be the foremost expert in her own health and fertility. She is taught to monitor and to identify her own biomarkers found by charting her cycle with the Creighton Model FertilityCare System. Using this method of fertility awareness, she keeps a daily record of her vaginal/cervical discharge and bleeding patterns and brings this record to her NaPro medical consultant who can then begin a formal evaluation of her infertility.


Using this type of approach is much more successful in in the short-term but the real success is in the long-term health of the woman and her babies. Mothers don’t stop nurturing their children when they deliver them but continue to pour themselves out so that their children will have life for many months and years to come. Those of us in women’s health must continue to partner with women to ensure that they are healthy enough to nurture their children beginning before pregnancy and continuing for many years beyond!


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