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nothing to make the couple healthier."
So what is behind this alarming
statistic that one in six couples struggles
with infertility in Australia?
Dr Cabot is firmly of the view that
being overweight is the most important
factor, together with an increasing
incidence of insulin resistance.
"Just being overweight can shut off
the pituitary gland or at least the FSHLH
(follicle stimulating hormone and
luteinising hormone) cycle so that it's out
of balance and you don't get proper
ovulation and then you get progesterone
deficiency. In turn, that causes an
inhospitable terrain in the uterus and then
the feedback to the pituitary is wrong.
And so the whole situation compounds
"It's a cascading effect that starts with
a woman being overweight."
Insulin resistance brings with it a
greatly added risk of polycystic ovarian
syndrome and women with the increasingly
common syndrome don't ovulate regularly
or at all.
But even without PCOS, we learn
that an overweight woman often fails to
ovulate. Even young obese women with
regular menstrual cycles usually take
longer to conceive than slim women.
The newfound saviour of IVF is also far
less successful when a woman is carrying
excess weight. But it's not all doom and
gloom because, say Cabot and Jasinska,
"Losing weight if overweight is one of the
fastest ways to achieve a pregnancy."
It's hard to escape the conclusion
that our society's inadequate diet with
everything skewed to convenience with
prepared, highly processed food taking
the place of natural, home cooked meals
is leading to a multiplicity of health
problems -- and now it seems they include
rapidly declining fertility.
"It's interesting," Dr Cabot continues,
"that we see a lot of women in our clinic
and if you took a dietary history from
them you'd think that's pretty good. And
these are women who are trying to be
"But in 50% of these cases who, to a
dietician would seem to have a good diet,
we find they are deficient in iodine and
Thyroid problems, particularly an
underactive thyroid gland, are "incredibly
common in women" and a common
cause of infertility in both women and
"Losing weight if overweight is one of the fastest ways to
achieve a pregnancy." - Dr Sandra Cabot
men. Vitamin D, the "sunshine vitamin",
is only now being recognised as being
seriously deficient in our society which
has learned to fear the sun; a deficiency of
this hormone precursor aggravates
Dr Cabot continues: "80% of Aussies
are low in selenium and that acts
synergistically with low Vitamin D, low
iodine and low progesterone and stress
and they all magnify each other. So that
seemingly simple problems become quite
profound when they're all put together."
Although often called the pregnancy
hormone, the importance of progesterone
in promoting fertility is poorly under-
stood by women and doctors, too, she
It performs a balancing role with
oestrogen to prepare the lining of the
uterus for the fertilised egg, to maintain
the pregnancy and boost the immune
system. Oestrogen dominance and the
corresponding fall in progesterone is yet
another of our modern world's emerging
patterns -- and once again, it's most
commonly caused by a high carbohydrate
diet, excess body weight, nutrient
deficiencies, ageing, and stress.
"Doctors are not trained to be aware
of the implications of progesterone
deficiency. And they're not trained to use
the natural progesterone. It's something
that is considered complementary and
also drug companies aren't interested
in doing clinical research because it's
natural," says Dr Cabot.
"But what we're talking about is
preventing women having to go to the
stress of IVF by making them aware
of progesterone so they can use it to
regulate their own cycles."
Men are also given the once over in
this very detailed fertility "manual" -- we
learn that males are currently responsible
for 40% of infertility with most cases
relating to sperm quantity and quality.
And while we learn some seriously
concerning details about what's happening
to males worldwide -- a Danish study in
1992 demonstrated that sperm counts in
healthy men had dropped by more than
half in 50 years -- with rapid cell division
in sperm making them vulnerable to
chemicals in the environment, especially
endocrine disruptors, there is hope at
continued page 28
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