Twelve Weeks to Maximize Your Fertility
ONE IN SIX American couples will experience infertility after a year of trying to get pregnant. Because infertility strikes so many, we have dedicated this chapter to advice and tips to maximize your fertility. One rule of thumb that applies in most cases is that you can expect your fertility to decline ten years before your mother experienced menopause.
Think about the long-term benefit for your family. Fertility treatment and screening tests like PGS might be more expensive, but it’s going to help you reach your goal quicker of having a healthy baby. It’s not always an easy option, but there are ways you can personally reach success. I changed my lifestyle completely between my IVF cycles and saw a marked improvement in quality. I let my fertility doctor know I was willing to try anything and commit. I went on a diet <20g carbs a day and started on a diabetes medication that has been shown to improve egg quality. I also stopped all alcohol and caffeine. I did weekly acupuncture and fertility yoga and meditation every night. I took a handful of supplements, and my husband took Cyvita. The improvement in our embryo quality was amazing. I was very empowered that our hard work and dedication made a huge difference.
—Sally, 38, critical care nurse
Before you invest in IVF or other costly fertility treatments, you’re better off spending 12 weeks to maximize your fertility. There are many women who can get pregnant without IVF; however, if you’re over 38, have irregular periods, suspect male-factor infertility, or have been trying over two years, we recommend you see a fertility specialist as quickly as possible. If you do not fit into any of these categories, the following steps will increase your odds:
WEEKS ONE THROUGH FOUR
• Start taking prenatal vitamins to make sure your body has all the trace elements it needs.
• Begin taking 800 mcg of folate to reduce the incidence of neurotube defects in your child.
• Begin taking DHA (algae-oil derived is safest, e.g., Naturally Smart DHA from MDR Pharmacy).
• Ask your partner to take three Cyvita tablets twice per day (www.cyvitafertility.com). This will maximize his sperm count and motility.
• Begin a daily exercise regimen. Walk continuously for 30 minutes per day. This will lower insulin levels and also increase your energy level and libido.
• Have sex with your partner regularly.
WEEKS FIVE THROUGH EIGHT
• Plan on having more sex with your partner during ovulation. You can do this easily with the help of an ovulation predictor kit, available at your local pharmacy or online. Each has numerous test sticks and instructions on how to test your urine for a hormonal surge indicating pregnancy. Begin testing your second voided specimen on day ten of your cycle. When the test turns positive, have intercourse for three consecutive days.
• Note your cervical mucous. When you’re fertile your mucous should have the consistency of uncooked egg whites and be able to stretch over an inch. Note whether there is good correlation between this and your ovulation predictor kit. Have intercourse with your partner on days when you feel your mucous is fertile, regardless of the ovulation kit results.
• Chart your cycles: bleeding days, sexual activity, ovulation kit results, and cervical mucous consistency.
• Have your primary doctor order a semen analysis for your husband. Once the results are in, contact a fertility specialist to arrange a consultation if you’re not pregnant.
Chances are good you’ve seen secrets to getting pregnant on the Internet and in magazines. Some are helpful yet many are not. Here are some we stand by.
Eating Healthy
To begin your quest, stay away from the typical American diet of three large meals a day. While the United States makes up only 4 percent of the world’s population, it consumes a staggering 25 percent of the food. This eyebrow-raising fact gives a whole new meaning to the word “supersize.” And although the United States has rightly earned the label “the fattest nation on the planet next to Mexico,” you don’t have to promote it. We don’t endorse any particular diet or exercise program, but moderate exercise (vigorous walking, jogging, or stair stepping, alternating a few times a week—or daily if you can manage it—interspersed with light weight lifting to tone muscles on alternate days) and eating the right amount of proteins, complex carbohydrates, and vegetables can facilitate weight loss.
So what’s the right amount? The size of your fist is roughly a cup, and your cupped palm is half a cup. Typically, a cup of protein (chicken, beef, tofu, or other protein dishes, like beans), a cup of whole grains (brown rice or certain types of pasta), and a cup of vegetables is all one needs at any given meal. Use these serving sizes as a guideline when eating. Keep in mind that your body stores what you don’t burn off. No one has big bones, even if they continually say they do.
If you have a sweet tooth, try eating fruit during the week, and limit your desserts to the weekend. If you’re a wine or beer connoisseur, taper your alcohol intake. Above all, moderation is the key to your long-term weight loss. If you run into trouble making any of these lifestyle changes on your own—after receiving a green light from your physician—you may want to seek support from a friend, weight-loss group, or personal trainer.
FIVE FOODS TO AVOID WHILE TRYING TO CONCEIVE
• processed carbohydrates and sugars
• processed meats
• unprocessed soy
• raw or undercooked eggs, meats, or fish
• unpasteurized cheeses
FERTILITY FOODS: ARE THEY REAL?
Chatter about fertility-boosting foods has been around for centuries. Unfortunately, most is complete nonsense. Tales of shark’s fin, camel’s hump, ginseng, pine nuts, prunes, figs, and chocolate have given false hope to countless couples eager to have a baby. But there is one food—often labeled as an aphrodisiac—that is making good on these claims.
Oysters are chock-full of zinc. This mineral facilitates semen and testosterone production in men and promotes fertility and ovulation in women. Zinc deficiencies can cause chromosomal changes in either you or your partner, reduced fertility, and an increase in miscarriage. This doesn’t mean that you should down a platter of these saltwater delicacies daily; you won’t be any healthier if you step up your mineral intake. In fact, the opposite may be true: excessive amounts of vitamins can actually reduce your fertility. But staying within the recommended daily allowance of zinc (9 mg a day) can help maintain your reproductive system. If oysters make you gag, other foods high in zinc include meats, seafood, dairy products, whole grains, breads, fortified cereals, nuts, and dried beans.
Eating healthy is all about making smart choices. If you want to eat smart, choose from the following foods.
Protein/Iron
What kinds of foods to you think athletes need? If you guessed protein, bingo. Meats (chicken, turkey, beef) and fish (oysters, mussels, sardines) as well as vegetarian options (beans, lentils, asparagus) are chock-full of protein and iron and essential for your reproductive health. Protein gives you energy, and iron is essential for avoiding the risk of anemia during pregnancy, as your baby will require iron to develop normally. Taking iron also reduces your risk of developing postpartum anemia. You may need to discuss with your fertility specialist taking an additional iron supplement if you adhere to a vegetarian or vegan diet.
Leafy Greens
It’s no surprise that green, leafy vegetables are on our list. After all, your parents likely encouraged you to eat them. They are chock-full of folic acid, which is a natural deterrent to birth defects. Folic acid is essential in both healthy sperm and eggs. Leafy greens contain lots of iron and are essential for helping women develop healthy endometrial lining.
Vegetables Containing DIM
George W. Bush may have given broccoli a thumbs-down, but you shouldn’t. Why? Broccoli, cabbage, cauliflower, and brussels sprouts all contain a compound called diindolylmethane (DIM), which helps with digestion. DIM also helps balance estrogen and testosterone. When estrogen is broken down in your body, it can form either beneficial or harmful estrogen metabolites, and DIM helps break down estrogen into the beneficial type. Honestly, there are so many reasons to like these vegetables. Besides, one of Jennifer’s favorite ways to prepare broccoli or even cauliflower is by sautéing it in garlic and olive oil. We can only imagine George W. Bush would have liked choices like this that don’t involve limp, overboiled veggies.
Brightly Colored Fruits and Vegetables
Besides looking appetizing in your kitchen, on your table, and, especially, on your plate, most brightly colored fruits and vegetables are loaded with antioxidants and micronutrients. They help reduce the effects of free radicals from sunlight and common environmental toxins like car exhaust, pesticides, and chlorine, all of which can impair reproductive organs, eggs, and sperm. One healthy example is raspberries and blueberries, both of which are packed with antioxidants. Other berries like strawberries and blackberries are also good for you. Likewise, kiwi and pineapple are also healthy choices. Avoid Goji berries, however, as they were promoted as a “superfood” yet they have not been medically proven safe during pregnancy and could even be harmful.
A great example of brightly colored vegetables is peppers. Many of us love shish kebabs and the yellow, red, and green peppers that often come with them. Obviously fruits and vegetables have more vitamins in them when they’re served raw or slightly cooked al dente and less when they’re overcooked.
Many other vegetables come to mind. We all have joked about rabbits’ reproductive capabilities, but bunnies are on to something. Carrots, another brightly colored vegetable, are high in beta-carotene, which is essential for keeping your hormones in balance. So eat up! If you won’t eat them plain, try them with hummus or your favorite spread. Whatever you decide on, you’ll want to eat two cups of fruit and three cups of vegetables a day.
Whole Grains and Complex Carbohydrates
Supermarkets are filled with refined grains that are stripped of fiber, protein, antioxidants, B vitamins, and phytonutrients once their outer shells are removed before packaging. These are exactly the nutrients you’ll want to enjoy once you toss white bread and white rice in lieu of healthier options like wheat bread, brown rice, whole wheat pasta, and oatmeal. But there are other health reasons to switch to unrefined whole grains and complex carbohydrates. Highly refined carbohydrates increase your blood sugar and insulin levels, and this can disrupt your hormone balance. Hormonal changes from increased blood sugar can affect ovulation.
Another reason to eat healthier is that you can avoid the constant peaks and valleys in your energy level that come from simple carbohydrates. To enjoy more complex carbohydrates, eat whole grains, beans, vegetables, and fruits. To find healthier choices, check food labels for ingredients, including whole wheat, stone-ground whole grain, whole-grain corn or cornmeal, whole or rolled oats, kamut, millet, oatmeal, amaranth, buckwheat (kasha), pearl barley, and brown rice.
Omega-3 Fatty Acids
You’ve likely heard your entire life that fish is good for you. Well, it’s true. Omega-3 is essential to maintaining good reproductive health, and fish is the best source. A good rule of thumb is two servings of fish per week. You’ll want avoid fish with high mercury levels, like king mackerel, swordfish, tilefish, and shark; instead, try catfish, cod, crab, salmon, canned light tuna, pollock, shrimp, and tilapia. If you’re concerned about the environment and overfishing, the Monterey Bay Aquarium has a great resource you can use to further refine your fish choice. Visit their website at bit.ly/SeafoodWatch for more details.
Water
Most of us take water for granted, but it’s one of the most vital resources we consume. It makes up about 60 percent of every man’s body and about 50 percent of every woman’s body, so now you have a valid excuse for water weight! Most of us can go only a few days without water. Thirst occurs when water is depleted in your body by just 1 percent. Muscle strength and endurance decline when water is depleted by 5 percent, causing you to become hot and tired. Delirium and blurred vision occur when water is depleted in your body by 10 percent. At 20 percent a fatality can occur.
But besides the fact that we need water to live, consuming water also helps us absorb nutrients and eliminate toxins. A good rule of thumb is that women need to consume about 2.2 liters (9 cups), and men need to consume about 3 liters (13 cups). Try adding lemon or lime juice if plain water isn’t appealing. There are also many fruits and vegetables that have a high water content. Try adding many of these high-water-content fruits and vegetables to your diet if you find you can’t drink as much water as you’d like.
Table 5.1. Water makeup
Striking the word diet from your vocabulary is perhaps the best place to start if you want to lose weight. But dieting in and of itself isn’t the answer. Extreme fluctuations in weight affect fertility. In fact, the ASRM says that 12 percent of all infertility cases are a result of women either weighing too little or too much. For best results, you’ll want to be in optimal health while undergoing fertility treatments.
Energetic exercise will not impair your fertility as long as it’s part of your current lifestyle. If exercise is not part of your daily regimen, you’ll want to increase your routine gradually until you feel comfortable handling vigorous exercise. This doesn’t mean you need to run a marathon and sweat for hours on end. Twenty minutes of vigorous exercise is enough to get your heart rate up, and it’s all most fitness buffs recommend daily. And if your gym has TVs or if you have a treadmill or stationary bike at home, it’s a small price to pay while soaking in your favorite TV program or the morning or evening news.
Research suggests that regular workouts may actually improve your chances of getting pregnant. A study in Obstetrics & Gynecology concluded that women who exercised 30 minutes or more daily had a lower risk of infertility due to ovulation disorders. Some studies have also indicated too much vigorous exercise lowers fertility. Two separate studies that confirmed both findings include the 2009 study in Human Reproduction and a Harvard study of elite athletes. There is no doubt remaining physically fit is an important factor in increasing your chances of getting pregnant; however, fertility specialists caution against too much vigorous exercise (over four hours a week) and too much or too little body fat. Incredibly intense exercise routines can disrupt your menstrual cycle and make implantation of embryos more difficult since irregular periods often result in uterine lining that is less hospitable. Brisk walks, casual bike rides, and activities like gardening are often preferred vs. extremely vigorous exercise, but talk to your fertility specialist about the best regimen for your particular situation.
Supplements can help you achieve optimal health and maximize your reproductive potential. When taking supplements, including prenatal vitamins, it’s key to take supplements that are carefully sourced. You want to avoid any supplements that might have substances that can be harmful to you or your baby. This means avoiding nonpharmaceutical grade supplements, which are typically made outside the United States or in a country lacking credible regulation and oversight.
For example, DHA can be important in achieving optimal fertility and supplying the needed components for your baby’s developing brain. A common source of DHA is fish oil, which always contains some amount of mercury. Another source of DHA is flaxseed oil, which is often grown with pesticides and herbicides unless otherwise specified. The preferred source for DHA is algae oil, which is both mercury- and pesticide-free. Name brands like Naturally Smart DHA are considered a wise choice, as it contains carefully sourced and only high-quality ingredients.
Vitamin Supplements
Supplements are a common staple in our pantries, but can they help with infertility? We wish we had a conclusive answer. While a number of studies have generated positive results, others question their worth, categorizing them in the same lot as placebos. Unfortunately, there are no definitive answers outside what you probably already know: eat healthy, exercise, manage your stress level, and get at least six to seven hours of sleep a night.
Table 5.2. Supplements that may increase fertility
There are many factors that can contribute to helping you get pregnant. Consider those that reduce your stress level. Changing protocols, starting a fitness regime, or even trying a complementary therapy can help.
Your fertility specialist will also recommend that you take folic acid three months prior to trying to get pregnant. The following are some foods that are high in folic acid.
* Black, garbanzo, kidney, navy, pinto **Collard, mustard, turnip
***One serving of lentils and black-eyed peas provides 40 percent or more of the RDA.
Table 5.3. Foods high in folic acid
Many women want to know if they are at the optimal weight for their height when trying to get pregnant. So far, the easiest way to determine this is your Body Mass Index (BMI). There are many sites online with tables to determine this just by using the search term BMI table or BMI calculator. Either will convert your height and weight into kilograms and meters, and it will be displayed as kg/m.
Relax if your BMI is between 18.5 and 24.9. This is considered normal. Anything less than 18.5 is considered underweight. Keep in mind, if your BMI is over 30 you are in the obese (over 40 are in the extreme obese) category, and your fertility specialist will likely ask you to start a diet and exercise program. Here is the breakdown.
A standard definition of “normal” body weight is a BMI of about 18.5 to 24.9.
• A BMI under 18.5 indicates that the person is “underweight.”
• A BMI of 25.0–29.9 indicates that the individual is “overweight” but not obese.
• A BMI over 30 indicates obesity.
• A BMI over 40 indicates extreme obesity.
HOW DOES BMI AFFECT FERTILITY?
Women who fall on either spectrum of the scale, either thin or obese, can have problems with monthly ovulation. Often your body can send a signal triggering ovulation to stop if you are severely underweight or overweight. But this doesn’t mean that all women in these weight categories will have problems getting pregnant. If your BMI falls in the underweight or overweight category, you’ll want to consult your fertility specialist about exercise, nutritional, and even hormonal issues that could affect your chances of getting pregnant. Some conditions that a hormonal evaluation can rule out include potential thyroid disease, insulin resistance, or type 2 diabetes.
CAN OBESITY KEEP YOU INFERTILE?
Not every study is in agreement, but most indicate that obesity lowers the success rates of IVF. Some even report a higher rate of pregnancy loss (spontaneous miscarriage) in obese women. Often obesity causes pregnancy complications in women, including gestational diabetes and preeclampsia, and even complications in the baby, such as birth defects. Obese women often have an increased risk for cesarean delivery. Men can have fertility problems from obesity too. They can experience low sperm count, poor motility, and changes in testosterone levels and other hormones key to reproduction.
Besides talking to your fertility specialist about lifestyle changes that include diet and exercise and a hormonal evaluation to rule out any imbalances, you may want to consider bariatric surgery to achieve your ideal weight faster if you fall into the obese category.
Doing Things Differently
I decided we had to do things differently. We had to modify something, somehow, some way. I stopped using caffeine, and I stopped overexercising (my normal routine was 15 miles on the lifecycle every day). Then my doctor told me about acupuncture. This is what seemed to make the difference. My last four cycles failed, but getting acupuncture every week made me relax. Before long I was pregnant. Afterward I found out what a miracle it really was. Out of eight women getting IVF and acupuncture, seven of us got pregnant.
—Jeanette, 36, sales representative.
Finding a balance in life is something we all strive for. Whether we’re talking about work, diet, fitness, family, spirituality, romance, vacation, or old-fashioned R&R, we’re all trying to make it work. Doesn’t it seem fair to think about fertility this way? If we could invent a magic potion to increase fertility, we’d all take it. But until then you may be wondering what you can do health-wise to increase your chances.
Excelling in anything takes commitment. Whether you want to shine at work, home, school, or while mastering a new hobby, you’ve got to give it effort. Think of fertility along these lines. Knowing that you did everything in your power to reach your goal is reassuring. This doesn’t mean that you should do your part in lieu of getting competent medical advice, but it does mean that you’ll feel like you gave it 100 percent and then some if you step up your resolve.
Likewise, today’s patient has changed. Years ago patients relied on their doctor’s opinion before pursuing treatments that we now consider benign like taking an antihistamine or an anti-inflammatory. Today patients want their doctor’s advice but they also want some control over their situation. This approach is the best and most proactive way to cure what ails you. Plus, patients and doctors who work as a team usually have the best outcomes.
TEN THINGS TO AVOID WHEN YOU’RE TRYING TO GET PREGNANT
1. caffeine
2. alcohol
3. smoking
4. stress
5. certain medications
6. lubricants
7. household chemicals
9. hot tubs
10. recreational drugs
Studies have linked certain medications to infertility. Some, while important for treating serious and chronic conditions, may hinder you from becoming pregnant. If you’re taking any of the following medications, speak with your doctor before discontinuing.
• ibuprofen (Motrin, Advil)
• prescription pain medications
• hormones
• antibiotics
• antidepressants
• chemotherapy
Here’s a rundown of other drugs you’ll want to limit or discontinue altogether.
Caffeine
Numerous studies indicate that more than 300 mg of caffeine can reduce your fertility by 27 percent. But moderate amounts of caffeine consumption, less than 300 mg a day (about three cups of coffee) don’t appear to reduce a woman’s chance of getting pregnant.
Try eliminating caffeine by weaning yourself off daily fixes of coffee, tea, or soda. And while you’re at it, say farewell to chocolate too; a 1.5-ounce dark chocolate bar contains around 30 mg of caffeine.
Alcohol
Drinking alcohol can cut your fertility in half. One study showed that women who consumed less than five glasses of wine a week were twice as likely to get pregnant over the following six months as those who drank larger quantities. Even your spouse will want to decrease his alcohol intake to one to two servings per day, only one serving per day the month before your fertility cycle and none two weeks prior to your cycle.
Tobacco
According to the ASRM, up to 13 percent of female infertility results from cigarette smoking. Tobacco use can initiate early menopause because nicotine kills eggs. Smoking can lower sperm counts in men, make sperm sluggish, and increase the percentage of abnormal sperm. The effect on men’s fertility increases with the number of cigarettes smoked. Besides, kissing a smoker is like licking the inside of a used ashtray—something that definitely makes natural fertility a lot less attractive.
We’ve all heard constant reminders to have safe sex. We hear them so often that we tend to ignore them. But what those reminders don’t tell you is that unsafe sex can leave you infertile.
If you’re using this book as a step-by-step guide during your treatment, your doctor has already tested you for STDs. If not, consult the following table for a list of diseases you need to be concerned about.
Table 5.4. What to know about STDs
Having some stress in our lives is positive. In proper proportions stress can actually motivate us to accomplish more. But in unhealthy doses stress can wreak havoc on our lives. How much stress is positive? This is impossible to answer because each individual has a unique threshold for stress. Situations that might cause one person to wig out may not bother another at all. Keep in mind that even though you’re going through a traumatic period in your life, you need to find balance. It’s important to take care of yourself and continue fostering your primary relationships (see chapter 10).
WHY DO YOU FEEL LIKE EVERYTHING IS FALLING APART?
Chronic stress can disrupt your digestive system, worsen symptoms of menopause, and interfere with infertility. Knowing this, it’s not surprising that experts believe that 60 to 90 percent of all doctor visits involve stress-related issues.
You also need to recognize the role stress plays in fertility. In recent years studies have shown that the mind and body are not only connected but are inseparable, so it’s not surprising that stress has a negative effect on fertility. It can interfere with normal function of parts of the brain (hypothalamus and pituitary glands) involved in regulating ovulation. In severe cases stress may interfere with hormone production or block ovulation completely. Stress can even interfere with the immune system, which plays an important role in embryo implantation and your body’s ability to recognize and sustain pregnancy.
Remember to take time to celebrate your partnership. Trying to make a baby with IVF can sometimes be frustrating and clinical. If you notice the “fun” is slipping out of your relationship, try exchanging massages, cooking a romantic meal, going away for a relaxing weekend, or doing something outdoors like river rafting, hiking, or camping. But whatever you do, don’t forget to celebrate your love for each other.
Besides traditional fertility treatments, there are many holistic treatments that can help increase your chances of getting pregnant. While the list is exhaustive (and often controversial), we have chosen practices and remedies that patients frequently ask about.
Keep in mind that most complementary practices have no controlled peer-reviewed studies. Limited information exists about their overall safety, effectiveness, and ability to provide consistent results. Each state and discipline has its own rules about whether practitioners need professional licenses. If you’re interested in trying any of the practices mentioned in this section, be sure to choose experienced, licensed practitioners.
Acupuncture
Acupuncture focuses on stimulating, dispersing, and balancing your energy flow (chi, or qi) to relieve pain and treat a variety of chronic, acute, and degenerative conditions. Chinese medicine has treated infertility in women for more than 3,000 years with a combination of acupuncture and herbs. Fertility specialists in the West have only recently recognized its benefits. Many are now recommending acupuncture as a complement to traditional fertility treatments for hard-to-treat patients.
A simple way to understand the theory behind acupuncture is to imagine your chi running through your body on meridians (energy pathways) as if it were cars on a highway. If the chi moves too fast, there will be accidents; too slow, and there’s congestion. Acupuncture regulates traffic speed so that everything flows harmoniously.
Acupuncturists believe that infertility is often a result of energy imbalances in the body. If you have tried to get pregnant on your own and have not succeeded or have failed several IUI or IVF cycles, acupuncture may help to restore proper energy flow. And if your partner has low semen analysis results, acupuncture may give his swimmers a head start.
When you visit an acupuncturist she’ll first examine your hands, feet, tongue, and pulse and will then ask you about sleeping habits, digestion, stress, and so forth. Based on her findings, she’ll identify meridians that need to be adjusted and will insert hair-thin disposable needles into specific points along those meridians. The procedure is relatively painless and will usually relax you (as odd as this might sound for anyone who hasn’t tried this technique). Depending on your situation, she’ll probably suggest you receive anywhere from 2 to 12 treatments. Once she has resolved your imbalance you’ll typically have three more treatments between ovulation and your subsequent pregnancy test. If you’re pregnant, count on another eight weekly treatments to strengthen pregnancy and prevent miscarriage.
You may ask whether sticking needles in your body can actually help. Peer-reviewed studies suggest it can. In one, a group of women undergoing IVF received acupuncture treatments 25 minutes before and after embryo transfer. These women showed a 62 percent increase in pregnancy rates over women who received no acupuncture. Other studies have demonstrated increased blood flow to the uterus and reduced stress levels. Many explain the benefits of acupuncture by stating, it makes the uterus friendlier.
Aromatherapy
This practice uses essential oils extracted from plants and flowers. Each oil has a distinctive energy and personality. Combined with massage, aromatherapy can help release mental, emotional, and physical stress as well as promote overall health. Trained massage therapists use essential oils to support many systems in the human body, including immune, hormonal, and reproductive systems (to promote ovulation and sperm production) and to prevent a variety of female reproductive disorders like fibroids and endometriosis.
Your practitioner may recommend aromatherapy to help relieve your stress. Essential oils of lavender, geranium, or rosemary reduce tension. Some aroma-therapists believe balms like rose and lemon enhance female sex organs and reduce stress. Cinnamon, peppermint, and ginger oils act as tonics, warming the body and increasing circulation. Sage alleviates tension and depression and evens out hormone levels.
There are dozens of prescriptions and philosophies for what combination of oils treat infertility. Like anything else, if you’re making your own homemade recipe, it’s important that you find the right one for you. Some of the recipes you find just might surprise you.
Biofeedback
This is a noninvasive technology that helps you achieve voluntary control of many normally unconscious body functions like blood pressure, heart rate, muscle tension, and skin temperature. You should avoid using this technology to treat symptoms that your doctor hasn’t diagnosed. But if stress is your primary concern, biofeedback may offer you significant relief.
Once your therapy begins, a certified biofeedback practitioner uses self-awareness strategies to help you understand how your body works. Your practitioner will use audio, visual, and digital cues to monitor changes in your body. Once you’re aware of how your body works, your practitioner will teach you how to influence your physiological responses through thought and behavior modification.
Besides relieving tense muscles or stress-related conditions, biofeedback is effective in a number of disciplines, including pain management, physical therapy, internal medicine, psychology, infertility, and dentistry. In fertility patients this technique concentrates on relaxation and stress reduction.
Breathing techniques, or paced respiration, can have a relaxing effect on your body. Regular practice can help you stay calm in the face of daily stress. Scores of studies show that once you pace your breathing, your blood pressure drops, your heart rate slows, and your muscles become less tense. You’re obviously aware that without oxygen you would die, but what might surprise you is that the amount of oxygen you take in isn’t as important as how your cells process what you breathe. Once you’ve mastered breathing techniques, you’ll feel calm, and this will help your body use oxygen more efficiently.
Guided Imagery/Visualization
Guided imagery and visualization has been around for ages. Civilizations before recorded history have used guided imagery for hunting, healing, and defeating enemies. In simplest terms, it’s turning your mind into a movie screen to view what you want to occur.
Chances are you use guided imagery on a regular basis. Have you ever competed in a sport? If so, you’ve probably relied on it to enhance your performance. Have you gambled on a card game and won? If so, you probably played the winning hand in your head long before outwitting your opponents. Have you ever played an instrument? If so, you’ve probably played a tune or two without leaving your bed. Have you ever had a painful injury? If so, you’ve probably used it for pain management or to imagine a speedy recovery.
Now you can use it in conjunction with your fertility treatment. Beginning with your initial workup and continuing through each step of your treatment, you can imagine synthetic hormones your doctor prescribes working to produce follicles that will ultimately house your eggs all the way through the process to delivery.
Herbal Medicine
Herbs have been a mainstay of Eastern medicine for thousands of years, with a long history of safe use. In China there is greater cultural awareness and general acceptance of the benefits that herbs bring, and patients often seek herbal treatment before seeing an OB/GYN. And since many of our modern drugs come from herbs, it stands to reason that herbal medicine has a solid foundation.
Typically an experienced practitioner of Traditional Chinese medicine (TCM) will prescribe specific herbs based on your situation. These herbs shouldn’t be over-the-counter, self-determined supplements nor part of a standardized commercial product (although many are available that way). This adds a layer of safety.
When companies misuse or mispromote TCM herbs, results can be disastrous. One only has to look at concerns over ephedra. While it’s extremely safe when used in small amounts in traditional formulas (often combined with other herbs to treat colds and flu), TCM practitioners don’t use it for weight loss.
Many acupuncturists also are TCM practitioners and will often combine both practices to maximize your fertility. Because these products are food supplements, they’re not FDA regulated. As a result, you’ll want to use your best judgment when taking something unknown to you. Ask the practitioner what it is, what he’s prescribing it for, and how effective it is. Also ask about side effects.
While there are no major studies in Western journals regarding TCM and infertility, Chinese studies demonstrate significant improvement in thin uterine lining, endometriosis, anovulation (lack of ovulation), PCOS, and tubal blockage. If you decide to give TCM a try, be sure to let your doctor know, as some herbs may interact with fertility medications.
Hypnosis
Hypnosis can treat a variety of conditions, including chronic pain, stress, addictions, obesity, repressed memories, performance, and a variety of health issues like anxiety, migraines, insomnia, allergies, phobias, and infertility. The goal is to reach a state of heightened awareness and focused concentration. The practice dates back to ancient Greece, when the technique was part of healing ceremonies. While hypnosis witnessed its fair share of naysayers, namely during the eighteenth century when Franz Anton Mesmer created stage hypnosis and again when Sigmund Freud denounced it in favor of free association, the technique has managed a comeback.
An independent panel from the NIH has approved hypnosis to manage chronic pain. Several studies suggest this technique may alleviate stress, anxiety, and pain, although researchers have yet to understand the mechanics of how it works and why it affects health. What they do know is during the hypnotic trance brain scans show an increase in activity in a part of the brain called the anterior cingulate gyrus. Hypnotism also activates the brain chemical called dopamine.
Hypnosis does not cure infertility, but like many natural therapies, it is a successful complement to IVF procedures. If you’re interested in hypnosis, find a licensed therapist you feel comfortable with.
Massage Therapy
A massage is certainly relaxing, but can it also improve fertility? The Gainesville, Florida, husband-and-wife team Belinda and Larry Wurn believe it can. Belinda is a physical therapist, and Larry is a licensed massage therapist. Their center (http://www.clearpassage.com) claims a 67 percent success rate in treating women with infertility. They claim that intense massage can break apart these adhesions that cause tubal blockages and allow sperm to flow freely through their patients’ once-blocked fallopian tubes, resulting in pregnancy. Many REs say this is nonsense.
The Wurns conducted two studies to substantiate their claims. The initial study did not use a control group, so there’s no way to evaluate what their patients did and what a normal group of people would do. For instance, patients in the study may have changed their lifestyle through other means like eliminating caffeine or starting an exercise program. Their second study also raises concern. They compared their study group to national statistics. There’s no way to control what advice they give their patients to influence success rates compared with what traditional fertility doctors do.
Perhaps the most problematic issue with the Wurns’ claim is that they calculate their success rate per couple rather than per trial (national infertility success rates are per trial). This means that if a Wurn couple went through three IVF attempts in a year with the last one resulting in a success, the Wurns would calculate this as a 100 percent success rate, whereas national statistics would calculate this as a 33.3 percent success rate. This also means that because the Wurns use their own calculation method, their statistics will always sound more appealing than national IVF statistics.
This doesn’t mean you shouldn’t try this or any other natural therapy mentioned in this chapter, but it’s wise to be skeptical of any treatment that does not have peer-reviewed scientific evidence to support its claims. You need to know what methods are available, the pros and cons of each method, the likelihood that the method will give you the desired result, and how much time and money you’re willing to spend to get that desired result.
There’s no debating that massage therapy is a wonderful stress management tool. Indulge yourself in a 30- or, better yet, a 60-minute massage, and try splurging on a facial. Once it’s over you’ll feel more relaxed and grounded. If you’re trying to save money for fertility treatment, apply a facial mask weekly and offer to exchange massages with your partner. This will revitalize you and can be a real bonding experience.
Meditation
Meditation involves focusing your attention on something positive in order to reach a state of extreme relaxation. Once accomplished, your body is at rest and your mind is free of extraneous thought. Several major religions embrace ritual meditation, but you don’t need to be religious or spiritual to enjoy its benefits. In a world inundated with daily crises, time constraints, and perpetual change, more and more couples are turning to meditation to help with fertility.
Frequent meditation helps lower your heart rate and breathing rate. If you’re a constant worrier, meditation will make you less anxious. If your doctor has diagnosed you with high blood pressure, meditation can help you maintain lower blood pressure. The medical community recently embraced it to treat medical conditions, including anxiety, stress, depression, premenstrual syndrome (PMS), and infertility.
Sleep
Sleep is incredibly important, even when it comes to fertility. Take East Bay Area ENT, face and neck surgeon Dr. Sassan Falsafi, for instance. Early in his career this one life-altering incident made him realize just how important sleep is to fertility. It also singlehandedly helped him convert from a head and neck oncologic surgery enthusiast to a rhinologic surgery practitioner.
In Dr. Falsafi’s words: A woman came into my office and told me she couldn’t get pregnant. I told her I’m a face and neck surgeon and quickly directed her to the OB/GYN in the building. She said, “I just came from my OB/GYN, and he sent me to you.” I must have looked baffled and said, “Why?” She said, “I can’t sleep.” So I examined her, and it turned out she needed a septorhinoplasty. Weeks went by and I didn’t hear from her. Six months later she came in with her husband, both were grinning, and she was clearly pregnant.
Naturopathy
Naturopathy consists of a wide range of natural therapies, including diet, herbal remedies, homeopathy, massage, acupuncture, and lifestyle counseling. The goal of naturopathy is to correct physical, emotional, and biochemical imbalances that you might have. It is not known whether any one of these complementary therapies used along with traditional fertility treatments may improve your chances of getting pregnant.
Prayer
Prayer may help improve fertility, though the linkage has yet to be scientifically proven. This has not prevented researchers in religion and health from trying to prove that prayer makes people well (and others from debunking the same studies). Over the past three decades researchers in religion and health have conducted hundreds of studies to prove whether prayer plays a role in making people well. Within the last decade major medical journals have published positive results from many studies of intercessory prayer (prayers made for the sick by others).
One such study in favor of prayer was from the Mid-America Heart Institute at Saint Luke’s Hospital in Kansas City, Missouri. The study, led by cardiologist William Harris, M.D., appeared in the October 1999 issue, Archives of Internal Medicine. Harris and his team set out to determine whether distant healing would reduce overall adverse affects of 990 cardiac patients. The researchers took great pains to eliminate the placebo effect. They pulled this off by conducting a double-blind study (not telling patients they were part of an experiment).
Results of this study leaned in favor of prayer. Patients who received prayers from designated volunteers and the hospital chaplain’s office had 11 percent fewer heart attacks, strokes, and other life-threatening complications.
Regardless of whether you call this transcending phenomena prayer, divine intervention, remote energy, spiritual healing, nonlocal empathy, or loving intentions, it describes the same thing. Whether we’re talking about one person’s prayer, group prayer, or prayers sent halfway around the world, what’s important is what’s in your head and your heart.
Progressive Muscle Relaxation
The gist of progressive muscle relaxation comes from the 1930s work of Edmund Jacobson, who held that mental relaxation is a byproduct of physical relaxation. This deep relaxation technique can help you cope with stress by slowing your body and quieting your mind. It can also help with anxiety, insomnia, and certain types of chronic pain. Used regularly, you can manage and prevent these ailments, especially when it accompanies infertility treatments.
Progressive muscle relaxation works for you on two levels: physical and emotional. When you’re under stress or emotionally distraught, you automatically tense your muscles. Training your muscles to relax helps you unwind because of the relationship between your muscle tension and your emotional tension. Muscle tension can cause a number of symptoms, including headaches, neck strain, backaches, and a host of other stress-related ailments.
Just about anyone can learn to master progressive muscle relaxation in a few short sessions. All that is required is 10 to 20 minutes per day in a quiet place away from any distractions. You can practice this technique seated or lying on your back. Start by tightening individual muscle groups for five to eight seconds and then release the tension. Try doing this with your toes, then your feet, then your calves, and work each muscle group throughout your body, with your temples, eyes. and forehead being last.
Each time you release tension, focus on the feeling you have when a particular muscle group is relaxed. This is a good time to use imagery. Try associating the feeling you have when a muscle group is relaxed with a place that relaxes you, like a running stream at a river’s edge, a serene mountain vista, or a picturesque beach at sunset. Now imagine stress wash out of your body and into the river, off the cliff, or into the tide, never to reappear. Once you have achieved this, stay in a relaxed state for about 15 to 30 seconds before moving on to the next muscle group.
Besides reducing stress and reaping numerous health benefits, progressive muscle relaxation will teach you about your body’s signals. In time you can identify when your body is under stress and what to do to relax it before the tension becomes problematic.
Reflexology
Reflexology revolves around reflex points in the hands and feet that therapists believe correspond to specific human organs and energy meridians (see page 86). Ancient Egyptian, Chinese, and Indian therapists have relied on this practice for thousands of years.
Trained reflexology therapists use pressure on the feet and hands in hopes of improving blood supply to various parts of the body. The goal of reflexology is to balance and realign the energy in the body by massaging the feet and hands. It’s most commonly a form of stress management and may hold some value when working toward fertility.
Yoga
Yoga is an ancient method of bodywork originating in India that melds physical, physiological, and spiritual realms. The practice consists of postures (asanas), breathing exercises (pranayama), and meditation, and it emphasizes the importance of healthy living. Yoga’s teachings can help increase your fertility by stressing the importance of healthy eating habits and living a healthy lifestyle. Low-impact posturing, breathing exercises, and meditation can also help you relax and reduce your stress.
While yoga has many different forms, the most common Western form is Hatha. It’s a gentle type of yoga that helps unblock energy (prana). Advocates of yoga claim that daily practice helps promote fertility by regulating menstrual cycles, balancing hormonal irregularities, and strengthening reproductive organs.
WHAT IF NOTHING SEEMS TO WORK?
By the time you made up your mind to seek fertility treatments, you may have already developed some degree of frustration and despair. Feelings of inadequacy associated with an inability to conceive can cause situational stress or depression. Signs of depression that you’ll want to watch for include feeling sad, hopeless or helpless, feeling guilty or worthless, thinking negative thoughts, and losing interest in social activities, hobbies, or sex.
If you find you’re falling into this category and nothing is getting you pregnant, this is the ideal time to discuss new screening methods like preimplantation genetic screening (PGS) or preimplantation genetic diagnosis (PGD). For more on PGS and PGD, see chapter 13, or to preserve your fertility for future use, see chapter 12.
Finding Out about New Treatments
I was in a depression, so I joined a support group through Resolve. Actually my best friend signed me up because she didn’t know how to help me. The support group was good for emotional support, and as a result, Cesar and I learned a lot. I heard about a girl with thin uterine lining who used Viagra. I learned about ultrasound-guided transfers and preimplantation genetic diagnosis (PGD). All these things were new to me, and if I hadn’t been there, I might not have known about them. This taught me that support groups are not just about a shoulder to cry on, but they can also be a source of knowledge. Before I knew it, I was out of my depression, making smart decisions, and feeling upbeat again.
—Christine, 32, human resources specialist
WHAT QUESTIONS SHOULD YOU ASK?
Following a healthy diet and a sensible exercise routine to maximize your fertility isn’t that different from getting in shape in general. Getting your mind and body in shape requires you to examine your priorities and make necessary adjustments. Replacing empty calories for healthy foods or trading grueling workouts for brisk walks might be some of the trade-offs you make while trying to get pregnant.
No one said that changing your life is easy. Getting your mind and body in shape requires you to examine your priorities and make necessary adjustments. This is something that most of us are not so sure about. Making a commitment to live a fertile lifestyle should be your initial step. Think of your health as a means to an end: if you’re not taking care of yourself physically, emotionally, and spiritually, chances are you’re not in the best shape to conceive. Knowing this, don’t you want to do everything (within reason) you can to increase your chances?
If the answer is yes, take a personal inventory of your physical, emotional, and psychological health. If you answer no to any one question, chances are you have some work to do.
• If you’re over 38 and have been trying to get pregnant for two years, are you seeing a fertility specialist?
• Are you taking proactive steps to maximize fertility?
• Are your eating habits healthy?
• Do you exercise regularly?
• Is your BMI on target for your height?
• Do you have a balance in all areas of your life?
• Have you quit habits that diminish fertility like smoking, drinking, or using certain medications or recreational drugs?
• Have you tried complementary methods to increase your fertility?
• Is your spiritual/religious life in check?
• If you’re older than 38, have irregular periods, suspect male-factor infertility, or have been trying more than two years, we recommend seeing a fertility specialist immediately.
• If you don’t fit into the previous categories, consider our 12-week plan to maximize your fertility.
• Twelve percent of infertility cases in women are weight related.
• Exercise and eat balanced meals with moderate portion sizes. Split meals.
• If nothing seems to work, ask your fertility specialist about treatments you haven’t tried, like PGS or PGD (see chapter 13).
• Caffeine, alcohol, and tobacco all reduce fertility.
• Reduce your stress levels through relaxation techniques. Stress affects fertility.
• Studies show some that complementary techniques are effective at improving fertility.
• If you start feeling symptoms of depression, speak to your doctor immediately.
• From what we know now, women don’t hold hidden egg reserves. But if scientists prove otherwise, the impact on female fertility could be huge.
