The nutrition industry alone is estimated to be worth $25.7 billion dollars a year. Clearly there is big money to be made from even poorly studied herbs and supplements—and even from substances we know have no effect or are even dangerous. In some cases (particularly in weight loss and body building) very dubious substances are marketed as health building. Not only are some of these substances unlikely to help you, some of them can kill you. Never take a supplement until you know what its history is.

When choosing a practitioner of any kind there are several things to keep in mind. The same rules apply to choosing a medical doctor, a naturopath, a massage therapist, or an acupuncturist.

*Do you feel comfortable with this person? If you get bad vibes, find someone else.

*What are their credentials? You want someone who has been properly educated and knows the risks of treatment as well as the potential benefits.

*How long have they been practicing? If they are new, is there an experienced practitioner keeping tabs on them? One of the best doctors I have had looked like he had just finished Junior High School. He knew his stuff, talked to me like I was a real person, and listened to my concerns. The fact that he was new meant that he was up-to-date on recent research and willing to try new things.

*Can you ask them anything and get a complete answer?

*Do they understand your health needs? You are unique and PCOS is complicated. If they don’t know at least as much as you do, are they willing to learn?

*Do they practice good cleanliness rules for patient interaction? Whether a doctor or an acupuncturist, you need to know that they are washing their hands, wearing gloves, and using clean needles!

*Do they offer references? Find out if they are for real or if they just talk a good talk.

In the end, the person you choose as your guide in the infertility journey as key to your success as well as your emotional health throughout the process. Studies show that your trust in the practitioner is sometimes even more important to successful treatment than the actual treatment.

Includes recipes, a gentle exercise program, and loads of references to the studies on which he bases his conclusions. Reducing inflammation is the key to treating the diseases we are all interested in preventing. Inflammation may also be at the root of many cases of infertility. Chronic inflammation can interfere with hormone production, cause swelling and circulation problems for the ovaries and other organs, and lead to auto-immune diseases such as celiac disease and thyroid problems.

Well-written in an easy to understand manner as are his other books, this one seems to have worked out some of the kinks in his earlier systems. Eating an anti-inflammatory diet makes it much, much easier to lose weight and restore your health. It seems so simple couldn’t be true, but the science is there to back it up. Eating this way can reduce cholesterol, reduce your risk of heart disease and diabetes, and improve your overall health. The healthier you are the better your fertility. Many studies have linked PCOS to chronic inflammation. Future studies will undoubtedly prove that inflammation is at the root of many other cases of infertility. Highly recommended!

One fertility clinic in Mumbai, India, offers a single round of IVF for a mere $3,000. Even adding in the cost of drugs ($800 versus $1500 for the exact same drugs in the US) a $1,200 plan ticket, 10-14 days of hotel accomodations and freezing of any excess embryos, the total cost would be less than $7,000 for the same treatment offered in the US. Don’t want to travel to India for the procedure? Consider Australia, Canada or the United Kingdom where government health care keeps costs down.

While the procedures are exactly the same, the costs vary widely due to many factors. Malpractice insurance in the US is very expensive. Doctors in the US are also free to charge what the market will bear without government interference. Finally, drugs are often offered much less expensively in other countries – even when they are produced by the same manufacturer.

Here are some things to consider if you are thinking about fertility tourism:

* Ask a lot of questions. Be sure you understand exactly what you are paying for and what the doctor or clinic’s success rate is.

* Talk to others who have used the same clinic. Ask for references.

* Understand how treatments may differ. For instance, in the US, Australia, Canada and the UK, doctors are limited in the number of embryos they can transfer in one procedure. This limits the risk of multple births and the attendant risks to mother and babies when more than two babies are carried. Doctors in India are free to use their own judegement about the number of embryos they transfer. This can increase the cance of pregnancy in difficult cases, but it can also lead to the heartbreaking need to selectively reduce the number of embryos if more than two implant.

* Consider whether you are comfortable with foreign travel or travel to a particular destination. While the idea of a vacation is appealing, it can be really unpleasant to be far from home and possibly alone while you go through the emotional roller coaster of fertility drugs(you can bring frozen sperm with your for the procedure if your spouse can’t travel).

I will never forget my first IUI. My doctor assured me that it would be much, much easier than the HSG (hysterosalpongogram) they had used to check for blockages in my tubes. I told him the HSG tech said my cervix was difficult. He said they’d use ultrasound to guide the way and that it would not hurt as much. Mostly he lied.

For one thing, my doctor didn’t perform the procedure. It was performed by two super nice nurses. They asked me to identify the donor sample we were to use. I said I’d never seen it before, but hey, looks like sperm to me. They asked me to check the numbers on the syringe and the numbers on the form I had to sign. Yup, looks like sperm to me.

They didn’t use ultrasound either. Don’t know if that would have helped, but for me the worst of it seems to happen when they are trying to find the opening to my cervix. Seems mine is never in the right spot. It took a long time for them to get the right size speculum in the right spot to see where they were going. I don’t want to scare anyone, because from what I hear mine was far, far worse than average (as usual). But this was not fun.

Once they figured out where to go, the insemination itself was a breeze. Then the cramping started. I had to stay on my back for 20 minutes while “gravity” did its thing. They tilted the edge of the table up in the air and left the room. I shifted, squirmed, cried, and tapped my feet for 20 minutes while I begged these anonymous sperm to swim the right direction despite my cramping uterus. My husband said, “Don’t worry, labor will be a lot worse.” He is a very, very lucky man. If I had not been afraid of losing $300 worth of donor sperm I might have broken my vow of non-violence.

Since that first time, I have had three more IUI. None of them have worked for me, but at least the next three were much more comfortable. I had a different doctor and she actually did the procedure instead of passing it off to nurses.

Studies have shown that IUI in conjunction with other treatements can improve your odds of conceiving.

Recent studies have linked diabetes with male infertility. Uncontrolled diabetes seems to damage the DNA in sperm cells and cause fertility problems, including a higher rate of miscarriage due to genetic problems.

Women with uncontrolled diabetes are more likely to have fertility problems as well. Polycystic ovarian syndrome (PCOS) is one of the most common causes of infertility and is associated with impaired glucose tolerance and insulin resistance. Many women with PCOS are also diabetic or pre-diabetic. When insulin resistance is controlled through diet, exercise and in some cases use of diabetes drugs such as metformin (sold under the name Glucophage) fertility tends to improve. For women with diabetes, good blood sugar control improves pregnancy rates and the success rate of pregnancy.

Once a woman becomes pregnant, diabetes or gestational diabetes (triggered by pregnancy) can lead to an increased risk of miscarriage, premature birth and birth defects. High blood sugar levels can also lead to larger than average birth weight and respiratory distress after birth. When diabetes is well-managed, many of these effects can be controlled as well.

If you have diabetes, or suspect that you may have insulin resistance or pre-diabetes, talk to your doctor about what you can do to improve your blood sugar and insulin levels. Most often doctors recommend a combination of diet, exercise and medication to control diabetes. If you are pregnant, it is important to talk to your doctor about diabetes as early as possible to prevent problems.

* If you smoke, stop. Smoking can hurt both male and female fertility and it is better to stop now so you don’t risk harm to your unborn baby. Smoking during pregnancy is linked to reduced birth weight and premature birth.

* Use a sperm-friendly lubricant such as PreSeed. Most lubricants can interfere with sperm motion or even block their path to the egg. Don’t use saliva or lotions as these can actually change the acid balance of the vagina and kill or immobilize sperm.

* Time intercourse correctly. A woman is most fertile approximately 2 days before and 2 days after ovulation. This window of opportunity can be even smaller as an egg can live only about 12-48 hours. Sperm live much longer, but even so sperm live on average just 24-72 hours. Learning when you ovulate is important to maximize your chances. The average woman ovulates at day 14 of her cycle (counting from the first day of red blood during her period) but I have talked with women who ovulate as early as day 7 and as late as day 25. If you have intercourse every other day during the peak fertility window, you will maximize your chances. The best way to learn when a woman ovulates is through a learning your personal fertility signs. You can read about signs of ovulation in Taking Charge of Your Fertility.

If after 12 months of unprotected intercourse you have not conceived, it is important to talk to your doctor. Male or female infertility could be the problem. Male fertility problems are the cause just as often as female fertility problems. Sometimes the cure is as simple as a round of antibiotics or may be as invasive and expensive as in vitro fertilization.

A simple sperm test is now available for use at home to help narrow down the potential issues, it is no where near as precise as laboratory tests, but it can be a first step to understanding your fertility.

Things can and do go wrong with some surrogate relationships, as one couple recently learned the day after their surrogate was inseminated with the husband’s sperm. The surrogate announced to the astonished couple that she had feelings for the husband. The insemination failed, but the potential difficulties in that situation are obvious.

A surrogate mother may carry the embryo resulting from the egg and sperm of a couple suffering from infertility or she may carry a baby that is genetically hers after insemination with the sperm of the father. In either case, there is usually an agreement in place beforehand that after the baby is born the surrogate mother will relinquish any parental rights.

Some things to consider when deciding whether or not to use a surrogate:

* Be sure you fully understand the laws regarding surrogacy in your state as well as the state the surrogate resides in if they live elsewhere. Laws vary widely and in most state the laws are not up to date with current reproductive technology.

* A written contract is vital to ensure that all parties understand the agreement. Don’t overlook details such as who is to be present at the birth and who is responsible for all expenses. Be sure you have a lawyer review your written contract. Even with a contract, be aware that the law does not allow a birth mother to relinquish her rights before a baby is born.

* Discuss the surrogate’s reasons for offering to carry a baby for someone else. Many clinics require a psychological evaluation as part of the medical workup before insemination. If the surrogate changes her mind after the birth and refuses to relinquish the baby, it can be an extremely difficult situation both legally and emotionally.

* Talk with the potential surrogate about any issues you feel strongly about including smoking, drug or alcohol use, healthy choices during the pregnancy and what type of birth they want. Keep in mind that you do have a right to an opinion about many things, but that ultimately you can not control every aspect of the pregnancy – nor should you.

Did you know:

* Losing as little as 10% of your body weight can improve pregnancy rates for overweight women?
* Exercising too much can stop ovulation.
* Eating processed foods can reduce your fertility.
* When your body has a problem processing insulin you may develop polycystic ovarian syndrome.
* Obesity is now considered a sign of chronic inflammation–chronic inflammation is considered a major cause of infertility and PCOS.

Learn how to eat and what your body needs for optimum fertility.

Natural Infertility Treatments

This is my most recent book. I have gathered research studies and information on supplements, herbs, exercise, prayer, meditation, relaxation and dozens of other topics that impact your fertility. Available as an ebook or as a paperback book.

Diet Books

If you are overweight and suffering from infertility I highly recommend trying a diet that lowers insulin levels. Many women are suffering from undiagnosed insulin problems. Any of these diets are good, you simply need to find one you can live with. All of these diets focus on what you eat, none require starvation or unhealthy restriction. All are good choices for people who get sick on low carb diets and gain weight on low fat diets.

The Insulin Resistance Diet

An effective and relatively simple diet plan. You don’t have to go to extremes to lose weight.

The Anti Inflammation Zone

Dr. Sears has updated the popular Zone diet to include recent research on chronic inflammation. If you have high cholesterol, are overweight, have PCOS, or any auto-immune disorder, this diet is a very effective one.

South Beach Diet

A very popular diet that works wonders for many people who have never been successful at losing weight. A very healthy plan, this one is a bit more restrictive than I like.

Eat Carbs, Lose Weight

Sensible and enthusiastic as ever, Denise Austin brings us a weight loss and exercise plan that includes healthy carbs and good fats. Yummy recipes too!

Low GI

Low Glycemic Index (Low GI) diets are about eating slowly absorbed carbs instead of carbs that go into your system too quickly. Slow absorption means less insulin, no blood sugar crashes, and reduced inflammation along with weight loss.

Many studies show that healing your body with vitamins, herbs, massage, and other safe, inexpensive methods can in many cases help you get pregnant faster than traditonal medical treatments. Many natural treatments can be used in addition to medical treatments so you know you are doing all you can to welcome your new little one home.

Women may want to consider these supplements:

• A quality multivitamin may increase fertility. (Czeizel AE, Metneki J, Dudas I. The effect of preconceptional multivitamin supplementation on fertility. Int J Vitam Nutr Res 1996;66:55–8).
• Iron (10-20 mg/day) Anemia can lead to infertility. Women who bleed profusely may be anemic, those who rarely bleed may in fact be either anemic or too high in iron.
• Vitamin C (500-1500 mg/day) This powerful anti-oxidant helps to protect cells and strengthen the immune system.
• Vitamin E (400-800 i.u. per day) Vitamin E may increase egg quality. In a preliminary human trial, infertile couples given vitamin E (200 IU per day for the female and 100 IU per day for the male) showed a significant increase in fertility. (Bayer R. Treatment of infertility with vitamin E. Int J Fertil 1960;5:70–8)
• PABA (para-aminobenzoic acid) (400 mg/day) Some women have become pregnant with PABA. PABA is believed to increase the ability of estrogen to facilitate fertility. (Sieve BF. The clinical effects of a new B-complex factor, para-aminobenzoic acid, on pigmentation and fertility. South Med Surg 1942;104:135–9)
• Co-enzyme-Q10 (30-100 mg/day) May improve egg quality.
• Folate, also known as folic acid (400-800 mcg/day). Folic acid may prevent neural tube defects and other birth defects. It also protects your heart.
• L-Arginine (16 g/day) Was shown to increase fertility in women who had previously failed in-vitro fertilization-IVF-procedures. (Battaglia C, Salvatori M, Maxia N, et al. Adjuvant L-arginine treatment for in-vitro fertilization in poor responder patients. Hum Reprod 1999;14:1690–7)
•Essential fatty acids (EFA) (1-7 grams per day) can help the health of your reproductive system, insulin levels, heart and brain. EFA reduce inflammation throughout the body (a possible cause of PCOS and other types of infertility) and promote overall health. The best source is purified fish oil (don’t take cod liver oil as it is too high in vitamins A & D and may prove toxic).

Men may wish to consider these supplements:

• Vitamin C (500-1500 mg/day) Vitamin C helps to combat the pollution we are surrounded with. Pollution, particularly agricultural chemicals have been shown to cause much lower sperm counts. Vitamin C has been shown to reduce DNA damage in sperm by 91%. It is also shown to reduce agglutination and abnormalities. Vitamin C (1000mg) per day raised sperm counts by 140% in the first week in one study and 200 mg increased sperm counts by 112% in the first week. After 60 days the 200 mg group had caught up with the 1000mg group. All of these men had impregnated their wives by the end of the study.
• Vitamin E (400-800 i.u. per day) Studies show that vitamin E can increase sperm potency by 2 ½ times. Two studies found that vitamin E supplementation lead to a 20% pregnancy rate in previously infertile men. That is higher than most assisted reproduction procedures! Take vitamin E in mixed tocopherol form. Take it with vitamin C but do not take it without consulting your doctor if you have anemia, poorly clotting blood, hyperthyroid, high blood pressure, or liver disease.
• Zinc (15-60 mg/day) Even a mild zinc deficiency can cause drastically lower sperm counts. Zinc may also improve sexual function. In one study, thirty-seven men with more than five years of infertility, and whose sperm counts were less than 25 million/ml took 60 mg of zinc daily for forty-five to fifty days. For the twenty-two patients with initially low testosterone levels showed an increase in testosterone and mean sperm count increased significantly, from 8 to 20 million/ml. Nine of the twenty- two wives became pregnant during the study. For the fifteen men with normal testosterone levels, sperm count increased slightly but there was no change in testosterone level and no pregnancies occurred. If you take zinc for longer than a few weeks you should add 1-3 mg of copper to prevent a copper deficiency.
• B-12 (10-100 mcg/day) and a B-Complex supplement can help balance testosterone and LH/FSH secretions. Lack of B-vitamins is very common in people who eat mostly refined and processed foods as well as those who smoke. Twenty-seven percent of men in one study with sperm counts under 20 million/ml took 1,000 mcg of vitamin B12 per day. As a result, their total sperm count increased in excess of 100 million/ml.
• Selenium (100-200 mcg/day) Selenium deficiency causes fragile sperm with easily broken tails. Semen is high in selenium so it must be replenished regularly. Selenium is toxic in large doses so don’t take more than 200 mcg day. One double-blind trial found that sperm counts doubled in previously infertile men after supplementation with selenium.
• Co-enzyme-Q10 (30-100 mg/day) increases sperm counts. Also an anti-oxidant.
• L-Carnitine (up to 3 grams per day) An Italian study found that 2 grams a day of carnitine for three months dramatically improved sperm counts and mobility.
• A good multi-vitamin including vitamin A. It is not a good idea to take vitamin A separately as it is very easy to overdose on this vitamin. A multi will not have enough of the other supplements, but it is a good starting place to make sure you are not missing anything. Vitamin A helps improve sperm production.
• Essential fatty acids (EFA) are even more important for men than for women. Eat lots of coldwater fish and ground flax seed or supplement with a combination of between 1-7 grams of fish oil and flax oil capsules. Fish oil and flax oil contain different EFA so you will need to add substantial amounts of both to your diet. EFA are important for lowering your risk of diabetes and heart disease, improving overall health, and improving sperm count. Be careful about taking too much if you are on blood thinners. Be sure to choose distilled fish oil because oils such as cod liver oil contain toxic levels of vitamin A.
• L-Arginine (2-4 g) Arginine has shown very promising results in numerous studies on both sperm counts and motility. It is best used when everything else has failed.

For more information see the book “Natural Infertility Treatments” available only at http://www.pcoscoach.com/infertility.html

If these methods are not successful then you may wish to pursue the milder fertility treatments and finally, if all else fails you can move on to stronger drugs and even in-vitro fertilization (IVF). At any point you can decide that you are unwilling to move up the ladder, you can even move down, but it is safest and most effective to start at the bottom and give each step several months or more to work before moving along the ladder. In some cases, however, you may see that there is no other option but to move to a higher level such as when a doctor recommends surgery and a second opinion suggest that this is the best option.re is even more important when you are pursuing natural treatments. Natural medicine has a tremendously strong safety record but even one problem is too many if you are it. Know what you are taking and why. Always seek more than one source of information about the topic. A simple internet search can yield all the information you need in many cases.

The First Steps

A thorough evaluation by a competent medical doctor is the first step towards treating infertility. It is important to be sure you are healthy before attempting to get pregnant. A variety of health problems can cause infertility, including such silent killers as cardio-vascular disease and diabetes. Some herbs and supplements can be quite dangerous even for a hidden illness. A good doctor will work with you to decide on the best form of treatment and will consider alternative medicine as well as conventional treatment.

Be sure to discuss the following tests with your doctor:
• Thyroid function and antibodies
• Adrenal function
• Tests for endometriosis, fibroids, tubal blockages, or cysts
• Tests for sperm count and health, structural abnormalities such as varicocele
• Blood sugar level
• Women’s hormone levels including FSH, LH, progesterone, testosterone and estrogen
• Tests for infections in the reproductive organs

Some doctors are too quick to start infertility treatments without evaluating the whole picture. Many couples have wasted time and money on infertility treatments when there was an undiagnosed underlying problem such as a thyroid problem, an infection, or low sperm count. Other doctors are too quick to dismiss infertility issues. If you have been trying for one year with no results, or you are over 30 and have been trying for six months or more, insist that your doctor take you seriously. If one doctor will not listen to your concerns—find a new doctor. You are the consumer and you have a right to a doctor that listens to your concerns.

About 20 percent of infertility is due to female problems, 20 percent due to male problems, 40 percent due to problems with both partners and about 20 percent is unexplained. For the best results, even if only one partner has been diagnosed with a fertility problem, it is best for both partners to work on naturally enhancing fertility. This will achieve the fastest results and spare you the heartache of waiting for a pregnancy only to find that the second partner also has some issues.

A good second step (after a medical evaluation) is to do a complete internal cleanse. This helps to reduce environmental pollutants and other factors that can reduce fertility and adversely affect all of your internal organs and systems. A cleanse can help to prepare a woman’s body for pregnancy, increase the quantity and quality of sperm or egg cells, and balance hormones.

A cleanse is also important because the herbs you choose will not be able to do their work if the liver and other organs are clogged with toxins. The liver is responsible for maintaining the levels of reproductive hormones in the body and it can not do so effectively if it is busy reducing your toxic load.
Finally, you will be ready to begin a program of herbs and nutritional supplements tailored to your particular situation. It is important to work with a skilled naturopath or herbalist who can help you choose the right herbs and dosages.

A Word of Warning

Fertility is big business. Desperate couples will sometimes pay anything and try outlandish treatments in the hope of fulfilling their dream of a baby. Be sure the treatments you try are safe. Always know what the treatment is and why it is considered safe. This goes for conventional treatments as well as herbs and other treatments. Anything strong enough to work is also strong enough to hurt you if it is misused. While most practitioners really want to help you, there are some who are poorly trained or simply want your money. Be a wise consumer!