Many couples that are unable to achieve pregnancy suffer from a combination of subclinical conditions, which may stem from long-term exposure to various environmental toxins. Such exposure to environmental toxins (in the form of industrial chemicals) both in utero and in the neonatal period may dramatically affect adult fertility. Environmental toxins that can alter hormone function are known as endocrine disruptors1. The strongest evidence of heavy metals and environmental pollution adversely interfering with healthy reproductive function in women has been found for lead. By interfering with normal hormone and endocrine function, endocrine disruptors contribute to the development of endometriosis and polycystic ovarian syndrome2. Activities in the oil and gas industry can contaminate surface, ground and drinking water through the drilling process, hydraulic fracturing, failure in well casings, wastewater spills, and structural failure in abandoned wells3. This has led to concerns about health risks to those exposed to the chemicals used and produced in the industry via either residential proximity or occupational exposure4. Petrochemicals have been associated with adverse effects on the menstrual cycle and overall fecundity in women. The report of Kassotis et al3 reveals that many chemicals used in and produced by oil and gas operations can disrupt estrogen receptor, androgen receptor, and progesterone receptor. Ekpenyong et al5 and Webb et al6 reported that exposure to chemicals produced in oil and gas operations impaired menstrual cycle and fecundity.
The fact that reproductive health hazards incurred by prolonged exposure potentially have transgenerational effects causes great concern7. Better understanding of the roles environmental toxins play on reproductive health may have significant impact on infertility management. The Mayr type of detoxification was employed for such patients as a complementary therapy.
Modern Mayr Medicine detoxification is based on the different processes by which toxic substances are eliminated from the body and thorough intestinal cleansing is achieved for a healthy digestive system. Emphasis is placed on rest and proper hydration, simplified alkaline diet with bias for individual food sensitivities and intolerances determined by bioenergetics resonance testing, use of orthomolecular supplements, therapeutic equipment for optimization of normal human physiology, and regular and supervised physical exercise. Bioenergetics’ testing applies the knowledge of the biology of energy transformations and energy exchanges within and between living things and their environment to identify deficiencies and intolerances, a useful tool in predetoxification evaluation
Materials and methods
Patient recruitment, Mayr therapy detoxification, and IVF procedures
Mayr therapy-IVF cycles were performed for 218 patients. All cycles took place between January 2014 and December 2017 in collaboration between Medical Art Center (MART), Lagos, Nigeria and Mart-life Detox Clinic, a Modern Mayr therapy center in Lagos, Nigeria. Inclusion criteria were history of infertility of two years or more, one or more repeated IVF failures, recurrent pregnancy loss, and body mass index (BMI) >27 kg/m2. Patients were divided into 2 groups, A and B. Group A included 131 patients who had one or more previous failed IVF cycles at MART before Mayr therapy. Group B included 87 patients with no prior IVF procedure at MART before Mayr therapy. Both groups contained patients who used their own oocytes and those who used donor oocytes
All the couples underwent the basic fertility work-up (blood screening, clinical examination, semen analysis, transvaginal ultrasound scan, day-3 female hormonal profile, hysterosalpingography) at MART. All couples also received, signed and returned necessary consent forms. Mayr-type detoxification therapy at Mart-life Detox clinic was carried out with protocols using special dietary nutrition8, equipment such as the hypoxicator which improves cellular mitochondrial function, colon hydrotherapy to help flush out intestinal waste9. Physiotherm, Steam baths, and Sauna were used to improve general circulation10,11, the sea-oxygenator to aid cellular rejuvenation, and the lymphodrainer to enhance proper lymphatic drainage. In addition, each person was placed on a customized diet that took into account individual intolerances.
After Mayr detoxification, IVF cycles commenced following standard IVF protocols in combination with micromanipulation techniques for intracytoplasmic sperm injection previously described in other studies12. Controlled ovarian stimulation using gonadotrophin-releasing hormone agonist (short or long) or gonadotrophin-releasing hormone antagonist protocols and follicle-stimulating hormone was initiated. Patients and donors were monitored regularly by ultrasound scans and hormone tests. Transvaginal ultrasound–guided oocyte pick up was scheduled for 36 hours after the administration of human chorionic gonadotrophin injection as reported previously13. Intracytoplasmic sperm injection, embryo culture and transfer takes place thereafter.
Eighty-nine percent of all patients achieved significant weight reduction and improvement in BMI. The mean ages of the women were slightly similar in both groups (Table 1). From a total of 131 patients placed in group A, 74 used their own oocytes and 57 used donor oocytes. The mean patient age was 37.16 and 45.9 years, respectively. For all patients who used their oocytes, 108 oocytes were retrieved from the last cycle before detoxification and 207 oocytes after detoxification. Ten of the 74 patients were identified as poor responders based on their previous IVF cycles. In this subset, there was a substantial increase in the total number of oocytes retrieved after detoxification. Twenty-seven oocytes from their last cycle before and 80 oocytes after Mayr therapy. Overall positive hCG rate in group A was 41.2% with clinical pregnancy rate of 27.5% and live birth rate of 23.7%. There are 5 ongoing pregnancies.
Of the 87 patients placed in group B, 43 patients used their own oocytes and 44 used donor oocytes. The mean patient age was 37.7 and 43.5 years, respectively. Overall, positive hCG rate in this group was 31% with clinical pregnancy rate of 21.8% and live birth rate of 15%. There are currently 6 ongoing gestations. Patients with own oocytes had a pregnancy rate of 30.2%, clinical pregnancy rate of 20.9% and live birth rate of 16.3%. Patients using donor oocytes had pregnancy rate of 31.8%, clinical pregnancy rate of 22.7%, and live birth rate of 13.6%.
The data suggests that supervised modern Mayr type of detoxification may positively affect fertility indices in infertile couples who undergo assisted reproductive technology. However, there is need for further studies on larger populations to establish pattern of response further. More published data on this process should be encouraged as this may even demonstrate an overall advantage of such an approach in dealing with environmental toxins and other occupational hazards.
Conflict of interest disclosures
The authors declare that they have no financial conflict of interest with regard to the content of this report.
1. Schug TT, Janesick A, Blumberg B, et al. Endocrine disrupting chemicals and disease susceptibility. J Steroid Biochem Mol Biol 2011;127:204–15.
2. Zoeller RT, Brown TR, Doan LL, et al. Endocrine-disrupting chemicals and public health protection: a statement of principles from The Endocrine Society. Endocrinology 2012;153:4097–110.
3. Kassotis CD, Tillitt DE, Lin CH, et al. Endocrine-disrupting chemicals and oil and natural gas operations: potential environmental contamination and recommendations to assess complex environmental mixtures. Environ Health Perspect 2016;124:256–64.
4. Rabinowitz PM, Slizovskiy IB, Lamers V, et al. Proximity to natural gas wells and reported health status: results of ahousehold survey in Washington County, Pennsylvania. Environ Health Perspect 2015;123:21–6.
5. Ekpenyong CE, Davies K, Daniel N. Effects of gasoline inhalation on menstrual characteristics and the hormonal pro1le of female petrol pump workers. J Environ Prot 2013;4:65–73.
6. Webb E, Bushkin-Bedient S, Cheng A, et al. Developmental and reproductive effects of chemicals associated with unconventional oil and natural gas operations. Rev Environ Health 2014;29:307–18.
7. Giudice LC. Environmental toxicants: hidden players on the reproductive stage. Fertil Steril 2016;106:791–4.
8. Klein AV, Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. J Hum Nutr Diet 2015;28:675–86.
9. Taffinder NJ, Tan E, Webb IG, et al. Retrograde commercial colonic hydrotherapy. Colorectal Dis 2004;6:258–60.
10. Crinnion W. Sauna as a valuable clinical tool for cardiovascular, autoimmune, toxicant-induced and other chronic health problems. Altern Med Rev 2011;16:215–225.
11. Persiianova-Dubrova AL, Badalov NG. Thermal therapy for the management of cardiovascular pathology. Vopr Kurortol Fizioter Lech Fiz Kult 2013;3:57–61.
12. Yanagimachi R. Intracytoplasmic injection of spermatozoa and spermatogenic cells: its biology and applications in humans and animals. Reprod Biomed Online 2005;10:247–88.
13. Jansen RPS. The effect of female age on the likelihood of a live birth from one in-vitro fertilisation treatment. Med J Aust 2003;178:258–61.