What are the signs and symptoms of infertility? Learn possible causes of infertility in females to know why you can’t get pregnant. 

Chances are if you are reading an article like this one, you and your partner are trying to conceive. And chances are that you have been trying for at least three months, or up to a year, or maybe even more… 

Did you know that by the time you find this article, no matter how long you have been trying to get pregnant, there are multiple aspects of your health and your lifestyle that have been impacting your fertility, (either for better or worse) long before you started trying to have a baby?

Let’s take a look at some of the signs of infertility and their causes. We’ll talk about some risk factors that increase the impact of these possible causes. We’ll explore some natural treatment options and clarify how to know if you need help from a fertility doctor. 

In my six years of working with couples who are hoping to have a baby, I consistently find that many are not aware of which fertility factors they may have the power to influence and are either confused about what they have read on the internet or think the IVF/IUI is their only option. 

What are the signs, causes, and risk factors of infertility?

Environmental factors have a huge impact on fertility. In fact, the EPA releases 100s-1000s of chemicals each year, all individually under the toxic safety limit, yet they rarely summate the total toxicity risk for chemicals approved in industrialization. Though we have no control over capitalistic tendencies to put profit over people, we can limit our exposures at home and do our part to preserve our fertility, our children’s health, and the Earth’s health. Here are a few at home considerations: 

  • Plastics, like your water bottles and food containers. can be contributing to your fertility struggle.  BPA/BPP is well known to interfere with fertility causing decline in egg health and sperm health. This is also in cans and on receipts. 
  • Opt for E-receipts. 
  • Your exposure to pesticides can be interfering with your delicate hormone balance. Take off your shoes as soon as you get home and find natural alternatives. There are many studies that show that farmers do not get pregnant until the winter time after their bodies have detoxed pesticides.
  • Your personal products like your make-up, shampoo, deodorant, and cleaning products can be contributing to your problems successfully conceiving. 
  • Cookware matters. Look for healthy ceramic, stainless steel, and cast iron. 

How? We are surrounded by estrogen-mimicking chemicals that can simulate to our brains that we have high estrogen, when in fact, we simply do not. Estrogen-mimickers can throw off the brain signaling to the ovaries when creating testosterone, estrogen, and progesterone. Honestly, most of the natural medicine world is in a full-on battle, spending excess dollars to battle industrial waste.  Us versus the .0001%, always.  We have only begun to scratch the surface in terms of understanding the impact of our toxic environment on our ability to continue our role of propagating the human race!

This is why it is so important to commit to detoxing your environment from exogenous estrogens before beginning a hormone balancing protocol. I recommend that my fertility clients start a liver detox program for at least 2-3 months before we launch into other aspects of natural treatment. This includes taking nutritional supplements as well as committing to conscious steps to eliminate toxins from your life as you begin to prepare both baby rooms: your womb and your home. During this time, you can begin working on both sperm and egg health, as it takes about 3-4 months to create healthy sperm and egg. Optimizing sperm and egg health gives your baby the chance to inherit the best DNA and be able to pass that down for generations to come. 

Adequate quality nutrition is also a big component that contributes to preparing your baby room, and serves you to become the healthiest parent possible.   Studies have found that simply shifting food and including exercise can improve fertility. Any diet, latin for dieta, that focuses on stress, targets insulin resistance, includes quality protein, vegetables, carbs, and fat will improve your chances at conceiving. Even if the diet does not lead to weight loss, it reduces inflammation, cravings, menstrual irregularities and those pesky androgen-dominant symptoms. This can only increase fertility. Refer to a fertility membership for fertility meal planning. And you can read about The Perfect Fertility Diet here.

Stress absolutely cannot be overlooked as you seek to begin your fertility journey. And boy, is it stressful for you and your partner to try to conceive. We know that elevated cortisol wreaks havoc on our HPA axis balance and disrupts the hormonal balance needed for healthy conception. The HPA axis is the adrenal-brain connection. The adrenals release cortisol which helps us wake up and go to sleep at night when healthy. As cortisol becomes imbalanced, so does your blood sugar, sex hormones, and thyroid. Don’t forget, this is a 50/50 job, dudes. The stats are 33/33/33 female/male/unexplained. In natural medicine, we go beyond the unexplained. And both parties are making the baby and raising the baby, so both parties are required as a team effort. 

Hormonal imbalance is a major contributor to prolonged infertility. 

How do we test for these imbalances? 

 It is essential to use appropriate lab analysis to find the underlying cause of infertility and hormone imbalance. EI use the World Health Organization values for fertility in order to evaluate hormone health. Basically, these lab values have a tighter range than what is accepted and used in the conventional medical system. It is also very important to note that you have other testing options that are not offered by your conventional doctor. These include functional medicine tests that can assess environmental toxicity, cortisol, free hormones, gut health, and nutrient analyses. 

Functional Medicine Labs are the labs that help your Naturopathic/ Functional Medicine Doctor take you “beyond fine” in your health goals. They are proprietary tests (unapproved by the American Medical Association) that help narrow down your fertility plan. One of my favourite tests to use is the DUTCH test, a dried urine hormone test. 

After PCOS, and/testosterone insufficiency,  estrogen dominance is a major cause of hormonal imbalances that lead to infertility. Excess unopposed estrogen may be caused by impaired detox function, such as liver and kidney impairments, “sluggish” bowels, “sluggish” circulation/” lymphatic congestion”,environmental toxicity or thyroid dysfunction.

Low thyroid function must be considered when we are trying to get a complete picture of the causes of your fertility struggles.  A complete evaluation of your thyroid function, which needs to be  optimal to have other hormones in balance.  TSH is the standard thyroid  test and should be run on every woman with infertility.  Anti-TPO  antibodies are a marker of thyroid autoimmune disease, and should be  run on women with unexplained infertility, premature decline in ovarian reserve, and implantation failure. A full thyroid panel is recommended for all women and many men experiencing infertility and or hormone imbalance. 

For a more thorough guide to which labs need to be run when investigating the possible causes of your infertility, you can check out my Lab Interpretation Guide for infertility in one of my fertility groups. It is the best navigation of where to begin with your Doctor that I have found. 

How will I know when it’s time to get medical help?

60% of couples successfully conceive in the first 3 months of trying.

90% of couples successfully conceive in the first year of trying.

But I always say, “Why wait until the 1-year mark to go through a battery of testing that will likely lead to ‘unexplained fertility’, Clomid, then IVF, or IUI?”

If you knew you could increase your chances of successfully conceiving faster, would you want to know how? Would you want to start sooner rather than later? We have talked about some steps you can take to begin to prepare for your fertility journey. My Fertility packages, both individual and group, use a non-invasive approach to helping couples conceive, and you can read more about that here. Besides diet and lifestyle changes, this approach seeks to balance hormones naturally. 

How will you help me balance my hormones?

I use a biphasic approach to balancing your hormones to prepare for getting pregnant and maintaining pregnancy. This means that I will give you special herbal blends, one for each phase of your cycle to build healthy estrogen and progesterone levels. This supports ovulation health, uterine health, and maintaining pregnancy. I also teach Cyclical Living, a way of living that allows you to focus on resting more during specific phases of your cycle, and allowing space for nourishing yourself, journaling, eating, and exercising to biohack your cycle . You can read more about this in my Cyclical Living article.

The follicular phase is from menses to bleed, the first half of your cycle when Estrogen is building up into a plump juicy egg (ovulation).  During this time, cortisol is a bit lower, and therefore you have a more regulated stress response. I have designed a formula to support the building of egg follicles that produce estrogen. My Follicular Blend is full of sex hormone-supporting herbs with plenty of Tulsi to support adrenal health.  

The luteal phase is from ovulation to bleed. During this time, after ovulation, cortisol, your stress hormone is generally higher, and man do we feel it when we have PMS?! This is the phase of your cycle when you will need progesterone support. My Luteal Blend has motherwort to ease PMS symptoms and Vitex to support luteinizing hormone and the follicle stimulating hormone, as well as the building of healthy levels of progesterone. I recommend using this product for three months before trying to conceive.

What about the role of male infertility?

Balancing your hormones will be a central goal in our work together as we seek to improve your health. But did you know that I also focus on your partner’s health as we consider male infertility as a possible risk factor in your struggle to conceive? Often this piece of the puzzle is only given secondary emphasis. If you are in a same-sex partnership, I can support the person carrying the baby, the partner, and/or the person donating sperm. 

Infertility/subfertility are 33% male factor, 33% female factor, 33% unexplained, and/or both. Or as I like to think of it 50/50, forget the unexplained and find the root cause!  So if your partner’s fertility is a factor, why does this possibility not receive more attention? Why is it always assumed that the fertility issue lies with the female partner? I am so tired of sexual health being on the shoulders of women. 

In regards to sperm, the reproductive endocrinologist selects the healthiest sperm based on morphology/motility. But often  this does not account for DNA fragmentation, which has had promising literature to help explain the unexplained. 

Studies show that overall male fertility is dramatically declining. Did you know that almost all men alive today would have been considered infertile just two generations ago? And that by 2048, the last viable sperm is expected to swim, making every couple that is trying to conceive needing to undergo IVF. Yet, egg freezing is marketed to women as a future consideration.

Factors influencing Male infertility include endocrine/hormonal disorders, anatomical disorders, sexual dysfunction, abnormal sperm shape and motility.  These factors may be influenced by genetics, environmental exposures, psychological factors, and alcohol consumption (daily use lowers ejaculate volume), marijuana, and more.  I recommend the following steps for your male partner as a complement to the work we will together:

Step 1: Semen analysis– involves the laboratory testing of a sample obtained by masturbation to look at the volume ejaculated, sperm count, poor motility, poor morphology (form and structure), leukocytospermia (high numbers of white blood cells present) and immunologic factors. If you order from Legacy, you can add on DNA fragmentation, though your insurance or HSA may cover this in a RE clinic or at another in-house lab. You need to check with your local lab to see if it is an offering, as the sample must be collected and delivered within a two-hour window, and kept close to body temperature. 

Step 2: Hormonal Evaluation– Men with abnormal semen or couples with troubles conceiving should then be tested And I don’t just mean testosterone! We all know that Testosterone is a critical hormone for men to feel male- strong, healthy,  and driven (sexually and otherwise).  Testosterone naturally declines with aging, but treatment is geared at bringing your partner’s blood levels to that of a healthy man.  Sometimes Clomid is used to increase male testosterone levels, yet there are many herbs and nutrients to help increase free and total testosterone including tribulus and saw palmetto. Also avoiding environmental toxins listed above help build healthy testosterone. 

Men should also have SHBG (Sex hormone binding globulin), FSH (Follicle Stimulating Hormone), and LH (Luteinizing Hormone). 

SHBG is a protein that binds to testosterone and kind of “stores” it away in an inactive form.  Many things can affect SHBG, including your stress levels, inflammation and diet.  SHBG tends to go up with age, rendering testosterone and other hormones inactive.

Made by the brain, FSH tells testicles to make sperm.  We want to make sure there is just enough around, and not too much, which can indicate that his body isn’t  “listening” to his brain’s signal well.

LH, also made by the brain, is released by the pituitary gland in the brain.  Luteinizing hormone (LH)  is the brain’s direct signal for his testicles to manufacture testosterone.  If his testosterone is low, and this is also low, it tells you that this is likely a problem driven by the brain not signaling testosterone production.

Step 3: Search for other causes–  When semen analysis is normal and female testing also produces normal findings, additional semen analysis may be necessary to rule out anatomical issues such as variocole (enlargement of the veins within the scrotum), immune involvement, and DNA fragmentation (a break in one or both DNA strands of the chromosomes within the sperm).  It is here where naturopathic and functional medicine thrives. There are many environmental causes, GI health factors, chronic insidious infections, and other stressors that may be the underlying cause of issues trying to get pregnant. 

DNA Fragmentation Risk Factors include:

  •  Infection
  •  High fever
  •  Leukocytospermia
  •  Elevated testicular temperature
  •  Varicocele
  •  Advanced age
  •  Obesity
  •  Poor diet
  •  Drug use
  •  Smoking
  •  Environmental exposures
  •  Sex lubricants (PreSeed ok, others have shown concern due to spermicides and shifting pH balance of vagina (KY, astroglide,
  • FemGlide)
  •  Cell phone use

I am more than happy to offer emotional support and practical guidance in advocating for both your partner and your health as you embark on your fertility journey together as a couple. In my fertility course and individual care packages, I see both of you, together and separately,  helping him/her see that their health matters! Often, fertility is one-sided. And the fact is that your quality of life, the strength of your relationship, and for the life of your future child, that creates a stronger partnership. A relationship alone, forms a separate being with the two of you together, from a spiritual standpoint. Now it is time to manifest that soul into reality with your baby. 


Fertility is frustrating and there are so many factors to consider if you are having trouble conceiving. Do not allow the story of sexual health solely to be the women’s responsibility to direct your fertility journey, as it is 50/50 male/female. Consider your direct environment, more extensive specialty testing and routine blood work, and your home as you are preparing your baby room. Adding natural medicine and a holistic framework to your fertility journey can greatly increase the chance of conceiving naturally and/or with IVF/IUI. To learn more about natural fertility treatment options, click here to schedule an initial visit.

In closing

If you are curious about a fertility journey with me; or what your best options are for you and your partner, you can book an initial visit in the pop-up on the blog.  I would love to have you both participate if your partner is willing. Because of the sensitive and intimate nature of this work, I require an initial consultation, during which a full medical history will be obtained. I will also schedule a manual pelvic organ mobility evaluation if necessary for Mercier Therapy. Also during this initial consultation, we can discuss your options that are the best fit for preparing your baby room.  If you are curious about sparking more intimacy for baby-making, refer to this article here.

Agarwal A,. Fertil Steril. 2009;92:1318–1325

Aboulmaouahib S et al.. Andrologia. 2018