Health Conditions (Like Infections) are the Real Cause of Infertility – Not Age

Infertility information and statistics center around a women’s age.

ACOG (The American College of Obstetricians and Gynecologists) says:

“A woman’s peak reproductive years are between the late teens and late 20s. By age 30, fertility …starts to decline. This decline becomes more rapid once you reach your mid-30s. By 45, fertility has declined so much that getting pregnant naturally is unlikely for most women.

Women begin life with a fixed number of eggs in their ovaries. The number of eggs decreases as women get older. Also, the remaining eggs in older women are more likely to have abnormal chromosomes. And as women age, they are at higher risk of disorders that can affect fertility, such as uterine fibroids and endometriosis.”

ACOG, Women’s Health

From the mainstream point of view, it seems like a woman’s lifestyle choices or level of health have little effect on her fertility. That age is the critical “risk” factor and that the passage of time causes swift, inevitable biological deterioration, no matter what. To be sure, age is highly correlated with fertility rates.

But is nature set against older women, by default? Should we view aging itself as the cause of infertility? I don’t think so. The evidence shows otherwise.

Infertility in the Young

Even young women experience infertility:

  • 6% at age 20 to 24
  • 9% at age 25 to 29
  • 15% at age 30 to 34
  • 30% at age 35 to 39
  • 64% at age 40 to 44

If age is the biggest driver, how do we explain high rates of infertility in the young? A 6% infertility rate before age 25, and 9% in women aged 25-30 seems excessive, for peak fertility years. Why are so many young women unable to reproduce?

The statistics for women in their 30s are staggering: 15% infertility rate in early 30’s and 30% in late 30’s. These folks are still pretty young, they should be able to reproduce. Great grandma had 12 kids, remember? Yes, she got started early, but she didn’t stop in her 30s.

When comparing a 20 year old woman to a 50 year old woman, of course, we expect a decline in fertility. But, should the infertility rate double in the 5 short years between the ages of 30 and 35?

No. Not for an optimized, healthy woman. Not unless the passage of time is compounding an underlying health condition.

“Cryptic” Infertility

Dr. Toth points out that the actual percentage of infertile couples is likely higher than statistics show. Possibly much higher. Think about it. How many people are infertile and:

  • Don’t report it or seek any treatment?
  • Aren’t aware of their infertility because they choose not to have children?
  • Have one child but are unable to have more children and suffer secondary infertility?
  • Are young (in their peak fertility years) and are already infertile but have no idea, because they aren’t trying yet, or are actively avoiding pregnancy with hormonal birth control.

That last one keeps me up at night.

Fertility is a Vital Sign

Healthy women are fertile through the full span of their reproductive years. Fertility is an essential vital sign. Infertility should not be looked at as an isolated issue— fertility and health are one in the same.

If a woman is experiencing infertility, she needs careful diagnosis and treatment. When the real causes of reproductive failure go undiagnosed and untreated, the woman loses her fertile years and her fundamental health erodes.

Epiphanies by the Dozen

Dr. Toth’s book, Fertile vs. Infertile: How Infections Affect Your Fertility and Your Baby’s Health, changed my life and gave me the biggest “Ah-Ha!” “WTF?” “OMG!!” “Come to Jesus” moments of my whole infertility journey. The book is basically about how hidden infections are the root cause of infertility.

By this time, I’d already been through the wringer:

In late 2016, I experienced a missed miscarriage at 12 weeks followed by a year of infertility and chemical pregnancies. After a year of exhaustive lab testing and searching, finally an answer– Lyme disease. I treated the infections for 6 months. The treatment restored my fertility and allowed me to get pregnant and stay pregnant, on the very first try.

After hearing my story, a woman in an infertility Facebook group recommended Dr. Toth’s book to me. I’d never heard of him or read his brilliant work. I found the free pdf online and devoured half of it on my laptop in a one night binge. Afterwards, I was so lit up, I could barely sleep. I ordered a paperback copy immediately and finished it in a matter of days.

For a non-fiction science book about something as miserable as infertility, it read like a murder mystery page turner. I was RIVETED. Epiphanies every other page. My poor husband, my poor friends and family…I would not shut up about it. I peer pressured my doctor into buying it. I ordered books and gave copies away. It was like that.

When I found Toth’s book, I had carried my pregnancy for 4 months and felt cautiously optimistic. I owed my success to antibiotics. Toth’s book about infections, infertility and antibiotic therapy was… preaching to the choir.

I knew that hidden infections could ruin someones fertility. In my case, they caused miscarriage, the inability to conceive and repeated chemical pregnancies. I also knew that a woman’s fertility was recoverable if she treated infections. None of this was news to me, it was my lived experience.

But, I thought perhaps I was an isolated case. I didn’t know many women who had walked my path. I knew of few doctors who even considered hidden infections as a cause of infertility. It was incredible to have my experiences validated by someone with a lifetime of clinical practice and laboratory evidence.

Infection: The Root Cause of Infertility

Dr. Toth focuses on infection as the root-cause of most infertility cases.

  • Not age
  • Not genetics
  • Not hormones
  • Not inflammation
  • Not immune system issues
  • Not diet
  • Not lifestyle

Infections.

All the items listed above are factors. But he argues that the trigger, the shared root-cause is usually infection.

You could work downstream to correct the hormones, reduce inflammation, calm/suppress the immune system, improve diet and lifestyle. You could be fastidious in these objectives. But, if you have an untreated infection (or a few), your fertility will still be greatly compromised.

Dr. Toth has dedicated his career to restoring fertility by treating chronic infections. Remarkably, he’s often able to accomplish this without the use of IVF. Comprehensive infection treatment improves all fertility parameters including egg quality, uterine lining, and hormone levels.

He is a lone voice of encouragement for women over 40. He says, in the absence of infection, a woman should have reasonably full fertility until close to menopause. Dr. Toth doesn’t buy the ‘age = fast and inevitable decline of fertility’ line of thinking. He says there’s a reason, and I agree:

“Despite their growing reliance on more and more sophisticated high-tech therapies, women in every category, and especially women over age 40, have been steadily losing ground for almost 30 years in their efforts to have a child.

It Is commonly said in the media and, regrettably, in many doctors’ offices that the average woman over 40 simply has biology against her. However, as this book will clarify, the problem is often not a “natural” deterioration of reproductive capability but a long-standing, far advanced infection — one that can be eradicated with proper antibiotic treatment, given timely administration.

The truth is that they \[women over 40\] are by nature far more capable of bearing children than current statistics indicate, provided their reproductive systems remain protected from infection.”

Attila Toth, MD, Fertile vs. Infertile p. 4-5.

But, Wouldn’t I Know If I Have an Infection!?

Chronic infections are incredibly common. Almost everyone has a chronic infection, probably a few! For some people, it’s not a big deal.

But, if you’re facing infertility, it’s possible that an infection is playing a central role in your reproductive troubles. For anyone considering big guns like IVF, a comprehensive infection screening should come first. IVF is often unnecessary when infections are cleared. If it’s still necessary, IVF is more effective when infections are cleared.

Chronic infections can be subtle, low-grade and virtually asymptomatic. Often, there is never an acute episode that would prompt a trip to the doctor.

For example, Chlamydia is a common infection that is very harmful to fertility. It is well documented in medical literature as a “stealth pathogen”. Many, many people carry and transmit chlamydia, never even knowing they have it.

While infections may go undetected, they’re still causing damage. And the damage can compound if the infection goes untreated for long periods of time. Pathogens directly harm reproductive organs, egg quality, and uterine lining. They hamstring the production of healthy hormones. They trigger immune system changes. A disregulated immune system creates systemic inflammation. Many seemingly mysterious health problems emerge as a result of chronic infections. Infertility is just one manifestation.

And, yes — even people who are fastidious about STI testing may still carry multiple undiagnosed infections. These hidden infections are often missed on ordinary STI screenings. The reality of faulty testing is critically important and deserves its own space. I will go into the issues with infection testing, in detail, in a future post. It’s worth noting, too… there are many infections that can affect reproduction, that STI tests do not screen for at all. Lyme is just one.

Yes — even virgins can carry chronic infections that harm fertility. Fertility damaging infections can be transmitted by vectors (animals, insects, spiders), casually (surfaces, shared drinking cups, etc…) and vertically (mother to child, in utero or during birth). It’s especially harmful to reproduction when pathogens are transmitted in family lines, because the infection is present for a lifetime. Toth describes this in great detail and says that the gravest cases of infertility usually involve vertical infections, as evidenced by family history.

More to Come

This is such a vast topic — Dr. Toth wrote a whole book about it!

In this post, I only scratched the surface. If you’re intrigued, I hope you’ll stick around. Most of my work will be dedicated to exploring the evidence that shows how infections harm fertility. I want to dismantle the cop-outs that doctors offer to infertile women: you’re too old, the cause is unknown, it’s genetic, there’s nothing we can do. There is a cause! There is something you can do!

This is the third post in my series about infertility revelations and ah-ha moments: