In one of life's ironies, every night, millions of men and women use condoms, diaphragms and other contraceptives to avoid pregnancy. Meanwhile, an estimated 10 percent of all couples who want a child can't conceive. To them it feels tragic. Sadness and self-incriminations can lead to discord in their marriages. Fortunately, simple nutritional and botanical remedies can often restore fertility.

Infertility is defined as a lack of conception after one year of unprotected intercourse. Hormonal imbalances, nutritional deficiencies, anatomic problems and various diseases are often to blame. Because it takes two to make a baby, the reason for conception difficulties may lie with the man, the woman or both.

The key to male fertility is large quantities of healthy sperm. A medical evaluation relies primarily on a sperm analysis, whereby fresh semen is examined for the quantity, form and motility of sperm. Sometimes anatomical problems such as enlarged scrotal veins (varicocele) or fluid accumulation in the scrotum (hydrocele) can impair sperm formation. Correcting circulation to the testes with exercise, alternating hot and cold sitzbaths or surgery may restore fertility.

Glandular diseases such as thyroid abnormalities and diabetes mellitus can interfere with hormonal control of sperm production, while infections of the prostate and epididymis (a tubular structure on top of each testis into which secretions drain) can interfere with sperm production or block the exit of sperm from the body. Treating both can resolve infertility. Other infections, such as mumps orchitis (an inflammation of the testicles following the mumps), can result in permanent infertility. Chromosomal abnormalities associated with infertility are likewise not correctable.

Sometimes sperm can't do their job because the woman's immune system creates antibodies to them. Examining the fluid in a woman's vagina after intercourse can determine if immune rejection is causing the infertility.

When examinations fail to find an illness or anatomical defect to explain an abnormal sperm count, nutritional and environmental factors may be to blame. For example, exposing the testes to excessive heat from jacuzzis, saunas or tight clothing can interfere with optimal sperm production. General malnutrition, as well as specific nutrient deficiencies, can also result in weak sperm.

To keep their groins cool, men should wear loose clothing and avoid heat exposure, such as long soaks in hot tubs. To maintain optimal nutrition,  a diet that is rich in organic vegetables, fresh fruits and whole grains and low in animal products is recommended. Evidence indicates that residues of the estrogens fed to cattle and poultry can interfere with human hormones. Furthermore, pesticides, plastics and other environmental pollutants can bind to estrogen receptors in the body and depress both male and female fertility.

Men are also recommended to take a good multivitamin and make sure they get sufficient amounts of nutrients specific for male reproductive health, such as zinc, vitamin E and the amino acids arginine and taurine.

• Zinc: Semen contains high concentrations of zinc. Supplementing the diet with 30-60 mg zinc a day may improve sperm count and sexual function. A good dietary source of zinc is pumpkin seeds, long recommended as a fertility-enhancing food and a remedy for benign prostate enlargement. Pumpkin seeds also are rich in two other nutrients beneficial to male sexual functioning: the plant steroid beta-sitosterol (which binds to the testosterone receptor) and vitamin E.
• Vitamin E: Formerly labeled the anti-sterility vitamin, vitamin E is crucial to proper reproductive function in both men and women. In fact, the chemical name for vitamin E, "tocopherol," originated from the Greek words tokos, which means "offspring," and phero, which means "to bear." One of the body's main antioxidant nutrients, vitamin E protects hormones from oxidation. As vitamin E becomes less available in processed foods and exposure to harmful oxidizing agents increases, supplementation with 400-800 IU a day may improve fertility for some men.
• Amino acids: Arginine has been shown to raise sperm counts and sperm motility. The recommended dosage is 2-4 g a day. Taurine, another amino acid that may enhance sperm production and motility, is supplemented at 2-4 g a day.

After a man adopts a healthy diet supplemented with the above nutrients, he should have his sperm count rechecked in three to six months.

Sources Of Female Infertility
As with men, hormonal abnormalities can lead to infertility in women and should be ruled out with blood tests. Uterine fibroids (benign tumors of fibrous tissue), endometriosis (abnormal location of uterine tissue in the pelvic cavity), ovarian cysts and infections of reproductive organs can all impair fertility and are easily detected by a physician.

Lack of ovulation can also be a cause of infertiltiy. Lab tests can document ovulation, but a woman can also determine ovulation by noting, throughout the month, variations in her body temperature and vaginal mucous. A woman's morning temperature usually increases half a degree around the time of ovulation and remains high until the menstrual period begins. Many medications and factors, such as excessive use of alcohol, electric blankets and restless sleep, can disturb this variation in body temperature. Prior to and after ovulation, when a woman isn't fertile, cervical mucous tends to be thick and sticky. At ovulation, the mucous becomes thinner, more watery and abundant.

Conditions that cause irregular menses or cycles without ovulation can also lead to infertility. These may stem from ovarian and uterine abnormalities. Women who are anemic may stop menstruating as their bodies attempt to avoid the loss of blood. Treating anemia and its underlying cause may restore fertility. Women who exercise vigorously or who have extremely low body fat may be below a critical body weight to sustain menstruation and pregnancy. Backing off the heavy exercise and gaining a few pounds is sometimes all that's required to become fertile.

As with men, the objective is to diagnose and treat any illness or imbalance that might secondarily cause infertility. In the absence of an underlying cause, hormonal therapies can sometimes help correct ovulation problems or irregular menses. Both pharmaceutical and botanical treatments may restore the hormonal rhythms that control ovulation.

Clomiphene citrate is a commonly prescribed fertility drug. It stimulates the brain to release luteinizing hormone, which causes egg maturation and release from the ovary. The drug is taken for just a few days and then stopped. A brief fertile period may follow. A drawback is that more than one egg may be released, resulting in a multiple pregnancy. In addition, nearly half of all pregnancies achieved in this way result in spontaneous abortion. Perhaps the miscarriage rate is so high because such medications only force ovulation without correcting underlying deficiencies or hormonal abnormalities. Botanical medicines on the other hand, nourish and support the female reproductive system to restore hormonal balance.

Herbs That Can Restore Fertility
Here are a few herbs, listed in order of importance, that are often recommended by naturopathic doctors and herbalists to help restore female fertility.

• Chaste tree berry (Vitex agnus-castus): This herb stimulates the release of luteinizing hormone (LH) from the pituitary gland in the brain. This, in turn, promotes ovulation. Chaste tree berry may restore normal periods in women with amenorrhea (lack of menstrual periods).
• Dong quai (Angelica sinensis): Widely used for female complaints, including menstrual irregularities and infertility, dong quai can tone a weak uterus by promoting metabolism within the organ,¹² regulating hormonal control and improving the rhythm of the menstrual cycle.
• Red clover blossoms (Trifolium pratense): These beautiful little flowers are categorized in many herbals as fertility promoters. Chemical analysis shows that the herb is rich in coumestans and isoflavones, estrogenlike compounds that may promote fertility, particularly in women who are deficient in estrogen.
• Licorice (Glycyrrhiza glabra): This plant contains hormonally active compounds categorized as saponins. A Japanese study found licorice-based medicines improved menstruation in women with infrequent periods. The study also found that licorice helped women with elevated testosterone and low estrogen levels, as commonly occurs in polycystic ovary disease.¹⁶
• Siberian ginseng (Eleutherococcus senticosus): This and other tonic botanicals can improve fertility by enhancing overall health and vitality. Siberian ginseng also acts on the brain to promote regulation of reproductive hormones.

Maintaining Pregnancy
Sometimes a woman's fertility problem lies not in conceiving, but in maintaining pregnancy. For habitual spontaneous abortion, several hormonal, nutritional and herbal therapies may help continue the pregnancy. In addition, numerous botanical medicines can improve both uterine tone and hormonal regulation. Here are a few:

• Black cohosh (Cimicifuga racemosa): Like chaste tree berry, black cohosh enhances pituitary secretion of luteinizing hormone with subsequent ovarian stimulation. It contains isoflavone constituents, which can bind to estrogen receptors in the body.
• Blue cohosh (Caulophyllum thalictroides): Sounding the same but of an entirely different genus than black cohosh, blue cohosh is a uterine tonic, meaning it can relax a hypersensitive uterus as well as increase the muscular tone of a weak uterus. Early American herbals list blue cohosh as a uterine botanical helpful in cases of infertility.
• Motherwort (Leonurus cardiaca): This feminine-sounding herb affects the nervous, cardiac and female reproductive systems. It is indicated for anxiety, tension and heart palpitations caused by heart weakness, nervous disorders, menopause, premenstrual syndrome and other hormonal imbalances. Motherwort is also a uterine tonic, useful for cramps and as well as uterine weakness.
• Wild yam (Dioscorea villosa): Very popular in recent years, wild yam contains plant hormones including the steroidal saponins diosgenin, pregnenolone and botogenin.²³ For several decades, the pharmaceutical industry has used wild yam as a raw material in the synthesis of pharmaceutical steroids such as progesterone, cortisone and prednisone. In its crude form, wild yam has a weak hormonal activity in the body that may help prevent habitual miscarriage due to hormonal insufficiency.
• Squaw vine (Mitchella repens): Used by Native Americans as a fertility and pregnancy tonic, squaw vine is a uterine tonic that increases uterine circulation and reduces uterine congestion. It also improves uterine tone, yet relaxes uterine spasm.
• Crampbark (Viburnum opulus) and black haw (V. Prunifolium): Both these herbs are considered uterine sedatives and tonic plants that are helpful for chronic miscarriage and uterine pain and cramps. Both are also used as preparatory herbs to condition the uterus for pregnancy and childbirth.
• Unicorn root (Chamalerium luteum), also called blazing star: A uterine tonic, unicorn root is especially useful for women who have a tendency toward pelvic congestion, a condition typically experienced as a sensation of heaviness. This herb may help prevent miscarriage and menstrual bleeding due to uterine weakness.

Some midwives and obstetricians recommend that women at risk for spontaneous abortion use herbs such as those listed above for several months prior to conception to improve uterine tone and hormonal regulation. They should lower the dosage during the first trimester. A formula used by early American physicians combined in equal parts blue cohosh, crampbark, unicorn root and squaw vine. The recommended dosage was 2-4 mL three times daily. Such herbs were also used during the last trimester of pregnancy to facilitate an easy delivery and rapid recovery, particularly in women with difficult or prolonged labors.

After a medical workup has ruled out serious diseases as the cause of infertility, natural medicines can offer a great deal. Just paying closer attention to the body's cycles can enhance a woman's fertility awareness. For men and women, a nutritious diet supplemented with a multivitamin and free of hormones and pesticides goes a long way toward improving both reproductive and overall health. Botanical medicines selected by a knowledgeable practitioner can further enhance hormonal rhythms and general vitality. Just add romance and you have the prescription for fertility.