H. pylori can affect fertility and reproduction in both men and women.
I know it sounds odd, but it’s true.
Sex drive, sperm health, morning sickness, foetal growth, miscarriages, pre-eclampsia, pre-term birth and even birth defects such as neural tube defects, are associated with H. pylori infections.
But how could a tummy bug like H. pylori affect body function that seemingly so distant and unrelated?
Let’s take a look.
I’ve just finished writing a mini-book on the relationship between H. pylori and reproduction because I feel it’s an important topic.
I’ll let you know when the book’s finished so you can take a peek. I’ll briefly summarize the book in this article.
As you know if you’ve been following my work for a while, the effects of H. pylori and other chronic digestive infections can spill over from the stomach and cause havoc in other parts of the body.
This happens via several mechanisms, all of which are important in relation to H. pylori’s effect on fertility and pregnancy.
What’s the evidence?
A growing body of evidence links H. pylori infections to both male and female reproductive and fertility problems.
Unfortunately, most regular docs and fertility specialists don’t link the digestive and immune systems with the reproductive system.
Thus, if you’re struggling with fertility issues, you’re not likely to be informed about some of the deeper underlying causes.
When writing the H. pylori, fertility and reproduction book, I came across two particularly helpful summary papers published in The World Journal of Gastroenterology.
These papers, all published in 2014, are titled:
I read these papers then found dozens of other studies and papers published from 2014 to present.
Whether or not your doc or fertility specialist has seen the data, there is a lot of it, and it points to H. pylori playing a significant role in some people’s pregnancy and reproductive disorders – perhaps even yours.
The book provides plenty of detail, so I’d prefer to give you a brief summary of what I unearthed from the literature (some of it is common sense, to be fair).
The diagram below provides a neat little insight. Take a moment to study it, and I’ll expand on it in the text, below.
Let’s follow the diagram from the top and fill in a few blanks that are not shown on the graphic as we go.
First, H. pylori infects the stomach. It buries into the stomach lining (gastric epithelium), creating local inflammation and damage such as gastritis and, in some people, ulcers.
We then see a cascade of events, which can ultimately lead to fertility and reproductive problems.
The first reproductive effect shown on the diagram is a condition called hyperemesis gravidarum, which is the medical term for nausea and sickness.
It turns out that H. pylori worsens these symptoms in some cases. In fact, the symptoms can be so severe that pregnant ladies can become dehydrated and nutritionally depleted through malabsorption.
It has been known for quite some time that H. pylori infections can reduce stomach acid production, thereby compromising nutrient absorption.
If we stay roughly on the right hand side of the diagram, we can see that H. pylori can lead to reduced iron and vitamin B12 absorption.
Some studies also suggest that H. pylori can lead to reduced folate absorption.
This can be catastrophic when it comes to fertility and pregnancy because these three nutrients are fundamental to reproduction.
Iron deficiency anemia can lead to reduced oxygen in the placenta and thus, the foetus. In turn, this may lead to foetal growth restriction and lower birth weight.
B12 and folate deficiency can cause all manner of problems, including neural tube defects such as spina bifida and cleft palate.
The adverse effects of B12 and folate depletion may be amplified in women who have MTHFD1, MTHFR and other folate/methylation gene mutations (I will write about these separately).
Pre-eclampsia (PE) is characterized by high blood pressure and the appearance of protein in the mother’s urine after week 20 of gestation.
It affects about 2%-8% of all pregnancies and remains a primary cause of maternal or fetal mortality and morbidity worldwide. It’s not something to take lightly.
Studies have shown that H. pylori is detected more frequently in mothers with pre-eclampsia compared with women with “uneventful” pregnancies.
Interestingly, it appears that the CagA H. pylori strain is more strongly associated with pre-eclampsia.
CagA is a virulent H. pylori strain that induces a higher level of inflammation. This inflammation may “spill over” and affect other areas of the body.
In the case of pre-eclampsia, the inflammation is focused in blood vessels. I
If you follow the left hand side of the diagram down, you’ll see that H. pylori infection induces inflammatory cytokines, which irritate the endothelium (lining of the blood vessels), potentially triggering pre-eclampsia.
It is very much worth noting that this mechanism is also one of the reasons why CagA H. pylori infections are associated with heart disease and stroke.
Finally, it has also been noted that Chlamydia pneumonia infections may be important in the context of pre-eclampsia.
Staying on the left hand side of the diagram, you can see that inflammation and immune activity caused by H. pylori may trigger miscarriages.
Miscarriage or spontaneous abortion occurs in 15% of pregnancies and is defined as an “unintended termination of pregnancy resulting in foetal death prior to 23 week of gestation.”
While evidence is limited, there are indications that H. pylori might induce miscarriages in some cases. Again, the CagA strain may be more important than other H. pylori strains in this context.
Many years ago, I attended a functional medicine training in which the late doctor William Timmins explained how he had isolated H. pylori from semen samples.
To most scientists and medical professionals, this would seem preposterous. However Dr. Timmins was an esteemed clinician and in my opinion there is no reason to doubt his claim.
I have not been able to find any additional research showing that H. pylori hangs out with sperm cells, but this is probably because nobody has bothered looking!
I have, however, located a bunch of interesting research associating of H. pylori with poor sperm health.
The World Journal of Gastroenterology presented research on H. pylori and poor sperm health.
To summarise the findings briefly, they found that:
Please note that all the studies mentioned here are fully explained and cited in the H. pylori, fertility, reproduction and pregnancy book.
Once ejaculated, sperm obviously have swim up the vaginal canal and through the cervix in order to meet an egg.
I found some data suggesting that H. pylori antibodies in cervical mucus may be hostile to sperm, interfering with sperm penetration after ejaculation.
It appears that H. pylori antibodies in cervical mucus could damage sperm through a mechanism called “molecular mimicry.”
Eggs (ova) develop in little sacs called follicles inside the ovaries. Within these sacs there’s a liquid called follicular fluid, which bathes the developing eggs.
During ovulation, follicular fluid is released from the ovary along with an egg, bathing the tissues of the fallopian tube.
In a Japanese study, H. pylori antibody levels in a group of women with idiopathic, or unknown causes of infertility were twice as high than in patients known causes of infertility.
The authors speculated that H. pylori antibodies may interfere with conception either by damaging the egg or by interfering with sperm trying to fuse with the egg.
Before we even consider some of the issues presented above, it’s worth noting that H. pylori can reduce sex drive.
When I had H. pylori, my sex drive was rock bottom. A host of factors, which I discuss in the book, may to blame, including increased stress hormone levels at the expense of sex hormones such as progesterone and testosterone.
I hope this “whistle-stop” tour of H. pylori’s influence on human reproduction has been helpful.
It appears that for some of these conditions, the CagA H. pylori strain seems to be more important than general, non-CagA infections.
H. pylori is obviously not to blame for all cases of infertility and reproductive difficulties and, indeed, many other factors can be involved in individual cases.
Gluten sensitivity and coeliac disease, for examples, are other digestive and immune disorders that can affect fertility.
If my partner – Dominika – and I were struggling to conceive, we’d be screening our digestive health as a matter of urgency. We’d want to know everything that was going on inside our digestive systems.
When it comes to H. pylori specifically, unfortunately, docs tend not to run tests that differentiate H. pylori strains (i.e. they don’t identify which specific H. pylori strains you have).
The upside is that testing is available to a) check H. pylori strains and b) thoroughly evaluate your digestive health.
You can do an H. pylori stool test at home that checks all the different strains. The lab is able to do this because it used a technology, which assesses DNA and genetic data in the stool sample.
The CagA strain can be identified, as well as VacA, BabA, iceA, and other strains (seven in total).
A home stool test can also be expanded to check for other bacterial overgrowth, parasites, yeast and fungal overgrowth, inflammation, immune activation, gluten sensitivity and food digestion.
You can also check for gene variants (mutations), which increase the likelihood for fertility issues.
These gene mutations don’t determine whether you’re fertile or not, but they do indicate whether certain lifestyle modifications will be needed to optimize reproductive potential.
When I looked at my genes, I was able to pinpoint why my blood pressure tends to rise too high, and why I have a tendency toward low potassium and magnesium levels in my body unless I take supplements.
I also realized that my genetic make-up explained why I had such a hard time with H. pylori. My gene mutations make me more vulnerable to H. pylori’s insidious effects.
Once I figured all this out, I was able to lower my blood pressure by 20 points inside 24 hours (yes, it was that quick) and keep it there.
If you’re concerned about your digestive or reproductive health – or both – and you’d like to dig a little deeper, all the tools are available to do so.
We would love to assist, so please don’t hesitate to raise your hand and ask for assistance.
There are two ways to get started.
Book a case review so we can review your health history, symptoms and any lab work you’ve had done. We can then recommend an individualized course of action for you.
Organise a home stool test and consultation using the special package we have on the website.
Again, I hope this article has been helpful, and please remember to look out for notification of the release of my H. pylori and fertility book.
All my best,
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