The 67th conference of the International College of Integrative Medicine is “Healthy Parents, Healthy Children: Healing the Next Generation,” in Toronto October 23-27, 2019. We’ll be looking at integrative approaches to prenatal optimization, infertility and childhood disorders.
Our conference is designed to pinpoint specific types of intervention that will give you new ideas and effective tools to help your patients enjoy a lifetime of well-being and prevention of chronic conditions.
One goal of this conference is to help develop an understanding of why we, as a species, are having such a hard time with reproduction. As integrative physicians we suspect that behind infertility lurk the same processes that are behind the rise of all chronic diseases: poor nutrition, toxins and endocrine disruptors, chronic stress, EMF pollution, the list goes on. Once we understand the underlying issues with infertility–the root causes–we can better understand the solutions. Learn more and register at www.IntegrativeMedicineConference.com.
Canadian speaker is Kali MacIsaac HBSc, ND offers an introduction to her topic:
In the past two decades societal norms have led couples, and especially women, to try and conceive later in life. In the years between 1994 and 2004 in Canada, the percentage of first births to women aged 30 to 49 increased from 27.9% to 43.8%.1 Demographics are changing in our communities and in our practices. Escalating fertility struggles, coupled with the decline of natural fecundity with age,2 means we are seeing more and more men and women in their 40s in our practices who are trying to expand their families.
Working with this population requires a different approach than promoting fertility in younger men and women. There are several special considerations to keep in mind, several risks for women in pregnancy, but also a few advantages to delaying child rearing. The really good news? We have a lot to offer our over 40 patients to support their reproductive health in the natural and functional medicine realm. In my practice every day, I work with couples in their late 30s and 40s who are concerned about their fertility. They leave empowered and with an evidenced-based, actionable plan, that helps them feel inspired about how changing their diet and lifestyle and utilizing naturopathic modalities will support them as they build their healthy family.
Unfortunately, there are reproductive challenges faced by couples over 40 – higher miscarriage rates, increased Down Syndrome and autism incidence, lower pregnancy achievement rates, and higher percentages of genetically abnormal embryos to name a few.3 Plus, couples feel the clock ticking at an accelerated rate as they realize the reproductive window may be closing. Not that it’s all bad! Women who give birth over 40 are more likely to be college educated, are more likely to read to their children, and don’t experience the same loss of wage from pregnancy and maternity leave as younger women.3
Until the reproductive clock truly stops ticking at menopause, it is possible for healthy couples to conceive and have healthy babies in their 40s, either naturally or with the help of ART.
Fertility is determined not just by the quantity of eggs a woman has (which certainly declines with age), or the number of sperm produced by the male partner, but also by the quality of the gametes. The likelihood of ovulating a genetically normal egg declines rapidly after age 35 – in fact, the percentage of genetically normal eggs decreases to less than 10% in women over 40.4 Fortunately, gamete quality is malleable with a naturopathic/functional medicine approach and is a special interest of mine. Using a holistic approach, we are able to affect biological aging, or help ‘turn back the clock’ – an important factor in the likelihood of both natural and ART-assisted pregnancy.5
It is important for any naturopathic or functional medicine physician to understand how to support men and women in their 40s who are trying to conceive because we are all already treating them in our practices. Docs should know the special considerations in patients trying to conceive over 40, understand phase 1 (basic) and phase 2 (extensive) workups that should be performed for both partners, feel confident interpreting labs that may suggest that reproductive aging is a factor, know the leading theories on why age impacts fertility, and be able to develop a comprehensive nutritional and botanical approach to improve fecundity in this special population. With this approach, we not only improve our patients’ fertility and help them conceive sooner, we also increase the health of their future children.
Dr. Kali MacIsaac is the naturopathic physician at Acubalance Wellness Centre in Vancouver, BC Canada where her clinical focus is in women’s health and fertility. Acubalance was honored to be named the Best Naturopathic Clinic in Vancouver by the Georgia Straight in both 2017 and 2018. Dr. MacIsaac believes that we all have big plans, commitments, and passions, and we are only capable of fulfilling all of our dreams when we have health in our corner. She is passionate about providing practical natural solutions for balancing all aspects of health to help her patients reach their highest potential.
References:
1. Statistics Canada Births and Stillbirths, 2014. Component of Statistics Canada catalogue no. 11-001-X.
2. Canada.com Infertility: more common than you think. Available at: https://bodyandhealth.canada.com/healthfeature/gethealthfeature/infertility-more-common-than-you-may-think. Accessibility verified May 10, 2019.
3. Gregory E. Ready: Why Women are Embracing the New Later Motherhood. New York. Basic Books 2007; 30.
4. US CDC National Vital Statistics Report 2010; 59(3).
5. Alviggi, C et al. Biological versus chronological ovarian age: implications for assisted reproductive technology. Reprod Biol Endocrinol. 2009; 7:101.