Getting from point A to point B by breaking down what needs to be done.

“Change is never a matter of ability, it is always a matter of motivation born from a compelling ‘why’. Once you are clear on your ‘why’ setting goals is the first step in turning the invisible into the visible” ~ Tony Robbins

INTRODUCTION

The goal of anyone experiencing infertility is to have a child. When times are trying, and you are adapting your lifestyle in what might be challenging ways, that is the goal that needs to be kept in mind. Sometimes when you’ve been trying for a while, this ultimate goal can seem frustratingly unreachable so breaking it down into more manageable steps is key. That’s what we’re going to talk about in this section.

It is my belief that the most important step in achieving anything is the process of goal setting. Without a target, how can one hit it? With clear goals and vision, each choice you make throughout each day can be evaluated by asking yourself, is this choice bringing me closer to my dream?

As a doctor, I determine my goals for treatment from the initial intake forms and the first appointment. By diagnosing the prominent signs and symptoms I feel are important to work on, combined with our joint decisions about larger aspects of life and your family vision, we provide the framework for setting goals. These goals become a guide to ensure we are staying on the path that we have created together.

Once your goals are clear and you are doing everything in your power to obtain them, it is time to surrender. Not everyone is ready to hear this and it can be tough to relinquish control, but having faith in your body is of paramount importance. Patience is one of the primary attributes of a good parent and you might want to think of this time as a dress rehearsal for what’s to come.

While each person’s path to fertility will vary, I have found that after a decade of working with couples trying to conceive that the following four steps can be a recipe for success:

1. Take care of yourself (set those goals).
2. Do your best to surrender and accept your circumstances.
3. Have faith that your dreams will come true.
4. Persevere.

Breaking down your goals into attainable and sustainable steps and sticking with them for enough time to allow the magic of the compound effect to manifest is the key to success. When setting goals, remember the wise words of Jim Collins (author of ‘Good to Great’): “If you have more than three priorities you don’t have any.” Figure out what is most necessary for you to do to accomplish your goals, forget about everything else and keep it simple.

Often, but not always associated with age, diminished ovarian reserve, i.e. low AFC (antral follicle count), high FSH (follicle stimulating hormone) and low AMH (antimullerian hormone) are all important test results which show a woman may be close to the end of her reproductive years and that egg quality may not be what it once was. This is a very challenging time for women as the clock begins ticking more loudly and many IVF centres may not even accept them as patients. At this point, a woman’s chances of conceiving naturally may be better (with the aid of TCM and acupuncture, supplements and lifestyle changes) than with IVF or other assisted reproductive technologies (ART). There is still hope, and it is important that you do not turn against yourself with emotions of regret, anger and resentment. This is a time more than ever when you must put trust in your body and do all you can to restore balance and deep holistic health to your life. The following suggestions are important if you have received this diagnosis:

• Chinese herbal medicine – This is likely one of the most powerful tools that exists when attempting to improve their reproductive potential when faced with any or all of these diagnosis. Six to twelve months of administration is recommended.
• Anti-inflammatory diet – Inflammation could very well be contributing to this diminished reproductive essence and hormonal imbalance. Understand what foods should be avoided. *Refer to the notes on inflammatory foods in the chapter on diet for more information. Consider a cleanse to kickstart this learning process. I recommend Mediclear from Thorne Research to my patients.
• Assisted reproductive technology – Especially if age is a factor, this is a diagnosis where I encourage considering IVF sooner than later, if it is an option. As stated above, if IVF is being considered, preimplantation genetic diagnosis (PGD) is a new advancement that may play a key role in success.
• Qigong – An ancient Chinese form of exercise involving soft movement and meditative breathing. Used for the cultivation of deep health, longevity. This is one of the few ways the Chinese believe one can reverse diminishing reproductive essence.
• Perseverance – The single most important quality one can possess when faced with odds such as this. Do not give up.

Setting attainable goals will keep you on track and restore a sense of control. During a time that can feel like so much is out of your hands, achieving the smallest of goals is often a much needed boost of empowerment. Small, simple commitments over time create the changes we desire in life.

DISTRACTION

Learning this simple principle changed my life. It really made me become clear on exactly what it is I need to be doing with each and every moment of every day so that I ensure the accomplishment of my goals and dreams and live a happy fulfilled life WITH REMARKABLY LESS STRESS. This simple principle is to avoid distraction. We are bombarded with distractions, from social media, email, television, shopping, and other peoples’ agendas are just the tip of the iceberg. We live in a society where we pride ourselves on being busy. If you ask 10 people today how they are doing, I would guess that at least eight of them will mention how busy they are in their response. Five of those eight may admit that they are busy being distracted, actually doing very little to deeply fulfill themselves and live the life they want to live. This is not their fault, as most people have not been taught how to sit down and take the time to get crystal clear on the way they want to feel, the things they want, and to create a vision for their future. Getting clear is the first step to success. Set precise detailed goals today. The second is prioritizing the skills, character, and tasks that are necessary to accomplish your goals. Then finally and most importantly, get rid of all the distractions in your life. This means everything that is not a part of your list of priorities has to be eliminated or delegated. This is a pearl of wisdom exampled by many successful people. I also want to emphasize that focusing your life in such a way sets you up to become an expert in whatever it is you prioritize, but it also means that you have to leave the notion that you can be great at many things behind. This notion is one of childhood dreams and is responsible for keeping people on the path to mediocrity. You are extraordinary; let your light shine.

“Be kinder than necessary, for everyone you meet is fighting some kind of battle.”~T.H. Thompson and John Watson

Learning to pay attention to your body’s signals.

“When we’re willing to listen to our bodies and begin trusting ourselves as much as we trust outer authorities, all the rules change. And so does our biology. Statistics no longer apply to us. We enter the realm of miracles and undreamed-of possibilities.” – Dr. Christiane Northrup, author ‘Women’s Bodies, Women’s Wisdom’

INTRODUCTION

I had a favorite old Chinese teacher during my TCM studies that imparted simple but wise words to us. He said, “Your body is your best friend, listen to what it is telling you!” That is the premise of self-monitoring and fundamental to working together with your TCM doctor.

In this step, we will discuss what to look for and what it means.

Much of the discussion of causes for certain menstrual health conditions reference TCM terminology. Remember that this is most important when you are reading steps such as ‘Diet’ as your personal TCM patterns are the guide to understand what to do on your road back to health and balance.

At most clinics, like Yinstill, new patients are asked to fill out an intake questionnaire so it is helpful for you to have observed yourself thoroughly. As treatment continues, tracking changes as you get healthier will help treatment continue on an effective path.

No one has a better knowledge of your body and what is going on with it than you. If you pay attention, your body will tell you everything you ever wanted to know. If you pay attention.

Some things to watch:

Menstrual cycle

One of the most important things to understand as a woman, particularly when you are trying to conceive a child, is your monthly cycle. Ovulation can and should be carefully tracked in order to know exactly when the ideal timing to have intercourse is. But beyond that, your period and vaginal discharge can tell you a lot about what is going on with your body. By tracking the color, consistency, pain and PMS symptoms you will be able to give your doctor a full picture of your health. Rich, red blood indicates that it is well oxygenated and full of nutrients indicating a healthy environment for an egg to implant. Many women view their periods as an inconvenience or maybe even something they dread every month, yet they are truly a gift. They cleanse your body every month and give you valuable information about what is going on inside.

Ideally, a woman’s cycle should be of moderate volume for 2-4 days then taper off for 1-3 days. Blood should be fresh looking in color with minimal brown and black or extreme brightness. It should be neither too thick or too watery in consistency and contain minimal clotting or tissue.

The most common complaints I see fall under the category of Qi and Blood blockage, which acupuncture is typically very effective for. After addressing the primary complaints I hear, including stress, tension and irritability, I address clotted menstrual blood. This is a symptom that is closely connected to fertility and as you can see in the statistics below, very common.

Top menstrual symptoms reported at Yinstill:

95% – clotted menstrual blood (38% small, 47% medium, 16% large)
78% – stress
74% – neck / shoulder tension
69% – PMS cramps
66% – PMS breast tenderness
64% – PMS bloating
61% – PMS moodiness
58% – irritability/impatience

Menarche (onset of menses)

According to TCM, and in my clinical experience, menarche starting at 14 years of age or older often seems to indicate a reproductive essence deficiency (Kidney Yin / Yang), especially if having difficulty conceiving. Conversely, the onset of menses too early in life (the age of 10 or earlier) shows possible involvement of environmental causes of hormone imbalance, and from a TCM perspective, excessive heat. So ideally, a woman’s cycle should commence around the age of 11-13.

Cycle length (based on an average of 28 days)

Typically, a woman’s cycle should consistently fall between days 26-32 every month (that said, slightly longer cycles can be quite normal and fertile for many women). If your cycle varies from this, it is one of the first things to get on track for optimal fertility. Don’t worry if you’re not there yet though. A combination of diet (as detailed in Step Five), acupuncture and exercise will make a difference and maximize your chances of conception.

So that you can cross-reference your symptoms with the Diet and TCM chapters, here is a brief summary of what your cycle may be telling you.

Always early (less than 26 day cycle)
This is caused by an overall deficiency of the body known as Qi deficiency, an accumulation of Heat (possible inflammation), or poor blood circulation causing blockage known as Blood Stasis.

Always late (more than 32 day cycle)
May indicate a deficiency or blockage caused by ineffective digestion and poor production of blood (blood deficiency). This is often accompanied by poor circulation of blood and body fluids known as Blood Stasis and/or Dampness.

Irregular (a combination of early and late)
Irregular cycles are often a result of extreme emotions also known as Qi stagnation. It can also be caused by an overall imbalance of health or lifestyle which causes irregular nourishment to the reproductive organs, manifesting as a body with disorganized cycles. Multiple TCM patterns are often involved.

Menstrual Blood

Volume

Most women observe this by the number of days they bleed and thus the type/amount of tampons or pads they use. The usual amount of blood loss per period is 10 to 35 ml. Each soaked normal-sized tampon or pad holds a teaspoon (5ml) of blood. That means it is normal to soak one to seven normal-sized pads or tampons (“sanitary products”) in a whole period (http://cemcor.ubc.ca).

A heavy flow shows an overall deficiency of the body (Qi Deficiency), and/or accumulation of heat (possible inflammation).

When periods are very light, it most often points toward ineffective digestion and poor production of blood (Blood Deficiency), and/or poor circulation of blood and body fluids causing blockage (Blood Stasis, Cold and/or Dampness).

Colour

In general, menstrual blood should not be purple, brown or black as these all denote poor circulation of blood and body fluids and cause blockage (Blood Stasis, Cold and/or Dampness). Very dark red or extremely bright red blood often points toward accumulation of Heat (possible inflammation). Diluted pink or pale blood most often implies poor production of blood (blood deficiency).

Consistency

Thick blood is due to accumulation of Heat (possible inflammation). Thin watery blood is due to an overall deficiency of the body (Qi Deficiency) and poor production of blood (Blood Deficiency). Clotted blood is most often due to emotional circumstances (Qi Stagnation) and/or poor circulation of blood and body fluids causing blockage (Blood Stasis, Cold and/or Dampness).

Menstrual Pain

Ideally, a woman’s cycle should not have any pain but most often there is slight cramping both before and during the first couple days of a woman’s period. This is considered normal but pain before or during menses is almost always due to poor blood circulation causing blockage (Blood Stasis from various causes). Pain around ovulation denotes poor circulation of body fluids causing blockage (accumulation of Dampness).

PMS

As a rule, a woman’s premenstrual phase should not bear symptoms that drastically affect her quality of life. From a TCM perspective, almost all premenstrual symptoms have their root in Qi stagnation, which often has emotional causes at its root. Being overly emotional, breast tenderness, bloating, nausea and headaches can all be regulated, at least to some degree by ensuring smooth flow of Qi in the body.

Cervical Fluid (vaginal discharge)

By paying attention to your discharge, you will have a much clearer understanding of when you are ovulating. The body gives clear signs that this event is most likely taking place, though the only true measure of ovulation is pregnancy.

Approximately 10-16 days before the onset of menstrual bleeding, a woman’s cervix (the opening to her uterus) will open to allow sperm through. When this happens, it produces a translucent, slippery and stretchy fluid that is an ideal medium for sperm to swim in. It also changes the acidity or alkalinity (pH) of the vagina, and contains nutrition for the sperm in order to sustain them on their long journey toward the fallopian tube where they court the egg. Think of the cervix as being in charge for creating the mood for romance.

Checking your cervical fluid is easy; no need for any tools other than your fingers and eyes. You can start monitoring once your monthly bleeding has stopped. After you have observed your body for a couple of cycles, pre-ovulation fluid will be obvious. Here is what you are looking for:

• A slippery consistency. This provides natural lubrication for intercourse. Some women report a wet sensation.
• A transparent appearance that resembles raw egg-whites. This is due to higher water content which makes swimming easier for sperm.
• The fluid should stretch when examined between the fingers and not appear tacky like lotion. The lotion-like cervical fluid is too dense for sperm to swim in.

For some women, examining discharge is very easy, since there is plenty to observe on her underwear. For others, it may be necessary to insert a finger into the vagina to check if smaller amounts are present around the cervix.

Fertile pre-ovulation fluid is over 90% water and not only looks and feels like semen, but is its best friend on the long journey toward penetration of the egg. A few reasons for this include:

Lubrication. Glycerol amounts increase during sexual excitement and around ovulation. This is thought to be responsible for the lubricating qualities that define these important reproductive events.

Vaginal pH. Reducing the acidity of the vagina helps sperm survive, which is a natural occurrence around ovulation. High acidity kills sperm and other invaders, which is very beneficial, except when ovulating and trying to conceive. Pre-ovulatory cervical fluid lowers vaginal pH. If this does not happen naturally; lubricants like Pre-seed will help.

Swimming. It is easier to swim in water than lotion. The consistency of this fluid is much more conducive to motility.

Food. Sperm needs to eat. Components in the pre-ovulatory cervical fluid such as calcium, sodium, potassium, glucose, amino acids, zinc, copper, iron, manganese, & selenium, give the sperm what it needs to thrive.

Healthy pre-ovulatory cervical fluid is a very important part of the fertility equation. The interaction of sperm and cervical fluid must be harmonious for success with conception. In many cases, women are not producing adequate amounts if any, but fortunately that can be remedied in the following ways:

• Use Pre-Seed sperm friendly lubricant. Currently, it is the only lubricant on the market proven to mimic the composition and functions of a woman’s natural fertile cervical fluid.
• Drink lots of water with lemon and/or coconut water.
• Use Traditional Chinese Medicine and acupuncture to help restore balance to body fluid levels.

LH Ovulation Strips for Tracking Fertility

The LH Ovulation Strip is a urine test that is fast and easy. It is used to predict when you are having your luteinizing hormone (LH) surge. Since it is one of the most reliable predictors of ovulation, it is my recommended method when determining the fertile window of the menstrual cycle. Some new ovulation urine strips are also measuring estrogen hormone levels, which is not necessary for the purpose of trying to conceive.

These strips are perfect for timing intercourse as they produce a positive result 12-36 hours before ovulation. They can also help verify a lack of ovulation.

It used to be that the most common way of monitoring your fertile days was to chart your basal body temperature. This involved taking your temperature every morning before getting out of bed and observing its fluctuations. A dip, then spike in temperature meant you had probably ovulated. Unfortunately, there were a few shortcomings with this method. First, there are other factors that can cause a temperature spike such as stress, fever, poor sleep, alcohol consumption etc. More importantly, the temperature spike usually occurs 12-24 hours after you ovulate, making it too late for intercourse by the time a temperature change is detected.

You are actually considered to be at peak fertility in the two days preceding ovulation, which is why you may have noticed your body producing the fertile cervical mucus before this. Sperm can survive inside your body for about 3-5 days, so having intercourse in these two days before egg release can make for the best chances of having sperm and egg meet. After being released, an egg lives for about 6-24 hours, after which it will dissolve if it isn’t fertilized. So if you are getting your important indicator 6-24 hours after the fact, as with basal temperature monitoring, you’ve missed the window.

When your egg is mature and it produces a sufficient rise in estrogen levels, your pituitary gland is triggered to release a surge of luteinizing hormone (LH). This tells your body it’s ready to ovulate. The increased LH (as measured on the LH ovulation urine test strips) triggers the release of the egg, which occurs about 12-36 hours after the surge. Since nothing other than impending ovulation triggers an LH surge, this method provides a clear message that your most fertile days have arrived.

Although using the LH ovulation strip is a great way of finding out when your best chance of conception may be, having regular sex (i.e., a few times per week or every other day) mid-cycle maximizes your chances of conception.

Bowel Movements

As embarrassing as this is for some people to talk about, it is one of the central indicators to a deeper understanding of what is happening for you internally. Your bowels are an expression of health, mainly digestive, but also may be great indicators of other underlying problems that should be investigated. What comes out dictates pretty clearly what’s going on inside. So before you flush, take a peek!

The Bristol Stool Scale is a system created to standardize the appearance of stool so that reporting to your physician is easier.

So, what is normal? According to Traditional Chinese Medicine:

1-2 bowel movements per day is average.
Without extreme urgency or incontinence.
Formed, not loose or dry bitty rabbit pellet stool.
Easy to pass (no grunting!).
No burning sensation.
No pain.
Not too foul smelling.
No undigested food should be seen.
No ‘unfinished feeling’ post movement.
If they float they are fabulous and filled with fibre.
Colored like a fawn (depending on what you’ve eaten).
No sense of fatigue post movement.
Should not see any oily residue floating on water in toilet.

If there is blood, it should be monitored to determine what the source is; fresh blood on toilet paper or in the toilet water around an otherwise normal looking stool is most often not cause for alarm, however blood from further back in the digestive tract will produce dark tarry stool, which could be as simple as an ulcer or something more serious. In any case, if there is blood, please consult your physician.

Sleep Quality

There are a few areas that I have strong opinions on and this is one of them. Sleep is when your body nourishes itself. During deep rest is when the body has a chance to pay attention to the systems that might not take priority in a busy day. The reproductive system gets a shot at optimal nutrition and oxygen delivery that might be redirected elsewhere during stressful waking hours so make it a priority to get enough sleep.

Digestion

Since your body knows best, how you feel after a meal will tell you a lot about which foods are good for you, and foods which you might be sensitive or allergic to. Fatigue, gassiness and bloating may be some signs that your food choices aren’t working for you whereas energy and vitality are signs that you should keep up the good work. Digestive issues can also be an indicator of stress so if you feel like you’ve been eating well but your digestion is still not optimal, you may want to consider slowing down and looking at the big picture. If you are not getting extraordinary nutrition from food, how can you expect your body to flourish?

Mental-Emotional

Moods can be just that sometimes but, more often than not, if you take a minute to assess what got you into the mood you’re in, it can be a good indicator as to what’s going on around you that may need your attention. Conversely, a positive mood can let you know that the company you’re keeping, your exercise routine or the way you spent your day is nourishing you.

Basal Body Temperature (BBT)

If your cycle is irregular, tracking basal body temperature (BBT) will allow for a better idea of what is going on internally but it is not my favorite way to predict ovulation since temperature range varies for individuals and can indicate not just fertility but thyroid or progesterone deficiencies, coldness or heat. The stress caused by taking one’s temperature first thing every morning may outweigh the benefits of the information obtained. You be the judge. If waking every day and turning away from your partner to take your temperature is something you want to do then that is great; we can utilize this information. But if not, then please, unless your practitioner specifically believes that it is necessary, put the thermometer away. Although it is not necessary, many Doctors of TCM use the BBT chart to diagnose whether there is Heat in the follicular phase (day 1 to ovulation), if the body needs help ovulating and whether there are deficiencies in the luteal phase (ovulation to menstruation) that require supplementing. In my practice, I rely more on other feedback that the body gives us to determine direction of treatment and when the woman is ovulating.

If done properly and for an extended period, BBT charting is another indication of ovulation but since the small and not always apparent temperature dip and rise that happens is after your egg is released, it is too late to start trying once you see it. In conjunction with the rise in temperature, your ‘fertile’ cervical fluid will dry up and your cervix will close as the hope for implantation begins.

Libido

Sex drive can be an indication of everything from ovulation to trouble within one’s relationship. Oftentimes the stress of trying to conceive a child will affect your desire to be intimate with your partner and can be rectified by expressing this. Counseling can sometimes be the way to go or it may be as simple as taking the time to enjoy each other’s company without focusing on reproduction.

There are 3-5 days of a woman’s cycle where her libido rises and the cervix softens and retracts higher into the vagina, making sex much more comfortable by accommodating an erect penis.

Food Cravings

What you want and what you need may not align. It is not uncommon in the western world for us to eat when we are overworked or bored and especially when we are emotional. Some people refer to this as ‘eating your feelings’. There are theories that suggest we might crave one thing when what we need is something entirely different, so do your best to be mindful of what you really want before consuming empty calories. Maybe a hug instead of a chocolate bar? And if that’s not available, would a piece of fruit satisfy your desire for a donut? I never recommend deprivation though, so if you’re sure you want a piece of cake, then have the cake. Just make sure you enjoy every morsel!

Skin

The largest organ on your body is a great indication of your health so observe it and learn what’s up. How does it look and feel? If it’s dry, drinking more fluids and eating more juicy fruits and veggies may help. Breaking out? Your body may be telling you it doesn’t like what you’ve been eating or if you’ve improved your diet recently, it may be releasing old toxins. If your skin is oily, it may be an indication of Dampness or a sign that you’re not assimilating nutrients. Yellow or grey? Get some fresh air! Your skin hides nothing so have a look and learn.

Trust your body. Your intuition in combination with your physical symptoms will guide you. And if you’re having doubts or questions, that’s what your TCM doctor is there for. This is a team effort.

Looking inside to get the whole picture

“What’s meant to be will always find a way.” -Trisha Yearwood

INTRODUCTION

If you haven’t already done so, consider incorporating fertility audio meditations into your life now! I have seen profound results with the reduction of stress levels and the cultivation of hope when women choose to instill this habit. Guided visualization is perfect for the woman with a busy mind and finds meditation difficult. This may be one of the most important things you can do to fully optimize your potential to carry to term. Circle+Bloom fertility meditation downloads.

Spirit can be a tricky thing to define and as such it can often be the last thing that people address when having reproductive challenges. I suggest you make it a top priority, however, as it is not only linked to physical health but quite often the cause of it. For me, spirituality comes in many forms, but I can boil it down to a nurturing of two values: growth and contribution.

Are you contributing in some way, making the world a better place? Are you growing as a person with new skills, learning from your mistakes, or looking past self and following the wisdom of something divine? It is also very important that you take the time to look at how you are feeling on a deep level, the nuts and bolts. How happy are you in your life as a whole? Do you feel like you have a purpose and if so, are you fulfilling it? Do you like your job or are you staying there because the benefits are attractive for when you get pregnant? Is the desire to have a baby putting a strain on your relationship?

Go back to church or temple regularly. Find time to meditate. Spend more time in nature. Volunteer for a worthy cause. Find things that nurture your spirit and decide right now that you are going to (re)incorporate them into your life. The fulfillment you will be gifted with is beyond words, and something that could have profound effects on your fertility and spirit of your unborn child.

The process of getting pregnant, or rather struggling to get pregnant according to plan, can be very stressful. Whatever caused the difficulty in conceiving originally is now compounded with the immense stress that accompanies infertility. Women instinctively understand that stress is not good for reproduction, so this results in more stress and a frustrating cycle emerges. Sadly, in this sense, infertility may become its own cause.

Taking the time to balance the big picture with staying in the moment is key to a contented inner life and being self ‘full’.

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STRESS

“Doing nothing is better than being busy doing nothing.” –Lao Tzu

You may have some friends that seem laid-back about almost everything and others who react strongly to the slightest stress. Most reactions to life stressors fall somewhere between those extremes. An article written by the Mayo Clinic states: How you react to stressors in your life is affected by such factors as genetics and life experiences. Fortunately, the article also goes on to mention that despite your genetics or bad luck you can learn to react to life’s stress in healthier ways by:

• improving your diet
• getting more quality sleep
• relaxation, massage, and meditation
• nurturing healthy friendships
• having a sense of humor
• counselling &/or acupuncture (The American Society of Reproductive Medicine (ASRM) recommends acupuncture for infertility stress reduction)
• moderate exercise

Stress is such an umbrella term these days. Since it covers everything from being overworked to emotional strain within a relationship or financial worries, all of us are bound to have some. It is how we deal with it that determines whether it becomes harmful.

There are mixed opinions as to whether stress has an effect on fertility but I question, how could it not? When someone experiences stress, the body releases a hormone called cortisol. Whether it’s meeting a deadline, fighting with your spouse or being chased by a pack of hungry wolves, cortisol bubbles through our veins. In the past (like when you may have actually been being chased by wild animals), cortisol was essential for survival because it heightened the senses making us faster, stronger and keenly aware of our surroundings. When the imminent danger was gone, cortisol levels dropped and our body slowly went back to functioning regularly. In a modern day world, however, we sustain these levels for prolonged periods of time and that is where the problems start.

In situations of long term stress, health dangers are rampant. The body is not designed to sustain heightened cortisol levels and it causes trouble for the immune system. When there is trouble in the immune system, there is trouble everywhere. From colds to cancer to chronic fatigue, a weakened immune system plays a role. And what about fertility? How does a compromised immune system play a role there?

Think of your body as a very busy life. There is a LOT going on. You have to maintain a job, you’ve got your relationships, both personal and professional. There’s your family, your social life, your health, maybe some travel, home maintenance and maybe that nagging little noise your car is making. You can’t do everything at once.

You have to schedule your time wisely and prioritize. If work is hectic, your social life might suffer and if you have to fly home to look after your sister’s kids while she’s sick, your job is going to have to take a back burner for a couple of weeks.

Your body is the same. It has a lot to do and it has to decide what is most important. When stress is a long term thing, reproduction is not the priority. Instead of making sure your reproductive organs are getting enough circulation, blood flow is going to the heart because the cortisol is telling it that there is imminent danger and it needs to beat faster.

Your body is highly intelligent and its job is to keep you alive. Producing offspring is secondary to the number one job – looking after you. When YOU are healthy, then your body is free to think about creating someone else.

Some stress is inevitable. We are all susceptible to the traffic jams and holiday dinners and trips to the dentist. Dealing with stalled fertility can be a huge stress. How do you avoid letting those instances make your cortisol levels rise?

Figuring out your stressors is a good place to start. I suggest making a detailed list of everything in your life that makes you a little edgy. Include both significant and minute from running late for an appointment to fighting with your spouse. Then qualify this list into two additional categories–things you have control over and things you do not.

For the list of things that you have control over, set some goals for yourself to move on from those stressful situations. Could you reduce the frustration that traffic causes by using public transit? Is there someone that you need to have a heart-to-heart with to get through a strained relationship? Can you delegate some of your duties elsewhere to free up some time for yourself?

And for the list of things you don’t have control over, I suggest you pair them with a third list. A list of everything that makes you feel relaxed and happy. It might be a deep breath to gain perspective and some dedication to reprogramming your reactions, but a hot bath, a run along the seawall or a cuddle with your dog are also guaranteed to combat stress. If it makes you feel good, it has the opposite effect that cortisol does. The chemicals released from pleasurable activities actually boost your immune system and like everything in Chinese medicine, good health is about finding balance.

Does Stress Impact Fertility?

The short answer is ‘Yes’.

However, a more accurate answer is that stress affects some women’s capability to build a happy healthy family, and seems not to affect others.

How stress impacts fertility is not completely understood but high levels of stress can prevent pregnancy and affect a woman’s chance of conceiving. What we do understand is that taking steps to manage stress provides a better quality of life during challenging times.

When one is inflicted with high levels of stress the body reacts by flooding the blood with ‘stress’ chemicals that direct blood flow away from the reproductive organs. Blood is the messenger of nutrients, oxygen, and gonadotropic IVF medications to the developing eggs and uterine lining. This simple correlation emphasizes the need to manage stress and anxiety when trying to conceive and carry to term.

After going down the peer reviewed research rabbit hole in an attempt to better understand how stress affects fertility, I have come to the following conclusions;

• Stress can affect hormonal balance and ovulation.
• Stress can affect sexual health in both men and women.
• Stress may negatively affect IVF outcomes.
• Stress may negatively affect the quality and quantity of sperm.
• Stress may contribute to miscarriage by reducing blood and oxygen flow to the fetus.
• More research needs to be done.

How stress impacts a fertility patient

For some, being unable to conceive breeds an obsession with pursuing anything and everything that might help, from prayer to vitamins to IVF. Others completely withdraw from life, loved ones and society as a whole. Either extreme must be addressed in order to accomplish their goal of creating a happy healthy family.

A potential problem arises with the increasing understanding of the role stress plays in infertility. In some women, stress can rise exponentially when they begin to understand that stress may affect their fertility. Fortunately, in my clinical experience, this knowledge is often the motivation required to dig deep and begin making empowered choices that facilitate change, and to do what is necessary to persevere on the journey toward family.

HOW TO REDUCE STRESS

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THE WORLDS BIGGEST LIST OF THINGS YOU CAN DO TO REDUCE STRESS

Proper stress management helps people feel more in control and can improve overall well-being. Reducing stress can help bring a sense of clarity and aid women and couples in making better decisions for their health and fertility treatment options. It should be remembered that being stress free during fertility struggles is an unrealistic expectation, but finding ways to minimize stress and its detrimental effects is recommended. Acupuncture, aerobic exercise, guided imagery, journaling, listening to music, massage therapy, meditation, mind-body groups, mindfulness, progressive muscle relaxation, psychotherapy, self-help books, support groups, visualization, walking/hiking and yoga. These are just a few suggestions that could be a part of a stress management program.

Acupuncture

is well known for its potent effect on relieving stress. Many couples turn to acupuncture before and during their IVF cycles to help reduce stress and alleviate anxiety. Generally, 1-2 acupuncture treatments per week in the weeks leading up to embryo transfer help reduce stress and optimize the ovaries response to IVF.

Meditation

“Muddy water, let stand becomes clear.” ~Lao Tzu

Meditation is a practice that is becoming more and more prevalent in the western world even though cultures have been practicing it for ages. It is a very simple concept that can be extremely helpful for allowing an individual the opportunity to get in touch with their inner self.

Here are the basics:

1. Sit comfortably in a warm, quiet place where you won’t be disturbed.
2. Relax and pay attention to your breath. Take deep belly breaths that fill your abdomen.
3. Clear your head. When thoughts arise, gently let them go and bring your attention back to your breathing.

It may be a challenge at first but start small. Five or ten minutes a day will have an impact and you can increase the time you sit as you get more comfortable with your practice. Be patient with yourself. Thoughts will arise and that is normal. When you realize you are thinking rather than focusing on your breathing, just guide yourself back lovingly. Regular meditation will lower your blood cortisol levels and help ground your energy so that you can embrace the journey to parenthood calmly.

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IF MEDITATION IF DAUNTING OR DIFFICULT FOR YOU, as it is with many of my female patients, it is highly recommended that you incorporate guided visualization audio meditations into your daily routine. I recommend IVF and fertility related tracks from:

• Circle + Bloom
• Anji Online

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Take a moment…or two

Some people are intimidated by meditation; maybe it sounds too new-agey or you just feel you don’t have time. If that’s the case, I suggest a less rigorous form of mindfulness that can be done throughout your day and is much more simple.

Choose an activity that you partake in daily such as washing your hands or having a glass of water or even opening a door. Each time that you do that activity, check in with yourself. Take a couple of deep breaths and consider for a moment where you’re at emotionally, physically and intellectually. You don’t have to address your feelings in any way nor judge them. Simply acknowledge where you are and what you’re doing. Then, most importantly, smile and be grateful for all the wonderful blessings you have in your life. Be in the moment for that moment and then carry on with your day. Think of it as checking in with yourself the same way you would your partner or someone else you care about.

When mindfulness practices are done consistently, they become programmed to be a part of your instinctual makeup. Over time, they play a massive role in changing your life. It is the little things that make big differences.

Self-Care

“Sleep is the best meditation.” ~Dalai Lama

Nurturing yourself is always important. This is even more crucial when you are wanting to become a parent. While it may be hard to define, spirit is always something that seems to thrive when you take good care of yourself. Self-Care means something different for everyone so I encourage you to find what works for you. A few favorites include: warm baths, alone time, time with friends and loved ones, exercise and regular massage.

Giving Back

Another way to nourish your spirit and to take your mind off things is to lend a hand to those that need it. Sometimes the best way to get out of our heads is to do something selfless. And again, putting others first can be great preparation for parenting. Helping someone in need not only gives us a sense of purpose, but will often induce gratitude for our own circumstances thus pulling us out of the rut of self-pity and frustration.

The American writer and philosopher, Ralph Waldo Emerson, put it best when he said,

“It is one of the most beautiful compensations of life that no person can sincerely try to help another without helping themself.”

This is such a great quote that it is used repeatedly in BFP+!

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Using food and supplements as medicine.

“Tell me what you eat and I’ll tell you what you are!” ~Anthelme Brillat-Savarin, 1826

DIET

In this step I need you to get crystal clear on exactly how you are going to eat from this day forward. Then, you simply must commit to sticking with your plan with the knowledge that it will take you closer to your goals and dreams.

There is a world of information out there these days about what a healthy diet consists of and it seems to be changing all the time. There are trendy health foods that come and go, countless books to read, and advice from anyone and everyone about what works for them. The abyss of rhetoric about what is healthy and what is not (raw, vegan, vegetarian, Palaeolithic, Mediterranean, blood type, juicing, fasting, cleansing, etc.) can be overwhelming. Even large scale scientific studies produce varying conclusions on what is right and wrong. No wonder so many people are confused about how to eat.

Due to the importance of diet and the impact it has on fertility, pregnancy, and the future health of your child, we put together a fertility diet plan and workbook that we give to each patient. It acts as a guide and accountability tool, including weekly self-evaluation and reflection. The foundation of the Yinstill Fertility Diet is one of individualization through Traditional Chinese Medicine (TCM) dietary principles, meaning the right nutritional path to being fertile is different for different people. Finding what is right for you is essential – above all else, this is the single most important dietary principle. Following a ‘one size fits all’ dietary plan meant to improve fertility may help, but it may also create new health issues that cause further imbalance, making your destination further away than it was before you started. I recommend the help of a qualified TCM practitioner to determine your unique needs in regards to following a accurate TCM diet.

Click here to download your copy of the
YINSTILL FERTILITY DIET AND WORKBOOK
now

Another consideration, especially if your diet needs a lot of work to restore what may be considered ‘healthy’, is to do a anti-inflammatory dietary cleanse focusing on liver health. The goal of this is to reduce inflammation (as stated above) and to aid the liver in restoring hormonal balance. This is something that should be supervised by a healthcare professional. A cleanse such as this will help get things back on track in an expedited fashion.

Click here to download the YINSTILL ANTI-INFLAMMATORY CLEANSE outline

Lastly, I strongly recommend considering supplementation (below) if the indications fit your case.

MICRONUTRIENT INJECTION THERAPY

Micronutrient injection therapy is the administration of vitamins, nutrients, antioxidants, amino acids, and some botanical medicines directly under the skin (subcutaneous), intramuscular (IM), or into the bloodstream (IV). Injection therapy is 100% natural and does not involve the use of any medications. It is the fastest and most effective way to deliver nutrients to the cells and tissues of your body. Injections provide 100% absorption versus 30-40% absorption through oral supplementation. Generally, injections / IV’s are recommended once a week for 8 weeks to start. Afterward, patients may either continue with weekly treatments or move to a maintenance schedule based on their needs. IV drip appointments are typically 1 hour in duration, and injections/pushes take 5-10 minutes and can be included in an acupuncture session.

IV (INTRAVENOUS) THERAPY

The goal of IV therapy in your specific case is to rejuvenate the eggs by providing the antioxidants and nutrients required by the mitochondria – the energy centre of the oocyte (egg cell). There is a close link between mitochondrial health and egg health, making it important to support this important structure with antioxidants like N-acetylcysteine, vitamin C, magnesium, trace minerals and more.

GLUTATHIONE INJECTIONS

Glutathione is a powerful antioxidant that is important for the health of each cell in the body, including the eggs, uterine lining, and sperm. It serves to both protect the cell and the mitochondria as well as detoxify. When glutathione is in sufficient quantity sperm and egg health flourishes. On the contrary, when glutathione levels are low, we see poor quality sperm and low fertilization rates. Glutathione cannot be absorbed orally so it must be taken via IV or injection.

• The effects of gluathione on fertility

MIC+ INJECTIONS

MIC+ Injections are recommended to any patient that is in need of stress reduction, increased energy, weight loss, improved digestion, and detoxification (heavy metals, homocysteine). Depending on individual need, MIC+ injections may include methionine, inositol, choline, B vitamin complex, B12, folate, taurine, and carnitine.

• Read more about MIC+ injections and their benefits

What to do and how to start

“An early-morning walk is a blessing for the whole day.” ~Henry David Thoreau

Definition of exercise: any bodily activity that enhances or maintains physical fitness and overall health and wellness. It is performed for various reasons including strengthening muscles and the cardiovascular system, honing athletic skills, weight loss or maintenance, as well as for the purpose of enjoyment.

Some people hear the word exercise and wince, but that doesn’t have to be the case. Like diet, different exercise plans work for different people and the key to finding what is right for you is that it be something you enjoy.

Finding something you like to do that also happens to be exercise should not be a problem. There are as many choices these days as there are types of people. What about a Zumba class? Or kickboxing? Martial Arts? Pole dancing? Rock climbing? A team sport like volleyball or soccer maybe? You could go kayaking or take a surf trip or try fencing if you’re feeling adventurous.

There are no limits to the possibilities for fun with fitness and the benefits of exercise are no secret. Expect to lower your body fat, increase energy and muscle mass, reduce stress, improve your circulation, better sleep, lower blood pressure and feel an overall sense of well-being and confidence. And let’s not forget the most important benefit of all – with increased health comes increased fertility. So if you’re serious about starting a family, some form of exercise is a must.

The goal is to maintain a healthy body weight and steer away from being too thin or keeping up with an exercise regime that may be too strenuous. If your body is repairing muscles that are being used excessively, it will have less energy to devote to reproductive health.

If your weight is too low or too high, it will affect hormonal balance and ovulation. Women that are underweight will often have a lack of estrogen which can cause menstruation to be irregular or cease altogether, so in spite of the cultural messages we see portrayed in magazines nowadays, there is such a thing as too thin.

If you find yourself overweight due to a lack of exercise but you’re not sure where to start, take a walk. Aerobic exercise is key for weight loss and is considered anything that involves performing continuous movements, in your specific aerobic target heart range, with large muscle groups such as your legs, for 20 minutes or more. Cycling, swimming, rowing, walking, dancing or jogging are just a few examples of aerobic exercise. Low-intensity sessions that last at least 30-45 minutes are ideal for weight loss.

There’s no need for a gym membership or athletic prowess, it can be as simple as four brisk, half-hour walks a week to get your heart pumping and increase circulation; something that strongly assists with increased fertility.

In conjunction with addressing physical activity, Traditional Chinese Medicine (TCM) emphasizes the importance of cultivating willpower to overcome conditions such as overeating, laziness, and obesity. Acupuncture and Chinese herbal medicine supplement the systems necessary for being proactive in one’s life and making healthy choices for mind and body. With time, discipline and simple small commitments, the trajectory of your entire life can change. A healthy life is a fulfilling life and everyone deserves that.

*Elements to consider when attempting to manifest a holistic exercise regime are: Agility, Flexibility, Strength, Speed, Balance, Stamina, Coordination and Endurance.

Exercise Recommendations for Advanced Maternal Age

The inevitabilities of time and possibly neglect take their toll on our bodies and it is important to address typical conditions and symptoms such as poor circulation and decreased muscle tone specifically. Improving blood flow to reproductive organs can often be the solution to age-related fertility hold-ups so cardiovascular, aerobic, and high intensity interval training activity is recommended as it gets the blood pumping where it needs to. Also, since muscle tone decreases with age, a fitness routine that includes yoga, pilates and/or moderate weight lifting would be beneficial to women over thirty-five.

I recommend the following each week;
*Substitute your favorite activities where appropriate (dance, cross country skiing, squash, swimming etc)

• Aerobic (fat burning) activity once per week for 30 minutes. You can go to the trouble of finding your aerobic target heart range but I simply recommend getting out of the house and either walking quickly or jogging very slowly – this should put you into the aerobic target heart range. You should be able to carry a conversation quite easily when performing aerobic activity.
• Cardiovascular training once per week for 30 minutes. This type of training is meant to target the health of your heart and circulatory system, hence improving blood circulation throughout the body, including to your ovaries and uterus. Cardio target heart range is slightly more intense than aerobic. Caution to not overdo this type of exercise when trying to conceive as it can take vital resources away from the function of reproduction, especially when you might be pregnant.
• High Intensity Interval Training (HIIT). This should be done once per week, only in the follicular phase of the menstrual cycle. Run as fast as you can for 20 seconds, then walk for 4 minutes (to rest and catch breath). Do this 5 times.
• Resistance training to increase muscle tone and balance insulin levels should be done twice per week. This should not be done to a point of exhaustion, but simply to gently nudge the body into gaining strength and maintaining bone density. You should not feel sore and tired the day after a workout – this shows you are overdoing it. I recommend yoga or pilates for your resistance training component. Yoga is a balanced form of exercise that often has a meditative aspect to it that will allow you to get in touch with yourself. Also, taking the time to breathe in combination with challenging poses will release stress and clue you into what’s going on with your body and spirit.
• Opening the Pelvis: The following additional poses are something you add to your yoga routine and do at home. They are most effective as a “relaxing” stretch in that they should be done gently, and for a minimum of 1 minute, maximum of 5 minutes. Choose 1-2 to do each day. They can be done before bedtime and we often hear people tell us that these poses help them sleep!
  • Pigeon Pose (instructions).
  • Hip rotator & gluteus ball rolling (instructions).
  • Supported reclining butterfly (instructions).
  • Supported straddle (instructions).
  • Cow-face pose (instructions).

OBESITY

As per my deeper research, I have found that a program called ‘LadyBoss‘ is transforming the lives of millions of women needing to lose weight. Please take a moment to explore LadyBoss, as it may hold the key for you.

If you are overweight, above all else, this is the area that should be tended to first, directly alongside any emotional stress that exists. The time is now to make the commitment to the lasting change required to lose weight. Often losing just a few pounds, or dropping your BMI (Body Mass Index) and waist circumference just a couple points is enough to get you to your goal. It is well known and accepted that being overweight or obese drastically reduces your chances of falling pregnant and carrying a healthy pregnancy to term. Do all the research you can and find all the help you need to make this happen, there are many amazing programs out there to help get you started and keep you on track.

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“A person generally gains fat-related weight by increasing food consumption, becoming physically inactive, or both. When energy (food) intake exceeds energy expenditure (movement), the body stores the excess as fat.” Despite this widely accepted statement being logical, it is shortsighted and oversimplified. It should be emphasized that it is the over-consumption of the ‘wrong foods’ at the ‘wrong times’ that is causing the storage of excess fats, even when energy expenditure exceeds food energy (caloric) intake.

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The American Society for Reproductive Medicine concludes;

• Obesity is associated with menstrual dysfunction (irregular ovulation and cycles), decreased fertility and increased risk of miscarriages.
• Obesity decreases fertility, even in women that are ovulating regularly.
• Obesity increases the risks of pregnancy and postpartum complications.
• Obesity is associated with abnormal semen parameters and may adversely affect male fertility.
• Preconceptual counseling for obese women should address the medical, pregnancy and postpartum consequences of obesity and its longer-term implications for offspring.
• Lifestyle changes involving a diet and exercise program are the first-line treatment for obesity.

The impact of obesity on reproductive function can be attributed primarily to hormonal imbalances. Excessive abdominal weight is associated with increased insulin levels, which result in increased male hormone (androgen) levels. Fat tissue transforms much of these androgens into estrogen which becomes chronically elevated causing an imbalanced menstrual cycle and pre/postnatal abnormalities listed above.

RECOMMENDATIONS

Quite possibly the most important element behind your success is having the proper support around you; do not underestimate the powers of your support peer group*. Please refer to the exercise below and make the changes necessary with the company that you keep. Start today.

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Traditional Chinese Medicine (TCM) and acupuncture can help reduce insulin resistance, regulate appetite, and encourage lipolysis (the breakdown of fat) which will help the body to lose weight and result in improved ovarian function and egg quality, translating into greater success rates both naturally and with IVF.

Since your weight management is largely in your control, you CAN do it, and it is simply choices and willpower that are needed to surmount the daunting task of weight loss. Perseverance, commitment and proper medical management is also absolutely required.

• Diet – So important it has its own section. Bottom line, we recommend combining your individualized TCM pattern specific diet with Blood type dietary principles. Obviously this particular diet requires the guidance of a TCM doctor and a Naturopathic physician.
• Move – It’s that simple. Sometimes it might be better to not call it exercise. Physical activity is key, raising your heart rate, sweating, and possibly most important enjoying yourself. Aerobic target heart range is optimal for fat burning, as is resistance training (weights) and high intensity interval training (HITT). If you need help in this area find a good personal trainer.
• Willpower – The ingredient of the recipe that holds the rest together. Coaching, public accountability and Chinese herbal medicine are all fantastic tools to utilize when needing to cultivate willpower. Call us if you need support along the way. Utilizing our consult or coaching services is a integral part of BFP and your success.
• Portions – There may be many reasons for the obesity epidemic, but the only action that breeds obesity is the overeating of empty calorie foods. First of all, if necessary, reduce meal portion sizes.
• Fasting – finish eating for the day by 7pm, and do not start again until at least 7am, 8 or 9am being even better. Also, move back to a ‘3 square meals’ each day schedule (without snacking in between). This time between food intake retrains your body to utilize fat stores for energy instead of always being dependant on the constant slow drip of sugar/carbs that we usually are feeding ourselves.
• Why – The element which trumps willpower, is the reason. If your ‘why’ is strong enough, you’ll find any way possible to achieve your goal. Keep yourself focused on losing weight and its correlation with having a family.

What to avoid when you’re trying to conceive.

“The essence of strategy is knowing what not to do.” ~Michael Porter

We’ve talked a lot about what to do to increase your chances of pregnancy but if you’re doing everything right and conception is still stalled, you might want to look at what not to do.

This chapter is of particular importance for women of advanced maternal age, with unexplained infertility, endometriosis, fibroids, cysts or polyps and for men since sperm are highly sensitive.

Environmental toxins are a very passionate topic in my life. My desire to create awareness through strong emphasis on the negative impacts of these substances and products may, at times, create fear and the feeling that major damage has already been done. This could then be followed by a sense of despair, resentment and not knowing what to do. I apologize if any version of this is your experience, but to some degree if it is, I have done my job! That said, beginning the process of reversing damage caused by toxins is simply a matter of starting to incorporate choices that lead to a cleaner, less toxic personal environment. Start today, it’s easier than you think.

No one is immune to the health ailments that are being caused by environmental factors and educating yourself is key not only for conception, but also for parenting. Health challenges like Autism and cancers are rising steadily for kids and have been linked to common pesticides. Learn as much as you can and avoid what you can.

There are over 80,000 manmade chemicals existing in the marketplace today. Most have been introduced since the end of World War II when the petro-chemical companies no longer had a market for chemical weapons, so they found uses for their products in the form of home and agricultural pesticides and fertilizers, food preservatives, household cleaners and personal care products. Current estimates place the existence of over 200 of these industrially produced chemicals in the human body at any given time. The time when a human is at greatest risk of the effects of these toxins is during fetal development, hence the added relevance for this book. Many of these chemicals are known toxins that disrupt hormonal balance and are contributing factors in infertility, PMS, irregular menstrual cycles, polycystic ovary syndrome, endometriosis, premature ovarian failure, recurrent pregnancy loss, anxiety and cancer of all kinds.

I recently heard a statistic that one half of all Americans will have cancer at some point in their life. It is time to start taking a hard look at the causes, instead of pouring all available money into treatments.

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Click here for a PDF list of toxic chemical ingredients commonly found in cosmetic and beauty products (look for on product label), what they are typically used for and the negative effects they have on humans.

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Beauty or beast?

Sixty percent of what goes on our bodies gets in our bodies so researching skin care and beauty products is hugely important. Fortunately there are now companies that are becoming more responsible.

Read the ingredient list on everything you buy and if there isn’t one, know that this is a very bad sign! Fortunately there are more and more companies getting on board with healthy alternatives. By doing your homework and buying products that don’t contain harmful ingredients, we increase the demand for them. Even though many cosmetics and beauty companies have been selling us products that can have fatal effects for many years, the consumer is in charge. Don’t buy it and they won’t sell it. It’s time for a beauty revolution!

Here are some more examples of what to look for and avoid:

Deodorant and antiperspirant: Toxic ingredients like parabens, Aluminum, Propylene Glycol, TEA & DEA have all been linked to breast cancer, Alzheimer’s disease, kidney and liver failure. As this has become more well known, many great alternatives have popped up. Supply and demand is a powerful tool.

Fragrance: This includes everything from perfume to shampoo to laundry soap to hand cream, air fresheners, dryer sheets and anything else that is scented. When you see the word ‘fragrance’ on a label it is a synonym for ‘chemical compound producing scent’ and by law does not have to be identified. Another dirty little trick is that the word ‘unscented’ can also be used to describe a number of chemicals. Many of which are linked to cancer, reproductive toxicity, hormone disruption and allergies. Opt for essential oils and natural products for a healthier you.

Talc: The primary ingredient in powder not only for you but for your baby’s bottom, it is classified as a carcinogen by the International Agency for Research on Cancer if it contains asbestiform fibers, which it often does, but is unregulated so they don’t have to tell you that.

Tampons: Have you heard of toxic shock syndrome? Tampons do come with a warning that ‘toxic shock syndrome’ is a possibility but how many women know what that means? Basically, a tampon causes micro tears in the vaginal walls which allow whatever is in that tampon to penetrate. Tampons have been rumoured to contain asbestos, bleaching agents, dioxins (which refer to numerous chemicals) and rayon fibers, made of wood pulp that has been bleached. While the FDA denies this, again, do your research and if there is an alternative (like a sea sponge or a cup) that you are comfortable with, give it a try.

Toothpaste: Fluoride, like we talked about with regard to water, though banned in many countries, still abides in many toothpastes here and is linked to reproductive problems in men, brain damage, decreased thyroid function and early puberty. Ingredients like detergent, formaldehyde, paraffin, titanium dioxide and saccharin can also be found in many brands and the side effects of these chemicals are nothing to smile about. Again. There are responsible brands out there now but if you want a safe and inexpensive alternative, baking soda and water works well or you can make your own paste using essential oils.

Nail Polish: The majority of nail polish contains chemicals like Dibutyl phthalate, Formaldehyde and Toluene, which are linked to cancer, kidney failure, respiratory problems and developmental issues as it is transferred through breast milk. Read more about nail polish at DavidSuzuki.org (Queen of Green blog).

Some brands that have your best interests and the ingredients to back it up:

• Aveda
• Osmosis
• Lush
• Nourish Organic
• Tom’s
• Taslie

For nail polish:

• Honeybee Garden
• Piggy Paint
• Suncoat.

These will all come off with rubbing alcohol.

*Coconut oil, avocado, and raw honey are great moisturizers for skin and hair and perfectly safe to consume. This is a good thing to keep in mind with babies and young kids since they are in close contact with you and may suckle your fingers, giving you delightful open mouth kisses, etc.

We are all in this together…

Everything is connected. A great example of this can be seen in Theo Colborn’s book, Our Stolen Future, in which he tells the tale of a single PCB molecule (a cancer causing chemical found in coolants and banned in 1979) travelling from a factory in Texas to the bottom of a Great Lake, to a Polar bear in Norway twenty years later.

Drastic changes in the reproductive health, patterns and behaviors of species living around heavily polluted areas (sewage, garbage, agricultural and pharmaceutical run off, PCB’s, etc.) is no secret and we are adding more chemicals each day. We are told by industry leaders and government that all are individually tested but the real danger, and something that can never be studied in totality, is how these chemicals interact when they are in our water, food and air.

A recent study of over 500 couples showed pregnancy rates declined significantly when increased levels of toxic chemicals were found in the blood (Buck Louis, 2013).

But you’re on your own…

The food and drug industry is big business and you really have to look out for yourself. Be sure to read labels and go organic when possible. Some women have had success by going vegan but if that seems too extreme, try your best to eat only free-range, organic fed animal products. When you can buy locally, by all means do. Not only are you getting fresher, less processed food, you are supporting the local economy and sending a message to the large corporations that care more about their bottom line than your health.

Remember, just say no to:

• Non-organic animal products ( i.e., meat, eggs and dairy)
• Non-organic foods due to pesticide use and genetic modification (see Step Five)
• Water that has been stored in a plastic container and possibly exposed to temperature extremes
• Cleaning agents that contain fragrance (laundry, body, hair, dish, household)
• Dryer sheets and fabric softeners
• Cosmetic lines that are not completely transparent about their ingredients
• Food that has been microwaved — especially in plastic containers
• Artificial and manmade sweeteners (see Step Five)
• Domestic home and garden pesticides
• Canned foods (unless specified non-BPA lining)
• Phthalates (used in cosmetics and to soften plastic)
• For new homes and office building environments (full of paint, new furniture and flooring, mattresses, photocopiers, etc.) please consider purchasing an air filtration system* that reduces Volatile Organic Compounds, like the one we use at our clinic. *(http://www.zandair.com – used in IVF laboratory settings to protect embryos from harmful volatile organic compounds)

Some really, really bad guys

Here’s a list of common substances that have been shown to have estrogen-mimicking and other endocrine-hormonal disruptive effects. Aptly named, they are collectively known as ‘endocrine disruptors’.

Dioxins are byproducts of manufacturing chlorine. They are formed during combustion and during the production of chemical compounds containing chlorine, such as pesticides and PCBs. The production and use of some chlorinated chemicals, bleaching of paper and waste incineration, including the uncontrolled burning of residential waste, are the major sources of dioxins. Reproductive effects, including decreased sperm production, decreased testis weight, decreased testosterone levels, delayed puberty and endometriosis have been observed in laboratory animals.

Phthalates are used as softeners, or plasticizers, in polyvinyl chloride (PVC, vinyl) products, including children’s toys, some teethers, food packaging and cling wrap, medical devices, backpacks, shower curtains, vinyl flooring, wallpaper, decorating and building products, blood bags, adhesives, mosquito insect repellents, plastic plumbing pipes, nail polish, skin moisturizers, perfumes, solvents, cosmetics, personal care products, wood finishes and insecticides. Studies have found damaged, shrunken, undescended, or atrophied testicles; reduced sperm production; damaged sperm, destruction of Sertoli cells (which produce sperm) and lowered testosterone levels in offspring where phthalates was present. One great way to avoid Phthalates is to stop drinking water that has been stored in plastic bottles – especially if there is any possibility that it has been exposed to heat.

Arsenic is a naturally occurring element, considered a heavy metal. It is used as a preservative in wood such as pressure-treated lumber for decks, fences, playground equipment and residential construction, in insecticides, weed killers, fungicides, glass production, semiconductors, to make metal alloys (used in lead-acid car batteries), some medications, and home and agricultural fertilizers.

Lead. The most significant sources of lead continue to be from paint in homes built before 1978, lead pipes placed before the 1930s and soil by highways and heavily traveled roads. Reproductive effects including decreased fertility, increased rates of miscarriage, preterm delivery, low birth weight, low sperm count, erectile dysfunction, abnormal sperm shape and size.

Mercury. The most common organic form of mercury in our environment (from volcanoes, coal burning and gold production) accumulates in the flesh of fish, animals and humans, most particularly predatory fish species, such as shark and tuna, and bottom-feeders, such as crab. Animals exposed orally to long-term, high levels of mercury in laboratory studies experienced adverse effects on the developing fetus, sperm and male reproductive organs and increases in the number of spontaneous abortions and stillbirths.

24-D is applied to grassy crops such as wheat, lawns and gardens. It can be found on roadsides, golf courses, forests and waterways. If you are a golfer, be sure to bring changes of socks so your feet stay dry and are not sitting in a moist chemical environment for a full 18 holes. Also use a rag to pick up your ball, especially after it has been on the green as this is an area of the course which is most heavily sprayed with chemicals and fertilizers.

Permethrin is an insecticide derived from chrysanthemum flowers. It has multiple uses, including head lice and scabies treatment, insect repellents (including household foggers and sprays), tick and flea sprays for yards and pets, termite treatments, agricultural and livestock products, forestry and timber treatment. There are alternatives that are much less toxic to control these pests, and many insect repellents do not contain this chemical anymore.

Toxic Sludge. This is a term used for the substances that get filtered out of our sewage and water treatment plants. It is comprised of industrial, petrochemical and pharmaceutical waste as well as heavy metals and plastics. Conventional farmers are now purchasing this Toxic Sludge as fertilizers to spread all over their land in an effort to produce more bountiful harvests. Another fantastic reason to support organic farming, isn’t it?

History repeating itself?

Obviously cigarettes, alcohol and drugs are a no-no. When we look to the not-too distant past, smoking in places like maternity wards and airplanes was perfectly acceptable. We may shake our heads in disbelief but I imagine future generations will feel the same way about some of the things we put in our bodies. From microwaving our food to drinking water from plastic containers and spraying perfume directly on our skin, I’m willing to bet that there will be a level of disbelief at our ignorance from future generations. The best advice really is to do your homework. If your doctor prescribes medication, ask about the side effects and take the initiative to read about them independently. If you see something on a food label and you’re not sure what it is, Google it. Knowledge is power!

By creating a clean environment in your own body, you are making it more hospitable for a baby and increasing the health and well-being of your future child. That’s worth making some adjustments for, right? It may seem daunting at first, but start small and work your way up. When you have adjusted to changes, choose more to implement. Dedication to your healthier-living path will ensure you are doing your part in protecting your fertility.

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Further resources

Here is a link to a basic cleanse. This should be done AT LEAST three months before conception. (As you know)
http://thegreenmama.com/blog/detoxing-your-insides/

Here is a link to cleansing during the period of conception, pregnancy, and postpartum.
http://thegreenmama.com/blog/detoxify-safely-while-pregnant-or-breastfeeding/

Here is a bit more information on food additives that we need to avoid (especially during pregnancy)
http://thegreenmama.com/blog/dangerous-food-additives/

Here is a link on understanding plastics (and why we ought to limit our exposure because they work as endocrine disruptors)
http://thegreenmama.com/blog/better-plastics/

An overview of Traditional Chinese Medicine

“A mediocre doctor treats disease, a good doctor prevents disease and a master doctor teaches his community to be well.” ~Huang Di Nei Jing Su Wen

An overview of TCM basic philosophy and ideas is important to understand when facing infertility. TCM provides a powerful treatments for optimizing reproductive health, therefore it should be considered by anyone struggling to get pregnant.

With explanations of the fundamental principles including patterns and their symptoms, treatment of these patterns through acupuncture and herbs and accompanying case studies, I aim to give you an understanding of what it is that I do and how it can help you achieve your dream of having a baby.

One of the key components of TCM that differentiates it from western medicine is that the body, mind and spirit are not separate from each other. Your emotions, sleep patterns, stress levels, relationships, job satisfaction and personal fulfillment for example, are all connected to your health and your ability to conceive a child. TCM looks at you as a whole individual, diagnosing your patterns of disharmony and treating you accordingly. You will never leave the office of a doctor of TCM with a diagnosis of ‘unexplained infertility’. There is an explanation for your reproductive challenges and I am fully invested in helping you discover what that is and overcoming it.

There is never a wrong time to begin to utilize the powers of TCM to aid in your fertility journey. When women and couples come to see me, they are at one of three places;

1. they want to optimize their chances of natural conception before any type of western medical intervention,
2. they want support while going through western medical assisted reproductive technologies, or
3. they have exhausted all western medical options and have turned to TCM as their last hope.

TCM is very much a partnership. Rather than telling you what is happening within your body, I will guide you through self-monitoring so that we can co-develop a plan that is tailored to you and addresses all areas of wellness – not only the symptom of infertility. The human body is highly intelligent and will tell you everything you need to know if you listen carefully.

The four ancient pillars of TCM pattern diagnosis are looking, listening/smelling, questioning and palpation (touch). By utilizing these simple and trusted techniques, an accurate foundation for diagnosis is identified so that specific acupuncture points, custom herbal formulations and individual lifestyle recommendations can be made.

Maintaining and restoring balance is at the heart of diagnosis and treatment in TCM and there are two primary tools used to do this: acupuncture and herbal medicine. While they are intricate and take years to master, the basic ideology is that acupuncture opens and herbal medicine heals.

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What IS Acupuncture and Herbal Medicine?

Acupuncture

Acupuncture is based on the premise that we have energy meridians running through our bodies which gives power to our nervous system and provides our organic physical being with fundamental life force. When this energy or ‘Qi’ (pronounced ‘chee’) is blocked or not flowing smoothly, it causes a variety of problems including infertility. Using a series of very tiny needles at key points throughout your body restores the flow of energy and aids the body in returning to its natural state of perfect health.

Acupuncture is not a drug, nor does it override physiology; instead, it promotes the body’s regular circulation and rhythms so that it can function unimpeded. Your body’s innate desire is to be balanced and healthy. Acupuncture gives it a helping hand. Like stitches for a deep cut, acupuncture addresses deep programming and allows the body to do what it was designed to do: be well. While it’s not the actual healer, it creates an optimal environment for the body to do its own healing, not unlike stitches.

Benefits of Acupuncture

• Optimizes natural fertility potential by correcting conditions that may be contributing to difficulties with conception. It is also utilized by those who are proactive and simply want to be at their pinnacle of health before conceiving and carrying a pregnancy.
• Improves pregnancy and live birth rates, as well as reducing miscarriage and ectopic pregnancy rates when used in conjunction with In Vitro Fertilization (IVF). There is a burgeoning body of research to support this. Refer to Step Nine for a more extensive discussion and references regarding TCM and how it helps improves IVF success.
• Improves blood circulation to the reproductive organs and thickens the uterine lining (for more things that you can do at home to enhance blood flow to the reproductive organs, see Step Eight). Blood delivers nutrients and oxygen to every cell, as well as carrying away waste. In the case of IVF, the possibility of enhanced delivery of IVF medications to the developing eggs via optimized blood flow is a well-accepted theory.
• Reduces stress and anxiety. Besides the effect acupuncture has on improving blood flow to the reproductive organs, this is likely the most accepted reason the Reproductive Endocrinologists (fertility & IVF doctors) send their patients to me. Its effect on reducing the tone or excitability of the sympathetic nervous system is well documented, reported by patients and observed time and time again in the clinical setting. This change in the nervous system further increases blood flow to the reproductive organs.
• Helps restore hormonal balance involved in all aspects of reproductive and whole body functioning (i.e. thyroid, insulin, estrogen, FSH-follicle stimulating hormone, progesterone, testosterone, adrenal).
• Regulates the menstrual cycle and induces regular ovulation by balancing hormones, helping with weight loss and removing emotional blockages (such as in women struggling with PCOS).
• Regulates immune function required for implantation and preventing miscarriage. The body’s delicate wisdom needs to be given the space to function as needed here. Too much or too little immune response may result in repeated implantation failure. If you suffer from allergies or atopic conditions like asthma, eczema, sinusitis or recurrent early pregnancy loss, then immune regulation should be an important health goal.
• Supports women suffering from recurrent pregnancy loss (RPL) on an emotional level. TCM can help reduce the fear of trying to conceive or being pregnant and boost the willpower necessary to once again move forward. It may also help mend the broken heart that accompanies these losses.
• Reduces pain and inflammation in conditions such as Vulvodynia (pelvic pain) and Endometriosis.
• Can improve sperm quality such as motility, count, morphology, and possibly DNA fragmentation rates (see Step Ten for more information on the treatment of male factor infertility).
• Enhances sexual function and desire, which so often becomes major obstacles after trying to conceive for a period of time.
• Eases the discomforts of pregnancy. Reduction of nausea, aches and pains, hypertension, headaches and many other symptoms observed in the clinic. The management of gestational diabetes, turning breech babies, and preparing the woman and the cervix for labour are also common applications.

Chinese Herbal Medicine

Using plants to heal the body is nothing new. While to some they are considered an alternative, in fact, plants are the original ingredients of westernized medicine as we know it today. Without the extraction and isolation of one single component of the plant, or the addition of synthetics and fillers, herbs are just medicine in its unadulterated state. They can be used in conjunction with acupuncture or on their own. Sometimes they will be in capsules or tablets, but often they will be prescribed in teas to maximize potency. They may be foul-tasting to the unaccustomed palate but tantalizing the taste buds is not the goal. There may be a little pain but there is much to gain!

Benefits of Chinese Herbal Medicine

• Aids a dietary cleanse, digestion, appetite control, and weight management.
• Gently encourages the body’s systems to move toward balance and optimal functioning.
• Increases blood circulation and helps remove blockages such as blood clots and cysts.
• Soothes emotions, sedates mental activity and reduces stress. Particularly effective in the premenstrual phase.
• Balances body fluid metabolism, helping reduce the retention of water and enhance elimination of waste.
• Boosts resistance to viral and bacterial attacks and helps reduce inflammation via immune system regulation.
• Warms the body if too cold; cools the body if too warm.
• Regulates the bowels and urinary function, optimizing the elimination of waste.
• Improves sleep conditions such as trouble falling asleep, light sleep, night sweats and waking early with difficulty going back to sleep.
• Helps in the management of painful conditions such as Endometriosis.
• Supplements deficiencies of vital energy and nourishes blood production.
• Helps stop unwanted bleeding as is the case with fibroids, polyps or the flooding that may occur as a result of hormonal shifting toward the end of a woman’s reproductive years.
• Regulates the menstrual cycle including ovulation and PMS via the restoration of hormonal balance.
• Is traditionally used to ‘secure fetus’ and reduce the incidence of miscarriage.
• Improves sperm parameters most notably by reducing the TCM pattern of Heat* (sperm’s #1 enemy) that so many men present with.
• Increases libido (both male and female) and helps manage erectile dysfunction and premature ejaculation.

* While there may be parallels between TCM terminology and western medical conditions (i.e., Heat=inflammation), direct correlations aren’t always the case and it’s best to seek a professional opinion.

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Wondering what it will cost?

The average cost of a private acupuncture treatment in North America ranges from $70-$100, and Chinese herbal medicine can vary drastically depending on quality, method of administration and dose, but in general will be between $100-$300 per month.

You could estimate weekly acupuncture treatments for one year (52) at $85 = $4420 and daily Chinese herbal medicine for twelve months at $200 per month = $2400. So for a full year of consistent acupuncture and Chinese herbal medicine, you would pay approximately $6,820.

This sum is considerably less than an average IVF cycle. In addition to the profound effects on your health and well-being, you are greatly increasing your chances of conception and a healthy child with TCM.

Most extended medical plans in Canada cover acupuncture treatment.

If you have the gift of time and you’re not rushing to conceive, preparing your body before pregnancy with TCM is a wise move…a decision I dream that every potential parent would make. It is becoming well accepted that the health of the mother and the father before conception plays a role in determining the health their child will experience throughout life. Being healthy preconception may be the best gift you can give your child.

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TCM Pattern Identification

It is my belief that the western world could benefit significantly by learning the basic theories of TCM because while structured and scientific, it is a beautiful and artistic way of interpreting the human body and achieving health.

TCM pattern identification is a system of diagnosis that organizes the signs and symptoms a person is presenting so that appropriate diet and lifestyle coaching, acupuncture points and Chinese herbal medicine can be administered.

Some of the terminology you’ll hear referenced in TCM may be unfamiliar. Below is a simplified version of the types of diagnosis and what they mean as well as case studies for better understanding.

Read through the following TCM Pattern sections and try to determine which best fit your current circumstance. This is particularly important when you decide to implement the Yinstill Fertility Diet into your life, as it is based on eating according to these patterns.

HEAT

General Features: Red skin eruptions like rashes, eczema and acne, constipation with dry stool, anxiety, red tongue with yellow coating, rapid pulse rate, restlessness, easy agitation and anger, high blood pressure, red face, bleeding from the nose or anus, bad breath, canker sores, feeling hot, disliking heat, fever, inflammation, dark yellow urine and a thirst for cold drinks.

Gynecological Features: Heat can manifest as short cycles (less than 26 days) with thicker blood consistency that is bright or dark red in colour and heavy volume. Bleeding may occur outside regular times as in premenstrual spotting. There may also be a lack of cervical fluid.

Interpretations: Heat may appear as inflammation or an overactive immune response, as is the case with allergies. A person with excess Heat might experience high stress and anxiety and be an overachiever. Dehydration can become an issue, particularly if excessive amounts of coffee are relied on for energy. Excesses of male hormones may be present such as with PCOS or hyperthyroidism.

Heat Example

Melanie

• general info – Melanie was a 31-year-old lawyer trying to conceive for one year. Her husband was 43 and traveled a lot. Since coming off her IUD one year prior, her cycles had been irregular in length.
• history – She admitted to being controlling and smiled with the knowledge that surrendering was an important part of her journey toward family. She emphasized that she was not the type of person to relax so I emphasized that relaxing would be one of our primary goals for treatment. She was extremely active, which may have contributed to her irregular cycles as well as allergies and childhood illnesses that may also have played a role. She reported that her husband’s being away a lot, financial debt and work were all major stressors in her life. All medical testing for both she and her husband came back without issue.
• presentations – She had irregular cycles ranging from 26-42 days with a very light menstrual flow and severe pain during periods with many premenstrual symptoms. She was very thin, typically held herself in closed postures and rarely smiled. Heartburn, eczema, aversion to heat and palpitations were present and she had multiple allergies and digestive problems.
• pattern(s) – According to TCM, Heat affecting the Heart was prominent. This was caused by Liver Qi Stagnation. There was also a pattern of Kidney Yang deficiency/cold resulting in Heart Kidney disharmony. Blood Stasis and Blood deficiency patterns were also displaying but of secondary importance.
• goals – Our primary goal was to address the length of her menstrual cycle length and its blood volume. We also worked on improving urinary frequency, stress, heartburn, palpitations, her aversion to heat, allergies, the condition of her skin, sweet cravings, gas, bloating, abdominal pain, painful periods, cervical mucous and PMS. Her ability to surrender and accept what was happening was vital to the outcome.
• recommendations & treatment –
  • Acupuncture once a week and a mild dose of Chinese herbal tablets
  • Decreasing coffee consumption and foods that may have been causing inflammation
  • Reducing exercise slightly
  • Paying attention to body signs that indicated ovulation rather than relying on temperature or ovulation strips
  • Having conversations with her husband about the stressors in her life and asking for help
  • Taking CoQ10 and fish oils daily
  • Accepting and surrendering to her circumstances
  • Chiropractic treatments to address her misaligned pelvic structure
• outcome – The first couple of months that we worked together, she had 30-day cycles with an increase in menstrual volume. She soon reported a major improvement in her digestive function which at the beginning inhibited her from taking all the recommended supplements and Chinese herbal medicine, but that improved very quickly. She tried a couple of rounds of Clomid (or clomiphene citrate, an oral medication used to help a woman ovulate) which were unsuccessful. After a TCM treatment course of 14 weeks, she decided to take a break from trying to conceive. Two months later, she contacted me to inform me that she was happily 8 weeks pregnant. Her pregnancy was without complication and she delivered a healthy baby boy.
• cost – Approximately $1,500 (included; 3.5 months of weekly acupuncture treatments, daily Chinese herbal tablets and recommended dietary supplements).

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DAMPNESS

Features: Slightly overweight, sluggish in overall energy and movement, water retention, loose bowel movements, gas and bloating, fatigue after eating, candida or yeast infections, achy joints, wet tongue, soggy pulse, painful ovulation, stringy mucous in menstrual blood.

Gynecological Features: An accumulation of dampness can manifest as blockage which causes long cycles (35 days) and watery discoloured blood. Painful ovulation and stringy mucous in menstrual blood are also signs of Dampness.

Interpretations: In general, the Damp person has dietary and/or digestive issues and quite likely favors starchy carbohydrates and sugary sweets often due to emotional eating. Fatigue inhibits regular exercise. The lack of exercise and emotional eating often result in weight issues and water retention causing a puffy appearance. They may be difficult to motivate and lazy, the opposite of Yin deficient.

Dampness (Phlegm) Example

Adrienne

• general info – Adrienne was a 33 year-old overweight woman with irregular cycles. She often did not ovulate on her own and showed many other characteristics congruent with PCOS. She had been trying to conceive for 14 months when she decided to try TCM.
• history – Very irregular ovulation and menses most often brought on by progesterone. Some of her cycles were over 100 days and her basal body temperature was also erratic. Most of her medical testing (thyroid, androgens, glucose) was within range but borderline.
• presentations – Irregular cycles, overweight, allergies (asthma, sinusitis, foggy mind), digestive issues (bloating, abdominal pain, heartburn), poor sleep, sweats easily, headaches, restlessness, cankers and acne.
• pattern(s) – According to TCM, Adrienne is most prominently displaying a Damp/Phlegm pattern. This is causing blockage of necessary functions which regulate ovulation. This pattern is the result of an underlying Qi deficiency and Qi stagnation. Also, due to this blockage, mild Heat is resulting.
• goals – Optimizing her reproductive health and fertility by inducing regular ovulation and regulating menstrual cycles. Weight loss through changing dietary habits and improvement of digestion. Regulating allergies and associated symptoms and increasing her sleep quality.
• recommendations & treatment –
  • Weekly acupuncture treatments and daily Chinese herbal medicine
    Dietary cleanse for one month
  • Eliminating gluten and dairy and drinking more water
  • An overall focus on a whole food plant-based diet
  • Hot foot soaks before bed
  • Increased fat burning activity
  • Implementing an earlier bedtime
  • Taking fish oils, Vitamin D and inositol daily supplements
• outcome – After 3 months of consistent treatment with acupuncture and with the aid of Clomid, she became pregnant. Unfortunately, this ended in an early miscarriage. We continued with regular acupuncture and incorporated Chinese herbal medicine as well as dietary supplements. She displayed a drastic improvement in allergies and her cycles started to regulate. Her commitment to good diet and exercise never failed. After 37 acupuncture treatments within 10 months and approximately six months of Chinese herbal medicine without the use of Clomid, she ended up falling pregnant again and carrying to term, giving birth to a healthy baby boy.
• cost – Approximately $4,500 (included 10 months of weekly acupuncture, daily Chinese herbal medicine for five months and recommended dietary supplements).

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YIN DEFICIENCY

Features: Night sweats, hot flashes, thin body, lack of bodily fluids, restlessness, flushed cheeks, light sleep and a persistent gnawing hunger.

Gynecological Features: Light volume of menstrual blood and cervical mucous that can lead to absence of ovulation and menstruation.

Interpretations: The phrase ‘burning the candle at both ends’ applies to this person. They are often restless with a lot on their minds, hence the difficulty shutting down properly at night to rest. These people tend to be quite rigid in character and may look tired or withered.

Yin Deficiency Example

Summer

• general info – Summer was a 38 year-old health care professional diagnosed with high FSH and diminished ovarian reserve (DOR). Originally she came to see me to optimize her chances of success with her upcoming IVF cycle. Her first child was conceived via IVF.
• history – FSH high, antral follicle count low and a diminished ovarian reserve. She’d had her first child via IVF two years ago. She had previously been slightly overactive with exercise but had cut back. While consistently undergoing acupuncture treatments, she went through two back-to-back IVF cycles within five months, the first resulting in an early miscarriage at five weeks. The first stimulated four follicles and the second only two, with one fertilized and transferred on day three post egg retrieval. She decided to take a break and regroup before doing another possible IVF cycle. This was when we implemented Chinese herbal medicine to restore balance and improve reproductive potential.
• presentations – Thin athletic-type body, night sweats and poor sleeping habits in general, scanty clotted menses, extreme emotional stress in the form of anxiety, fear and irritability, especially with her husband. Bowels that alternated between loose to constipated, multiple premenstrual symptoms, multiple digestive complaints, eczema and low libido.
• pattern(s) – According to TCM, Summer primarily displayed Yin deficiency. She also had a clear pattern of Qi Stagnation. Both Yin deficiency and Qi stagnation were creating Heat, which may have been responsible for the high FSH and difficulties stimulating with IVF medications.
• goals – To optimize her reproductive health and fertility by alleviating night sweats, soothing the emotional stress in her life, regulating bowel movements and digestion, increasing menstrual volume and reducing clotted menses.
  recommendations & treatment – Unwavering commitment to weekly acupuncture appointments and daily Chinese herbal medicine. My plan was to systematically reduce the number of tasks she was doing daily in regards to her ‘fertility’ enhancement.
• outcome – After 33 acupuncture treatments (supporting two full IVF cycles) and only three months of taking Chinese herbal medicine (and deciding against more IVF), Summer became much more relaxed, displayed a drastic increase in cervical mucous and sleep quality, an increase in PMS (which can sometimes be a positive biomarker for improved hormonal function in women of advanced maternal age) and fell pregnant, naturally! She went on to have a beautiful baby boy.
• cost – Approximately $3,300 (included eight months of weekly acupuncture treatments, recommended dietary supplements and Chinese herbal medicine for three months).

Commentary – This is a classic case of a woman who was doing too much, trying to accomplish pregnancy versus taking the steps necessary to receive pregnancy. She was a ‘doer’ and because of this was a very accomplished woman, respected by all those around her as being ‘the one that knows’. It was only when she decided to step back from trying so hard, stop convincing herself that IVF is the only way she could become pregnant, let her body’s innate wisdom shine through and take a course of reproductive-enhancing Chinese herbal medicine, that she was finally in a place to allow pregnancy to occur and it did. We became very close with each session consisting of profound conversations about her deeper inner needs and requirements for holistic health.

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YANG DEFICIENCY / COLDNESS

Features: Whole body is cold, lower back pain and/or knee pain that is relieved by heat, low libido, often lethargic, water retention and a puffy pale bright complexion are common.

Gynecological Features: Cold can cause blockage with blood and bodily fluids creating painful periods with light bleeding known as a cold uterus. Yang Qi deficiency can cause heavy bleeding and copious cervical mucous of watery consistency.

Interpretations: Because of low energy, motivation to exercise is minimal, sometimes encouraging excess weight. Yang deficiency and coldness can often be attached to advanced maternal age and kidney deficiency.

Yang Deficiency/Coldness Example

Barb

• general info – Barb was 40 years old and had been trying to conceive for over four years without success. She and her husband were married when she was 35 and began the journey of trying to conceive almost immediately.
  history – Medical testing showed that her ovarian reserve was diminished and she was told that her egg quality was most likely poor. Semen analysis showed low motility, morphology and borderline low concentration.
• presentations – She had a bright pale complexion, was slightly overweight and complained of frequently being cold. Her libido was very low. She loved running but had to stop due to pain in her knees. She reported that her menses were very heavy, watery in consistency and contained many large purple clots.
• pattern(s) – According to TCM, Barb was very clearly displaying Yang deficient Cold patterns. This was most likely due to a combination of genetics and advanced maternal age.
  goals – From a TCM perspective, optimizing her reproductive health and fertility was accomplished by improving her menses, losing weight, improving libido and increasing her subjective body warmth.
• recommendations & treatment –
  • Weekly acupuncture appointments and daily Chinese herbal medicine
  • Making sleep a priority
  • Four half-hour sessions of aerobic jogging each week to burn fat
  • Drinking only warm water
  • Focusing on nutrition while drastically limiting raw and cold food intake
  • Creating boundaries on taking work home with her
  • Scheduling regular quality time with friends
  • Cleaning her house and life of all toxic substances
  • Taking high doses of CoQ10
• outcome – She reported that her key to being able to stick to the plan was that she wanted to be an example of a healthy mother to her child. This resulted in an overall improvement with her menstrual imbalances, losing 21 pounds, and an increase in sexual interest. Barb became pregnant in just over seven months of TCM treatments. She carried to full term and gave birth to a healthy baby boy.
• cost – Approximately $3,800 (included seven months of weekly acupuncture treatments, daily Chinese herbal medicine and recommended dietary supplements).

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QI DEFICIENCY

Features: Fatigue, poor digestion such as gas and bloating, loose stool, weak immune function, worry, fear and pensiveness.

Gynecological Features: Qi deficiency can cause heavy bleeding and copious cervical mucous of watery consistency. Menstrual cycles may be short with bleeding of heavy volume and watery consistency. Bleeding may also happen outside regular times as in premenstrual spotting.

Interpretations: Fatigue is a common complaint among the Qi deficient. Digestive function can be due to poor food choices and fatigue-based decisions may perpetuate the cycle. Exercise, deep breathing and healthy food choices are often the cure for this mild to moderate state. This can be the early stages of Dampness or Yang deficiency and a good time to make changes before it gets harder to do so.

Qi Deficiency Example

Shannon

• general info – Shannon was 35 years-old. Shortly after trying to conceive, she became pregnant. Unfortunately, after eleven weeks, the baby stopped growing and a natural miscarriage followed by a surgical abortion to ensure a full evacuation of the uterus was done. The trauma was immense but she was ready to try again. Fear of another miscarriage was quite powerful and was addressed through the treatment of the Qi of the Kidneys which manages fear and will power. She had come to traditional Chinese medicine for support as she began her journey of conception again and to be an integral piece in helping produce a healthy pregnancy and carry to term.
• history – No medical testing or diagnostics were undertaken. Factor V Laiden (a blood clotting disorder) was in her immediate family so she was considering testing for this as it has implications with blood clotting and possible contributions to miscarriage.
• presentations – Shannon had gained a lot of weight since her miscarriage and to her detriment, had an unrelenting work ethic. She did not get enough sleep and had some bad habits such as soda and dairy consumption. She quite clearly had emotional stagnation manifesting as irritability and seemed easily frustrated with others. She showed a number of possible signs of inflammation such as anxiety, restlessness, aversion to heat, cankers, allergies, dry skin, psoriasis and the preference for cold drinks. The Qi deficiency was highlighted by her emotional eating, sweet cravings, ankle swelling, nasal drip, fatigue after eating, difficulty waking in the morning, pensiveness, weight issues and sweating without exertion. She also reported many premenstrual symptoms plaguing her each month.
• pattern(s) – According to TCM, Shannon primarily displayed a pattern of Spleen Qi Deficiency. This root pattern was giving rise to the accumulation of both Dampness and Phlegm. The Dampness and Phlegm combined with the moderate Qi Stagnation she also displayed was causing the formation of Heat which was rising to the Heart. The Heart was already experiencing non-free flow due to the emotional toll the second trimester miscarriage had taken on her.
• goals – Reducing her weight, allergies, sweet cravings, pensiveness, PMS, menstrual pain, clotting and improving her sleep and cervical mucous.
• recommendations & treatment –
  • Weekly acupuncture treatments
  • Stopping the antidepressants she was taking (her decision)
  • Eliminating soda pop and dairy consumption and increasing water intake
  • Incorporating daily femoral massage and nightly foot soaks
  • Finding ways to better manage stress at work
  • Getting more sleep
  • Exercising more
  • Spending more time in nature
  • Avoiding environmental toxins
  • Starting on a whole food homocysteine blend (Vitamin B6, folate, and B12)
  • Adopting a more plant-based whole food diet and reducing starchy carbohydrate intake
  • Getting back in touch with her Christian roots to nourish her spiritual side
• outcome – After two months of the above recommendations, Shannon got pregnant. Regular acupuncture continued weekly until 22 weeks when she felt comfortable that all was well with the pregnancy. Her little boy was born healthy and happy a couple of weeks before his due date.
• cost – Approximately $2,800 (included 7.5 months of weekly acupuncture treatments and recommended dietary supplements).

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BLOOD DEFICIENCY

Features: Pale complexion and nails, dryness of skin, nose, throat, eyes, hair and nails, scanty menstruation and possible anemia.

Gynecological Features: Light or scanty bleeding that may be pale or diluted with a watery consistency. Cycle is often long as it takes the body more time to mature the egg and build the uterine lining.

Interpretations: This pattern often accompanies Qi deficiency and is a stage that if left unchecked, may eventually become Yin deficiency. It is most often a result of excessive emotions causing poor digestion which in turn does not produce enough blood.

Blood Deficiency Example

Tina

• general info – Tina was a 35 year-old teacher with a very difficult group of students that year. She had been trying to conceive naturally for almost two years. Within this time, she’d had two early miscarriages. She had recently taken some time off work to cope with anxiety and depression. She also admitted to not exercising.
• history – Medical testing repeatedly showed iron deficient anemia. Both miscarriages required medications to fully evacuate the pregnancy. Her tubes were clear after a recent hysterosalpingogram (HSG), an x-ray dye test, but they did find and remove two polyps. Tina and her husband were considering IVF but wanted to give TCM a chance first and at the very least, be prepared in body mind and spirit for the IVF.
• presentations – Menstrual cycles were usually 35-40 days in length, with very light flow that was pale red and diluted or watery. Her complexion, tongue and nails were very pale and she complained of hair loss, always being tired, dizzy spells, difficulty falling asleep and dull headaches when tired. She had extremely dry skin, poor digestion including, gas, bloating and dry bitty stools and was slightly underweight.
• pattern(s) – According to TCM, Tina was presenting with Blood deficiency caused by Spleen deficiency digestive problems, quite likely from a genetic predisposition as her mother is very similar in health history and appearance.
• goals – Improving diet and digestion, shortening her cycles and increasing menstrual flow volume, returning colour and moisture back to her skin, supporting her emotionally and helping her sleep better.
• recommendations & treatment –
  • Weekly acupuncture treatments and Chinese herbal medicine daily to help build and restore her depleted state
  • Highly nutritious plant-based whole foods that were mostly cooked to improve digestion. Soups, stews and smoothies were her foundation.
  • Eliminating dairy and increasing water intake
  • Fish oils, vitamin D, homocysteine blend (B6, folate, B12) and probiotics were recommended
  • Consistent yoga practice three times per week
  • One half hour of jogging four times a week
  • Tina also took the remaining five months off of teaching and really took care of herself.
• outcome – After 20 acupuncture treatments and five months of consistent Chinese herbal medicine administration, Tina’s cycles shortened to an average of 30-32 days and bleeding volume increased. She was sleeping better, eating better and felt better overall with more energy and a sense of well-being. She became pregnant again and continued on with the acupuncture and Chinese herbal medicine through the first trimester to help prevent another miscarriage. She had a healthy baby girl.
• cost – Approximately $2,900 (included five months of weekly acupuncture treatments, daily Chinese herbal medicine and recommended dietary supplements).

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BLOOD STASIS

Features: Blood Stasis is almost always (aside from trauma) a result of other patterns of disharmony such as Qi stagnation, Coldness, Dampness, Phlegm or Heat. Over time, the condition of Blood Stasis typically leads to Heat and/or Blood deficiency. Common manifestations are fixed stabbing or severe pain, spider veins, dusky complexion and darkening patches of skin.

Gynecological Features: Clotted menstrual bleeding that is brown, purple, or black. Periods will often be light and be severely painful.

Interpretations: Blood Stasis can result from almost any of the other patterns being present over a period of time. If Qi is stagnated, or other blockages ensue due to cold, lack of Yang, Dampness or Heat, eventually blood circulation will be impeded. There is a well-known saying in ‘Statements of Fact in TCM’ by Bob Flaws that any chronic disease will involve Blood Stasis.

Blood Stasis Example

Samantha

• general info – Samantha had recently been through two miscarriages and was not quite ready to get pregnant again. She felt off and wanted to get right. My instincts were that she needed to better manage emotional stress, improve blood circulation and have her heart healed. Ultimately she needed a break from her in-laws but that wasn’t possible so we utilized Chinese medicine to help her adjust to her circumstances.
• history – Her doctors had told her she couldn’t get any testing done as she had not had three losses and that it was likely an egg quality issue. Basic fertility testing had never been done. Even if diagnostic testing had taken place, there is little treatment for recurrent loss.
• presentations – Fear and frustration trumped all else with Samantha. Sleep was very light and plagued with night sweats. She suffered from intense pelvic pain during sex and on the first two days of her period. Both back and neck pain were also quite severe. She had spider veins and darkening patches of skin particularly around her armpits and near skin folds. Her tongue was purple and dusky in colour and her cervical mucous was scant.
• pattern(s) – According to TCM, she was clearly presenting both Blood Stasis and Qi Stagnation, so our primary principles of treatment were to restore optimal blood circulation and soothe emotional blockage.
• goals – Soothing emotions and managing stress to reduce the chances of miscarriage and aid in carrying pregnancy to term. Instilling more peace of mind and stress reduction surrounding circumstances in her life, helping her mind and body heal and get strong enough to conquer her fear and feel ready to conceive again, improving sleep, reducing pelvic pain, eliminating night sweats, reducing back pain and neck tension and increasing cervical mucous.
• recommendations & treatment –
  • Weekly acupuncture treatments and Chinese herbal medicine daily
  • A dietary cleanse for one month
  • With everything that was going on in her life that was out of her control, I strongly suggested doing some work with our Integrated Professional Life Coach, Thomas Kevin Dolan
  • Supplements including vitamin D, fish oils, CoQ10, and a homocysteine blend (vitamin B6, folate, B12)
  • Eliminating soda pop, dairy and gluten
  • Avoiding toxins that are known endocrine disruptors
  • Moderate exercise
  • Nurturing her spirit
  • Self-administering castor oil packs and femoral massage in her follicular phase (cycle day 1 to ovulation) to help
  • optimize blood circulation to reproductive organs
• outcome – From my experience, Blood Stasis and Qi Stagnation are two patterns that respond quite quickly to treatment with acupuncture and Chinese herbal medicine. When treatment restores overall smooth flow to both Qi and Blood, these are the types of stories I receive:

  “When I met Spence, he listened to my thoughts, fears and concerns. It was nice to be able to tell someone everything I had kept inside for so long. Spence was extremely kind and compassionate, he seemed to understand exactly what I was feeling and going through. I left his office feeling hopeful, and went home feeling positive. My husband seemed relieved and somewhat excited to see me so happy. I no longer felt alone. I felt like someone was working with me toward a common goal and was going to help me. It was a good feeling. It has now been a little under two months since I first met Spence. In this time, I have been receiving acupuncture sessions and taking Chinese herbs at Spence’s recommendation. I have cut sugar, gluten and dairy from my diet completely. I have never felt better. I can’t really explain what has started to bring my sense of self back. I can’t even explain what made me awaken and realize that I needed to stand still, surrender and embrace what was happening to me. I needed to live in the moment enjoying what I have, in this moment. As I sit here writing this, I feel a smile on my face, and warmth in my heart that I have not felt for a long time. No, I am not pregnant, not yet anyway, but I am no longer afraid to try again. What I have realized in this short time is that I matter, and for so long I had forgotten that. I wish I had walked into Spence’s office a year ago, but it’s never too late for anything. I truly believe that Spence has made a difference in my life. Whether it’s the Acupuncture, the herbs or my healthy diet; my body, mind and spirit has started to find its way back to me. I feel light-hearted, happier and hopeful. My husband has noticed a drastic difference in my mood, my body language and my overall presence. I am very grateful to Spence; his guidance and kindness has truly made a difference in my life.”

  The cycle after she wrote this, Samantha became pregnant again. She continued with weekly acupuncture treatments and daily Chinese herbal medicine through her first trimester. This time she carried to term with no complications.

• cost – Approximately $3,000 (included 5.5 months of weekly acupuncture treatments, daily Chinese herbal medicine and recommended dietary supplements – including first trimester of pregnancy).

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QI STAGNATION

“Holding onto Anger is like drinking poison and expecting the other person to die.”
~Buddha

Features: Qi stagnation, most typically of the liver, has its causative root in the deregulation of emotions. Common manifestations are feeling emotionally stuck, irritable, angry, impatient, frustrated, unfulfilled and stressed out.

Gynecological Features: Length of menstrual cycle will often be irregular–sometimes late, sometimes early with bleeding that starts and stops. Mild to moderate pain before and during the period is common. PMS signs and symptoms such as moodiness, breast tenderness, nausea and bloating are prominent.

Interpretations: If a person feels stuck, unfulfilled, not in control of their emotions, stressed out, overwhelmed and full of anxiety, then they likely have Qi stagnation. One might say that to some degree, this is almost every adult on earth and they are right. Management of this pattern is a part of every treatment plan I create. It should be highlighted that there are many degrees and severities of this pattern.

Qi Stagnation Example

Charlotte

• general info – Already very frustrated and impatient, 33 year-old lawyer Charlotte had been trying to conceive for seven months so inducing a greater state of inner peace was my ultimate goal for her. Being calm does not mean getting less done; it is just an adjustment of attitude while completing tasks. She was a very strong lady who knew what she wanted and was ready to put the plans into action to accomplish her goals. We went through exactly what the next three months would look like so that I could be Charlotte’s accountability partner each week when we met.
• history – No medical testing had been done to date except basic blood work such as thyroid and complete blood count, which was all normal. I suggested an HSG to check if her tubes were clear.
• presentations – In addition to being a very Type ‘A’ (i.e., supercharged, impatient, restless and over-exercising), her bowel movements alternated from loose to constipated and felt unfinished. She had sleep issues, partook in emotional eating, experienced headaches, cold hands and feet, neck tension, sighing, night sweats, low libido, acne, difficulty waking in morning, gas and bloating, was slightly overweight and craved sweets. She had only three days of menstrual flow that was clotted and moderately painful with many prominent premenstrual symptoms.
• pattern(s) – According to TCM, she presented with textbook Qi Stagnation. This also caused concurrent patterns such as mild Blood Stasis, depressive Heat rising to her Heart and Qi deficiency which resulted in some Dampness accumulation.
• goals – To calm her spirit and reduce restlessness, irritability and impatience. I also wanted to relieve her back pain, increase menstrual blood flow, reduce clotting and PMS, improve her sleep, regulate bowel movements, reduce headaches, neck tension and sighing, improve her digestion and encourage weight loss.
• recommendations & treatment –
  • Weekly acupuncture treatments and Chinese herbal medicine daily
  • Changing her thinking about down time being boring and unproductive. The word ‘opening’ which is what acupuncture does, was brought up a lot. She really resonated with the concept of conception being about reception, not accomplishment. It is often a challenge to explain to people how TCM will benefit them in a language they understand. Since she was a litigator, I used the language of negotiation (i.e., I will allow two Yin yoga classes each week if she gave up two of her three spin classes). We did this with various dietary concepts and lifestyle habits as well. It was quite incredible how involved she was in the creation of her plan and when negotiations were done, she was passionately committed and excited. It was inspiring to see.
  • Understanding when ovulation was occurring through self-monitoring
• outcome – The transformations I was fortunate enough to witness with this woman paid off quickly. After only two months of deep commitment to our plan, she became pregnant and nine months later gave birth to a healthy little girl. She continued with acupuncture through the first and most of the second trimester of pregnancy as there was much spotting and lots of debilitating nausea, then powerful headaches throughout the first few weeks of the second trimester. It is cases like these that I cherish deeply. When I get to watch someone’s whole life shift toward wellness, I know the effects of our time together will have positive implications on her health and well-being forever.
• cost – Approximately $2500 (included six months of weekly acupuncture treatments, recommended dietary supplements, and two months of pre-pregnancy daily Chinese herbal medicine).

In the Yinstill Fertility Diet & Workbook we go into the importance of diet in curing these conditions and which foods will be beneficial and what to avoid.

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Integration

I respect western medicine; it has given us so much. I have seen assisted reproductive technologies such as In Vitro Fertilization (IVF) help women and couples have children that otherwise would not have been able to; for example, with blocked fallopian tubes. It is a wonderful technology that can help improve any woman or couples’ chances of conception. Without western medicine, premature babies would rarely survive, penicillin would not have saved millions of lives and many more women would still be dying in childbirth. It is my belief that both western and eastern medicine have something to contribute and when used together, can have greater results. In fact, I believe we live in a time where the integration of different styles of medicine and healing are producing a massive leap in the evolution of human health.

But the philosophies do vary quite drastically.

Reductionism (the belief that any complex system is nothing more than the sum of its parts) is the foundation of western medical practice. Western practice uses randomized controlled research and statistics to explain the human body and to categorize people. Traditional Chinese Medicine takes into account the whole individualized picture and is aptly referred to as (w)holistic (the belief that the whole is greater than the sum of its parts).

From a western medical perspective, the top three diagnosis women come to me with are:

• Unexplained
• Male Factor
• Advanced Maternal Age (AMA)

By contrast, the six causes of infertility and any other dis-ease in the body according to Chinese Medicine are:

External Evils: From a modern perspective this would include bacteria, viruses, medications, environmental toxins and/or smoking, as well as some mental disorders.

Overwork: Since age is a considerable factor in infertility these days, ask yourself if you are putting financial certainty before having a child. If you are working too hard, is there even room for a baby? If a baby is your priority, then it is important to live your life in a way that is conducive to the welcoming of this priority. Career or financial advancement must take a back seat, or at the very least share the spotlight.

Diet: We will go into more detail about finding what is right for you in the step on diet but in short, lots of colorful food provides the required nutrition for fertility and healthy pregnancy, and portions need to be controlled.

Emotions: Stress creates disease and comes in many disguises from sadness and anger to loneliness and anxiety. We will talk more about this throughout the book because its impact is huge. Remember to check in with yourself throughout the day and take a deep breath to see where you’re at. Healthy mind, healthy body.

Activity Level: Too much or too little can be detrimental so find what’s right for you. If you’re at a desk all day, go for a 20-minute walk or incorporate some stretches in your day. And if you train every day and participate in a triathlon every three months, maybe slow down a little. It’s all about finding balance.

Trauma: Your body is both immensely strong and a delicate balance. Trauma can be interpreted as STI’s, a D&C procedure (surgical procedure used to clean the uterus of the products of conception due to a non-viable pregnancy or abortion), injuries sustained from sporting accidents (particularly for men), surgery or a car accident that has thrown off pelvic structure. There are corrections for these traumas though, so don’t feel like there is nothing you can do or it’s out of your hands.

As far as fertility is concerned, there are both obvious and some not-so-obvious adaptations a person can make to their lives in order to get a handle on these causes, putting the patient much more in a proactive role rather than feeling helpless. And that brings me to our next topic: what can you do? Set some goals.

In Chinese Medicine, the body is considered a garden and you the gardener. For a bountiful harvest, in this case a healthy child, you must do so much more than plant a seed. Tend the soil, give your garden plenty of water, fertilize it and see that it gets plenty of sunshine. With careful tending, your garden will flourish and you will reap its abundance.

What does a course of TCM treatment involve?

Since the most important paradigm of TCM is the individualization of treatment, courses of action will vary from person to person to meet their specific needs. The two primary tools are Acupuncture and Chinese herbal medicine. They may be used separately or in combination, depending on the requirements of the patient and determined by the doctor.

Acupuncture is usually administered one to two times per week, and Chinese herbal medicine is taken daily via pills or teas. Consistency and commitment is key for treatment to be effective.

Here is a basic general sample DOR treatment plan:

Diminished Ovarian Reserve (DOR) requires acupuncture one to two times per week until pregnancy is confirmed, then continues throughout much of the first two trimesters. Chinese herbal medicine is absolutely necessary in these cases. This treatment often requires six to twelve months to begin to display effect. If assisted reproductive technologies such as IVF with PGD (Preimplantation Genetic Diagnosis) are being considered, TCM offers support and optimization for success. I counsel this patient population not to wait very long before making this choice, as it is well known that age is the single most important determining factor in IVF success. Time is of the essence.

How to increase your chances of success.

“Stay committed to your decisions, but stay flexible in your approach.” –Tony Robbins

Naturopathic Medicine

The following article was written by the naturopathic doctor at Yinstill Reproductive Wellness. She touches on some great points and offers good recommendations for helping overcome Diminished Ovarian Reserve (DOR).

Diminished Ovarian Reserve – Learn how you can rejuvenate your eggs with the help of Naturopathic Medicine
By Dr Nora Shilo

Following up on my previous post about Advanced Maternal Age, I wanted to write about a topic that is closely related. DOR or Diminished Ovarian Reserve is definitely not a desired diagnosis if you’re looking to conceive. It’s important to understand, however, that this diagnosis is not the be-all & end-all of your fertility journey. The term “diminished” makes it sound quite bleak but it’s important to look at the big picture and remember that it takes just one egg and one sperm to create a healthy baby.

I frequently see women who have been given this diagnosis by their doctors or fertility specialists. They come to Yinstill for deeper insight, perspective, and understanding for what can be done to support and rejuvenate the remaining eggs they have and create a healthy environment in their body that would potentially house a fetus. I would recommend seeking naturopathic or alternative care if you have been given a diagnosis of DOR whether you’re wanting to try and conceive naturally or to help prepare your body for an upcoming IVF cycle.

As always, the earlier you start, the better because the more time we have to work with your body’s natural cycle. If you are able to see us for a couple of cycles before starting fertility medications, stimulations and hormones, this is much more beneficial as we get to observe the true nature of your cycle. We start by taking a thorough case history and discussing your health concerns. We then order pertinent lab tests. Some that you may have already done or heard about include day 3 FSH, LH, AMH, estradiol, and day 21 progesterone. We also look at your iron levels, thyroid function, and other hormone levels to help determine a more functional cause for the DOR, and narrow down treatment options. In addition to blood tests that you may do with your doctor or fertility specialist, I provide functional testing that maps out the cycle and establishes more specific hormonal imbalances if we feel like they might be present.

Next, we get into treatment. One of the most important treatment goals for us in this case will be to try and rejuvenate the eggs, and flood the reproductive organs with nutrients, vitamins, and antioxidants. Research is emerging on the role of the mitochondria (powerhouse of the cells) in egg quality and fertility. Supporting the mitochondria is important in slowing down the aging process of the eggs as well as influencing our genes in a positive way through the way we live and eat (epigenetics). Mature eggs in women with ovarian insufficiency have been found to contain fewer mitochondria than those with a normal ovarian profile. Treatment of the mitochondria involves supplementing with certain nutrients that aid energy production within the cell. This includes high doses of antioxidants like glutathione which are generally administered intravenously for superior absorption. Other nutrients to consider are CoQ10 and D-ribose. By supporting the mitochondria, we hope to rejuvenate or at least maintain good function of the oocytes.

So how does this all fit into the context of your lifestyle? Well, treatments are encouraged once per week, especially in the very beginning, this being more of a time-sensitive scenario. Patients are encouraged to come in for both IV treatments for egg quality as well as acupuncture for stress reduction. Secondary goals are hormonal balance, optimizing digestive function and sleep, and creating an overall healthy and open environment in the body that is more receptive to fertilization and pregnancy. This is done through a holistic approach that involves dietary and lifestyle recommendations, potential counselling, mindfulness education, and of course a wide array of the in-office treatments that we provide.

References:
1. http://www.iaac.ca/en/tick-tock-goes-my-biological-clock-coq10-and-its-role-in-aging-eggs-3

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Reproductive Clinical Counselling

Trying to conceive and experiencing setbacks brings up a lot of feelings that can be difficult to process independently or even with your partner. Finding someone to talk to that is not directly involved can be very helpful. Reproductive health counselling provides emotional support for all aspects of reproduction from infertility to postpartum depression to recurrent pregnancy loss and IVF support.

An experienced counsellor will give perspective that can be hard to see when you are deeply immersed in the goal of having a child. Find someone with experience and compassion. They will be an invaluable support system.

Q&A with Holly Yager, M.ED. RCC
Well Woman Counselling

Why reproductive health & fertility counselling?

Many of the 1 in 6 Canadian couples who experience infertility consider it to be one of the most stressful times in their lives. In fact, infertility is ranked just as distressing as a diagnosis of a terminal illness, such as cancer (IAAC, 2012). The months (or years) of riding the monthly emotional roller coaster, of coping with treatment failure and pregnancy loss, and of seeing everyone else managing to successfully achieve the dream of raising a family can eventually take its toll.

Infertility can affect mood, stress levels, self-esteem, and overall quality of life. It can bring on spiritual, health, career, financial, and relationship concerns. It is common for couples’ relationships to become so focused on fertility that both emotional and sexual intimacy can become compromised. Relationships with others can be affected as well, because many couples keep their fertility struggle to themselves and avoid family gatherings and social events where they may be emotionally triggered. Many women and men who are experiencing infertility report feeling a lack of support from others.

What is reproductive health & fertility counselling?

Reproductive health & fertility counselling addresses the emotional concerns and challenges related to infertility, pregnancy, and hormones. Whether you are trying to conceive, undergoing fertility treatments, coping with miscarriage, or transitioning to pregnancy and parenthood, it is crucial to have support from someone experienced in these matters. A reproductive health & fertility counsellor can provide support and guidance throughout all stages of the reproductive health cycle.

How can reproductive health & fertility counselling help you?

Reproductive health and fertility counselling can help you cope with the stress of infertility, whether trying to conceive naturally or with the use of assisted reproductive technologies (ARTs), such as IVF and IUI. It can also help you while building your family through the use of third-party reproduction, such as donor conception or gestational surrogacy. Reproductive health counselling can help you cope with any fertility-related challenges that may arise, such as maintaining intimacy and communication in relationships, managing stress related to fertility treatments, coping with pregnancy loss, treating anxiety or depression during or after pregnancy, and preparing for childbirth and parenting. If the need arises, a reproductive health counsellor can also provide assistance with the decision to end treatment, to adopt, or to live child-free.

What should you look for in a reproductive health counsellor?

When looking for a professional to help support you during your fertility journey, it is important to make sure that your counsellor is qualified in this area. First, you will want to make sure that your counsellor is graduate-level (Masters or PhD) educated in a mental health discipline from an accredited institution. Your counsellor should also be registered or certified with a professional organization, such as the Canadian Counselling & Psychotherapy Association or the BC Association of Clinical Counsellors. This ensures that your counsellor follows ethical standards of practice and engages in regular professional development. It also ensures that your counsellor uses proven, evidence-based psychotherapies. In addition to providing support, a qualified reproductive health counsellor is trained in the use of psychotherapeutic techniques, such as cognitive behavioural therapy (CBT) or mindfulness-based stress reduction (MBSR).

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Acupressure

Another facet of TCM is acupressure. Not unlike acupuncture, acupressure is a tool that is based on the concept that life energy flows through meridians in the body and that by applying pressure at key points, this energy can better flow to clear blockages that may be causing health problems.

My preference is for acupuncture as it offers more in-depth and effective treatment. But for stress, acupressure is ideal in between acupuncture appointments at home or if you live in a rural area where acupuncture isn’t available. Acupressure is free and can be done wherever you are once you educate yourself.

Since one of the major factors to less than perfect health is stress, feeling relaxed is paramount to increased fertility. The following are three pressure points that will help with stress and are literally right at your fingertips.

1st point – YINTANG
Sometimes called the “3rd eye” point that is located on the forehead, dead centre between the inner edges of both eyebrows. There is usually a small bone depression at this point, and sometimes it can feel a bit sensitive. It is easy to know when you’re in the right spot, as the soothing effect is usually immediate. Wonderful for inducing a general calm state, it can also help relax a tired face and eyes, and may help quiet a stress headache. Adding a gentle circular motion to pressing this point can increase the effect.

2nd point – SHENMEN
Also called “Heart 7”, this is the source point of the heart, which in Chinese Medicine is thought to govern the mind and spirit. Hold your hand in front of your face with your palm facing you. On your wrist, at the corner of your palm directly below the base of your little finger, you should be able to see or feel a ropey tendon. Place the thumb of your opposite hand on this tendon, and roll your thumb inwards on the wrist. As your thumb sinks into a soft spot, you’ve found the point. Because it goes to the heart, this point is very useful when stress is causing uncomfortable feelings or palpitations in the chest, and is highly effective in anxiety or panic attacks.

3rd point – NEIGUAN
Also called “Pericardium 6”, this is a very versatile point that you may recognise from the travel bands people wear for motion sickness. This point is located about 3 finger breadths above the inner crease of the wrist, centred between two major tendons. Not just for motion sickness, this point can be very useful when stress is causing any sort of digestive upset.

Traditional Chinese Medicine holistically restores balance in all systems of the body and when all systems are in a state of balance, fertility potential is realized.

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Integrative life coaching

An integrative life coach works with individuals and couples to provide solutions and possibilities for achieving a more meaningful life. The goal is to help you move from where you are to where you want to be by helping you realize your strengths and recognizing where you might be self-sabotaging. Sometimes a subtle shift is all someone needs to help them reach their goals and the unbiased opinion of a professional offers insight that you may not otherwise have.

Thomas Dolan, coach on Integrative Coaching:

“Unlike traditional counseling or therapy where you look to someone else for guidance, Integrative Coaching guides you to find your own answers. It is a process designed to support becoming whole and expressing oneself. The work opens people up to receiving the wisdom of how they are blocking themselves from claiming the magnificence of creating a life.”

Tracy G. on Thomas Dolan:

“Working with Thomas has opened up a new world of possibilities and wonder for me. At the heart of our sessions was the connection to my heart center and with this, the actualization of finding my own answers within instead of seeking them from an external source. Initially I was concerned that I wouldn’t have any answers, but with gentle coaching and much patience, Thomas supported me time and again in resurrecting latent intuition and hidden gems of insight that could only come from my inner wisdom. Through the work, I have come to greater acceptance of myself, focusing on letting go of societal pressures, owning my power, and uncovering desires or self-expressions that have resulted in a new passion and potential career. All this through taking responsibility for my choices. Life is fuller and more meaningful having worked with Thomas. Thomas has supported my mind, my emotions and my soul with much needed lessons in sticking to facts and releasing my pain-producing stories, along with creating greater peace of mind in the process. This has been a welcome addition to my fertility treatment focusing on the body with Dr. Spence Pentland, who has also been instrumental in my finding balance physically, holistically and energetically.”

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See a Chiropractor

A chiropractor will evaluate your physical structure/posture and get you ‘straightened out’ if need be. When pelvic alignment is off, posture is poor or back issues are apparent, necessary smooth muscle movement of the uterus may be restricted making conception a challenge. It is something that is easy to fix and can be the difference between a baby and no baby, so is definitely worth it!

Dr. Janelle B.
Chiropractor

Susan sits across from me in my office talking excitedly about the weekend ahead, an impromptu trip to the Gulf Islands with her husband. Susan has travelled to almost every continent. She is happily married, loves her job and sports the open, infectious smile of someone who is by all accounts a happy person but this hasn’t always been the case. For the first two years of their marriage, Susan and Bryan tried without success to become pregnant naturally. According to Bryan, “It was the hardest thing for us. We always just assumed things would fall into place. It was difficult to go through and left us feeling just so powerless.”

Like so many other couples I’ve seen, the experience lead them to the realization that they might just need a little help. Susan and Bryan are two months into their new plan which includes a modified diet, exercise, IVF, acupuncture and other alternative therapies to put them both in top shape. They’ve come in to my office on the advice of a friend. Susan’s hopes are fragile and delicate after so much disappointment, but she has done some research and would like to know how a chiropractic adjustment could possibly help her get pregnant.

A quick Google search of chiropractic and infertility leads to several case studies and new research on the benefits of chiropractic when trying to resolve fertility issues. Chiropractic is becoming increasingly popular with fertility clinics and couples who are having difficulty conceiving because of the close relationship between the spine and nervous system. When the brain can properly communicate to all organ systems without interference, miracles (or simply, proper function) can happen.

The main reason for a properly functioning reproductive system in both males and females (uterus, fallopian tubes, ovaries, prostate, testicles, etc.) is a good nerve connection from the brain down to all of these different parts. For example, if someone were to cut these nerves, no amount of good nutrition, supplements or even chiropractic adjustments could help these organs heal or even keep them alive. The role of a Chiropractor is to help remove the physical stress on that nerve and restore proper nerve function to the different organ systems.

There are several stressors that can cause interference to messages traveling down to the organs. In my opinion, all should be looked at for overall health and well-being. Whether it’s poor nutrition or medications causing chemical stress, tension in the muscles or soft tissue caused by emotional or mental stress, or poor biomechanics of the spine causing physical stress on the nerves, all could be affecting the health of the organs and the entire body.

As a chiropractor, I find and locate the physical stressors coming from a misalignment of the spine or pelvis. Most lower back nerves and sacral nerves innervate the reproductive organs. A full assessment of this area is essential in ensuring a healthy conception and pregnancy. The entire spine is often looked at as an old injury or current stress in the neck or upper back can also cause interference in the signals traveling down the spine to the reproductive organs.

Susan is like so many women who come in, ready to do everything she can to improve their chances of conceiving. I would love to say that after getting a few simple chiropractic adjustments, conception will happen naturally and easily. No chiropractor can make that prediction, but I can promise that you won’t have wasted your time, money or energy. Although I don’t know the particular reasons for every instance of infertility, I do know that clearing stress on your central nerve system will help nourish your organs and optimize your overall health, getting your body in the best possible shape to conceive and bringing you one step closer to having a baby. For Susan and her husband, the road to parenthood has been long but they are facing the future more brightly and dreaming that their next big trip will require travel plans for three. I can’t wait to get that postcard!

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Massage

You will be hard-pressed to find an argument against the stress-relieving qualities of massage. Whether you are experiencing the anxiety of trying to conceive or the changes in your body that pregnancy brings, massage therapy is a highly beneficial indulgence.

It can be used to increase circulation (which is imperative for fertility, particularly in older women), restore a connection to your body, improve posture and prepare you for labour during your pregnancy. All that and it feels fantastic. What’s not to love?

Natalie Woodhouse
Registered Massage Therapist

All aspects of a mature adult city life; work, financial, family, relationships, home renovations, school deadlines, health concerns, life changes and other ongoing responsibilities can make the road to pregnancy a stressful one. Clients seeking optimum fertility need to examine how much of their life operates at high stress levels and how much that stress takes away from self-care. This can lead them to tolerating a wide variety of physical discomforts, exhausting the nervous system and disrupting the chemical balance in the body. Common complaints related to chronic tension and stress show up in the neck, head, and shoulders, low back and hip pain, and often in the stomach, or other abdominal or pelvic systems. These complaints are easily aggravated by stress, repetitive daily use, poor posture and lack of activity. Hands-on bodywork ultimately opens our ability for intuitive communication with our body, providing wonderful relief for the nervous system and in turn, hormone management. For people experiencing infertility, the simplicity of a massage therapy treatment can diminish pain and stress levels in the body and mind. This window can significantly relieve stress, anxiety and pain levels long enough for the brain stem and nervous system to do corrective management for hormone regulation.

In one case, a female client came in with physical discomforts in the neck and shoulders, so painful it would often cause nausea. She had been receiving regular acupuncture for fertility but needed further assistance in relieving the muscle spasms. The tension in the neck had been long term, compounded from a series of old car accidents, and most recently aggravated due to the accumulation of stress. The goal of using massage therapy in this case was to help her restore a calm nervous system by resolving the pain and tension in her neck and shoulders so that she could feel a sense of ease and relaxation in her own body. As she settled onto the massage table with deep breathing, the focus was placed on postural alignment to restore to the spine, pelvis and shoulder girdle to help reduce the ongoing heavy ache in her shoulders. Myofascial Release and Neuromuscular therapy were used with a deep tissue Ayurvedic flare to ease painful trigger points in the upper back, neck and sacral area to essentially nurture and soothe the nervous system. Treatments often begin with a basic postural examination to establish the tissue quality in the area of the main complaint and to observe for other whole body factors that could be contributing to the posture dysfunction of the pelvis, spine, cranium and abdominal area. Other Massage techniques that work specifically well for fertility involves working with the abdomen to mobilize the viscera (organs), and the treatments often involve visualization or energy work. The aim of a Yinstill RMT treatment is to balance the nervous system, encourage blood flow, and reducing physical discomforts with hands-on therapy, improving posture to the pelvic organ function.

For those working toward fertility, it would be recommended to receive treatments before, or, after ovulation, or menstruation to help relieve abdominal tension, increase circulation and clear energy blocks held in the body. In this case mentioned above, each individual treatment had a positive relaxing effect on the client but the cumulative effect of the treatments working together is what created the lasting softness to the tissue quality and aided in developing the client’s level of body awareness and deeper sense of connection to her posture and self -care. When she returned at a later date, excited about her recent pregnancy, the massage evaluation and techniques were changed again to support her body in nourishing the embryo development. Even without consecutive treatment, the client saw small changes towards correct posture, and had a positive stress-free experience, contributing to her ultimate goal of pregnancy.

If you’re undergoing expensive infertility treatments, spending money on anything that doesn’t directly involve eggs and sperm may seem unnecessary and excessive, but consider the amount of stress and tension your body is going through and give yourself permission to get an occasional massage. The relaxation will do your body good. Developing a health care plan that includes massage and other body therapies is important to help maintain quality of life and encourages healthy function of major systems like fertility.

Top three things to consider in how massage can benefit fertility:

1. A harmonious sonata happens between your nerves and hormones as you relax into your massage. A gentle shift in stimulation of the nervous system from ‘fight or flight’ to ‘rest and digest’ can change the function that nurtures the activities of hormones that play a big role in fertility success.
2. Abdominal massage and deep breathing can act as a pump for the lymphatic system and blood flow in the lower abdomen allowing for delivery of essential nutrients to developing follicles and supporting organs.
3. The benefits of structural support and postural adjustments will result in pain relief and less stress on muscles and bones that may have been compensating.

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Increasing Blood Flow to the Reproductive Organs

Optimal circulation to the reproductive organs is essential for men and women to maximize fertility and decrease miscarriage since blood delivers nutrition and oxygen where needed.

Sluggish blood flow can be caused by stress, a lack of exercise, not enough rest or joy and even certain foods. All the usual culprits! Here are a few ways to turn it around.

Castor Oil Packs

A castor oil pack can be placed on the skin to increase circulation and promote elimination and healing of the tissues and organs; in this case, the ovaries and uterus. I recommend doing it in the evenings with a hot water foot soak as outlined below. It is a great way to have some relaxation time that is also productive.

The best timing for this is during the ten days of the follicular phase of your menstrual cycle (approximately days 3 through 12).

The packs are made by soaking a small piece of flannel or cotton about the size of a folded facecloth in castor oil and placing it on the skin immediately above the pubic hairline. A hot water bottle is then placed on top of the cloth for 30-60 minutes to heat the oil, aiding in absorption.

Be sure and rest while the pack is in place. After removal, cleanse your stomach with a diluted solution of water and baking soda. Store the cloth in a covered container in the refrigerator. There is no need to wash it; the oil can be left on for its next use.

Hot Water Foot Soak

Great to do in concert with castor oil packs as an evening ritual. Research shows that hot water foot baths at 49 degrees Celsius (120 degrees Fahrenheit) can be very beneficial to a woman’s fertility by increasing blood flow to the reproductive organs. Every night before bed, especially during the follicular phase (i.e., approximately days 3 through 12) of the menstrual cycle, give your feet some love! Run your hot water tap for one minute. Most water furnaces are set to approximately 120-140 degrees but if it feels far too hot, check the temperature. Fill a container large enough to fit both feet, then kick back and relax for 15-20 minutes.

Femoral massage

This is a great way to provide nourishment to the uterus, ovaries, testes and penis. You can do this massage on your own (but having a partner perform is best) by following these few simple steps.

The femoral artery is located level with your pubic bone, just beneath the crease in your groin between your thigh and lower abdomen.

To begin, compress the femoral artery with your fingers using fairly heavy pressure. When you feel the flow has ceased, hold for 30 seconds. The blood will then back up and increase the pressure gradient in the iliac arteries which forces more blood into the pelvic arteries. This floods the pelvic organs and genitals with more blood. When the hold is released, you should feel a sensation of warmth rushing down your legs as the blood supply returns to the lower extremities.

Women should perform femoral massage from the end of menses to ovulation or retrieval date if undergoing IVF. Do 2-3 times each leg, 1-2 times per day. It is actually even better if the woman can relax while their partner does the massage.

Tips for increasing male fertility.

“The best relationships are partnerships.” ~Rinatta Paries

INTRODUCTION

Men’s health and their sperm quality are indeed an important part to getting pregnant and carrying to term, especially when Diminished Ovarian Reserve is a factor. It needs to be assumed that this is a possibility as common medical testing will very rarely uncover anything pointing to the male factor. But, sperm DNA fragmentation and epigenetics may be where the key information on sperm lies and little to no medical facilities run DNA or Epigenetic assays. Male infertility affects 10-15% (asac per normal sperm testing) of reproductive-aged couples worldwide yet is a condition that gets little attention in the current western biomedical model of care. Without this medical focus men often become complacent with their involvement in the path to pregnancy and family. But it is important to remember that men are most often half the equation and it is a time to step up and be accountable for optimizing their reproductive health. There is no better time than the present to show love and support to your wife by being relentless in researching the possible causes of your condition and doing everything in your power to make fatherhood a reality.

BE PROACTIVE

“I am confident that we are going to look back at this time in history and wonder why the male role in fertility was so under-emphasized when it is clearly such a large part of the baby-making equation. One of the best ways to increase the chances of overcoming infertility, becoming pregnant, and having a healthy happy baby is to cultivate healthy men and healthy sperm.”Dr Spence Pentland

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It is my belief that the most important step in achieving anything is the process of goal setting. Without a target, how can one hit it? With clear goals and vision, each choice you make throughout each day can be evaluated by asking yourself, is this choice bringing me closer to my ideal vision of my life, and my dreams of having a baby?

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As a doctor, I determine my goals for treatment from the initial intake forms and the first appointment. By diagnosing the prominent signs and symptoms I feel are important to work on, combined with our joint decisions about larger aspects of life and your family vision, we provide the framework for setting goals. These goals become a guide to ensure we are staying on the path that we have created together.

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Breaking down your goals into attainable and sustainable steps and sticking with them for enough time to allow the magic of the compound effect to manifest is the key to success. When setting goals, remember the wise words of Jim Collins (author of ‘Good to Great’): “If you have more than three priorities you don’t have any.” Figure out what is most necessary for you to do to accomplish your goals, forget about everything else and keep it simple.

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We have worked with hundreds of men needing to improve their sperm quality with much success. At the same time, we work on any other health issues that may be contributing to the reproductive challenges (i.e. erectile dysfunction, premature ejaculation, low libido, back pain, low energy, poor sleep, etc). Our primary goals for treatment are as follows;

• Improved Sperm and Sexual Performance.With all of the tools you will learn coupled with the dedication to implementing the recommended changes, you will optimize your sperm and chances of getting pregnant, as well as improve your libido and sexual performance.
• Improved Health and Well-being.Optimal overall health is integral to producing good sperm. It also has a drastic impact on the health your child will experience throughout their lifetime. Lastly, being a healthy dad is important.
• A Simpler More Enjoyable Life. Enjoy reduced stress levels, less anger and frustration, improved performance at work and play, as well as a multitude of other tangible health benefits.

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Since there is so much that can be done for men and their reproductive health, coupled with the fact that the health of the sperm is far more important than anyone is telling you (or understands), finding a competent doctor of TCM and acupuncture to help men move forward with their journey toward optimized health and sperm is an essential choice for every couple. Even if sperm looks ok on paper, there is always room to engineer a plan that will bring them to peak reproductive potential.

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Once you are working with a competent TCM specialist in men’s reproductive health and have set clear health and wellness related goals it is important to be realistic. An understanding of what to expect is important so that proper commitment is cultivated.

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The outline and recommendations below are based on clinical evidence and experience (what we and our peers have observed as being necessary to obtain desired improvement), as well as current available research. Please understand that every human is unique and therefore so may be their requirements for treatment to be effective. The recommendations outlined below are general.

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It is also important to understand that our natural holistic treatment is not only focused sperm. Whole health is important for optimal reproductive health and semen quality. We also implement strategies that focus on the improvement of overall health, as well as addressing the stress that infertility inevitably bestows upon the couple.

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GENERAL RECOMMENDATIONS

BASIC SEMEN ISSUES

This includes issues with semen that are often more basic in nature (count, motility, volume) without confounding more complicated medical reasons for poor semen quality.

• ONE course of consistently administered treatment is most often sufficient to obtain desired improvement:
  • 12 acupuncture treatments in a 6-12 week timeframe
  • 12 weeks of daily Chinese herbal medicine, vitamins & supplements, as well as diet and lifestyle recommendations

COMPLEX REPRODUCTIVE ISSUES

This includes more complex issues with semen production and quality and/or other aspects of reproductive health (morphology, antisperm antibodies, hormonal imbalance, DNA fragmentation) as well as multifactorial epigenetic factors.

• TWO courses of consistently administered treatment is most often sufficient to obtain desired improvement:
  • 24 acupuncture treatments in a 3-6 month timeframe
  • 6 months of daily Chinese herbal medicine and supplements, as well as diet and lifestyle recommendations

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A few simple suggestions everyone can benefit from:

• Jump on a rebound trampoline for 10 minutes each day.
• Contribute to your community.
• Prioritize your life and spend little time doing things that will not take you closer to your dreams and goals.
• Avoid spending time with people who trigger your bad habits.
• Express gratitude for what you have.
• Find ways to cultivate spiritual well-being.

CHECK YOUR SWIMMERS

Semen Collection and Analysis

To begin the process of semen analysis, it must be collected in one of two ways. The first option is to ejaculate into a sterile container, but because masturbation on demand is not easy, it may take some mental preparation and may be less preferable than option two. This method is most conveniently performed in the facility provided at the laboratory.

The second option is to be sent away with a special condom that can be brought back at a later time. Collection at home is acceptable provided the sample is transported within one hour and kept at body temperature. This may also be the preference of men that are prohibited by religious or personal practices that do not permit masturbation. Semen should never be collected in an ordinary condom, however, as they contain substances that kill sperm.

It should be noted that it is important to refrain from ejaculation for 2-4 days before the sample is required and that semen collected by interrupted intercourse is not favoured since it risks the loss of sample, particularly the first fraction of the ejaculate.

If sperm parameters come back as abnormal, I recommend men going to a local fertility clinic to get a more accurate and thorough semen analysis done as often times, busy community labs do not do their analysis within the recommended time limit of sixty minutes. This can have negative effects on outcome measures. A urine sample after ejaculation is also a good idea to check for retrograde ejaculation.

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WHAT THE RESULTS MEAN…

This next bit of information is somewhat technical but it will empower those of you that thrive on science. For those of you that find the medical jargon confusing, feel free to read ahead.

• *Normozoospermia – An ejaculate falling within normal range of parameters.
• *Liquefaction – Semen should liquefy within 15-60 minutes (with 15 minutes being the norm).
• *Appearance – Normal semen is opalescent and grayish. Yellowish semen may show high intakes of vitamin supplements, abstinence or jaundice. An infection may show some red in the semen.
• *Volume – Total volume can range from 1-5ml. Too much can mean it is diluted. Low volume may show past infection blocking the tubes, retrograde ejaculation, or problems with accessory glands such as the seminal vesicles or the prostate. Sometimes there is an absence of the vas deferens. Volume drops 20% between 30 and 50 years of age. (Aspermia = no ejaculate).
• *Agglutination – Higher amounts of agglutination (sperm sticking together) point to antiSperm antibodies and can affect motility by coating the sperm and bind to cervical mucus preventing proper movement and difficulty fertilizing the egg. This is common in men who have had reproductive tract surgery.
• *Motility – Rapid progressive motile swimmers are really all that matter when it comes to conception and ability to penetrate the egg. This is not distinguished in community labs – even twitching non-progressive sperm are factored into a motile %. At least 32% should be progressive (the higher the percentage of rapid progressive the better). Motility decreases by 3.1% per year. (Asthenozoospermia = low motility). Sperm DNA fragmentation should be noted here.
• *Concentration – There should be at least 15 million sperm per ml of semen. Caffeine, tobacco, alcohol, drugs, diet, exercise and stress can also affect this. If it is very low, there may be a genetic chromosomal defect. (Oligozoospermia = sperm concentration of less than 15 million).
• *Count – >39 million. This is total sperm count per ejaculate. (concentration X volume (ml) = count). Count drops nearly 5% per year. (Azoospermia = no spermatozoa in the ejaculate).
• *Morphology – At least 4% of the sperm in a semen sample should be shaped normally. Avoiding things that are toxic to sperm are very important with morphology. (Teratozoospermia = poor morphology).
• *Acidity – Semen has a pH between 7.2 and 8.
• *Round Cell Concentration – Immature sperm or white blood cells. Too many of these in a sample may indicate infection.
• Sperm DNA fragmentation – The structural integrity of the DNA within the sperm may be associated with miscarriage (*see ‘sperm and miscarriage’ section) and diminished fertility. As a result of testing for this semen parameter being expensive, research has attempted to correlate more common semen parameters with DNA fragmentation. In a retrospective study of over 1000 men, data indicated that poor motility is the sperm parameter abnormality most closely related to sperm DNA damage. Therefore, we can hypothesize that if we can treat and improve sperm motility, DNA fragmentation rates may also improve (Belloc, 2014).

*WHO standards 2010 can be viewed at – http://whqlibdoc.who.int/publications/2010/9789241547789_eng.pdf?ua=1

LOVE IS A VERB

Supporting Your Partner

“If you love someone tell them…because hearts are often broken by words left unspoken.”
Pamela Daranjo

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At any given time, I have at least two to three women who, as far as western medical testing is concerned, have absolutely nothing impairing their fertility. Time and again, I see women doing everything they can to better understand their circumstances and optimize their health, while the husband does nothing to improve his health and sperm or support his wife’s efforts. This isn’t right. It’s a lot for a woman to take and hardly fair to her.

Supporting your partner during this time and taking responsibility for your role in creating a life is imperative not only to a healthy and happy relationship but I believe, to the success of conception. You want your partner and your future child to know that you were as much on-board with this pregnancy as was the person carrying the baby. A lack of participation may be causing stress to your partner during an already stressful time.

Make the lifestyle adaptations as recommended, go to as many doctor’s appointments as possible, communicate about what you’re feeling and listen to your partner. This is a chance to get closer if you allow it and excellent practice for the team building that makes for great parenting.

Through my own personal development and growth, I was able to recognize arrogance and fear in myself and am compassionate when I see it in other men. A great book that helped me a lot was ‘The Way of the Superior Man’ by David Deida. It will help you deeply understand how to really understand and succeed with women. He also wrote ‘It’s a Guy Thing – An Owner’s Manual for Women.’

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“Love is a Verb.”
Martin Luther King Jr.

TOXIC SPERM

“The essence of strategy is knowing what not to do.”
Michael Porter

This section is of particular importance for men since sperm are highly sensitive to their environment.

Environmental toxins are a very passionate topic in my life. My desire to create awareness through strong emphasis on the negative impacts of these substances and products may, at times, create fear and the feeling that major damage has already been done. This could then be followed by a sense of despair, resentment and not knowing what to do. I apologize if any version of this is your experience, but to some degree if it is, I have done my job! That said, beginning the process of reversing damage caused by toxins is simply a matter of starting to incorporate choices that lead to a cleaner, less toxic personal environment. Start today, you are constantly making new sperm and the changes you make today will be reflected in your sperm 75 days in the future.

No one is immune to the health ailments that are being caused by environmental factors and educating yourself is key not only for conception, but also for parenting. Health challenges like Autism and cancers are rising steadily for kids and have been linked to common pesticides. Learn as much as you can and avoid what you can.

There are over 80,000 manmade chemicals existing in the marketplace today. Most have been introduced since the end of World War II when the petro-chemical companies no longer had a market for chemical weapons, so they found uses for their products in the form of home and agricultural pesticides and fertilizers, food preservatives, household cleaners and personal care products. Current estimates place the existence of over 200 of these industrially produced chemicals in the human body at any given time. The time when a human is at greatest risk of the effects of these toxins is during fetal development, hence the added relevance for this book. Many of these chemicals are known toxins that disrupt hormonal balance and are contributing factors in infertility, PMS, irregular menstrual cycles, polycystic ovary syndrome, endometriosis, premature ovarian failure, recurrent pregnancy loss, anxiety and cancer of all kinds.

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Click here for a PDF list of toxic chemical ingredients commonly found in cosmetic and beauty products (look for on product label), what they are typically used for and the negative effects they have on humans.

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Male fertility can be adversely affected through any of 5 basic mechanisms:

1. Direct toxic effects on the testicles,
2. Disruption of the pituitary gland and its stimulation of the testicles,
3. Direct effects on ejaculation and/or erectile function,
4. Decrease in libido (sex drive)
5. Blocking the sperm’s ability to fertilize an egg

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MEDICATIONS

Medications that have a direct toxic effect on the testicles can damage the cells which produce sperm. This can result in lower sperm counts or in severe cases – cause a complete absence of sperm. Damage to the sperm producing cells can be temporary or permanent.

Normally, the pituitary gland, which is located just beneath the brain, will produce hormones that will stimulate the cells in the testicles. These cells will, in turn, produce sperm and produce hormones such as testosterone. The testosterone that is produced, along with some other hormones from the testicles, will regulate the level of stimulation to the testicles.

In some cases, medications may disrupt the connection between the pituitary gland and the testicles and result in inadequate stimulation to the testicles. This can result in lowered sperm counts and abnormal hormone levels.

In order for sperm to be delivered into the female reproductive tract, the male must be able to acheive an erection and subsequently, he must ejaculate. The coordination of these events is very complex and can be disrupted in a number of different ways.

Some medications may act to decrease male sexual interest in intercourse, or libido. Other medications may interfere with the ability of a man to get an erection or ejaculate.

Finally, some medications may affect the sperm directly. For example, a group of medications which are commonly used to treat high blood pressure called calcium channel blockers have been shown in some studies to block the ability of the sperm to fertilize an egg.

Listed below are several categories of medications and their effect on the five areas influencing male fertility. Men should not stop any prescription medication before discussing it first with his prescribing physician.

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Volatile Organic Compounds (VOC)

Volatile Organic Compounds (VOC) are very useful in the natural world. Humans, animals and plants all use subtle VOC scents to communicate with one another on instinctual levels but manmade VOC’s are very hazardous to human health. Respiratory, allergic, and immune problems are amongst the primary concerns, especially in infants and children. Perfumes and scents of synthetic nature, flooring, paint, furniture, solvents, cleaners, smoke, vehicle exhaust, by-products of plastic and synthetic fiber manufacturing, adhesives (and removers), bed mattresses, dry cleaning, office equipment off gassing and ceiling tiles all emit toxic Volatile Organic Compounds, and their effects to our reproductive health are largely unknown.

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SOME BASICS ABOUT EATING

Diet and Nutrition

“How am I going to live today in order to create the tomorrow I’m committed to?”
Tony Robbins

Here we will talk about some specific sperm-friendly foods and how best to incorporate them.

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Folic Acid

Two studies conducted in the Netherlands emphasized the importance of folic acid for healthy sperm.

The first study, published in The Journal of Andrology, emphasized the importance of B6, folate (B9, folic acid), B12 and homocysteine levels in the production of sperm (Boxmeer et al, 2007).

The second, published in Fertility and Sterility, had a similar result stating that low concentrations of folate (folic acid, B9) in seminal plasma may be detrimental for sperm DNA stability (Boxmeer et al, 2009).

So how can you boost the folic acid in your diet? As referenced on the Dieticians of Canada website (dietitians.ca), dark green vegetables like broccoli and spinach and dried legumes such as chickpeas, beans and lentils are good natural sources of folate (folic acid). The best sources of Vitamin B12 include eggs, meat, fish and poultry, and the top sources of Vitamin B6 are liver, wild Atlantic salmon, tuna and fortified meatless alternatives.

Sarah Kimmins, an expert in epigenetics and reproduction, has published many articles emphasizing the importance of the father-to-be diet. The study focused on a diet deficient in folate and found excellent motivation for men to adhere to a folate-rich diet.

A father’s diet before conception can affect the health of his offspring. There’s a common perception that the father can do whatever he wants without consequence to others. Kimmins research shows that this isn’t the case — men really need to think carefully about the life they’re living because future generations can be impacted.

The researchers examined the sperm of males with a folate deficient diet, and found genetic links to development of diseases such as cancer, diabetes, autism and schizophrenia. They also found a link between a father’s diet and possible muscular and skeletal birth defects (Kimmins, 2013).

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Lycopene and Carotene

In a study published in Fertility & Sterility, a prominent peer reviewed medical journal, positive correlations between the intake of the antioxidant lycopene and sperm morphology (shape), and the antioxidant carotene and sperm motility (movement) (Zareba, 2013) were found. As talked about in the Step on diet, adding color is always encouraged.

Here are some examples of lycopene and carotene rich foods:

• Lycopene Rich Foods for Sperm Morphology: Tomatoes (sun dried are best, raw and cooked are also good), guava, watermelon, grapefruit, parsley, basil, asparagus, liver, red cabbage.
• Carotene Rich Foods for Sperm Motility: Sweet potato, kale, carrots, greens (spinach, mustard, turnip, collard), butternut squash, red leaf lettuce.

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Protein

Men need to make sure they are getting enough protein. This is not an issue for most men, but for some it can be. If you are a vegetarian or vegan and are having trouble conceiving, TCM would advise you to begin including some animal or fish protein in your diet. Get as much as you can from fish and vegetable sources but a good quality steak (happy cattle only, please) can be medicinal. It shouldn’t be a large part of a man’s diet because cholesterol levels should also be paid close attention to but consider it an augmentation.

A good rule of thumb – if it is bad for your heart, it is bad for your sperm and balance is always good. Certain foods, such as fish, will combat cholesterol so the more fish you eat, the more fatty four-legged animal muscle you can have.

And speaking of four-legged animals…

In a study of bulls, the conclusion published in the Journal of Animal Science stated that plant-based diets reduced the amount of fructose in the semen samples of the bulls being observed (Shirley, 1963). Fructose is a simple sugar present in semen necessary to feed the sperm so that their mitochondria can produce ATP (cellular energy). Sperm needs this sugar to get the energy required to whip their tail so they can swim.

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Alcohol

If you are healthy and your sperm shows no abnormalities, than two or three drinks once or twice a week should be okay. But while you are trying to conceive a child, giving up alcohol for a while certainly wouldn’t hurt. If your sperm does show abnormalities or you have a reproductive hormone imbalance, I would definitely recommend abstaining from alcohol.

MOVE YOUR BODY

“If your dog is fat you are not getting enough exercise.”
Author Unknown

Exercise Recommendations

I recommend the following each week;
*Substitute your favorite activities where appropriate (dance, cross country skiing, squash, swimming etc)

• Aerobic (fat burning) activity once per week for 30 minutes. You can go to the trouble of finding your aerobic target heart range but I simply recommend getting out of the house and either walking quickly or jogging very slowly – this should put you into the aerobic target heart range. You should be able to carry a conversation quite easily when performing aerobic activity.
• Cardiovascular training once per week for 30 minutes. This type of training is meant to target the health of your heart and circulatory system, hence improving blood circulation throughout the body, including to your ovaries and uterus. Cardio target heart range is slightly more intense than aerobic. Caution to not overdo this type of exercise when trying to conceive as it can take vital resources away from the function of reproduction, especially when you might be pregnant.
• High Intensity Interval Training (HIIT). This should be done once per week, only in the follicular phase of the menstrual cycle. Run as fast as you can for 20 seconds, then walk for 4 minutes (to rest and catch breath). Do this 5 times.
• Resistance training to increase muscle tone and balance insulin levels should be done twice per week. This should not be done to a point of exhaustion, but simply to gently nudge the body into gaining strength and maintaining bone density. You should not feel sore and tired the day after a workout – this shows you are overdoing it. I recommend yoga or pilates for your resistance training component. Yoga is a balanced form of exercise that often has a meditative aspect to it that will allow you to get in touch with yourself. Also, taking the time to breathe in combination with challenging poses will release stress and clue you into what’s going on with your body and spirit.
• Opening the Pelvis: The following additional poses are something you add to your yoga routine and do at home. They are most effective as a “relaxing” stretch in that they should be done gently, and for a minimum of 1 minute, maximum of 5 minutes. Choose 1-2 to do each day. They can be done before bedtime and we often hear people tell us that these poses help them sleep!
  • Pigeon Pose (instructions).
  • Hip rotator & gluteus ball rolling (instructions).
  • Supported reclining butterfly (instructions).
  • Supported straddle (instructions).
  • Cow-face pose (instructions).

Definition of exercise: any bodily activity that enhances or maintains physical fitness and overall health and wellness. It is performed for various reasons including strengthening muscles and the cardiovascular system, honing athletic skills, weight loss or maintenance, as well as for the purpose of enjoyment.

Some people hear the word exercise and wince, but that doesn’t have to be the case. Like diet, different exercise plans work for different people and the key to finding what is right for you is that it be something you enjoy.

There are no limits to the possibilities for fun with fitness and the benefits of exercise are no secret. Expect to lower your body fat, increase energy and muscle mass, reduce stress, improve your circulation, better sleep, lower blood pressure and feel an overall sense of well-being and confidence. And let’s not forget the most important benefit of all – with increased health comes increased fertility. So if you’re serious about starting a family, some form of exercise is a must.

The goal is to maintain a healthy body weight and steer away from being too thin or keeping up with an exercise regime that may be too strenuous. If your body is repairing muscles that are being used excessively, it will have less energy to devote to reproductive health.

If you find yourself overweight due to a lack of exercise but you’re not sure where to start, take a walk. Aerobic exercise is key for weight loss and is considered anything that involves performing continuous movements, in your specific aerobic target heart range, with large muscle groups such as your legs, for 20 minutes or more. Cycling, swimming, rowing, walking, dancing or jogging are just a few examples of aerobic exercise. Low-intensity sessions that last at least 30-45 minutes are ideal for weight loss.

There’s no need for a gym membership or athletic prowess, it can be as simple as four brisk, half-hour walks a week to get your heart pumping and increase circulation; something that strongly assists with increased fertility.

In conjunction with addressing physical activity, Traditional Chinese Medicine (TCM) emphasizes the importance of cultivating willpower to overcome conditions such as overeating, laziness, and obesity. Acupuncture and Chinese herbal medicine supplement the systems necessary for being proactive in one’s life and making healthy choices for mind and body. With time, discipline and simple small commitments, the trajectory of your entire life can change. A healthy life is a fulfilling life and everyone deserves that.

*Elements to consider when attempting to manifest a holistic exercise regime are: Agility, Flexibility, Strength, Speed, Balance, Stamina, Coordination and Endurance.

Traditional Chinese Medicine (TCM) and acupuncture can help reduce insulin resistance, regulate appetite, and encourage lipolysis (the breakdown of fat) which will help the body to lose weight and result in improved sperm quality, translating into greater success rates both naturally and with IVF.

Since your weight management is largely in your control, you CAN do it, and it is simply choices and willpower that are needed to surmount the daunting task of weight loss. Perseverance, commitment and proper medical management is also absolutely required.

• Diet – So important it has its own section. Bottom line, we recommend combining your individualized TCM pattern specific diet with Blood type dietary principles. Obviously this particular diet requires the guidance of a TCM doctor and a Naturopathic physician.
• Move – It’s that simple. Sometimes it might be better to not call it exercise. Physical activity is key, raising your heart rate, sweating, and possibly most important enjoying yourself. Aerobic target heart range is optimal for fat burning, as is resistance training (weights) and high intensity interval training (HITT). If you need help in this area find a good personal trainer.
• Willpower – The ingredient of the recipe that holds the rest together. Coaching, public accountability and Chinese herbal medicine are all fantastic tools to utilize when needing to cultivate willpower. Call us if you need support along the way. Utilizing our consulting or coaching services is an integral part of BFP+ and your success.
• Portions – There may be many reasons for the obesity epidemic, but the only action that breeds obesity is the overeating of empty calorie foods. First of all, if necessary, reduce meal portion sizes.
• Fasting – finish eating for the day by 7pm, and do not start again until at least 7am, 8 or 9am being even better. Also, move back to a ‘3 square meals’ each day schedule (without snacking in between). This time between food intake retrains your body to utilize fat stores for energy instead of always being dependant on the constant slow drip of sugar/carbs that we usually are feeding ourselves.
• Why – The element which trumps willpower, is the reason. If your ‘why’ is strong enough, you’ll find any way possible to achieve your goal. Keep yourself focused on losing weight and its correlation with having a family.

“A person generally gains fat-related weight by increasing food consumption, becoming physically inactive, or both. When energy (food) intake exceeds energy expenditure (movement), the body stores the excess as fat.” Despite this widely accepted statement being logical, it is shortsighted and oversimplified. It should be emphasized that it is the over-consumption of the ‘wrong foods’ at the ‘wrong times’ that is causing the storage of excess fats, even when energy expenditure exceeds food energy (caloric) intake.

Summary

• Obesity is associated with abnormal semen parameters and may adversely affect male fertility.
• Lifestyle changes involving a diet and exercise program are the first-line treatment for obesity.

The ins and outs of integrating Wellness with IVF.

“Miracles come in moments. Be ready and willing.” –Wayne Dyer

INTRODUCTION

Choosing In Vitro Fertilization (IVF) is a big step. Especially when diminished ovarian reserve is a factor and preimplantation genetic diagnosis (PGD) is being recommended by your doctor. Deciding to put your faith (and money) into assisted reproductive technologies such as IVF should be done with eyes wide open. Although success rates get better with each passing year, in no way does this treatment guarantee you the child of your dreams. You must do all you can to best prepare yourself and your body before stepping into IVF. Be ready on all levels; become one with your body mind and spirit. If you haven’t already done so, stop seeing conception or your body as something that needs to be accomplished or conquered. Have faith that your body knows how, and that your baby will come. Be as loving to yourself as you would be to your child. This may be difficult, but it is an appropriately tailored assignment when planning for IVF success.

How Traditional Chinese Medicine (TCM) Can Optimize Your Chances of IVF Success

Women and couples come to me at various stages of their journey to conception. Sometimes they have been trying for years and others they are just starting out. While conceiving naturally is everyone’s first choice, alternatives that garner the same results, a baby, should not be overlooked. It is for this reason that I have included this chapter.

Assisted Reproductive Technology (ART) is a term used to describe the current western medical treatments available for women and couples having difficulty conceiving and desiring or requiring medical aid such as In Vitro Fertilization (IVF).

With current changes in cultural perceptions regarding IVF, and consistent advancement including better freezing techniques, better embryo culture, ways to choose embryos, pre-implantation genetic diagnosis (PGD) and new drugs, IVF is becoming more and more common. I am happy to work with women that choose this route and to implement treatment that aids in their success.

Forward thinking IVF clinics are forming strong alliances with TCM practitioners (with the integration of procedures such as acupuncture). They realize that in addition to successful IVF outcomes, traditional practices enhance the patient’s experience by managing stress and cultivating emotional balance.

I am inspired by the integration and kinship that has grown between my practice and that of the local IVF clinics and I am glad to hear of similar relationships being formed elsewhere. We all share the goal of building happy families and by working together, the patient is looked at as a whole and better supported along their journey. This is the growth of great medicine.

A recent article by Michael Fiorani and Dr. Paul Magarelli reviewed the mechanisms and published clinical trials supporting the use of acupuncture with ART and determined that acupuncture should be considered as a viable adjunct therapy for IVF. Their conclusion states:

“The use of acupuncture for infertility as an adjunct therapy to conventional treatment in ART (mainly as an adjunct to IVF) has continued to increase in popularity through evidence-based publications demonstrating clinical efficacy. Although acupuncture is based on ancient medical theory, an increasing number of published scientific studies show that acupuncture positively impacts fertility and IVF success rates due to possible mechanisms influencing the menstrual cycle through B-endorphin secretion, affecting gonadotropin secretion through their action on GnRH. These possible mechanisms also impact uterine and ovarian blood flow, cytokines and depression, anxiety and stress. Retrospective and randomized controlled trials have found that acupuncture has a statistically significant positive impact on IVF success rates, including implantation, pregnancy, and live birth rates, while reducing the number of miscarriages and ectopic pregnancies.”

The article also clearly summarized possible mechanisms of how acupuncture positively impacts fertility and IVF success rates:

• Affects the hypothalamus-pituitary-ovarian hormonal axis causing changes in the menstrual cycle (through the secretion of b-endorphins which affect gonadotropin-releasing hormone [GnRH])
• Improving uterine and ovarian blood flow
• Secreting cytokines and regulating the immune system
• Relief of depression, anxiety and stress

Supporting ART treatments with TCM is advantageous in many ways for the patient. Below is evidence (made up of over 5000 women in various trials) that shows how acupuncture administered on the day of embryo transfer immediately before and after the procedure can significantly improve success rates.

• Oxford Journals Human Reproduction: Acupuncture administered on the day of embryo transfer is most advantageous for those patients whose chance of success with IVF is not high (Manheimer, 2013).
• Fertility and Sterility: Acupuncture improves clinical pregnancy rates and live birth rates among women undergoing IVF. Increased positive effects from using acupuncture in IVF can be expected if more reasonable acupuncture programs are used (Zheng, 2012).
• Cochrane Database of Systematic Reviews: Acupuncture on the day of Embryo Transfer improves the ongoing pregnancy rate and the clinical pregnancy rate (Cheong, 2008).
• British Medical Journal: Current preliminary evidence suggests that acupuncture increased the odds of clinical pregnancy by 65%, and improved live birth rates when compared with the control groups (Manhheimer, 2008).

Time permitting, researchers Magarelli/Cridennda found that it is optimal to work with TCM for a period of at least 9 consecutive acupuncture treatments before embarking on western medical reproductive treatments. The appropriate time frame for pre-IVF/TCM care depends on the pre-existing conditions the woman or couple has. By helping women regulate their menstrual cycle, lose weight, reduce stress, regulate hormones (Zhou 2013, Magarelli/Cridennda 2009) and increase blood flow (nutrition, oxygen, and medications) to the ovaries, eggs, and uterine lining (Stener-Victorin, 1996 & 2003), TCM plays an important role in the optimization of overall reproductive health and well-being.

Acupuncture and IVF Patients

“Acupuncture could benefit IVF patients beyond potentially improving rates of IVF pregnancy success, noting that it is safe and inexpensive and may aid these patients in coping with the emotional and psychological challenges related to IVF and fertility.” – Excerpted from the Oxford Journals Human Reproduction Meta-analysis by Manheimer et al, 2013.

An assessment of patient demand and importance of acupuncture to patients of an IVF fertility clinic in the UK during lead up, procedures and treatment published in ‘Human Fertility’ surveyed 200 patients (Hinks, 2010). They discovered that there was a clear demand for acupuncture and that this treatment may be valuable in improving the general well-being of women during infertility and IVF lead up, procedures and treatment. They also felt that patient resilience may be increased by the use of acupuncture when used in conjunction with their IVF treatment such that patients would persevere with increased numbers of IVF cycles, thereby increasing their ultimate chance of starting or expanding their family.

Patience

IVF is a groundbreaking treatment. It helps get women pregnant that may never have been able to do so otherwise. It is truly a miracle of modern science that fulfills the dreams of so many women and couples, but if you are young and healthy and if your fertility specialist recommends continuing to try to conceive naturally, its time to commit to a course of treatment with TCM.

If you can find the patience to utilize TCM to prepare your body for the journey of pregnancy before resorting to IVF, you may be pleasantly surprised that you become pregnant naturally. And if not, you have optimized your body mind and spirit for success with your IVF.

Being impatient, according to Traditional Chinese Medicine, is a major cause of infertility struggles and is often a key trait of the women that are diagnosed with ‘unexplained infertility’. This is a symptom that responds very favorably to TCM and is of primary importance to balance with our treatment. Your child will come when she or he is ready; have faith.

After speaking with Julie Indichova (author of ‘Inconceivable’) and listening to her speak, she inspired the following important message: Before stepping into IVF, please be ready on all levels; become one with your body mind and spirit. If you haven’t already done so, stop seeing conception or your body as something that needs to be accomplished or conquered. Have faith that your body knows how and that your baby will come. Be as loving to yourself as you would be to your child. This may be difficult, but it is an appropriately tailored assignment when planning for IVF success.

The Ideal Time for TCM if Considering IVF

• If you are overweight: The importance of a healthy BMI before attempting an IVF cannot be overstated. Take the time and make a commitment. Use the vision of your dream family to cultivate a compelling reason to dedicate to stepping up. Make it the first great parenting decision you make and the first example you set for your children.
• Unexplained Infertility: This can be a frustrating diagnosis and most often involves a large degree of emotional stagnation and stress. In my experience, this is far more common in couples in their early 30’s. Acupuncture administered consistently for 4-12 weeks before the IVF embryo transfer has proven to be very beneficial.
• Advanced Maternal Age: Because time is always a factor with IVF and advanced maternal age, it must be carefully determined how much time is spent using TCM to optimize a woman’s remaining fertility potential and egg quality. This is where seeing an experienced practitioner of TCM is important – they will be able to help you plan for the utmost benefit while being mindful of time.
• Recurrent Pregnancy Loss: If you are getting pregnant easily but miscarrying, TCM is a good option to utilize in an attempt to correct the issues that may be contributing to the recurrent loss. A study of 238 women undergoing IVF treatment showed those who received acupuncture had significantly less first trimester miscarriages when compared to the women that did not receive acupuncture (Khorram et al 2012). IVF itself does not help reduce miscarriage unless pre-implantation genetic diagnosis (PGD) is implemented.
• Stress: Our preliminary clinical data tells us that acupuncture administered consistently, 4-12 weeks before the IVF embryo transfer, significantly reduces stress levels.
• Thin uterine lining: Evidence based research demonstrates that acupuncture, done correctly, increases blood flow to the reproductive organs such as uterus and ovaries (as noted in studies by Stener-Victorin in 1996 & 2003). I have seen problematic thin uterine linings that would potentially delay or cancel many IVF cycles thicken significantly with just a few acupuncture treatments.
• Male Factor Infertility: I am confident that we are going to look back at this time in history and wonder why the male role in fertility was so under-emphasized when it is clearly such a large part of the baby-making equation. One of the best ways to increase the chances of overcoming infertility, becoming pregnant, and having a healthy happy baby is to cultivate healthy men and healthy sperm.

Basic TCM Treatment Recommendations

• In most cases, 13-14 acupuncture treatments in the 2.5-3 months prior to embryo transfer is ideal. This recommendation is based on our own clinical data and experience cross referenced with current peer recommendations and available research cited throughout this chapter. This can vary depending on pre-existing conditions. It may be extremely beneficial if appropriate and time permits to give up to six months or more before an IVF cycle when a woman needs to lose weight or has multiple hormonal imbalances and irregular menstrual cycles such as with PCOS.
• Two acupuncture treatments per week during stimulation injections. This is a time to work on three main things: 1. increasing medication delivery to the ovaries, 2. improving the quality and thickness of the uterine lining, and 3. managing stress.
• On site (at IVF clinic) acupuncture immediately before and after embryo transfer. A number of studies cited earlier (Manheimer 2008 & 2013, Zheng 2012, Cheong 2008) which displayed improved pregnancy and live birth rates involved the administration of acupuncture immediately before then again immediately after the embryo transfer on site at the IVF clinic. I will touch on the importance of on-site embryo transfer day acupuncture more below.
• Acupuncture once per week throughout the first trimester of pregnancy. Supportive treatments, particularly during the emotional two-week waiting period post embryo transfer when a woman has to go home and patiently await the arrival of her pregnancy test results or her menses. Then throughout pregnancy as continued emotional support (especially for those who have suffered recurrent loss) and for conditions along the way such as nausea, aches and pains, high blood pressure and in the unfortunate case of miscarriage. Finally, preparation for labour and delivery from week 36 onward is highly recommended.

Frequently Asked Questions

What are the recommendations for acupuncture treatment during an IVF cycle?

• 1 acupuncture treatment per week in the weeks/months leading up to the IVF cycle for both men and women. 9-14 treatments in the 6-12 weeks prior to IVF improves chances of positive outcomes.
• 2 acupuncture treatments per week while undergoing IVF stimulation injection for both men and women.
• On site acupuncture treatments (at IVF clinic) immediately before and after embryo transfer (see below).
• Continued acupuncture 1 per week throughout the first trimester of pregnancy.

How does acupuncture help with an IVF cycle?

• Improves blood flow to ovaries and uterine lining (delivering nutrition, oxygen, and necessary medications used for various A.R.T. protocols).
• Reduces stress and improves overall experience of the IVF treatment.
• Helps correct imbalances in health that may be inhibiting conception.

Why is it good to have acupuncture between retrieval and transfer?

• Reduces inflammation and bloating caused by the retrieval procedure.
• Increases blood flow to uterine lining and aids in healing.
• Relieves stress and soothes emotions.

How does acupuncture help 3-7 days post embryo transfer?

• Reduces stress and soothes emotions.
• Gently increases blood flow to uterus and embryo (delivering nutrition, oxygen, and necessary medications).
• Creates an environment favorable to implantation.

Why do you do on site acupuncture treatment (on embryo transfer day) instead of at your personal clinic?

On-site Embryo Transfer Day Acupuncture

The Importance of Treatment at the IVF Clinic

Several studies cited earlier have shown that pregnancy rates improve when acupuncture is done the same day an embryo is transferred, with an acupuncture treatment just before the procedure and again afterward.

In all but one of these studies, the acupuncture was administered on site at the IVF clinic.

In the case of the study where the acupuncture that was administered off site (Craig, 2007), in contrast to previous reports, acupuncture before and after embryo transfer was associated with lower biochemical and clinical pregnancy rates when compared to the control group. This outcome was hypothesized to have occurred due to the increased stress associated with navigating busy traffic and a more tightly-packed schedule, when ideally before and after embryo transfer should be a time of rest and relaxation.

Embryo transfer day is potentially very stressful as a lot of factors culminate to hopefully achieve the ultimate goal of pregnancy. Whatever can be done to alleviate stress and improve the chances of success should absolutely be done.

While acupuncture is tremendous for helping hopeful parents to relax, the weeks leading up to the embryo transfer day cannot be overlooked. In my experience, they actually have more impact on positive outcomes and stress levels than does acupuncture the day of transfer. The acupuncture is only one part of an individualized program to properly prepare both the man and the woman for their IVF cycle.

According to the results of our recent clinical research (retrospective cohort) using the Perceived Stress Scale developed by Sheldon Cohen that can be viewed at http://en.wikipedia.org/wiki/Perceived_Stress_Scale, women who are treated with acupuncture at our clinic for >1 month prior to their IVF embryo transfer experience significantly lower stress levels than women who get > 1 month of acupuncture treatments at other non-reproductive focused clinics or women who opted for acupuncture treatments on embryo transfer day only (using a p < 0.05 as a measure of significance). These findings, when cross-referenced with a study done at Stanford (Turner, 2013) that used the same Perceived Stress Scale which concluded: "Women with lower stress and anxiety levels on the day prior to egg retrieval had a higher pregnancy rate. These results emphasize the need to investigate stress reduction modalities throughout the IVF cycle."

This clearly displays the important role acupuncture can play in optimizing chances of IVF success.

Laser vs. Needle Acupuncture for Embryo Transfer

We sometimes get asked whether we use laser acupuncture to support clients on embryo transfer day, and the answer is no. At the time of this publication, approximately 20 quality studies (as summarized in the systematic reviews cited earlier) have been done regarding the administration of traditional needle acupuncture on embryo transfer day during an IVF cycle.

From this list, there has only been one study (Fratterelli, 2008) that included the use of laser acupuncture. This particular study reported an increase in implantation rates with the use of laser acupuncture, however, the data also showed little difference in ‘ongoing pregnancy rates’ between traditional manual needle acupuncture and laser acupuncture. Therefore, until much more research is done and displays further benefit, and most importantly, no harm from laser acupuncture, it is recommended to choose the administration of the evidence supported technique of traditional manual needle acupuncture (not laser) for your on site embryo transfer day acupuncture treatments.

What people are saying:

“I was thankful for the treatment before and after the transfer. Because it was onsite, it was only a few feet away, which meant more time to let the embryo “snuggle in”. It greatly helped to relieve all the tension that I felt leading up to the transfer.”

“Having the clinic onsite is great, helps decrease some of the stress of having to drive around to places and make it for the transfer on time. Loved it ! Having Dr. Pentland there was calming for me because he’d been there right from the beginning with us. I went into the transfer very relaxed and I’m certain it contributed to our success.”

“The acupuncture was helpful in that it was relaxing and it took my mind off the transfer. The heated bed and blanket was quite nice as the room is somewhat cool. I felt well taken care of.”

“I found the whole experience to be very relaxing. I would highly recommend listening to the IVF meditation mp3 that Dr. Pentland suggested before embryo transfer. It made what could have been a stressful day a very positive experience. I was also very appreciative that he was on site and that there was such a smooth transition to the embryo transfer procedure.”

“After 6 rounds of Clomid and a failed IVF cycle, I explored the option of IVF acupuncture for my second IVF cycle. Having acupuncture on my embryo transfer day gave me the confidence that my body and mind were at their epitome of relaxation. Also, having it done on site gave me the calming, positive and warm thoughts I was seeking for the moments leading up to my embryo transfer – and the relaxation right after. I am currently 22 weeks pregnant with twins. I truly believe Dr. Pentland’s help has contributed to my success!”

Conceiving Naturally After IVF

“Be thankful for what you have; you’ll end up having more.” ~Oprah Winfrey

Some interesting studies:

• One in three women who have their first baby through infertility treatment become pregnant again naturally within two years of their first birth (Wynter, 2013).
• A Monash University study, published in the Australian and New Zealand Journal of Obstetrics and Gynecology, was the first to examine the rates of unexpected conception in Australian women who had a first child through assisted reproductive technology such as IVF. The study of 236 women who had a baby through assisted reproductive treatments found 33 percent of them conceived a second child naturally within two years of their first birth and women whose infertility was initially diagnosed as ‘unexplained’ were more than twice as likely as others with a specific infertility diagnosis to become pregnant naturally.

To me, these findings make perfect sense, especially unexplained infertility, which 9 times out of 10 in traditional Chinese medicine carries a huge emotional component. Once a woman has started her family, the pressure lifts and baby number two often comes easily. Deep internal blockage is removed and life flows a little more smoothly. According to Traditional Chinese Medicine, we call it coursing the liver and rectifying the qi.

If you have been trying for some time for your first child and are considering IVF, I suggest taking some time to prepare with TCM. Nourish the soil before planting the seed. From my experience, this can sometimes make IVF unnecessary.

Adhering to the recommendations of this program may not only help you conceive, but will create a healthy environment for your future child. By improving your diet, minding your stress and getting proper exercise and fulfillment, you will be optimizing your chances of of a healthy and happy family, be it naturally or with ART.

How to Improve a Thin Uterine Lining to Increase Fertility

Every woman that has gone through or is currently involved in assisted reproductive therapy will know that the thickness of her uterine lining is almost as important as the number of eggs that are developing. To use the common metaphor of growing a garden; the soil must be sufficiently nourished for the seed to have success once it is planted. During an IVF cycle or IUI cycle, a woman will be given different medications that will either directly or indirectly increase the estrogen delivered to the uterus and more specifically, the endometrial lining. For those that are trying to conceive without assisted techniques they will not know the thickness of their endometrial lining but this may be a limiting factor in their chances of conceiving.

The optimal thickness for the endometrial lining is between 8 and 12 mm with it reaching its maximum thickness at the time of implantation at around day 21 of a woman’s menstrual cycle. The growth of the endometrial lining is dependent upon the quality of blood flow to the uterus as well as the effect of estrogen in encouraging the lining to develop. Therefore the treatment approach when working with women that are prone to having a thin uterine lining is to increase blood flow to the reproductive organs, increase receptivity of the uterus to estrogen and balance reproductive hormones.

During an IVF cycle or IUI there are two main approaches used to increase the uterine lining and both have to do with increasing estrogen. One approach is to administer estrogen directly, either orally or vaginally. The common prescription we see most women on is Estrace (estradiol, E2) which is a micronized 17β-estradiol. The other method that may be used is to give human menopausal gonadotropin (hMG) such as Repronex or Bravelle. HMG works by stimulating the pituitary to release follicle stimulating hormone and luteinizing hormone which also triggers the release of estrogen by the reproductive organs. This is more of an indirect method of stimulating estrogen to act on the uterine lining. Both of these methods are effective and may be used in combination for some women.

Acupuncture and Chinese herbal medicine

The approach with Chinese herbal medicine and acupuncture works at both improving estrogen response and increasing blood flow to the uterus. Since acupuncture does not involve the injection of any substance into the body, its focus is more on regulation and increasing blood flow. Some favourable studies have been published that show a positive effect of administering acupuncture with low frequency electric stimulation to points in the lower abdomen and on the lower limbs for increasing blood flow to the uterus and ovaries. Acupuncture has also shown to be quite effective for relieving stress and relaxing the sympathetic nervous system. This is beneficial for improving the body’s response to hormonal signals and increased blood flow throughout the body. Chinese medicine on the other hand does involve the ingestion of active ingredients from natural substances and these can have estrogenic effects as well as blood invigorating effects to improve circulation. For example, Angelica (Dang Gui) has exhibited estradiol increasing effects in controlled studies and has been used for hundreds of years as a primary herb in many Chinese medicine formulas for the treatment of women’s health and regulation of menstrual cycles. Flattened milkvetch seed (Sha Yuan Zi) has been shown in clinical trials to have the effect of increasing the blood flow to the uterus and increase its weight. The combination of these two herbs may be utilized in treating women with a thin uterine lining. However, Chinese medicine is prescribed based on an individualized diagnosis and should only be administered by someone who is a licensed practitioner qualified to prescribe Chinese medicine.

So what can women do on their own to increase blood flow to the reproductive organs, increase receptivity of the uterus to estrogen and balance reproductive hormones?

Rest

The number one thing you can do for improving a thin uterine lining is get enough rest and sleep. Most of the women we see coming to the clinic for fertility and reproductive support all check off that they do not get adequate sleep. You need a minimum of 7 hours of restful, uninterrupted sleep to recharge your body and allow for optimal repair and growth to take place. Try to get to sleep and wake up at the same time every day, even on weekends. Your sleep and wake hormones influence your reproductive hormones so keep them balanced and your uterus will get the right message. If there is a dog or cat that is waking you up during the night, you will need to train them to sleep through the night, put them in another room or let your partner deal with them. Your sleep is too important to lose.

Exercise

Exercise is important for increasing blood flow. Strive for 30 minutes per day of exercise that incorporates movement of the legs and hips such as yoga, walking, running, cycling, swimming, elliptical, or aerobics. The goal of exercise is to invigorate circulation and not to exhaust your body. If you are not used to doing exercise then take it slow, build up to a comfortable routine that elicits a light sweat and improved circulation to your hands and feet.

Femoral Artery Massage

Another helpful self-treatment is femoral artery massage. This is done daily in the first half of a woman’s cycle to increase the blood flow to the uterus and reproductive organs. Perform from end of menses to ovulation or retrieval date if undergoing IVF. Do 2-3 times each leg (separately), 1-2 times per day. This massage increases the blood flow to the pelvic organs, providing more nourishment to the uterus and ovaries, testes and penis. Compress the femoral artery with your fingers, fairly heavy pressure will be required. When you feel the flow has ceased, hold for 30 seconds. The femoral artery can be located level with your pubic bone, just beneath the crease in your groin between your thigh and lower abdomen. The blood will then back up and increase the pressure gradient in the iliac arteries which forces more blood into the pelvic arteries. This floods the pelvic organs and genitals with more blood. When the hold is released, you should feel a sensation of warmth rushing down your legs as the blood supply returns to the lower extremities. Do not perform this exercise if you: are pregnant, are post-transfer during an IVF cycle, have high blood pressure, have heart disease or circulatory problems (aneurisms, varicose veins, phlebitis, thrombosis), have a history of strokes, or detached retinas.

Stress

Stress can also play a major role limiting blood circulation and can interfere with the correct communication between the uterus and hormones. It is recommended that women take time each day to relax, breathe and calm their mind. This can be done with yin style yoga, meditation, guided relaxation, and prayer. Choose one or more of these to do on a daily basis and relieve the effects of stress.

Diet

Diet can also play a major role in increasing receptivity of the uterus to estrogen, balancing hormones and increasing blood flow. It is recommended to focus on a primarily whole food high fiber, paleolithic/primal style diet that is low glycemic. Eat at regular intervals throughout the day and stick to a routine so your body knows when it will be getting food each day. This helps to balance your insulin and cortisol hormones which have an indirect effect to balance reproductive hormones. Include cruciferous vegetables of the Brassica genus. Some of these vegetables include broccoli, Brussels sprouts, cabbage, collards, cauliflower, kale, kohlrabi, mustard greens, rapeseed, and root vegetables such as turnips and rutabagas. These foods help the liver detoxify and restore hormonal balance. Eliminate glucose-fructose, or high fructose corn syrup, these are sugars that are not well metabolized by the body and can cause insulin resistance which can negatively affect the communication of reproductive hormones. Reduce or eliminate coffee and other forms of stimulants. Avoid animal meats, cheeses, milks and other food items that have been raised with the use of hormones. Choose organic, free range, grass fed animals whenever possible. From a TCM dietary perspective avoid sour food when bleeding (yogurt, vinegar, pickles, grapefruit, currants, and green apples. Eat more blood nourishing foods when bleeding such as eggs, carrots, spinach, dates, & goji berries. Consume more blood invigorating foods when bleeding such as fish, ginger, cinnamon, and turmeric.

CoQ10

Co-enzyme Q10 is commonly recommended for women and men while they are trying to conceive and to improve the micro-circulation of the heart. CoQ10 is a powerful anti-oxidant and therefore assists in reducing oxidative stress to tissues. Since the uterus is reliant on the nourishment of blood and undergoes growth and sloughing at regular intervals, the use of CoQ10 can benefit the integrity of the tissue and possibly improve blood circulation.

Castor Oil Pack

Castor Oil Pack. Castor oil is derived from the castor bean, Ricinus communis. Castor is indigenous to the southeastern Mediterranean Basin, Eastern Africa and India but widespread throughout tropical areas. Castor is rich in triglycerides mainly known as ricinoleic acid, which is believed to be the result of castor oils many benefits.

It has been found to help congestion and stagnation in the pelvic floor, increase blood flow and circulation to the uterus and ovaries, soften scar tissue from laparoscopic surgery or cysts, shrink fibroids, and help with pain management.

Castor oil does this by helping the body detoxify naturally through the lymphatic, circulatory and liver systems. One study which focused on Castor oil’s benefits on the lymphatic system found an increase in the number of T-cell lymphocytes (a type of white blood cells) within patients after utilizing castor oil. Lymphocytes are disease fighting cells in the immune system. They help eliminate toxins and waste from the body which in turn helps eliminate inflammation. Think of it like highways that are congested with traffic, Lymphocytes are like the ambulances that help move the congestion to be eliminated out of the body. This congestion stimulates the liver, which is the main detoxifying organ in the body. In Traditional Chinese Medicine the liver is in charge of the smooth flow of the body’s qi and blood to prevent illness or disease in other words stagnations. Therefore, cysts can be viewed as toxins that the body does not properly eliminate.

For the reasons above, the anti-inflammatory properties will help in removal of prostaglandins. This can decrease pain during your menstrual cycle, the presence of adhesions, enlarged follicles, fibroids, cysts and metabolic imbalances that you may experience with PCOS.

A castor oil pack is placed on the skin to increase circulation and to promote elimination and healing of the tissues and organs underneath the skin. It is used to stimulate the liver, relieve pain, increase lymphatic circulation, reduce inflammation, and improve digestion. Castor oil packs are made by soaking a piece of flannel in castor oil and placing it on the skin. The flannel is covered with a sheet of plastic, and then a hot water bottle is placed over the plastic to heat the pack. Castor oil should not be taken internally. It should not be applied to broken skin, or used during pregnancy and breastfeeding. METHOD: Place the flannel in the container. Soak it in castor oil so that it is saturated, but not dripping. Place the pack over the lower abdomen, above the uterus. Cover with plastic. Place the hot water bottle over the pack. Leave it on for 45-60 minutes. Rest while the pack is in place. After removing the pack, cleanse the area with a dilute solution of water and baking soda. Store the pack in the covered container in the refrigerator. Each pack may be reused up to 25- 30 times. NOTE: It is generally recommended that a castor oil pack be used for 3 to 7 days in a week to treat a health condition or for detox. best if the packs are used on alternating days for the first week. After that, usually the packs may be used on consecutive days from that point on. 30-60 min per use.