It is estimated that one in seven married couples worldwide experiences difficulty conceiving. Experts at the UAE Reproductive Symposium 2014 put local infertility rates at somewhere around 10 per cent, and all agreed that the demand for fertility treatments here in the UAE is higher than the global average, and rising.
According to the World Health Organization, 85 per cent of couples fall pregnant after one year of trying naturally. Where the woman is below the age of 35, fertility advice is recommended after 12 months without conceiving. Above the age of 35 specialist help is recommended after six months of trying. Dr Lanalle Dunn, naturopathic physician at Dubai’s Chiron Clinic, says the number of those seeking help is on the rise.
“In 2010, the Dubai Health Authority released a report that estimated around 30,000 couples in Dubai were struggling with fertility – that was four years ago, the figure is thought to be higher today. I would estimate that as many as 15 per cent of my patients come to me with fertility-related issues.”
One of the factors leading to the high incidence of infertility is undeniably lifestyle. “Obesity, smoking, alcohol, stress and poor nutrition all play a role,” says Dr Dunn. “But many are unaware that certain toxins in our homes also contribute to infertility.”
Environmental health is an ever-growing field of study. Since the second half of the 20th century, we have seen the introduction of more than 70,000 new chemical compounds. Not all of them are bad, but in this age of consumer awareness, a little knowledge can go a long way.
Dubai London Clinic’s obstetrics and gynaecology specialist Dr Anna Sepiolo says that lifestyle and environmental pollutants are some of the leading causes of today’s growing incidence of infertility. “Reports suggest that environmental oestrogens [or chemicals that mimic our natural oestrogen] are creating infertility problems by confusing the body’s own oestrogen receptors. These are referred to as endocrine disruptors and can be found in pesticides and herbicides but also in many household items. It’s important to realise, however, that it’s not as simple as just cutting out one chemical to achieve pregnancy; the inability to conceive is usually due to a combination of factors, not just environmental toxins alone.”
The dirty dozen
The US-based Environmental Working Group (EWG) has identified 12 hormone-altering chemicals found in our homes that may affect fertility, and suggests ways to avoid them (for the full list and more information on the studies visit www.ewg.org/research/dirty-dozen-list-endocrine-disruptors). One culprit currently under the spotlight is bisphenol A (BPA), a chemical that is commonly used in hard plastics such as water bottles, baby bottles, mobile phones, reusable food containers and the linings of food cans. “What’s concerning is that BPA can leach from the plastic and into the food and drink we consume,” says Dr Dunn. “BPA can disrupt our hormone balance even at very low concentrations. Avoid it by switching to fresh, organic foods and don’t use BPA plastics that are marked with the recycling label #7 or PC.”
Another to avoid is the antibacterial chemical triclosan found in many personal-care products such as liquid soap, mouthwashes, deodorants, portable hand sanitisers and household cleaning products. “Not only does the overuse of triclosan increase antibiotic-resistant bacteria, it also alters our body’s hormone regulation,” says Dr Dunn. “It can be avoided by using organic, unscented or essential-oil-scented personal-care products. Read labels and avoid products that simply list the catch-all term ‘fragrance’. And when it comes to household cleaning products the rule of thumb is: If it’s truly clean it has no scent.”
Flame-retardants or PBDEs are a family of chemicals that are difficult to avoid. Some have already been banned since 2004, but many still lurk in our homes – particularly in couch cushions, mattresses, paints and carpets. The chemicals used to coat these fabrics or upholstery may make them water or fire resistant, but they are also accused of disrupting our body’s normal hormone functioning.
Dr Dunn says, “Aside from being aware of them, the only way to avoid PBDEs is to take practical steps. Refrain from any house renovations if trying to conceive, especially painting, reupholstering furniture or laying new carpet. Instead look for ‘safe’ upholstery and fabrics made of non-treated natural materials, such as cotton, wool, and latex.” Another worry is that certain older models of non-stick pans contain a chemical coating of perfluorinated compounds (PFOAs) that have been linked to reproductive problems. The same compound is used as a grease-resistant lining in food packaging. “The evidence is so overwhelming that since 2012 Teflon and other non-stick pan manufacturers have been using alternative formulations,” says Dr Dunn. “If you have any non-stick pans more than three years old, discard them. Also avoid grease-resistant food packaging such as in microwave popcorn, pizza boxes and other fast food items. Read labels on nail varnish and eye make-up and watch out for terms such as ‘fluoro’ or ‘perfluoro’.”
When it comes to infertility, “Everyone is individual,” says Dr Dunn. “But infertility is commonly a sign of imbalance somewhere in the body with a number of factors at play. From the initial consultation there is a treatment protocol we tend to follow – aside from normal blood work, we may also suggest tests for organ functioning and the presence of environmental toxins. A full home and diet detox is often part of the treatment.
“I may then prescribe specific herbs, homeopathy and vitamins. A typical nutritional supplement I often recommend is powdered maca – a South American root vegetable that’s effective for both men and women in increasing fertility naturally.”
Acupuncture is another method of regulating cycles, rebalancing hormones and flushing out environmental toxins. “One of my patients came to me with irregular menstruation and difficulty staying pregnant. She was in her mid-30s, conceived easily but she’d then had a series of traumatic miscarriages. I put her on a full-body cleanse and home detox. She had acupuncture twice
a week over three months. Her monthly cycles gradually normalised and she fell pregnant quickly. To help secure the pregnancy we continued with acupuncture throughout her first trimester, then started again just prior to birth. She is now the proud mother of a beautiful, healthy baby boy.”
Other factors to watch out for
Infertility in the region is a growing concern and a number of clinics in the UAE are pioneers in various IVF and fertility treatments. Dr Rupin Shah, urologist at Dubai’s Fakih IVF Fertility Center, is an internationally recognised expert in the field of male infertility. He says there is a cultural shift under way in the GCC where men are more open to accepting the blame for infertility. “Which is just as well. The current estimate for the region is that men are the cause of infertility as much as 70 per cent of the time. Sperm are highly sensitive to heat and environmental toxins, more so than a female’s eggs.”
Regarding lifestyle choices, Dr Shah advises his male patients to avoid certain household chemicals and solvents. “I also suggest a diet high in antioxidants and chemical-free, high-quality foods. Working for long periods of time with a laptop on the lap is not a good idea either.”