Infertility and Recurrent Miscarriages

Our naturopathic doctors have an integrative approach to reproductive health and fertility. They encompass the foundations of wellness (i.e diet, lifestyle, nutrient deficiencies, etc.), herbal medicines, plus the addition of ovulatory drugs and intrauterine inseminations when indicated.

Our doctors take each patient through the foundational phases 1-3 of the IHC Fertility Program (see below), after which more individualized therapies may be prescribed. This may include prescribed bio-identical hormones from a compounding pharmacist (bi-est, tri-est, progesterone, etc.), and /or ovulatory, superovulatory drugs (i.e. Clomid, Tamoxifen, Human Chorionic Gonadatropin [HCG] injections, etc.). Intrauterine inseminations (IUI) may be recommended if you and your partner meet the eligibility criteria, and if IUI is likely to increase your chances of conceiving.

The naturopathic doctors at IHC frequently help couples struggling with one or more miscarriages. Often couples need to experience three miscarriages before an in depth work up is initiated. One or multiple miscarriages may be a result of inadequate progesterone production, hyper-coagulation syndrome, environmental influences, or associated with a reproductive immunological pathophysiology. We believe one miscarriage is indication enough to dive further into possible reasons for the unsuccessful pregnancy. The path from infertility to parenthood is an emotionally difficult journey. We strive to treat each person with the utmost compassion, and we offer customized approaches with the ultimate goal of achieving parenthood.

Integrated Health Clinic provides a whole-person, patient-centered approach to treating infertility, which can be divided into 6 distinct phases.

Phase 1 – Foundation First

The first visit is 60 minutes in length, and both partners are encouraged to attend. A comprehensive intake, physical exam, and fertility history is taken. Any current or past lab tests, diagnostic imaging, and semen analysis are reviewed. Lifestyle recommendations and diet are addressed. Natural cycle monitoring is initiated.

Phase 2 – Identify and Remove Obstacles

Blood, urine and saliva tests are ordered, based on patient history, to identifying vitamin/mineral deficiencies, environmental toxicities, endocrine/ hormone imbalances, and ovarian reserve. Ultrasound is used to identify structural abnormalities, uterine lining and ovarian function. Ultrasound monitoring continues throughout cycles to monitor follicle development, ovulation, and changes to cycles.

Phase 3 – Supplementation/ Nourish

Oral and/or intravenous nutrient replacement therapy, for any fertility-specific vitamins, minerals and amino acids. Herbs to promote ovulation, and to correct subtle hormone imbalances. Based on the results from the semen analysis, male factor infertility is addressed with recommendations to increase sperm concentration, motility, and morphology, decrease leukocytosis and reactive oxygenation species.

Phase 4 – Balance Hormones

Compounded bio-identical hormone prescriptions may be prescribed for lab-determined hormone imbalances, (ie. Bi-Est, Tri-Est, and Progesterone). These may aid in follicular development, endometrial lining thickness, and luteal phase support. Specific nutritional supplements can influence hormone production pathways to promote conversion to beneficial hormones for fertility, and inhibit the conversion of hormones to less favored hormones.

Phase 5 – Ovulation Induction/ Superovulation

Utilize pharmaceuticals such as Clomid, Tamoxifen, and HCG for ovulation induction and superovulation. Metformin and Hydrocortisone are also prescribed in certain cases. Ovulation induction is used for those patients who fail to ovulate or have irregular and/or longer cycles. Superovulation is a term used to describe utilizing ovulatory drugs, in a normally cycling woman, with the expectation of creating larger follicles or multiple follicles in that cycle. Ovulation induction and superovulation treatments may cause the risk of conceiving multiples, and may also lead to ovarian hyper-stimulation syndrome, (OHSS). They require physician monitoring and follow up with each cycle is recommended.

Phase 6 – Non Medicated/ Medicated IUI

Intra-uterine insemination(IUI) is recommended when a couple has failed to conceive after having completed steps 1 through 4 of the IHC Integrative Fertility Program. It is may be combined from the outset during Phase 5, alongside the ovulatory/ superovulatory drugs. IUI may be initially given when the patient is unmedicated, and timed with a woman’s natural LH surge. They also may be prescribed with the use of HCG as a trigger with the LH surge. However, IUI is most often prescribed with an ovulatory or superovulatory drug regimen, as research shows better pregnancy rates with medicated cycles (ie. Clomid, Letrozole, or Tamoxifen). The most common indication for IUI is unexplained fertility, but it is also indicated for infertility secondary to cervical factor, mild male factor, and mild endometriosis. IUI’s are often prescribed for three consecutive cycles/months. If the 3 cycles have been medicated, often a 1-2 month break is recommended before initiating more rounds. If the couple has not conceived after 6 months of IUI treatment, patients are often referred to other fertility clinics offering assisted reproductive therapies such as IVF.