Many complementary practices work well with a fertility yoga practice to help enhance fertility. Acupuncture and Traditional Chinese Medicine are used alone as well as in conjunction with yoga and ART (Assisted Reproductive Technology). In fact, some reproductive endocrinologists work with acupuncturists who will come into the office on the day of transfer while you are going through an IVF cycle.
Fertility abdominal massage is another technique that can be very useful either alone or in conjunction with the other methodologies mentioned. This technique involves manual stimulation of the reproductive organs through a massage of the abdominal area. The massage can help with a number of issues related to this area of the body, but has been very effective for women who are experiencing difficulty trying to conceive.
This chapter will explore each of these practices and how they may be used to help enhance your fertility. Hypnotherapy, talk therapy, and consulting with a life coach are also explained and explored in this chapter. At the end of the chapter, you will find suggestions for talking with family members about your fertility journey.
ACUPUNCTURE
Traditional Chinese Medicine is a system of health care that employs acupuncture, dietary advice, Chinese massage, and moxa (heat treatment) to help clear blockages in the body and enhance fertility and conception. Acupuncturists look at the body as a system, and emphasize balancing the Yin and Yang energies. They assess the interactions of various substances like Qi (pronounced chee), the word used for vital life energy, and blood, the denser lubricating fluid of the body. The Qi is considered to be the Yang force in the body, while the blood is the Yin component. When blockage occurs in the flow of Qi or blood, it can create an imbalance, resulting in disease or pain. Acupuncture treatments use tiny needles into the skin along meridians or energy centers to unblock the obstructions. This encourages the free flow of Qi and blood which leads to optimal health.
One Acupuncturist’s Thoughts on Fertility Issues
According to acupuncturist Ruijuan Liu, the reason we are seeing such an increase in infertility is due to the age at which women are trying to conceive as well as toxicity in the body. Kidney/Yin and Yang energy dominate reproduction and start to decline after age 35. Acupuncture and Chinese herbs rejuvenate the kidney energy, helping to enhance the function of the reproductive system. Toxicity in the body can be caused by diet and lifestyle choices as well as environmental factors. The chemicals we are exposed to from the air we breathe, medication, and cleaning products are a few factors which can cause toxicity. Acupuncture can help reduce the levels of toxicity in the body. Every patient is different and is born with a certain weakness or imbalance in the body. However, there are lifestyle choices which can cause an increase in these imbalances. Our 21st century, fast-paced lifestyle of multitasking and “doing” can cause stagnation in the liver. Cold drinks and overwork/exertion can cause a spleen deficiency. Chinese herbs and acupuncture help to bring the Qi back to these energy centers so that the energy can flow more freely and conception can take place. According to Dr. Liu, if you don’t have good soil, the seed cannot grow.
For thousands of years, Chinese medicine has had a strong focus on women’s health and fertility. One reason for this is that having children has always been highly valued in Chinese culture. Many fertility clinics now encourage their patients to seek out acupuncture as a supportive component of their care. Acupuncture can also help specifically with conditions like high FSH, thin uterine lining, ovulatory problems, low sperm counts, painful menstrual cycles, and stress or anxiety. For example, Chinese medicine seeks to improve the quality of the eggs, which can become weak due to depletion of the kidney, spleen and liver systems. Modern lifestyles, stress and poor diet can all stress these systems. Once these are rebalanced, the egg quality improves. Receiving acupuncture during an IVF cycle can help reduce the side effects from the fertility drugs, as well as create a more optimal environment for implantation. The stimulation from acupuncture can also boost the number of follicles produced when patients do acupuncture during an ART cycle. Like fertility yoga, acupuncture can help regulate hormone levels, reduce stress and help increase general well being.
When you see an acupuncturist he/she will review your history and ask many questions about how your body works. You may be asked questions such as when are you thirsty and if you get up in the night to urinate, or about the regularity of your menstrual cycles. These questions are designed to help make a diagnosis from a Chinese medical perspective, and you may hear phrases like Liver Qi stagnation, blood deficiency, or Kidney Yin deficiency, which can all be common when fertility is compromised.
In Traditional Chinese Medicine, treatment plans are very individualized, because two different people with the same symptoms may have different underlying problems. Your acupuncturist will come up with an individualized plan of action that may include dietary changes, herbs, and acupuncture treatments to support your goals. Acupuncture and fertility yoga together are very complementary, and are beneficial to both your physical and emotional well being.
A Few Basic Fertility-Supporting Practices from Chinese Medicine
Some basic fertility-supporting recommendations from Traditional Chinese Medicine, that are simple to implement, include:
· Choose warm food over cold food.
· Avoid drinking very cold liquids, and don’t use ice in your drinks. Room temperature liquids, or hot liquids are recommended.
· Keep your feet warm, so always wear socks or slippers. A warm foot-bath before bed is recommended.
To find a qualified acupuncturist, you can ask your yoga instructor, doctor, or a friend who has gone through a similar situation. All acupuncturists should be state licensed and have passed the national exam through the National Certification Commission for Acupuncture and Oriental Medicine. A directory of certified acupuncturists can be found on the NCCAOM website. See the Resource Pages at the back of the book for more information.
FERTILITY ABDOMINAL MASSAGE
Fertility abdominal massage is another ancient healing method that was used for thousands of years by midwives, shaman, and other healers in many places around the world. The most popular form of this external massage was brought to the United States by Dr. Rosita Arvigo. Dr. Arvigo was trained by one of the last traditional Mayan shaman, Don Elijio Panti. She spent 10 years studying with him and combined what she learned from him with her naprapathic and herbal training to form the Arvigo Techniques of Maya Abdominal Therapy™. To find a therapist trained in the Arvigo Techniques of Maya Abdominal Therapy™, you can visit their website at www.arvigotherapy.com.1
This non-invasive, external massage helps put the reproductive organs, most specifically the uterus, back in its proper position in the body. The massage helps improve organ function by releasing physical and emotional congestion and bringing health and vitality back to the pelvic region. Before doing the massage, the therapist will ask many questions about your body and previous traumas or injuries that may have caused the uterus to shift from its optimal position. The therapists are looking to clear both physical and emotional congestion in the abdominal area. They may also make other recommendations about nutrition or other complementary practices to aid in their work. You can expect to spend up to two hours with the therapist on your first visit, with subsequent visits lasting about an hour. Many women feel that fertility abdominal massage, either by itself or in combination with yoga or ART, has played a very powerful role in helping them become pregnant.
HYPNOTHERAPY
Hypnotherapy involves dealing with emotional issues and obstacles at the level of the subconscious mind. The theory behind using hypnotherapy for fertility issues is that often, especially in cases of “unexplained infertility,” no physical reason has been found to explain why pregnancy is not being achieved. However, the mind can have a strong influence on the health of the body, and emotional obstacles to pregnancy can be equally as important as physical problems. Hypnotherapy works to reduce the body’s stress response by processing old subconscious issues that may be causing stress around trying to conceive. These old issues can be present as blocks even if our conscious mind appears very eager to attain pregnancy. The book The Mind-Body Fertility Connection, by James Schwarz explains more about using this modality, and offers suggestions for finding a therapist.2
COUNSELING AND LIFE COACHING
Counseling in the form of psychotherapy or talk therapy can be very helpful if you have been trying to conceive for a long time or have had a difficult time on your journey. Talking with another person who is not in the medical field and who can be objective about your situation may help you get more clear on your feelings, as well as help you make important decisions around your treatment options. Experiencing miscarriages or simply the normal highs and lows we go through each month when we are trying to conceive can impact emotional and mental well being. It is not uncommon to have strong feelings of sadness, anger, resentment and even jealousy, especially right after an unsuccessful treatment or a miscarriage. When talking with your spouse, friends or family members is not enough, it may be wise to look into finding a therapist or life coach who can help you work through your feelings of loss and sadness. There are many ways to find a therapist in your area. RESOLVE, the National Infertility Organization, has a list of mental health professionals and life coaches who deal specifically with fertility. You may also want to consult your insurance company, as therapy or counseling may be covered under your insurance plan. There are also many websites that can help you connect with a therapist or life coach. Please see the Resource Pages in the back of the book for a full list of websites and resources.
ASSISTED REPRODUCTIVE TECHNOLOGY (ART)
Assisted Reproductive Technology is an option offered by fertility clinics for couples who are having difficulty conceiving. The rule of thumb that the clinics typically recommend is that you seek the help of a doctor when you have not become pregnant within a year of trying to conceive naturally if you are under 35 years of age and within six months if you are over 35 years of age.3 When you visit a reproductive endocrinologist, they will do a series of tests to see what factors, both male and female, may be affecting your ability to conceive.
Each fertility practice has their own approach to treatment, and their pregnancy success rates are published each year on the CDC website. The following list provides some information on common treatment protocols. This list is by no means exhaustive. We offer it here to give you an idea of which treatments are commonly used in conjunction with yoga and the other techniques described in this chapter.
Clomid/IUI: Many practices will advise you to start taking a drug such as, clomiphene citrate (Clomid), or letrozole (Femara). These may be taken either with or without assistance in the form of an IUI (intrauterine insemination), as a fairly non-invasive form of treatment. Clomid is a synthetic drug that stimulates ovulation by blocking estrogen receptors in the hypothalamus. The hypothalamus responds by secreting GnRH and stimulates the pituitary gland to produce FSH (follicle stimulating hormone) and LH (lutenizing hormone). The IUI consists of injecting sperm, which has been carefully prepared in the lab, directly into the uterus through a catheter.
IUI with Injectable Drugs: Depending on your age, the outcome of your test results, and the practice you are working with, you may be advised to use injectable drugs to stimulate the ovaries, combined with an IUI (intrauterine insemination) as a form of treatment. The injectable drugs are the same stimulation drugs used with in vitro fertilization (IVF). A much lower dose of the drugs is needed since the goal is to produce only 2–3 eggs. Unless special circumstances exist, fertility clinics often recommend trying IUI’s before moving on to IVF (in vitro fertilization).
IVF (in vitro fertilization): This is a more invasive treatment which requires stimulation of the ovaries, followed by a procedure to remove the oocytes (eggs) that have grown as a result of the stimulation. Sperm from the husband/partner or a donor are carefully prepared by an embryologist and placed in a petri dish with the eggs. Sometimes a procedure called ICSI (intra cytoplasmic sperm injection) is used, which involves injecting a single sperm into the egg to get better fertilization rates. Once the eggs are fertilized, the embryos begin to divide and are placed back into the uterus via a catheter between 2 and 5 days after the egg retrieval. The number of embryos transferred depends on a number of factors, including the quality of the embryos, as higher quality embryos have greater fertilization rates. The more embryos that are transferred, the more likely that pregnancy will occur. However, transferring several embryos also increases the chance of a multiple gestation and a high risk pregnancy. If there are embryos left over, clinics will offer cryopreservation (freezing) so that the embryos can be used for subsequent IVF cycles.4
Collaborative Reproduction/Donor Egg: This treatment option is often recommended by fertility clinics if the typical IVF protocol does not work, or if the doctor believes that the woman’s eggs are not viable for a healthy pregnancy. Egg donation is one of several techniques that require a third party in order to have a baby. Others include sperm donation, embryo adoption, traditional adoption, and using a gestational carrier or surrogate. While IVF with a donor egg has very good success rates, it is also quite costly and presents ethical, emotional and psychological considerations.5 To learn more about this and other forms of ART, see the Resource Pages in the back of the book for a list of helpful books and websites.
Jill’s Story
Doing fertility treatments can be very exciting but also scary. We often don’t realize what we are getting into when we go down this path, and I hope for your sake you don’t have to go too far down this road to become pregnant. One of the reasons I began teaching fertility yoga was to help other women deal with the stress of fertility treatments and trying to conceive in general. When I did my first Clomid/IUI, I just assumed that it would work. I can remember how devastated I was when I got my period that month. Each treatment got progressively more stressful as I continued down the road. I felt like so much was riding on the treatment and each negative pregnancy test was making me more and more depressed. I felt like something was wrong with Me. What did I do wrong that this wasn’t working? I kept blaming myself for not going to the doctor sooner or for drinking too much coffee or alcohol. My husband and I were fighting a lot as he felt so helpless and just wanted me to get pregnant and feel better. The only solace I found was in my yoga and meditation practice and the support group that I was going to once a month. If you have not found support through yoga, friends or a support group, I highly recommend going to Resolve’s website (www.resolve.org.) and finding a yoga class or support group in your area. You will find more information about doing yoga while going through fertility treatments as well as a stress relieving yoga practice in Chapter 6 of this book.
SUGGESTIONS FOR FRIENDS AND FAMILY
Talking about your fertility journey with friends and family can be both challenging and comforting. Well-meaning friends or family members may make a comment like, “If you just relax, you’ll get pregnant,” without realizing how this statement minimizes what you are going through. Conversely, a friend or family member may say just the right thing like, “I know you and Tom are going to be wonderful parents regardless of how long it takes or how that baby comes to you.” This section will give you suggestions about how to talk about your fertility challenges, as well advice you can share with friends and family on how to better understand your situation.
Deciding on how much you want to share about your difficulties trying to conceive is a completely personal decision that is best discussed between you and your partner. You may have different feelings about who you feel comfortable talking to about your situation and how much you want to share. If you decide to talk openly about your situation, you may find the following tips from Resolve, the National Infertility Association, helpful.
Kim’s Story
I went to visit my OB/GYN after a year of trying to conceive and not getting pregnant. He did some tests and told me that he thought I might have a mild case of PCOS and referred me to a reproductive endocrinologist. While I was in the midst of the tests and trying to find out why I was not getting pregnant, a family member got married. At the wedding reception, the bride and groom told me and my husband that “the race was on” to see which couple might get pregnant first. I remember going to the bathroom and crying hysterically as I knew I was already losing this so-called race. These family members didn’t know the extent of what my husband and I were going through, and were just trying to be funny, but that didn’t help how devastated I felt at the time.
1. Decide how much detail you and your partner want to share. Respect each other’s need for privacy about certain details.
2. It may help to rehearse exactly what you are going to say. Decide on specific words or phrases to use, such as “infertility” or “we are trying to get pregnant and seem to be having a problem.”
3. Pick a time to talk when people are not rushed or distracted. Make sure it is a private place where you won’t feel embarrassed to show emotion.
4. Explain that infertility is a life crisis, and that 1 in 8 couples, or more than 7 million people experience it.
5. Let them know how they can support you—whether you want phone calls, questions, etc.
6. Explain that you may need a break from family gatherings, and that it isn’t about them—it’s about using your energy wisely.
7. Tell them that you will share results about a treatment or procedure when you feel up to it, and not to ask about pregnancy tests or treatment results.6
One of the best ways that friends and family members can support you is by educating themselves about infertility. Most people don’t know a lot about the subject other than what they may have seen on TV or have heard from other people. And people assume that if they got pregnant without any trouble, then so can you. In my experience, it’s not that those people are all insensitive jerks; they just don’t know the facts about infertility. If you are comfortable, you can help educate family members yourself, or direct them to helpful websites or books found in the Resources Pages at the back of this book.
Another way that friends and family can support you is by listening. People often feel that they have to say the right thing, which is hard to do when it comes to this topic. Often what we need is a compassionate friend who will just listen to what we are going through without offering advice. I have found that it’s best if you are very clear with your friends and family about not really needing advice, but rather just someone to listen to your experience.
Sometimes, you just need to spend time with friends and family without talking about or being reminded of what you are going through. Again, find the friends and family members that you feel you can communicate with most honestly and openly, and try to spend time with them, letting them know that you are not up for discussing your situation.
The following list is something you may want to print out and share with your close friends and family. It’s a list of the common statements and advice made by people with the best intentions, unaware that saying these things may cause more harm than good. You can let them know that it’s okay if they’ve said any of these things to you and your partner in the past. You might tell them you are just making a simple request, and letting them know about some things they can avoid saying to anyone they know who might be having difficulty conceiving.
Things That Are Not Helpful to Hear
1. Just relax, and you will get pregnant.
2. Stop thinking about it and you will get pregnant.
3. Go on vacation, and you will you get pregnant.
4. Why don’t you just adopt?
5. Maybe you guys just aren’t meant to be parents.
6. I’m sure it will happen when you least expect it.
7. I know someone who adopted and then got pregnant.
8. Why don’t you try IVF?
9. Why don’t you try egg donor or a surrogate?
10. There are worse things that can happen.
While this is not a comprehensive list of all the wrong things to say (people can always come up with more variations!) these are some of the more common and difficult things to hear, even if the person saying them has the best of intentions.
Now, here is a list of some of the right things to say to someone who is having difficulty trying to get pregnant. Again, this list is not comprehensive, but is just meant to help people who really don’t know what to say.
Helpful Things to Say
1. I’m sorry that you are going through this. It must be really hard.
2. I’m here for you no matter what happens.
3. If you need someone to talk to, I will listen and not offer advice unless you ask me for it.
4. I love you.
5. I wish you didn’t have to go through this.
6. Is there anything I can do to help you through this difficult time?
7. I wish I had the right thing to say to help you feel better.
8. How can I best support you during this difficult time?
9. I understand if you can’t make all of the family functions during this time. You and your partner have to do what’s best for you right now.
10. If there is something I say or have said that was painful for you to hear, please let me know so I can avoid saying it again.
Again, these are just some suggestions to help the people who are closest to you support you and your partner during a difficult time. If you want to individualize the list to meet your specific situation, by all means do. Personalizing your top 10 list of “right and wrong things to say” may be therapeutic for you and your partner, and may be really appreciated by the people closest to you.