7 Things that May Interfere With Fertility

"When in the throes of trying to get pregnant, many may be discouraged and saddened about the process when it’s not immediate", says Dana Bufalino , a health coach at Parsley Health. "While there may be underlying conditions and even some lifestyle factors that may be impact fertility , it’s also important to know that infertility is not someone's fault", she says.

Likewise, Parsley Health’s healthcare team is able to provide help, from finding and treating the root cause to maximizing patients' chances of becoming pregnant through nutrution and lifestyle, as well as conventional medicine.

Below are seven reasons someone may have trouble getting pregnant that can often be overlooked in conventional medicine. Remember, these are not the only answers to trouble getting pregnant. Coupled with physician recommendations and an understanding of a patient's individual health, they may decide that pursuing medical intervention and due treatments are the best option. Just know that whatever you decide, Parsley Health medical providers and health coaches can support before, during, and after the fertility journey .

Thyroid dysfunction

Both an underactive (hypothyroid) and overactive (hyperthyroid) thyroid can affect ovulation, cause irregular menstrual cycles, and lead to imbalances in sex hormones , which can impact chances of getting pregnant . (Proper thyroid levels are also essential for a healthy growing fetus, as well.) “We see a lot of thyroid issues that contribute to struggles in the fertility journey,” says Bufalino. The problem is that symptoms of thyroid disease , like weight gain or loss, constipation or diarrhea, irritability, or sleep issues can all be attributed to other things, like a stressful schedule, so they’re easy to miss.

Chronic stress

It’s clear that fertility issues cause stress. Those undergoing fertility treatments report greater amounts of stress, anxiety , and depression, as detailed in Dialogues in Clinical Neuroscience . What’s less clear is if stress is a direct cause of fertility issues, though initial research has shown that individuals undergoing fertility treatments who participate in mindfulness-based relaxation programs lessen anxiety and have higher rates of pregnancy.

This indicates a correlation between the two, if not causation, but the science checks out: “If the body senses that you’re in danger—and this can be from anything, like stress from work or family issues—functions that are not necessary for survival will become deprioritized,” says Jessica Wei, MD, a certified functional and integrative medicine physician formerly with Parsley Health. That includes reproduction, and so resources are diverted away from the production of sex hormones and hormonal signaling is also disrupted.

“There is a cascade of physiological changes that happen when you’re in a worried and anxious state ,” she says. There are numerous anecdotal reports of people who underwent fertility treatment for years, “and the moment they decide that they’re not going to do it anymore and that stress lifts—boom, they get pregnant,” adds Dr. Wei.

Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS ) is a condition marked by hormonal imbalances and metabolic dysfunction. PCOS is extremely common (though many women struggle to get a proper diagnosis .) According to the US Department of Health and Human Services , PCOS affects 1 in 10 women of childbearing age, and it’s one of the most common causes of infertility in women, as it interferes with ovulation.

According to Bufalino, PCOS can be seen in three instances: women who have been on birth control for a long time and their periods don’t return after stopping; women who have high insulin levels (who may have trouble losing weight and have some of the more classic PCOS symptoms, like hair loss on the scalp); and women who have a more inflammation-based disease . “These individuals are not overweight but they have inflammation in their body due to factors like a high glycemic-index diet, high-sugar diet, and chronic stress,” she says.

Hormonal imbalances

Some know they're ovulating regularly because of the test strips that affirm they are releasing an egg like clockwork every month. And still, they are not pregnant. Is this a cause of infertility? “For many people who aren’t getting pregnant or are unable to stay pregnant, we find that they’re not producing enough progesterone in the second half of their cycle,” says Dr. Wei. The cause can be due to the aforementioned stress or nutritional needs that are missing.

Restrictive eating and intense exercising

Being “super healthy” should help with fertility, right? In actuality, it can backfire: a commitment to the gym and eating clean can turn harmful when taken to the extreme. It can be difficult to recognize this in yourself, especially if you’re praised for the behavior. “Unfortunately, it’s common to think that you’re taking great care of yourself by society’s standards, but it can still be taxing to the system,” Bufalino says. One sign is that periods are irregular (or entirely unpredictable), or that it's been lost altogether.

"Overexercise” can mean too much exercise, or exercise that’s too intense for the body. “We think of workouts as being stress relieving, but they can raise cortisol levels if too intense. And raising cortisol in an unhealthy way will steal from other hormones that you need for a healthy cycle,” Bufalino says. If you have too strict a commitment to "being healthy" and notice that periods are irregular or absent, try to slow down with more walks and light yoga.

Gut issues

Good digestive balance affects everything , and gut dysregulation is a common problem Dr. Wei sees. “If you’re not digesting or absorbing nutrients properly, you are not setting up the proper foundation for hormonal and overall health,” she says.

GI health is one element needed to support a healthy pregnancy, so if a patient is struggling with fertility issues and Dr. Wei suspects gut dysregulation may be a factor, she may suggest pausing efforts to get pregnant for a period of time so that they can work on digestive health , something that (understandably) can be disappointing.

Endocrine disruptors

Endocrine disruptors are a class of chemicals that mimic or interfere with the body’s hormones , says the National Institute of Environmental Health Sciences . “We have so many in our daily environment from household cleaners to beauty products and in food storage,” says Bufalino. “These types of chemicals break down the communication between the brain and endocrine system,” she explains.

Research shows that men, too, suffer the effects of these chemicals. A 2017 study concluded that sperm counts have fallen by 50 to 60 percent, with endocrine-disrupting chemicals and pesticides two factors that may account for the drop. While research is ongoing in both men and women, there’s also evidence that certain pesticides, heavy metals, phthalates, parabens, and other chemicals may interrupt a menstrual cycle, suppress ovulation, leading to fertility issues, and cause a decline in fertility at an earlier age. Still, it’s unclear what dose of chemicals is needed to affect fertility and how the overall load of exposure affects each individual woman. Exposure in utero —which we have no control over—may also affect future fertility.