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Getting to the Root Cause of Infertility

Getting to the Root Cause of Infertility
When couples are struggling to conceive, it can be difficult to understand the cause and what steps to take. While there is no simple explanation for what causes infertility, a Functional Medicine approach can help. Functional Medicine looks at the underlying root cause of imbalances within an individual’s body. When that can be done, successful treatments can be identified. For many people, fertility can be improved with a focus on diet, nutrition, and lifestyle.

Here are the most common factors tied to pregnancy challenges and how they can be addressed:




When dealing with infertility, it’s important to evaluate all of the systems in a person’s body, including a full scope of their hormonal health. This includes thyroid levels, adrenal levels, and sex hormone levels. Often women need thyroid support, as inadequate thyroid hormone levels can be the cause of infertility. Foods rich in iodine (seaweed), selenium (Brazil nuts,  just 1-2 daily), and iron, can all support proper thyroid function. It’s important to be careful with iodine supplementation – getting too much can negatively impact your thyroid, which is one of the reasons I recommend food first.



I also test for signs of insulin resistance when investigating hormonal health – in both men and women. This can be done through fasting blood sugar and insulin, a glucose tolerance test with insulin, and waist-to-hip ratio measurements. If there are signs of insulin resistance, it’s time to follow a low-glycemic diet, which can have a tremendous impact, though some people need to be more strict than others.


“Low-glycemic” means the foods eaten do not spike blood sugar, they keep it at a lower and more consistent state. Low-glycemic foods include healthy fats like avocados and nuts, fibrous non-starchy plants like kale and cauliflower, low-sugar fruits like berries, and high-quality protein from meat and fish. Examples of high-glycemic foods are white sugar and refined flours, bread, white rice, and even non-fat sweetened yogurt. Your provider can help you decide exactly what diet is right for your body and your hormonal needs, but keep those high-glycemic foods to a minimum.



Another common piece of infertility is toxicity. Supporting the body’s natural detoxification processes is part of the Functional Medicine protocol. This means helping the body get rid of excess hormones and toxins. There are many toxins that impact our hormones, like  BPA, phthalates, parabens, and pesticides, just to name a few. It’s important to avoid plastics and be aware of what you’re putting on your body, using around your home, and what ingredients are in your food, if you want to completely detoxify your life.


In this step, I always make sure my clients are having regular bowel movements, eating sufficient fiber, drinking enough water, and sweating, in order to fully help the body eliminate toxins. Cruciferous vegetables (broccoli, cauliflower, cabbage, and kale) help support detoxification as well. I also look for the right balance of good bacteria in the gut, since imbalances in bacteria can hinder detoxification of hormones. Fermented foods, resistant starch, and probiotics can all be useful in balancing the microbiome when imbalances are present.


Lifestyle is an important aspect of improving fertility. This means having healthy and consistent daily rhythms of life, like getting 7-9 hours of high-quality sleep, which supports the adrenal glands and all hormones. Acupuncture is another practice that can reduce stress and help patients regain the normal biological balance that helps support conception.


Over exercising and undereating can impact fertility. A general rule of thumb – if you are more tired after exercise or the next day, then you may be working out too hard. If your period stops, this is also a sign of exercising too much or not eating enough calories to support your exercise routine. Is working out 6-7 times a week too much? Well, that depends on the person. This frequency may be ok for some, but it’s important to mix up different types of exercise and include less intense activities, like yoga or going for a walk.


The American College of Sports Medicine recommends 150 minutes of cardiovascular exercise and 2 days of resistance exercise per week. 

Exercise is a wonderful stress reliever and great for our health, but too much exercise can hurt our fertility and actually prevent weight loss in some women.

A Connected System 

In Functional Medicine, we believe all systems in the body are interrelated. Unrelated symptoms could be contributing to problems with conception. A chronic cough, for example, could indicate exposure to an allergen in food or the environment. Inflammatory foods have been shown to trigger insulin resistance in some. These are all things we will take into account for our plan of action.


A woman might also have a nutritional deficiency that’s preventing her body from getting pregnant. That makes sense, since we don’t want to be bringing children into a world where there is not enough food, and the body thinks that when we’re lacking in essential nutrients. So, we work with women to get them on the most nutrient-dense diet possible.


Many women think they are healthy, but because of junk food sneaking in, or restrictions to help maintain weight, or because of our low-quality food supply, some women have nutritional deficiencies that are quietly harming their fertility. Screening for Celiac disease and other autoimmune conditions such as autoimmune thyroiditis, can provide us with valuable information, as these can cause malabsorption, inflammation, and nutrient deficiencies that can make the body unable to support a new life.


The good news is that when we discover these root causes, we’re often able to reverse frustrating symptoms and regain fertility. If you’ve been struggling with infertility and you’re not sure where to start, I highly recommend finding a Functional Medicine practitioner to help you understand the root cause of your problem.

A woman and man sitting while holding her pregnant belly

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Elizabeth Boham

Elizabeth Boham

Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women’s Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine.

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