Holistic Reproductive Medicine

Holistic reproductive medicine (reproductive medicine) always considers – in the diagnosis and therapy of man and woman – the body (old Greek σῶμα soma for body, body and life), the mind and the soul (old Greek ψυχή psyché for breath, breath and soul) equally.The following circumstances of the patient’s life are recorded or considered:

  1. Diseases that may affect the natural fertility (fertility).
  2. Psychosomatic disorders
  3. Body weight (underweight or overweight).
  4. Diet
  5. Consumption of stimulants (caffeine, alcohol, tobacco)
  6. Physical activity
  7. Continuous medication incl. drug use
  8. Environmental pollution – intoxications (poisonings)

Ad 1) Diseases that can affect natural fertility

Diseases that can affect natural fertility can be found in the chapters “Fertility – Male” (male infertility) and “Fertility – Female ” (female infertility) under “Pathogenesis – Etiology” (causes).

Ad 2) Psychosomatic disorders

Psychosomatic disorders such as anorexia nervosa, bulimia, etc., can affect natural fertility. Among other things, they lead to a disturbance in the production of gonadotropin releasing hormone (GnRH). This is necessary for the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), both of which are important for follicle maturation (development of eggs) and for ovulation (ovulation).

Ad 3) Body weight (underweight or overweight)

Deviations from normal weight – overweight and underweight, respectively – have an impact on natural fertility.Male: overweight, especially android body fat distribution (body fat on the abdomen) leads to a decrease in free, that is, biologically active, testosterone (male hormone).

  • Men with severe obesity have an increased risk of decreased testicular activity compared with normal-weight men; obesity promotes hypogonadism (underactivity of the gonads); however, obesity had no effect on sperm production – except for an increased DNA fragmentation index in the group of metabolically unhealthy obese men.
  • Average lower levels of testosterone and sex hormone-binding globulin (SHBG) and higher blood estradiol levels in obese patients compared with nonobese, metabolically healthy individuals.

Woman: scientific studies show that circa 12% of primary infertility (infertility) is due to severe deviations from normal weight, that is, due to overweight or underweight:

  • Obesity (BMI > 35) → 4-fold prolonged TTP (“time to pregnancy“; time to pregnancy onset).
  • Underweight (BMI < 19) → 2-fold prolonged TTP.

BMI: body mass index/body mass index.

The success of infertility treatment is thus also dependent on body weight.Cause of this fertility disorder is, then too much or too little body fat. This affects the production of Gonadotropin Releasing Hormone (GnRH) in the hypothalamus (diencephalon), which is necessary for the release of luteinizing hormone (LH) and follicle stimulating hormone (FSH) in the pituitary gland. Both hormones are important for follicle maturation (development of eggs) and ovulation. Furthermore, it is discussed whether the increased secretion of leptin in obesity contributes to the disturbance of menstrual rhythm (cycle) by influencing the hypothalamic pulse generator. Note: The most common manifestation of obesity (overweight) encountered in gynecologic consultations is polycystic ovary syndrome (PCO syndrome)-see the condition of the same name.

Ad 4) Dietary pattern (balanced, whole-food and vital substance-rich* )

A diet rich in vital substances and full of nutrients is of great importance for the fertility of men and women: scientific studies for both men and women show that the intake of certain vital substances* (micronutrients) can improve the pregnancy rate. Vital substances (micronutrients) that can positively influence natural fertility can be found in the chapters “Desire for children – man” male infertility) and “Desire for children – woman ” (female infertility) under the sub-topic “Micronutrient therapy” (incl. literature reference).

Ad 5) Consumption of stimulants (caffeine, alcohol, tobacco)

Caffeine consumptionWoman: consumption of more than two cups of coffee daily may already impair conception (conception; fertilization rate): Coffee (> 2-3 cups per day) → 45% decrease in fertility.Alcohol consumptionAlcohol consumption can impair fertility in both men and women: sex hormones (e.g., estrogens) can no longer be adequately broken down due to alcohol-induced liver damage, leading to hormonal disruption at the hypothalamic-pituitary level, i.e., at the level of the diencephalon and pituitary gland. This, in turn, leads to impaired formation of gonadotropin releasing hormone (GnRH), which is necessary for the release of luteinizing hormone (LH) and follicle stimulating hormone (FSH).Man: Increased alcohol consumption can lead to poorer quality of spermatocytes (sperm cells): Sperm density is reduced (oligozoospermia) and the proportion of malformed spermatozoa (teratozoospermia) increases. Furthermore, increased alcohol consumption leads to impaired libido, i.e. sexual desire.Woman: Increased alcohol consumption can cause disturbances in follicle maturation (egg maturation) and the menstrual cycle, which impairs female fertility: Alcohol (> 2 drinks per day) → 60% increase in risk of infertility.Tobacco useMale: Smoking can lead to asthenozoospermia (decreased motility of sperm), reducing the chances of conception (chances of fertilization).Histones and protamines (responsible for packaging and stability of DNA genetic information in sperm) have been shown to be present in smokers at significantly reduced levels than in nonsmokers. This can lead to no or incomplete fertilization of the oocyte (egg cell) and thus to subfertility.Woman: Smoking jeopardizes the success of “artificial insemination“!Consuming more than 10 cigarettes a day reduces the chances of an embryo implanting in the uterus (womb). (Pregnancy rate: 52% if less than 10 cigarettes/day; 34% if more than 10 cigarettes/day). Furthermore, smoking leads to increased multiple pregnancies (comparison group: 31%; smokers with more than 10 cigarettes/day: 60%).A reduced pregnancy and implantation rate was observed in the transfer of embryos subjectively judged to be morphologically sound in smokers compared with nonsmokers.

Ad 6) Physical activity

Excessive competitive sports, for example, have a detrimental effect on fertility (fecundity).

Ad 7) Continuous medication including drug use

Male: Antibiotics such as cotrimoxazole or gentamycin or antihypertensives such as reserpine or methyldopa can lead to impaired spermatogenesis (spermatogenesis).Drug use – cannabis (hashish and marijuana) leads to decreased testosterone production and oligozoospermia (lower sperm density) when used regularly. Woman: the following drugs can lead to hyperprolactinemia, i.e., elevated serum prolactin levels (> 20 ng/ml in women and > 16 ng/ml in men) and lead to follicle maturation disorders (oocyte maturation disorders) in women and loss of libido in men, among other symptoms:

Detailed information on the above agents or groups of agents (including literature review) can be found under “Desire for children – woman” under causes or anamnesis.Cytostatics (substances that inhibit cell growth or cell division) damage the testes and ovaries (ovaries) – eg cyclophosphamide.

Ad 8) Environmental exposures – intoxications (poisonings)

Man: overheating of testicles – work at blast furnace, bakery, frequent sauna; heated car seats: long and frequent driving with heated car seats can reduce the ability to conceive. Sperm cells become fewer in number (oligozoospermia), slower (asthenozoospermia) and are more frequently malformed (teratozoospermia);Environmental pollutants such as polychlorinated biphenyls (PCBs) impair male fertility.Note: Polychlorinated biphenyls belong to the group of endocrine disruptors (synonym: xenohormones), which even in the smallest quantities can damage health by altering the hormonal system. Woman: Occupational contact with anesthetic gases can impair female fertility

Conclusion!The physical and mental health of man and woman as well as a healthy lifestyle are important prerequisites for successful fertility treatment. Therefore, before starting any reproductive medical procedure (e.g. IUI, IVF, etc.), I recommend that you undergo a health check and a nutritional analysis to optimize your personal fertility (fertility). * Vital nutrients (micronutrients) include vitamins, minerals, trace elements, vital amino acids, vital fatty acids, etc.