These are the books I wish I’d found much earlier in my infertility journey. If you’re struggling with more questions than answers, I hope they offer you fresh ideas and new avenues to explore.
Fertile vs. Infertile, Attila Toth, MD
Fertile vs. Infertile: How infections affect your fertility and your baby’s health
Dr. Toth’s premise: undiagnosed, asymptomatic hidden genital tract infections are the root cause of nearly all types of infertility.
The good news is that proper antibiotic treatment– the safest, least invasive, and least costly form of infertility treatment– can usually restore fertility. The bad news is that antibiotic treatment is often bypassed in favor of the quick technological fix, which involves more expensive and risky but more impressively sophisticated procedures like hormone therapy, in vitro fertilization, and intrauterine insemination.”
Dr. Toth, Fertile vs. Infertile, preface page IX
You can buy the print copy on Amazon, or get the PDF version free on Dr. Toth’s site.
Dr. Toth describes what we all learned in sex ed: sexual (horizontal) transmission of reproductive infections is common, and it damages fertility. But! — there is another, often overlooked way of acquiring these bugs. Vertical transmission is of special interest to Dr. Toth. This occurs when a parent passes an infection to their child during conception, gestation or birth.
This is revolutionary thinking. The current medical paradigm places emphasis on things running in families due to shared genetics and lifestyle factors. Infections run in families, too! He says,
In fact, given the way vertical transmission works, the true origin of these agents may go back for generations in either or both of the parents’ family lines. The result is a chain of intermittent fertility problems that gets passed along until, eventually, there may come a ‘final generation’ individual or couple that can’t produce a child”
Dr. Toth, Fertile vs. Infertile, page 37
For people struggling to conceive, the concept of vertical transmission matters two-fold. First, vertical infection could explain the source of your infertility and the target of your treatment. Second, you can prevent the transmission of infections to your own offspring.
He argues convincingly that many people have low-grade infections from birth. These infections are hard to detect with normal STD testing and can go unknown for years. Over a lifetime, untreated chronic infections lead to all sorts of problems– especially the sort that contribute to infertility.
- For women these conditions include:
- damaged fallopian tubes
- abnormal ovulation
- pelvic inflammatory disease
- endometriosis
- damaged ovaries
- luteal phase defect
- hostile cervical mucus
- hormone deficiency
- immunological issues
- For men, these conditions include:
- low sperm count
- varicocele
- damaged sperm ducts
- inflammation in the reproductive tract
- hormone deficiency
- impotence
Science lacks satisfying causal explanations and medicine lacks effective treatments for many of the conditions listed above. If you have endometriosis or PCOS there’s a sense that you lost the genetic lottery, will have to manage the symptoms for the rest of your life, and may not be able to successfully reproduce. It is SO refreshing to read simple and sensical ideas regarding causes of and treatments for these issues.
- Fertile vs. Infertile covers all the bases regarding infections and infertility:
- how pathogens damage fertility
- modes of transmission
- the signs and symptoms of infection
- the consequences of forcing fertility with IUI/IVF when pathogens are present
- diagnosis
- treatment
- self-assessment questionnaire
The self-assessment questionnaire is very thorough and can help you and your partner connect dots that you may not otherwise have considered.
Dr. Toth’s book changed my life. I read it in 2 days, amid a frenzy of incredibly satisfying epiphanies and ‘ah ha!’ moments. If I had to recommend only one book, it would be Toth’s.
Is Your Body Baby Friendly?, Alan Beer, MD
Is Your Body Baby Friendly? How “unexplained” infertility, miscarriage & IVF failure can be explained and treated with immunotherapy
Alan E. Beer, MD
In the 1980’s, it became clear to me that products of an activated immune system could damage the placenta and cause miscarriage, as well as damaging the embryo and causing implantation failure. Natural killer cells, which help to keep the body from developing cancer, can overpopulate the uterus or exist at too high levels in the blood stream. These cells then go overboard, killing the embryo or interfering with the endocrine system that produces the hormones essential for pregnancy. This response can often be associated with complications for both the mother and her baby if the pregnancy continues without immunosuppressive treatment.
My research has also taught me, among many other things, that there are couples who are an unlucky match, who produce embryos that are misinterpreted by the immune system as foreign objects, or even cancer like cells.
The reproductive system is incredibly overbuilt for success and when it fails, something is surely wrong.”
Dr. Beer, Is Your Body Baby Friendly, page 4
Dr. Beer’s premise: the immune system plays a fundamental role in the acceptance or rejection of pregnancy.
According to Beer, a couple struggling to conceive should first rule out and treat for chromosomal abnormalities, anatomical problems, infections and hormone imbalances. If there are still reproductive difficulties, the immune system is a likely suspect. If the woman has a known autoimmune disease or autoimmune markers (like ANA+), the suspicion increases.
Immunology is a medical frontier, and science is just beginning to understand how a woman’s body accepts foreign genetic material and grows an entire baby without rejecting it the way it would other foreign material – say, an infection, a tumor or an organ transplant.
There is a truly fascinating orchestra of events that must go off without a hitch for a mother’s body to accept and nourish a healthy, full-term pregnancy. The reality is that this immune tolerance process is not well understood in normal pregnancies, and even less is known about what role immune dysfunction might play in infertility, miscarriage, recurrent miscarriage, and pregnancy complications.
Dr. Beer passed away in 2006, but his clinic in California is still operating. He (and after his death, his clinic) has had success with thousands of couples, even those considered ‘hopeless’ cases. Women who have had miscarriages numbering in the double digits finally got their take home babies using Dr. Beer’s methods. Dr. Beer’s work has inspired a small group of doctors to specialize in Reproductive Immunology and to offer his style of immune testing and treatment to women with complex fertility issues.
Dr. Beer’s pioneering methods of testing and treatment can help couples who are experiencing the whole spectrum of infertility:
- no positive pregnancy tests
- early losses / implantation failure
- IVF failure, and recurrent miscarriage and/or stillbirth
Is Your Body Baby Friendly lays out five categories of immune system problems:
- The couple’s tissue is too compatible (DQ Alpha and HLA similarities)
- Blood clotting problems (Antiphospholipid antibodies, Factor V Leiden, Protein C & S Deficiencies, MTHFR)
- An immune reaction to the baby (ANAs)
- Antisperm antibodies
- Natural killer cell (NK) and other white blood cell over-activity + downstream effects
After giving a thorough description of these issues, he details testing and treatment. The testing and treatment part is actionable and easier to comprehend than some of the (pretty deep) science that precedes it. He includes inspiring case studies and some suggestions for naturally supporting healthy immune activity. The book concludes with nearly 150 pages of impressive citations with relevant notes provided.
Which came first, the immune dysfunction or the infection?
It’s a chicken or egg question. Beer suggests that immune dysfunction can be triggered by infections such as Chlamydia and Gonorrhea, but my sense is he does not consider infections the only trigger. Toth acknowledges that infections can set off immune dysfunction, and I think his special insights about vertical transmission are a major clue as to what sets off autoimmune disease and other chronic health issues that can’t be otherwise be explained.
Sidenote: I synthesized Beer and Toth’s strategies to achieve my successful pregnancies after loss. I needed to BOTH treat the infections and modulate the immune system, in order to stay pregnant. I’ve read evidence that makes me believe that long-standing chronic infections can cause more or less permanent changes to a person’s immune system. I don’t believe that simply removing the infection fully restores a person to health, as if the chronic infection were never present.
Making Babies: A Proven 3-Month Program for Maximum Fertility
Sami S. David, MD and Jill Blakeway, LAc
Dr. David’s premise: Don’t skip to IUI and IVF without laying the foundations of health and doing proper detective work.
The program laid out in this book will guide you through the process of conceiving as naturally as you can given your own particular situation. This decreases the risks of ARTs and comes as close as is humanly possible to eliminating the risk of not having a child. It’s the paralyzing fear of that worst risk coming true that drives the whole crazy way the infertility industry works today. The latest and greatest technologies are sold as the one true path to salvation, the only things keeping patients away from the abyss. But fear is a terrible place to proceed from.
What a couple being pushed that way really needs is basic information, good advice, judicious use of conventional and adjunctive treatments, and a certain amount of clearheaded patience. What they often don’t need is IVF. They don’t need the physical strain of extreme hormone doses and repeated invasive procedures. They don’t need the long-term increased health risks to mother and baby. They don’t need the emotional strains the IVF roller coaster puts couples on. They don’t need the tremendous expense…
All these patients really need is a baby. When that goal proves difficult to achieve, they need careful detective work to uncover what’s really going on and to so reveal how best to address it. Then they need a wise guide to help them naviage through their choices — all their choices — until their primary need is fulfilled. Sometimes the solution is indeed IVF, but most times something far less drastic will do the trick”
Sami David, MD, Making Babies, page 17
This book marries concepts of Traditional Chinese Medicine (TCM) with Western medical ideas and terminology. I found this book easy to understand and highly actionable. Sami David, MD and Jill Blakeway, LAc do a great job of covering all the basics of fertility: menstural cycle, BBT charting, sex do’s and don’ts, lifestyle basics: diet, exercise, sleep, avoiding toxins, and how drugs influence fertility. They also discuss things that many other general fertility books overlook, including the role of infections and immune issues – though at nowhere near the depth of Dr. Toth or Dr. Beer.
The book includes plenty of practical advice about techniques to help you de-stress, what foods build health and contribute to fertility, what nutrients support fertility, which foods contain them, and how to supplement. There’s also a comprehensive supplement guide with suggested daily targets.
If you’re a grizzled infertility veteran and this book sounds like a review, please know part of the value is that it’s succinct, well organized, beautifully formatted and easy to read with lots of nice bulleted lists, charts and illustrations. It’s easy to use as a quick reference. Sometimes when you’re in the deep end you get confused and overwhelmed and neglect the basics — this book can reel you in! There are action plans based on your particular diagnosed issues and your TCM fertility type.
The Five TCM Fertility Types (Tired, Dry, Stuck, Pale, Waterlogged) are described, along with questionnaires that will help you determine how much you identify with each type. There are ‘prescriptions’ for each of the types, too, including supportive: foods, exercises, lifestyle ideas, supplements, medical assistance, and Chinese medicine.
Then the books switches to discussing various fertility conditions, starting with a nice list of questions to help you create your own thorough medical history, and a list of tests you might request to cover all the bases. The fertility issues are discussed at length (hormonal and endocrine, structural or anatomical, infections, immune issues, and general health). They relate the various western fertility diagnosis’ with the TCM fertility types, and you start to get a sense of where your weak spots may be and how to talk to both your Western medical doctor and your TCM specialist.