Thousands of years ago, Chinese doctors closely observed and analyzed the human body and developed a paradigm for medical treatment. Traditional Chinese Medicine (TCM), is still in use today, is radically different from modern conventional medicine’s approach of treating diseased or malfunctioning parts of the body. This ancient medical art recognizes the entire body-mind as an interconnected, interrelated system of flowing energy and incorporates an arsenal of approaches that encourages the restoration of the body to a state of balance. One of these methods is acupuncture.
Until recently, acupuncture in the United States has been closely associated with pain management, particularly back pain. Today, however, the World Health Organization recognizes acupuncture and TCM’s effectiveness in treating over forty common ailments. The list includes reproductive and gynecological disorders, cancer chemotherapy support, migraine headaches and other problems associated with gastrointestinal, urogenital and respiratory systems.

To determine an appropriate course of treatment, acupuncturists have their patients complete a detailed intake form before their first appointment. Aside from the expected health-related questions, acupuncturists also take an inventory of the diet, lifestyle and emotional aspects of the patient’s life. Acupuncturists keenly observe the patient’s general appearance, complexion, body type and tone of voice in establishing an overall assessment of the patient’s general health. Other diagnostic techniques unique to TCM include assessing the appearance of the tongue and evaluating 28 distinct qualities of the pulse. Acupuncturists also factor in information about the patient ascertained by conventional medical labs. Often, symptomatic complaints that do not conform to conventional diagnosis are treatable within the framework of TCM.

Acupuncture and TCM are based on the premise the body is imbued with vital life energy, called “qi,” which traverses the body via channels known as meridians. The flow of qi travels through the body in the same way that water flows across the earth. Disruption of that flow results in symptoms associated with poor health, much like a dam alters the environmental state of surrounding areas.

TCM philosophy also views the human body as a microcosm of the Earth. Thus, our bodies are subjected to the same climatic factors of heat, cold, dampness, dryness and wind. In TCM, most health conditions are categorized in some combination of these terms.

An acupuncturist treatment involves the insertion and manipulation of hair-thin, sterile, disposable needles. The acupuncturist inserts the needles at specific sites on the body called “points,” many of which lay along the meridians. Needles are inserted and manipulated at these points to alter the circulation of blood and qi, as well as influence the flow of chemical and hormonal reactions. After the needles are placed, a patient is typically encouraged to relax, a key element in subduing the “fight or flight” nervous system response. Therapeutically, this frees up the body’s energy for use in healing.

Heat and electrical stimulation may also be applied to the points. The heat is provided by moxibustion, the therapeutic use of artemesia vulgaris, a member of the sage family. It is burned over the points with or without the acupuncture needles in place. A battery-operated device that supplies a safe, therapeutic current to stimulate the acupuncture points provides electrical stimulation.

Both the length of treatment time and the number of treatments necessary are indicated by several factors. Acupuncture is best delivered as a therapeutic course of eight to twelve treatments, but the length of treatment depends on the patient’s constitution, age, energy level and the type and severity of the problem to be treated. Studies from China indicate that daily treatments are generally necessary two or three times per week at minimum. Treatments with less frequency are usually recommended for maintenance. Like many other forms of therapy, regular and constant visits yield the greatest results.

Generally, some improvement in one’s condition becomes noticeable after three or four treatments; however, factors such as dietary indiscretions or chronic, emotional or physical stress may inhibit the progress. Although treatments are more frequent in the beginning, as cases begin to improve, treatment frequency can be tapered off. Patients are encouraged to explore other areas of TCM philosophy pertaining to diet, exercise, stress reduction and meditation. With a qualified practitioner, they may also have the opportunity to investigate the other associated branches of TCM, which include the therapeutic use of herbs, “Tui na” (Chinese-style massage and chiropractic treatment) as well as exercise and meditation such as qi gong and tai qi.

Progressive hospitals are intergrating acupuncture into their pain management departments as well as their oncology and women’s health departments. Physicians who perform acupuncture are called “medical acupuncturists,” which means they have approximately 300 hours of continued medical education in acupuncture. By contrast, non-MD acupuncturists have had a minimum of 2,000 hours of training and have received and passing score on the National Certification Commission on Acupuncture and Oriental Medicine board exam, a licensing credential for the Ohio Medical Board.

When performed by a trained practitioner, acupuncture treatments are, for the most part, pain-free and side-effect-free with an excellent safety record. For many, the initial thought of having needles stuck in their body is unsettling; yet many patients find acupuncture so relaxing that they fall asleep on the table during the treatment.

Anyone can benefit from receiving acupuncture. It promotes natural healing and improved functioning of the body and is also useful in treating many conditions of discomfort or disease as an adjunctive, curative or preventative therapy. It may serve as an alternate mode of treatment for patients who cannot tolerate the side effects associated with conventional drug therapy or for those who have failed to respond to conventional allopathic medicine protocols.

Chinese herbs have a long history of use in aiding fertility. Records indicating herbal treatment of infertility and miscarriage date back to 200 A.D., including mention of formulas that are still used for those purposes today, in the famous medical text Shang Han Lun. The first book devoted solely to gynecology and obstetrics, The Complete Book of Effective Prescriptions for Diseases of Women, was published in 1237 A.D. In modern China, herbs are used to treat infertility in both men and women and the results of large scale clinical trials are reported in Chinese medical journals; these results have been abstracted in English by a research group in Hong Kong since 1986, and translations of whole articles are obtained, by request, from several translators. The Institute for Traditional Medicine has acquired dozens of these reports and has analyzed the information to aid practitioners in selecting the appropriate herbs for different infertility cases and to explain the dosage, duration of treatment, and prognosis.

The herbs used to aid fertility

No individual herb is considered especially useful for promoting fertility. Rather, more than 150 different herbs, usually given in complex formulas comprised of 15 or more ingredients, are used in the treatment of infertility with the purpose of correcting a functional or organic problem that caused infertility. The design of the formulas has varied somewhat over the centuries, based on prevailing theories and available resources, and individual practitioners have a preference for particular herbs, thus accounting for some of the variations among formulas that are recommended. However, differences among individuals being treated accounts for the greatest variation in the selection of herbs and formulas to be used. There are some “exotic” materials that are frequently found in fertility formulas, such as deer antler and sea horse, but the prominent materials are derived from roots, barks, leaves, flowers, and fruits. Formulas for men and for women tend to be different, but there is considerable overlap in the ingredients used.

How the herbs are acquired and consumed

In China, a number of fertility formulas can be purchased off the shelf in public pharmacies, and for uncomplicated cases, this is often adequate. However most men and women in the Orient are treated for persistent infertility by obtaining prescriptions from a doctor who is expert in Chinese herbs. In the U.S., it is uncommon to find fertility-promoting formulas in stores or other outlets; rather, they are prescribed by acupuncturists, naturopaths, or medical doctors who are familiar with Chinese herbs. The Institute for Traditional Medicine maintains a listing of such practitioners, to aid individuals anywhere in the U.S. to find a local expert in this field. Depending on the circumstances, one may be asked to ingest herbs in the form of pills, tablets, granules, or decoctions (teas). Some of the treatment plans involve using a single herb combination regularly, while others suggest using two, or even three, different formulas at different times of the menstrual cycle. All of these means can be effective, so long as the correct formula and correct dosage are used for an adequate period of time.

The success rate for Chinese herb treatments

Although the outcome for any given individual cannot be predicted, the clinical studies conducted in China indicate that about 70% of all cases of infertility (male and female) treated by Chinese herbs resulted in pregnancy or restored fertility. Depending on the particular study and the types of infertility treated, success rates ranged from about 50% up to more than 90%. Included in these statistics are cases of infertility involving obstruction of the fallopian tubes, amenorrhea, absent ovulation, endometriosis, uterine fibroids, low sperm count, nonliquification of semen, and other causes. In China, due to the greater experience with using herbs, the ability to directly integrate traditional and modern methods of therapy, and the willingness of individuals to consume relatively large doses of herbs, the success rates are probably somewhat higher than can be achieved in the U.S. at the present time. Nonetheless, U.S. practitioners have had many experiences of success in treating infertility.

Duration of treatment to attain fertility

In the Chinese clinical studies, daily or periodic use of herbs usually resulted in restored fertility within three to six months. Many Chinese doctors feel that if pregnancy is not achieved within about eight to nine months, then it is unlikely that the treatment will be successful with continued attempts. In Japan, where doctors give lower dosages of herbs and are restricted to using a smaller range of herbs, treatment time is usually longer: from six to fifteen months. In the U.S., nearly the full range of Chinese herb materials are accessible, but the dosage to be used is usually lower than in China; as a result, it is estimated that pregnancy can be achieved within six to twelve months. It must be remembered, however, that approximately one-third of infertility cases may fail to respond to all reasonable attempts. One advantage of the Chinese herbal approach is that even if pregnancy does not occur, benefits to health can be attained because the herbs address imbalances that affect other aspects of health besides infertility.

Safety of the herbs

Chinese herbs are used in the U.S. as traditional foods and not as drugs. As such, there has been no formal testing of either the safety or efficacy of any of the individual herbs or formulas. The Chinese have had long experience using these herbs; from all informal reports and clinical studies, the Chinese claim that the herbs are not only safe to use, but that healthy children are usually born without any problems during delivery. However, it is important to recognize that the use of Chinese herbs is relatively new in the U.S. and that Americans today may have more stringent safety standards than the Chinese have had in the past. Therefore, one should pay attention to perceived adverse responses to the herbs. The Chinese herbs that are used in the U.S. are not overtly toxic, but there are a few possible adverse reactions which are rare and can usually be avoided by slight adjustment in formulation or method of administration. These reactions may include dizziness or headache, dry mouth, nausea, flatulence, or change in bowel conditions. If such reactions are not resolved naturally within about three days or if they are severe, the prescribing physician can make an appropriate adjustment. In any case, by discontinuing use of the herbs, any of these reactions will disappear promptly. Allergic reactions to herbs are rare, but if a person suffers from “environmental allergy syndrome,” then the herbs can also cause the same reactions as other materials encountered in the normal environment.

Mechanism of action

The mechanism of action of the herbs is not known precisely, and undoubtedly varies according to the type of infertility problem being treated and the herb formula that is used. The traditional Chinese views are that infertility tends to arise from one or more of three prominent causes:

1. A “deficiency” syndrome prevents the hormonal system from properly influencing the sexual and reproductive functions. This is said to be a weakness of the “kidney and liver” which may influence various body functions producing symptoms such as frequent urination, weakness and aching of the back and legs, impotence, irregular menstruation, and difficulties with regulation of body temperature. Deficiency syndromes are treated with tonic herbs that are said to nourish qi (e.g., ginseng, codonopsis, atractylodes, astragalus), blood (e.g., tang-kuei, peony, ho-shou-wu, gelatin), yin (e.g., lycium fruit, ligustrum, eclipta, ophiopogon), or yang (e.g., epimedium, cistanche, cuscuta, eucommia), and are selected according to the overall evaluation of symptoms.

2. A “stagnancy” syndrome prevents the sexual and reproductive organs from functioning despite normal hormone levels and normal ability to respond to hormones. This is said to involve a stagnancy of “qi and blood,” which has the impact of restricting circulation to the tissues involved. Qi stagnation is often noted by tense muscles, restrained anger, and digestive disorders; herbs for resolving the stagnancy include bupleurum, cyperus, lindera, and various citrus products. Other symptoms that might arise include abdominal pain or bloating, chronic inflammation, and formation of lumps (including cysts and tumors). Blood stagnation often occurs following childbirth, surgery, injury, or severe infection and is typically noted when there is severe pain (such as dysmenorrhea), or hard swellings and obstructions; abnormal cell growth, including dysplasia and cancer, are thought to involve blood stagnation. Herbs such as salvia, red peony, persica, and carthamus may be used.

3. A “heat” syndrome, which causes the affected organs to function abnormally. Heat syndromes may be associated with an infection or inflammatory process. This type of syndrome can produce abnormal semen quality leading to male infertility, while gynecologic infections can maintain female infertility by blocking the passages, altering the mucous membrane conditions, or influencing the local temperature. Herbs that inhibit infections and reduce inflammation are used, including gardenia, phellodendron, patrinia, and lonicera.

In each case, the purpose of the Chinese herbs is to rectify the underlying imbalance to restore normal functions. Western medicine can diagnose tubal blockage (which usually corresponds to blood stagnancy in Chinese medicine) and infection (which corresponds to heat syndromes of Chinese medicine) and in many cases can successfully treat these causes of infertility. However, Western medicine often fails to diagnose deficiency syndromes and most of the stagnancy syndromes. Therefore, the majority of Chinese herb formulas to be applied in the U.S. are those that counteract the deficiency (called tonics) and those that resolve the stagnancy (called regulators). A description of Chinese herb formulas used for infertility is presented in the appendix to Chinese Herbology, a training manual produced by the Institute for Traditional Medicine.

The hormonal effects of Chinese herbs used to treat impotence and infertility and to prevent miscarriage have been demonstrated in laboratory experiments. For example, the laboratory evaluation of Huanjing Decoction (composed of rehmannia, ho-shou-wu, ligustrum, morus fruit, achyranthes, dipsacus, cynomorium, astragalus seed, and cuscuta) was administered to senile mice for four months, two weeks treatment, one week break. Estradiol and dihydrotestosterone receptors in the nucleus of thymic cells were decreased to levels found in young mice; cytosol estradiol receptors increased. Also, the formula influenced the immune system: it increased thymus weight, thymic index, and prevented atrophic changes in the ultrastructures of thymic lymphocytes and epithelial reticular cells.

Combining Chinese herbs and Western therapies

In China, the combined use of modern drugs or other Western medical techniques along with Chinese herbs is not uncommon; some doctors are trained in both methods, and Western and traditional doctors often work together in Chinese clinics and hospitals. When the modern methods are applied, the herb therapies do not usually need to be altered compared to cases where the herbs are used alone. Most of the cases of infertility successfully treated in China do not rely on techniques such as in vitro fertilization, which are quite expensive and have only a modest rate of success in the U.S. where the modern fertilization methods are most highly developed.

Infertility problems not overcome by using Chinese herbs

It is not advisable to suggest that something simply cannot be accomplished in the field of health care (because there are almost always exceptions), but there are some areas where chances of success are considered quite low. Some women suffer from amenorrhea that is associated with a very low body fat content. This is apparently exacerbated by strenuous exercise (e.g., distance running). Changes in diet and exercise may be necessary before Chinese herbs or other therapeutic methods can be effective. In a few cases, a woman’s immune system will attack her husband’s sperm and thus make fertilization virtually impossible; this can not be overcome with Chinese herbs. People who are under very high levels of stress or who have multiple health problems may need to have these things addressed—partly with use of Chinese herbs—before a reasonably high chance of success can be expected in the specific treatment of infertility.

Use of herbs when pregnancey occurs

The herbs for inducing fertility are usually discontinued once pregnancy is suspected or confirmed. In most cases, it is not necessary to use herbs during pregnancy. Women with a history of miscarriage or who are deemed at high risk for miscarriage (somewhat more common among women who have experienced prolonged infertility) may wish to take herbs that are traditionally used in such cases by Chinese women. Certain herbs can be used during pregnancy to enhance the health of the mother and to counteract symptoms of morning sickness. In addition, it is reported that labor can be made easier by proper application of herbs and acupuncture. Books on the subject of herbal health care for pregnancy and nursing can be traced back to such important works as A Precious Medical Book on Obstetrics for Home Use, published in 1184 A.D.

Threatened miscarriage

Threatened miscarriage, if due to an imbalance in the mother’s system (but not if due to genetic problems with the fetus), can often be overcome with application of herbs and possible adjunct therapy with moxa or acupuncture. The method to be used and the procedures to follow should be discussed early in the pregnancy so that appropriate steps can be taken should bleeding, fetal agitation, or early contractions occur. It is important to note that most cases of early miscarriage (sometimes called spontaneous abortion) are not related to an imbalance in the mother’s system but are rather a natural and fairly common event, possibly due to a development problem of the embryo. Later in the pregnancy, weaknesses in the mother’s system or excessive fetal movement, become a more prominent factor. There is a particular herb formula, called Tang-kuei and Peony Formula (Dang Gui Shao Yao San), which forms the basis of most treatments aimed at avoiding miscarriage—but the formula is intended to be used mainly as a daily preventive therapy rather than an emergency treatment. Extensive testing in the Orient indicates that this formula is safe to use and it appears highly effective; modified versions of this formula, such as Tang-kuei Formula (Dang Gui San), are used to address specific concerns and are probably of equal safety and efficacy. Other formulas, such as “An Tai Yin” (which means Peaceful Fetus Formula) and “Shou Tai Wan” (which means Fetus Longevity Pill) are popular remedies in China for use during the latter part of pregnancy.

Role of acupuncture

Chinese clinicians appear confident that most fertility problems can be overcome solely or primarily with the use of herbs; most medical books describing Chinese methods of treating infertility do not mention acupuncture. However, acupuncture therapy may address particular symptoms of concern either directly related or unrelated to infertility, and might be influential in speeding up the development of normal fertility. In the event that infertility is mainly due to functional disorders, it is possible that acupuncture alone could resolve the problem.

Here’s a doctor-approved list of which fish are safe to eat anytime—and which ones you may want to eat sparingly or avoid, especially if you’re pregnant.

According to ABC-TV’s Dr. Ian Smith, here’s what you need to know about your favorite kinds of fish:

Salmon

Low mercury levels
High omega-3 levels
Moderate protein
Farm raised-High dioxin levels
Wild-Lower dioxin levels

Fresh tuna

High mercury levels
High omega-3 levels
High protein

Canned tuna
Albacore, high mercury
Light, low mercury

Swordfish

High mercury levels
Medium omega-3 levels
Non-fatty fish

Striped/sea bass

High mercury levels
Medium omega-3 levels

Sardines

Low mercury levels
High omega-3 levels
High protein

Shellfish

Low mercury levels
Low omega-3 levels
Cook immediately

These fish are UNSAFE to eat if you’re pregnant

Shark
King Mackerel
Albacore Tuna
Swordfish

These fish are SAFE to eat if you’re pregnant

Shrimp
Scallops
Salmon
Pollock
Catfish
Canned Light Tuna

When you’re selecting a fish, choose one that has bright, clear eyes, strong scales, red gills, a fresh odor, and firm flesh, advises Smith.

(Originally published in Organic Style, July-August, 2004)

When Shaye Henderson of Galveston, Texas, and her husband, Richard, started trying for a second child in July, 2001, they were optimistic. After all, nine years before, Shaye got pregnant the first time they tried. So it was a jolt when they couldn’t conceive.

“Both of us are active and fit, and we don’t feel like we’re in our forties,” says Shaye, who was 42 at the time. (Richard was 44) “Why couldn’t we get pregnant?”

After six months of trying, the couple headed to an endocrinologist. The problem, the doctor told them, was simply this: Shaye was old. Up to age 30, women have a 20 percent chance of conceiving naturally each month. By age 40, the chances drop to five percent.

Shaye and Richard tried in vitro fertilization (which involves fertilizing eggs in a petri dish and placing them in the uterus) for 10 months. After a devastating miscarriage, they decided to pursue an unexpected path that’s attracting an increasing number of couples: acupuncture, herbs, and mind-body medicine. “You get into a desperate mode” Shaye says. “I felt I’d do whatever I had to.”
Such anguish is the norm, along with anger and frustration, says psychotherapist Mary Jane White, director of Wellness Works in Houston, a private infertility clinic.

A booming industry

Shaye’s situation is all too common. More women than ever are waiting until their late thirties and early forties before they try to get pregnant—20 percent of women 35 to 39 were childless in 2002, compared with 10 percent in 1976, according to the U.S. Census Report on Fertility in American Women. Approximately 10 percent of American men and women who want a baby are unable to conceive after a year of trying; about 90 to 95 percent of childless couples turn to Western medicine for answers—opting for drugs, surgery, or assisted reproductive technology, procedures that place sperm in the woman, use donated eggs, or retrieve, fertilize, and re-implant eggs. From 1996 to 2001, the number of Western medical interventions performed for infertility rose 66 percent, to 107,587. Helping women conceive has become a high-tech industry, pulling in $4 billion a year.

Whichever method they choose, an infertile couple confronts tough odds. One cycle of in vitro fertilization for example, has a 30 percent chance of succeeding for a woman under age 35. But after age 40, chances plummet to as low as six percent. One cycle of intrauterine insemination, a simpler procedure (costing from $300 to $700 per insemination) in which sperm is directly inserted into the uterus, averages a 15 to 20 percent success rate, again depending on age and the reason for treatment. Such medical protocols, often not covered by insurance, can be hugely expensive. In vitro fertilization costs between $10,000 and $25,000 per attempt.

The psychological burden is also bruising. “Each month is a roller coaster,” says Diane Clapp, R.N., medical information director of Resolve, a national infertility association based in Somerville, Massachusetts. “You hope that this time it will work, and then you crash when it doesn’t. That begins to wear you out emotionally.” It’s tough on a marriage too: Lovemaking turns to sex on demand, and a husband can be confused by his wife’s misery.

In addition, the fertility drugs used in many assisted-reproductive technologies can be risky to take. About 53 percent of these procedures result in multiple births, which carry a higher risk of death for an infant and complications for the mother. Then there are the drugs’ possible side effects, such as ovarian cysts, hot flashes, nausea, weight gain, headaches, and fatigue.

In one out of 100 IVF procedures, women can develop severe ovarian hyperstimulation syndrome. The result is fluid and electrolyte imbalances that can endanger liver and kidney function, cause blood clots, and (rarely) lead to death. Clomid, a commonly prescribed drug that boosts egg production, has been associated with ovarian tumors and ovarian cancer in women who use it for more than a year. Another egg-producing drug, human menopausal gonadotropin, may double or triple the risk of breast cancer in women taking it for six months or more.

Like 10 percent of infertile couples, Shaye and Richard had unexplained infertility; a month-long series of tests yielded normal results. Their doctor recommended intrauterine insemination, in which Richard’s sperm would be inserted into Shaye’s uterus.

Over the course of six procedures, Shaye took both Clomid and human menopausal gonadotropin. She knew the possible cancer risks, “but I felt so desperate for the procedure to work,” she says, “that I put up with almost anything to get my ‘old’ eggs to grow.”

During each week she expected to ovulate, Shaye took trips to her doctor every three to four days—more than an hour round-trip—for ultrasounds and blood work to pinpoint the timing of ovulation. Says Shaye: “At one point I was afraid for anyone to see the veins in my arms, they were so pocked with needle marks.” On ovulation day, when Richard needed to donate sperm, they had to go to the clinic separately so that one of them could stay home to care for their son. “Richard and I were never even in the same room when I was inseminated,” Shaye says. “It was very lonely.”

After a miscarriage and then six more months without a pregnancy, Shaye and Richard were brokenhearted. Their marriage was weighted with sadness. Shaye felt increasingly isolated; they had told no family members and few friends that they were trying to have a baby. “I didn’t have anyone to talk to about what was happening to me,” she says. And I didn’t know anyone who had gone through it.”

A promising approach

In October 2002, Shaye began researching infertility on the Internet and stumbled across the name of Randine Lewis, Ph.D., an acupuncturist based in Houston at the time; she had a background in both Western and Chinese medicine. “I was ecstatic that she was only 50 miles away, Shaye says. ‘But what struck me as soon as we met was that to her; I wasn’t a protocol. I was a woman hurting, and she was going to help me.”

Since the early 1990s, an increasing number of studies have pointed to reasons why acupuncture may work. For one thing, it significantly increases the blood flow to the uterus, helping the uterine lining to nourish a fetus. Other studies suggest that acupuncture can re-normalize hormone secretions that affect ovulation. It can also relax the uterus, making it easier for an egg to stay put. In fact, in a widely accepted 2002 German study of women undergoing assisted reproductive technology, 43 percent of participants also using acupuncture became pregnant, compared with 26 percent of those using only reproductive medicine.

Lewis, however, doesn’t rely on needles alone. She also offers herbal remedies that regulate hormones, mixes of 10 to 15 carefully vetted, pesticide-free herbs per capsule that she assembles for patients individually. “We find out what each person’s pattern of imbalance is,” she says. “And then we make up formulas that address those imbalances.”

The stress connection

Shaye continued taking herbs, but she had to discontinue the acupuncture treatment because it was too expensive. Typical treatments run from $85 to $200 per session (minimal recommended treatment is once a week for three months). In March 2003, six IVF procedures and $2,500 of the Hendersons’ own money later (Shaye did have some insurance coverage), her doctor called it quits, telling Shaye that at 44 she was too old for in vitro fertilization to work.

“I was devastated and depressed,” Shaye says. “My stress was off the Richter scale.” Shaye was also grieving for the 16 months she and her husband had lost, robbed by an increasingly punishing pursuit of a baby.

Then Randine Lewis suggested Shaye attend a 10-week behavioral-treatment program (exercise, nutrition, group therapy, and once-a-week mind-body sessions) that was run at the time by psychotherapist Mary Jane Vihite at Wellness Works in Houston. White’s program is based on one developed in 1987 by psychologist Alice Domar, who was one of the first to investigate using mind-body techniques to treat infertile women. “I couldn’t get the first three women who signed up for my study to stop crying long enough to fill out the forms,” she says. Their grief was so palpable it drove Domar to create the world’s first mind-body program for infertile women. The results astonished her: “They came in depressed, and within 10 weeks they became psychologically healthy again. A third of them got pregnant. These were women who had been trying to conceive for more than three years.”

Numerous studies document the effect of depression on the ability to conceive. A study by Memorial Hospital in Pawtucket, Rhode Island, for example, found that depressed women were twice as likely to be infertile as women who were not depressed. Another study indicated that depressed women had abnormalities with the luteinizing hormone necessary for ovulation. “There are a lot of things that can happen when you have ongoing stress,” White explains. “You can disrupt hormonal balance, have fallopian tube or cervical spasms, or shut down ovulation. If your body is having a fight-or-flight response, everything inside it is gripped.”
Since her program’s debut, Domar has documented that women struggling to conceive are as depressed as those with life-threatening illnesses such as heart disease, cancer, and HIV.

She has found that alleviating depression can help at least some women become pregnant. In her 2000 study of 184 women, more than half of those in a support group or a cognitive-behavioral group conceived and had a baby, compared with only 20 percent of those in the control group. But for Domar something more important happened: These women, pregnant or not, got their lives back.

The return to living

Not everyone who enters these programs conceives. Catherine (not her real name), a 33-year-old physical therapist from Chicago, has been trying to get pregnant for two years. Like Shaye, she took fertility drugs, suffered a miscarriage, and then learned about Lewis and White’s three-month fertility workshops in Asheville. Much of Catherine’s relief has come from meeting other women who understand her. “I’ve felt an overwhelming sense of power in sharing my experience within the safe embrace of women also trying to conceive,” she says. “I don’t think bringing my stressed-out, imbalanced body to the table gives doctors much chance of helping me.”

“Every week I insist that they tell me one really good thing,” White says. “Not about fertility but about their garden, a good dinner, a vacation. I’m trying to get them to put fertility in perspective.” For Shaye, such an assignment was tough. Initially she felt she had nothing good to report. “When Shaye came into my program, she was so depressed she couldn’t figure out what to do next,” White says. “She cried throughout our initial evaluation.” But gradually, the permission to resume living transformed her.

Within weeks, Shaye brightened. And she began riding horses, a childhood dream. “I was taking care of my family again, and I was okay with not having another child,” she says.

Shaye finished White’s program in June 2003 feeling relaxed and at ease: “I was back to being grateful for the beautiful family I had, and I was living every day with them instead of living every day as cycle day number X.” On August 17, her period was one day late. “I did a home pregnancy test, and there it was, positive.” The couple’s baby boy, Caden, whom she calls “our little miracle,” was born April 20, 2004. As Shaye says, “It is a very happy ending – and beginning.

That’s the word from researchers at the University of Texas Southwestern, who have concluded in a laboratory study with mice that tasty foods, especially those high in fat, send a signal to the brain to keep eating. Specifically, the molecules of some types of fat travel to the brain, which then instructs the body not to stop eating just yet.

HealthDay News reports that the type of fatty acid that appears to do the most damage is palmitic acid, which is found in beef and dairy products, such as butter, cheese and milk.

“Normally, our body is primed to say when we’ve had enough, but that doesn’t always happen when we’re eating something good,” study senior author Deborah Clegg, an assistant professor of internal medicine, said in a university news release. “What we’ve shown in this study is that someone’s entire brain chemistry can change in a very short period of time. Our findings suggest that when you eat something high in fat, your brain gets ‘hit’ with the fatty acids, and you become resistant to insulin and leptin,” which are chemicals that tell the body to stop eating, Clegg said. “Since you’re not being told by the brain to stop eating, you overeat.”

How long does the effect last? In the rodents, it lasted three days after eating the food.

The study findings were published in The Journal of Clinical Investigation.

You’re all set to begin your new weight loss program. The diet book has been read, the treadmill is working and you just bought cute new workout shorts. One more thing: Go to your doctor and get your vitamin D levels checked.

The level of vitamin D in your body at the start of a low-calorie diet can predict your weight loss success–or failure, according to a study from the University of Minnesota. “Vitamin D deficiency is associated with obesity, but it is not clear if inadequate vitamin D causes obesity or the other way around,” said the study’s lead author, Dr. Shalamar Sibley, an assistant professor of medicine.

The study: The circulating blood levels of vitamin D were measured in 38 overweight men and women before and after they followed a diet plan for 11 weeks consisting of 750 calories a day fewer than their estimated total needs. Each participant’s fat distribution was measured with DXA (bone densitometry) scans.

The results: On average, the participants had vitamin D levels that many experts would consider to be in the insufficient range. But Sibley discovered that the baseline, or pre-diet, vitamin D levels predicted weight loss in a linear relationship.

For every increase of 1 ng/mL in level of 25-hydroxycholecalciferol–the precursor form of vitamin D and a commonly used indicator of vitamin D status–the dieters lost almost a half pound more on their calorie-restricted diet.

For each 1-ng/mL increase in the active or “hormonal” form of vitamin D (1,25-dihydroxycholecalciferol), they lost nearly one-quarter pound more.

In addition, higher baseline vitamin D levels predicted greater loss of abdominal fat. “Our results suggest the possibility that the addition of vitamin D to a reduced-calorie diet will lead to better weight loss,” Sibley said.The study findings were presented at The Endocrine Society’s 91st Annual Meeting in Washington, D.C.

by Jo Merchant

A combination of stress, dieting and exercise can dramatically affect female fertility, research on monkeys suggests. Although stress is known to reduce fertility, researchers now warn that if a woman is also dieting and exercising, the effect could be many times greater.

In stressed women, increased levels of a hormone called cortisol block the signal from the brain that tells the ovaries to release eggs, explain Sarah Berga and her colleagues at Emory University School of Medicine in Atlanta, Georgia.

In severe cases, a woman can stop producing eggs altogether and have her periods cease — a condition called amenorrhoea. About 5-10% of women suffer from amenorrhoea and Berga has previously found that giving such women behavioural therapy to control stress levels can help restore periods and fertility, without the need for specific fertility treatment1.

Amenorrhoea is also caused by severe dieting and exercise, so to find out how these factors interact, Berga subjected a group of female monkeys either to mild stress (by putting them in a different room each day), or to a regime of calorie-restricted diet and exercise. The team presents its findings at the annual meeting of the European Society of Human Reproduction and Embryology (ESHRE) in Prague.

Potent mix

In each group, 10% of the monkeys stopped having periods. But when the monkeys were subjected to stress as well as diet and exercise, 75% of them stopped having periods.

Berga says the results show that women hoping to conceive should be particularly careful about dieting and exercising when stressed. “A little of each was much worse than a little of one,” she says. “They feed off each other.”

Having periods stop altogether is relatively rare, but Berga believes that stress levels could be affecting fertility to a lesser extent in many women. She is now starting a study that will track daily hormone levels in the urine of around 3,000 US nurses over the course of a year, to see how many of them have menstrual cycles disturbed by tension.

Researchers are also seeking clear evidence to show whether reducing stress can improve a woman’s chances of getting pregnant during fertility treatment. Studies looking at stress in women undergoing IVF have so far been quite small. But Bea Lintsen of Radboud University Nijmegen Medical Centre in The Netherlands and her colleagues presented to the Prague meeting the results of a larger study, involving 1,088 women.

The researchers gave the women questionnaires about their anxiety levels while they were on the waiting list for treatment, and again one day before their eggs were collected. They conclude that stress didn’t significantly affect the women’s chances of conceiving. “We did not find a relationship between psychological stress and IVF outcome,” they told the meeting. “Women who are concerned that their stress might harm their chances of conceiving can be reassured.” This study, however, did not look at the additional effects of dieting and exercise.

Clowning around

However a unique study from Israel suggests that at a key time immediately after IVF treatment, using humour to lighten stress levels temporarily might improve the success rate. Shevach Friedler of the Assaf Harofeh Medical Centre in Zerifin is a graduate of the Jacques Lecoq school of mime and theatre in Paris. “My background is in clowning and movement,” he says. “I’m also a physician who works in IVF. I thought we could combine the two.”

He decided to employ a clown to entertain his patients as they recovered from their treatment. “After embryo transfer, stress could be critical, so we think this is a good time to use clowning to relax them,” he says. “Everybody knows that humour is an effective way to reduce stress.”

Over ten months, 93 patients aged between 25 and 40 were treated to the clown’s performance for 10-15 minutes, shortly after their embryo transfer. Some 36% of them conceived, compared with just 19% in a group who didn’t see the clown.

Worried that sophisticated adults might not find a traditional clown amusing, Friedler came up with a comedy chef character who offered the women steak and chocolate cake. “A clown with a red nose is fine for children, but we had to invent a new character for these adult women,” he reflects. “The point is to get the women to smile and laugh.”

YOUNGSTOWN — Traditional Chinese Medicine (TCM) recognizes the entire mind-body system as an interconnected and interrelated system of flowing energy (Qi) and seeks to restore the body to a state of balance. Anne Kinchen, R.Ac., explains how imbalances may be determined, and what steps may be taken to create wellness.

Kinchen, of Youngstown Acupuncture and Massage Therapy, is a registered acupuncturist, who earned her masters degree in TCM from the Pacific College of Oriental Medicine, San Diego. She is also a National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) in Chinese Herbology and Acupuncture, and an Ohio Medical Board licensed acupuncturist. She specializes in women’s health issues and infertility, but also treats numerous other illnesses.

Point of view

Kinchen uses three main methods to gain understanding of a client’s condition. Each client is asked to fill out a lengthy form containing questions about medical history, diet, symptoms, sleep patterns, emotional conditions, lifestyle, and many other factors that influence a person’s well-being. She also asks the clients how they feel, what they are feeling. Next, there are six pulse positions she uses for further information. Then she does a thorough examination of the tongue. She notes color, coating, shape and motility. “The tongue is divided into three sections: upper [tip], middle and lower,” she says. “Each section represents a different part of the body.” For instance, the upper represents the heart and lungs, the middle, stomach and spleen, and the lower, reproductive and elimination organs. The sides of the tongue represent liver and gall bladder.

In the most simplistic terms, TCM seeks to balance “yin and yang.” Yin is “cool, rest, night, water,” while yang is “heat, activity, day, fire.” If a person is hot, cool them off, if they are cold, warm them up. TCM diet goes against what many people today believe to be healthy. For instance, it does not advocate raw foods, salads, cold drinks. “The stomach wants warmth,” says Kinchen. “The liver needs a good supply of blood [meat].”

Symptoms

A person suffering from too much heat could be irritable, dry and thirsty, while someone who is cold might be lethargic and have aches and pains. Someone with Qi deficiency would feel breathless or listless. A person suffering from dampness could have phlegm or an accumulation of fluids, and from wind, would have shaking or palsy, or transient pain.
Kinchen then uses this information gained to help determine a course of treatment, which includes acupuncture and herbs. Where there are multiple problems, she begins with the area that is most troubling to the client.

Acupuncture needles are very thin, sterile, disposable needles that are gently inserted into “points,” specific sites along the meridians where it is believed “Qi” flows through the body. The points correspond to specific organs, and the needles are believed to open or stimulate the flow of “Qi.” Most people do not experience and painful sensations with the needles, and many become so relaxed that they fall asleep during treatment.

Differences

“One of the reasons TCM is not too effective in America is from the infrequency of treatments,” says Kinchen. “In China, 10-15 treatments would constitute a course of therapy over a 2-4 week period (for acupuncture). Sometimes two different sets of points are alternated over the period. After that course of treatment is finished, the client is re-evaluated. However, in America clients may come on once a week or less, and the treatment is just not as effective.”

Lynn Shandor of Petersburg, a client of Kinchen, came to her as a last resort and had found relief. She was diagnosed with liver disease in 1988, and had a liver transplant in 1999. She did well for about 3 years, but then the pain and symptoms returned.

“I was frustrated with the pain and the medications. I just didn’t want to do that again,” said Shandor. “I came to Anne out of desperation.”

Kinchen does regular acupuncture treatments for her, and also recommended castor oil in a pack, which is placed on the skin, covered in flannel and plastic wrap, then a heating pad. “This helps the blood move around and relieves stagnation,” says Kinchen. Since infertility is Kinchen’s specialty, when she has clients with other issues, such as Shandor’s, she often takes them to Dr. Guo in Chicago, whom she considers an expert. He is an M.D. (oncologist), also trained in TCM.
Kinchen regularly takes her cancer clients to Dr. Guo. She compares Chinese to Western philosophy in the treatment of cancer: “Life is like a field with plants and weeds. Western medicine says, ‘Let’s raze everything, burn down everything [chemo and radiation], and hope something good survives and grows back.’ Chinese medicine says, ‘Support the normal. Nourish the good plants so they crowd out the bad.’ Chinese medicine addresses the thing that lead to the disease in the first place.”

(HealthDay News) — Your body may make better use of a vitamin D supplement if you take it with your largest meal, new research suggests.

Researchers at the Cleveland Clinic examined 17 patients with vitamin D deficiency who weren’t getting better under treatment. Over a period of two to three months, the patients were told to take vitamin D supplements with the biggest meal they ate each day.

This boosted the level of vitamin D in their blood by an average of 56 percent, the researchers said.

“This is an important finding for patients being treated for vitamin D deficiency,” study senior author Dr. Angelo Licata said in a news release from the Cleveland Clinic. “By doing something as simple as changing when you take your vitamin D supplement, you can improve the level in your blood by over 50 percent.”

The study was recently published in the Journal of Bone and Mineral Research.

More information

For more about vitamin D, see the U.S. National Library of Medicine.
– Randy Dotinga

SOURCE: Cleveland Clinic, news release, May 5, 2010