On a bitter-cold December night five years ago, I took a pregnancy test. Negative. For the seventh month in a row. In bed, I asked my husband, "Do you think I'm able to have a baby?" I needed him to believe in me -- to trust my body. "I think it's possible," he said, placing his hand on my belly. A year from that night, I was pregnant. Then, just 10 weeks later, my morning sickness disappeared. My breasts, which had begun to swell, shriveled. And as I had so many other months, I bled.
The miscarriage was particularly devastating because it forced me to finally confront the harsh reality that I was no longer in my prime baby-making years. Even though I felt young and healthy, I was approaching 35. A woman's fertility begins to decline after 30, sliding by 3 to 4 percent each year, according to a Netherlands study published in the British Medical Journal, and doctors consider 35 to be an "advanced maternal age." Another study found that getting pregnant is nearly impossible after age 44. I knew every month was critical. So when I recovered, I saw a doctor, who diagnosed me with endometriosis and suggested I see a fertility specialist. After one unsuccessful round of artificial insemination and a few months of taking Clomid, a fertility drug that gave me awful headaches, I became a candidate for in vitro fertilization (IVF), a costly process in which the egg is fertilized outside the body. Administered about 148,055 times in the United States each year, it's successful in roughly a third of infertile women my age. As someone who shies away from cold medicine, let alone injectable hormones, I was afraid of what the shots would do to my body. Though my fears weren't based on any medical study, my gut told me IVF was a line I wasn't willing to cross.
I turned to a world that offered me some semblance of control: holistic fertility treatments. I already practiced yoga regularly, and that led me to its sister science, Ayurveda, an ancient system of medicine that prescribes specific guidelines on diet, behavior, and daily routines. When I read about a trusted women's health clinic in Kerala, India, the epicenter of Ayurveda, I signed up for a three-week detoxification program. Traveling halfway around the world may seem radical and extravagant to some, including my husband, initially; the $3,000 program wasn't covered by health insurance (most holistic fertility treatments aren't). But it was still cheaper than IVF, and I was desperate to conceive. I had to do something.
The months that followed were interesting -- and confusing. After leapfrogging from one treatment to the next and burying myself in research, what emerged were five noteworthy therapies, each with its own benefits and drawbacks. While my journey hasn't resulted in pregnancy yet, the world of holistic medicine armed me with tools like resiliency, flexibility, and optimism. I don't know yet what the road ahead will look like for me, but I feel ready for it -- and grateful for the journey.
Nearly a quarter of infertile couples turn to acupuncture, a practice in which thin needles are inserted into various points along the body to stimulate and balance the flow of energy, known as chi.
A number of well-designed studies have been conducted on acupuncture. "About half show a significant positive effect," says Alice Domar, Ph.D., of the Domar Center for Mind/Body Health in Waltham, Massachusetts. In 2002 Weill Cornell Medical Center researchers published evidence that acupuncture may increase blood flow to the uterine lining, making it more receptive to implantation. Acupuncture seems to be most promising when used with IVF. One German study showed that women who underwent acupuncture both before and after an IVF embryo transfer had a 43 percent success rate, while the no-acupuncture half had only 26 percent. But not all doctors are persuaded. "Though some of these studies seem encouraging, the overall results haven't been particularly positive," says Brent Bauer, M.D., director of the Complementary and Integrative Medicine Program at the Mayo Clinic.
I tried acupuncture before I left for India. Unfortunately, a throbbing ache lingered at each insertion point -- I suspect my anxiety over treatments canceled out any possible benefits.
The bottom line
If you can handle the possible sensations (a pinch or sharp pain or tension at the pressure point), go for it. Unlike some holistic fertility treatments, acupuncture is a licensed medical profession in most states with recognized standards and regulations. Find a certified practitioner at nccaom.org.
In Greek mythology, pomegranates are prized for their fertility powers. Here on earth, though, no single food will make a woman magically conceive, but analysis shows that diet does play a role.
A recent study linked a Mediterranean-style diet rich in vegetables, vegetable oils, and fish to a better chance of conception after fertility treatments. And the Harvard Nurses' Health Study found that eating more beans and nuts and less trans fat had benefits, too, correlating with higher pregnancy rates in women with ovulatory infertility. "Nutrition can affect inflammation, and there's an intersection between that and certain [fertility-reducing] conditions, like polycystic ovary syndrome (PCOS)," says Beth Heller, co-owner of Pulling Down the Moon, a holistic fertility center with offices in Chicago and Washington, D.C.
In India I followed an Ayurvedic diet: rice, lentils, vegetables, fruits, and nuts. Each morning I drank raw whole milk from a cow at the clinic, because according to Ayurvedic tradition, raw milk -- since it comes from a peaceful, mothering animal -- is said to enhance fertility. Now that I'm home, I try to get the milk through an Amish farmer -- not sure if it's worth the effort.
The bottom line
Don't obsessively follow any so-called fertility diet, Domar says. Instead, eat a variety of fruits and vegetables, whole grains, lean meats, and fish. Most doctors agree that reducing carbohydrates and processed foods, especially ones loaded with sugar or salt, helps. "Those foods make us pump out lots more insulin, which can affect the reproductive system," says Alan Penzias, M.D., a reproductive endocrinologist at Boston IVF and an associate professor at Harvard Medical School.
"Just relax!" Easier said than done. But infertility is associated with higher levels of tension. Massage can release some of the stress. More clinics are offering fertility rubdowns, such as myofascial release and Ayurvedic abhyanga, in which the abdominal area is gently kneaded to target the uterus. "Imagine the blood vessels that go to the uterus as hoses -- for many women, they're a little kinked," says Jill Blakeway, a licensed acupuncturist with the YinOva Center in New York City. "By moving the position of the uterus, you can increase blood flow to it." This can help optimize the thickness of the endometrial lining, where an embryo implants.
Little if any evidence shows that fertility massage improves pregnancy rates. But one study found that massage decreases levels of the stress hormone cortisol, and others show it helps relieve depression and anxiety, which many women struggling with infertility face.
Every morning on my retreat, I had an Ayurvedic oil massage: Two therapists rubbed my scalp, joints, and abdomen. It felt great, and I was relaxed for the first time in months. The clinic sent me home with herb-infused oil and encouraged self-massage every morning.
The bottom line
"If you enjoy massage, go ahead," Domar says. Just stick with licensed therapists who specialize in fertility, especially if you're undergoing assisted reproductive technology. "Massage may affect the way fertility medication works," Heller says. Avoid massaging the reproductive area after receiving injections or an embryo transfer.
Chinese and Ayurvedic Herbs
These remedies may seem like the least invasive method, but their use is controversial. Traditional Chinese Medicine (TCM) practitioners almost always prescribe common plants such as "suo yang" and "nu zhen zi" fruit in blends, making their effects difficult to track and study.
Though certain TCM treatments are reputed to regulate hormone imbalances and menstrual cycles in women and abnormal sperm morphology in men, there's no Western research to support either claim. Further, studies have found that up to 20 percent of Ayurvedic and 30 percent of Chinese herbs manufactured abroad are contaminated with traces of lead, mercury, or arsenic. (In 2007 the FDA instituted new regulations to help ensure the safety of imported and domestic herbs.)
At the Ayurvedic clinic, I took a variety of herbs (personally picked by therapists) from the garden three times a day to help regulate my cycle. When I got my period, my luteal phase (roughly the two weeks following ovulation) had lengthened. Before, it had been too short, making it hard for a fertilized egg to implant. That little shift tricked me into thinking the herbs were working.
The bottom line
Considering the risks, take only herbs prescribed by a board-certified practitioner.
Women struggling with infertility may be branding themselves with a modern-day scarlet letter: S. Stress plays a role in 30 percent of fertility problems, studies find, yet it's often the last thing women address. "We're programmed not to reproduce when we're under stress," says Elizabeth A. Stewart, a professor of obstetrics and gynecology at the Mayo Clinic College of Medicine. In response, more wellness centers and hospitals are offering mind-body therapies such as yoga and meditation.
It's promising. Domar found in one study that women who participated in five to 10 mind-body sessions over 10 weeks had a 52 percent pregnancy rate, compared with 20 percent in a control group. Other studies suggest that yoga can "arrest stress and open the body," says Brenda Strong, spokesperson for the American Fertility Association. Meditation looks hopeful, too: "Breathing techniques can redirect your mind from fight-or-flight to a rational, problem-solving place," Bauer says.
Deep sleep, yoga classes, walks through coconut groves -- I enjoyed them all. After a few group meditation sessions, finding my inner stillness wasn't much of a struggle.
The bottom line
A group session of fertility-focused yoga, meditation, and cognitive therapy could be one of your best bets, Domar says. "Simply being with other people who understand what you're going through is really powerful."
By Jenny Rough; additional reporting by Michelle Herrera Mulligan
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