Articles
Fertile Ground:
If at First You Don't Conceive, Alternative Therapies May Deliver a Baby
Natural Health, Sept, 2005
by Suz Redfearn
"STICK OUT YOUR TONGUE--farther," says Eugene Y. Zhang, L.Ac., C.M.D. When I do, he takes a digital picture, which reveals a thick white coating at the back, a crack in the center, and teeth marks on the sides.
None of this is good news, apparently. The doctor then moves to my wrists, listening carefully to my pulse. "You have a deficiency in kidney yin and yang," he says, brow furrowed, "some dampness in the lower abdomen, and slight blood congestions and liver qi stagnations."
Can Zhang, known for treating infertility with Traditional Chinese Medicine, help me overcome all that and have my first baby, something I've been trying to do for more than three years? If he can treat my deficiencies in order to balance my hormones and improve blood flow, then, he says, I should be receptive to new life.
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So far, Western medicine's treatments for infertility haven't worked for me. I've tried fertility drugs to help release more eggs from my ovaries; artificial inseminations, which placed sperm in my uterus; and in vitro fertilization cycles, which involved injecting myself with fertility drugs, having my eggs surgically removed, placing them with sperm in a laboratory, and transferring the resulting embryos to my uterus a few days later. All of this was expensive--especially IVF, which costs about $12,400 per cycle--and, ultimately, fruitless.
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And so I sign on for five acupuncture sessions per month ($80 per visit), along with four blends of herbs ($70 per month), each to be taken during different parts of my menstrual cycle. I pledge to avoid alcohol, caffeine, tobacco, and carrots (too many can suppress the ovaries, according to Zhang); to only drink spring water; to eat one boiled egg per day; and to help myself to a generous helping of fish eggs twice a week (chewed, not simply swallowed--ugh) before I ovulate. And yes, I will boil beef bones and drink a cup of the broth each day.
My hopes are high, though the treatment I'm following is far from a sure thing. To date, there are no large, placebo-controlled investigations to back it up. But there are smaller-scale studies out there showing the efficacy of acupuncture, herbs, dietary changes, and mind-body work--and anecdotal evidence abounds. After two failed IVF cycles, that's good enough for me.
Finding Options
IT'S GOOD ENOUGH for a number of doctors, too. "Three years ago, most reproductive endocrinologists were very closed-minded, and pooh-poohed [alternative medicine] as voodoo," says William Schoolcraft, M.D., founder and director of the Colorado Center for Reproductive Medicine in Denver. "But so many patients come in wanting to try it, the patients are driving their doctors to be more accepting."
Still, most Western physicians can't or won't guide patients toward complementary therapies. Couples must figure it out for themselves, whether coping with infertility or just hoping to preserve their well-being for future childbearing. Here's a look at natural options for promoting and preserving fertility.
ACUPUNCTURE. In the late 1990s, researchers found that restricted blood flow to the uterus--for which there is no Western remedy--translated into low pregnancy rates. At about the same time, small-scale studies indicated acupuncture could improve uterine blood flow. When Schoolcraft suggested acupuncture to patients with uterine blood flow problems, the results were "amazing," he says. Doppler ultrasound technology showed improved blood flow for most of the patients, and pregnancy rates spiked. (Schoolcraft's clinic now offers acupuncture in-house.)
Preliminary research has also determined acupuncture can restore normalcy to the endocrine system and trigger ovulation. In a 2002 German study, 80 IVF patients received acupuncture treatments before and after embryonic transfer into the uterus. Nearly 50 percent of the women conceived, according to a report in the journal Fertility and Sterility, compared with a 26 percent success rate in the control group.
Acupuncture is an integral part of the fertility-enhancement retreats offered by Randine Lewis, Ph.D., author of The Infertility Cure: The Ancient Chinese Wellness Program for Getting Pregnant and Having Healthy Babies. The therapy is useful for nearly all infertility diagnoses, she says, from advanced ovarian aging and polycystic ovary syndrome to fibroids and endometriosis.
Finding a qualified practitioner is key. Lewis suggests contacting local chapters of RESOLVE: The National Infertility Association and asking for personal referrals (resolve.org, or 888-623-0744). When you make an appointment, be sure your acupuncturist has relevant experience and is recognized by the National Certification Commission for Acupuncture and Oriental Medicine.
HERBS. A part of infertility remedies since 300 B.C., herbs are said to harmonize the endocrine system, which regulates the menstrual cycle. Nevertheless, endocrinologists worry about potential estrogenic properties.
"The data don't exist for herbs," says Schoolcraft, who tells patients it's OK to take them up until planning conception, but not after. "Do they help? We don't know that they don't and we don't know that they do."
Chinese herbs are commonly used to treat infertility in Asia and now in the United States as well. However, there aren't many Western studies to verify their efficacy, says Adriane Fugh-Berman, M.D., associate professor in the complementary medicine program at Georgetown University School of Medicine. And since herbs aren't patentable, there's little financial incentive for U.S. companies to fund research, she adds.
Yet anecdotal evidence is plentiful. Take Christine P. of Detroit. At 37, after trying to conceive her first baby for a year and a half, her hormone levels showed her to be pre-menopausal, just as her mother and sister had been in their mid-30s.
Christine's doctors advised her to consider using donor eggs. Instead, she attended one of Lewis' retreats in June 2004 and began boiling a mix of 15 fresh Chinese herbs daily, drinking the resulting tea. Three months later, she attended another retreat and added acupuncture treatments and stronger herbs. By November, her hormones had normalized. By December, she was pregnant.
"I just hope any woman who's ever been told there's no chance can experience this," says Christine.
Many certified acupuncturists also dispense herbs; another way to find an experienced practitioner is to contact the American Herbalists Guild (americanherbalistsguild.com).
DIET. While the negative effects that caffeine, alcohol, and tobacco have on egg production have been well documented, the potential impact of certain foods is less clear. That didn't stop Fern Reiss when she was battling infertility about 10 years ago. Reiss dug up all the bits of data she could find on diet and reproduction--there were hundreds--and incorporated them into her meal plan. She cut down on dairy because a Harvard Medical School study found milk consumption is associated with age-related fertility decline in lactose-intolerant women. Other research showed that foods rich in zinc, such as pumpkin seeds, boost reproductive health and that yams may support reproductive hormones--so Reiss added more of both to her diet.
Two months after changing her eating patterns, she was pregnant. Reiss went on to have two more children--and authored The Infertility Diet: Get Pregnant and Prevent Miscarriage.
Lewis recommends an organic diet for those trying to conceive. It stands to reason, she says, that the pesticides, fertilizers, hormones, and antibiotics used to produce non-organic foods could have a deleterious effect on human eggs. Also, she suggests taking supplements to regulate hormone levels, including wheat grass, fish oil, and the amino acid L-arginine.
And what about the boiled-egg-and-fish-eggs plan advised by Zhang? "It just makes sense," says Pak Chung, M.D., an endocrinologist at Cornell University's Center for Reproductive Medicine and Infertility. "Eating good-quality protein helps manufacture oocytes and sperm, too."
Other than telling patients to eat well and stay at a normal weight, Schoolcraft adopts a wait-and-see attitude toward diet. "I don't have a problem with patients going organic; it can't hurt. It's just that no one's done the studies yet," he says.
POSITIVE THINKING. There's something to be said for staying optimistic, especially when you're trying to have a baby. A University of California, San Diego, study published in Fertility and Sterility found women who expressed very negative emotions prior to starting an IVF cycle were 93 percent less likely to have a baby than those who were very positive.
Infertility clinics now offer stress-management strategies like yoga, meditation, deep breathing, positive imagery, and support groups, says Alice Domar, Ph.D., director of the Mind-Body Center for Women's Health at Boston IVF. "Stress has an impact on the hypothalamic-pituitary-adrenal axis, which in turn can affect the gonads," says Domar, author of Conquering Infertility. "It can interfere with ovulation and implantation as well as with sperm production."
In a National Institute of Mental Health-funded study, more than half of 56 participants with fertility problems gave birth one year after joining a mind-body program, compared with just 20 percent in a control group. About 10 such studies have been conducted; the majority of them produced similar results.
"It just makes sense," Schoolcraft says. "Trying to conceive while stressed is trying to conceive handicapped."
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Melissa Flanigan, 37, knows that firsthand. After three failed IVF cycles, the Berlin, Mass., resident attended a 10-week session of Domar's mind-body program; she stayed in touch with the group and kept up her anti-stress work. Several months later, IVF finally worked. Daughter Katherine was born last year on Halloween.
Flanigan gives substantial credit to the program. "Being there calmed me," she recalls. "Especially helpful was the support from the other women." To find a similar workshop, contact your infertility clinic or your local RESOLVE chapter.
what's a mother?
DURING MY VISITS to Zhang, I doze lightly while his myriad needles protrude from my body. I've had two months of acupuncture and twice-daily doses of my herbal tea mix, which can be quite nasty. And now my husband is drinking the tea, too, just for good measure. Zhang has asked us to give him six months to affect change in my body. After that, my husband and I may do IVF one last time. We just hope we won't have to.
But what if we--or you--fall into the population for whom nothing seems to work? Options like using donor eggs (or sperm) and adoption mean that if you want to be a parent, you will be.
Once a grieving period has passed, many couples become ecstatic after choosing such alternatives, according to Domar. "Women who used donor eggs or adopted often tell me, 'I used to be convinced a genetic baby was what I needed, but I now see I couldn't love my children more,'" she says.
Other couples decide to live childfree. The biggest hurdle for them can be acceptance; women without children often end up feeling somehow "less than" those who have been able to give birth, says Lewis. This despite U.S. Census numbers showing that a record 44 percent of women ages 15 to 44 have never given birth.
The key for these women, says Lewis, is not to be limited by preconceived thoughts of what a mother is, but rather to redefine motherhood for themselves, broadening the concept of fertility to include creativity and redirecting their maternal energies toward art, nieces and nephews, or whatever feels right.
"What makes a woman a mother is not her ability to have a child," says Lewis, "but rather an ability to express her nurturing spirit in the world."
HOW HE CAN HELP
Spermatogenesis--the creation of new sperm--takes about three months. Efforts to improve sperm health should begin at least 90 days before attempted conception. Here's what wanna-be fathers can do to help increase the odds of conception:
Avoid tobacco, caffeine, X-rays, and steroids.
Go organic. Pesticides have been linked to a worldwide decline in sperm counts. A study in the Lancet found men who ate mostly pesticide-free organic foods had sperm concentrations 43 percent higher than those who ate a standard diet.
Including zinc-rich seeds like pumpkin and sunflower in your diet is good for sperm count and motility, says Fern Reiss, author of The Infertility Diet.
Exercise tones the cardiovascular system and boosts testosterone, which pumps up sperm production.
Reduce heat around the genitals. Cut back on hot-tub visits, long bike rides, tight underwear, and even working with your laptop on your lap. Place a cool pack on the scrotum for 15 minutes a day.
Supplement. Studies have shown zinc, ginseng, and folic acid raise sperm count. To improve motility, try vitamins C and E, beta carotene, coenzyme Q10, the amino acid L-carnitine, and ferulic acid, an antioxidant found in pycnogenol.
KEEP YOUR OPTIONS OPEN
A woman without reproductive problems who hasn't gone through menopause is said to be capable of pregnancy. Yet fertility rates peak in your early 20s and drop by So percent to 95 percent in your 40s. Also, your eggs can age at an accelerated pace due to environmental or genetic factors.
While scientists are pretty good at freezing human eggs, they haven't yet mastered the thawing part. So you may want to take steps to slow the sands of time and extend your fertility. It's as simple as maintaining as healthy a lifestyle as possible, says reproductive endocrinologist Pak Chung, M.D.
Rebalance your diet. Stick to whole grains, lean proteins, and plenty of fruit and vegetables--and little or no junk food, alcohol, caffeine, and tobacco.
Exercise at least three times a week for 30 minutes. If you're trying to conceive, however, remember that extreme workouts can throw hormones out of whack.
Rest, then relax, then rest some more, says Randine Lewis, Ph.D., author of The Infertility Cure. She suggests daily meditation, yoga, deep breathing, or just lying still and listening to music--"anything that gets you back in touch with yourself and away from the anxieties of the world."
Think ahead. Identify imbalances and prime your endocrine system for a future pregnancy by paying a few visits to an acupuncturist and herbalist, advises Lewis.
Bibliography for "Fertile ground: if at first you don't conceive, alternative therapies may deliver a baby"
Suz Redfearn, "Fertile ground: if at first you don't conceive, alternative therapies may deliver a baby". Natural Health. Sept. 2005. FindArticles.com. 19 Nov. 2007.
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