Читать книгу Pathways to Pregnancy - Mary Wong - Страница 9

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You Are Not Your Diagnosis

A woman is like a tea bag; you never know how strong it is until it’s in hot water.

ELEANOR ROOSEVELT

Vanessa: Unexplained infertility

Vanessa met her husband, Robert, at thirty-two, married at thirty-four, and started trying to have a baby right away. After six months, they went to her family physician to get a referral to a reproductive endocrinologist (RE). Couples must have tried to conceive for at least a year without success to be referred to a fertility specialist. For some, every passing month feels like an eternity. This must have been the case for Vanessa, who fibbed to her family doctor, telling her they’d actually been trying for a year.

At the same time as Vanessa was seeing the RE, she was coming to my clinic for acupuncture. I encourage my patients to get medical testing if they’re having trouble conceiving because it provides a baseline from which I can help them more naturally align themselves and their environment to support conception. It also allows us to rule out any structural or genetic issues.

Through my TCM examination, I discovered Vanessa had premenstrual symptoms, including several days each month of breast tenderness, back pain, lower abdominal pain, weakness, and moodiness. Like many patients who have visited a fertility clinic, Vanessa was surprised by the depth of my inquiry into all aspects of her health and lifestyle. At the fertility clinic, her diagnosis of unexplained infertility was based solely on her report of not becoming pregnant despite trying for a year and the clinic’s inability to find an explanation. Her RE advised her to begin treatments as soon as possible because she was thirty-five—approaching what fertility clinicians call advanced maternal age.

A jumping-off point

One of the most difficult things I see in my clinic is a woman who is in her mid-thirties, still feeling young and vibrant, yet distressed after a fertility doctor has used terms like “unexplained infertility” and “advanced maternal age.”

I greatly respect fertility specialists; as I discuss in Chapter 8, my own daughter was born through IVF. I’ve experienced the stress of fertility clinics first-hand, as well as the miracle of birth using assisted reproductive technology (ART). The difficult part is healing the emotional impact of a diagnosis on my patient’s body, mind, and spirit.

I have my work cut out for me when a healthy thirty-five-year-old is weeping in my office, having been told to consider intrauterine insemination (IUI) and in vitro fertilization (IVF) before her aging eggs reach their expiration date. My first job in this situation is to shrug off my own anger at a doctor who would say such cold words to a woman who’s come seeking help.

I am not suggesting you ignore your diagnosis, or live in denial of it, but that you think of it as a jumping-off point, an opportunity to become proactive in your fertility journey and overall health. You are a dynamic human being; with a renewed perspective, you and your body can both change. Do not let a doctor’s words stop you. Your pathway to pregnancy may just be different than the one you had planned.

White-coat hypertension

There is a well-known effect called white-coat hypertension or white-coat syndrome. This is when a patient whose blood pressure is normal when monitored at home becomes elevated at the doctor’s office. Just sitting in front of a doctor can cause emotional anxiety and raise your blood pressure. I well remember my heart racing and my palms sweating on my first visit to a fertility clinic.

I tell patients that a blood test captures conditions at a moment in time. During those initial visits, a woman is at her most vulnerable—nervous, anxious, and worried. If her doctor says he doesn’t expect she can get pregnant naturally and she’d better start treatments right away, she may feel sadness, despair, grief, anger, frustration, fear, worry, and anxiety. Worse, she may barely have time to take in this information and process her emotions before feeling pressured to choose her next steps.

I felt all of these emotions over the course of my own fertility treatment, and I want to share with you how important it is to acknowledge, process, and release them. Words from a physician are powerful and can elicit strongly negative emotional, psychological, and physiological impacts. This is called the nocebo effect, Latin for “I shall harm,” a term coined by Walter Kennedy in 1961.¹

I see the nocebo effect every day in my clinic. Many patients believe a doctor’s words are the absolute truth, but that diagnosis represents a particular doctor’s beliefs and theories, based on experience, statistics, and research. Without intending to discount these, any doctor’s knowledge of research can be outdated, and their experience is necessarily confined to their own practice.

Over the years, I have seen many women who have undertaken extensive fertility treatments go off on their own, whether to take a break from treatments or stop entirely, and spontaneously conceive. It happens too often to be written off as coincidence.

You have a filter

The first step in hearing your diagnosis in a healthier way is to change the filter through which you hear it. This is not simple, and it’s not likely to happen overnight, but you can start by becoming aware that you have a filter and paying attention to its impact on your ability to remain positive. Here are some ways you can change your filter:

•Ask yourself, is your diagnosis the ultimate truth? When I received my diagnosis (see Chapter 8), I acknowledged the condition but refused to live with the label “infertile.” Instead, I opened myself to creative ways of building a family, including IVF, donor eggs, and adoption. At the same time, I continued with my healthy diet, moderate exercise, and positive lifestyle.

•Surround yourself with positive people.

•Be grateful for your overall health.

•If the doctor says you are reproductively old, find examples of women who defy the odds and tell yourself you can be one of them. (I hope you will find yourself in some of the women I describe in this book.)

•Remind yourself that the tests form a baseline picture of your current reproductive health. Focus on what you can do to improve that picture by taking charge of your diet, lifestyle, and stress-management strategies.

•Remember that a diagnosis is usually more opinion than fact; you can always get a second opinion.

Pregnancy really is a miracle

We see pregnancy around us so often that we take it for granted. Few of us realize how many conditions must line up perfectly just to prepare a woman’s body to conceive. Consider this simplified list of requirements for an embryo to become implanted:

1.The brain (hypothalamus, pituitary) must release the right hormones properly to stimulate egg development.

2.An egg of good enough quality must develop to maturity, and it must be chromosomally normal.

3.The brain must release luteinizing hormone (LH) to stimulate final ripening of the egg and ovulation (release of the egg).

4.The follicle in which the egg develops inside the ovary must rupture at time of ovulation and release the egg.

5.The fallopian tube must “pick up” the egg.

6.The sperm must be of good enough quality to survive and swim up the fallopian tube from the vagina and through the cervical mucous.

7.Once there, the sperm must sit ready and perched, waiting for the egg to drop so it can penetrate the shell.

8.The sperm must release its DNA of twenty-three chromosomes into the egg to fertilize it.

9.The fertilized egg must undergo cellular division to become an embryo and then continue to divide normally.

10.The embryo must make its way down the fallopian tube into the uterus by the third day of development, where it will have a different environment in which to survive and grow.

11.Once there, the embryo must continue to develop and expand into a blastocyst (a multi-celled embryo) and then hatch out of its shell and implant in the uterus.

12.The endometrial lining of the uterus must be ready for implantation (a complicated, multi-step process of its own).

Western medicine and fertility clinics focus on what might be wrong with any of these details, how they might explain it, and how they might fix it. They test blood levels of reproductive hormones and examine ultrasounds of developing follicles. They administer hormones; perform IUI, IVF, or surgeries; or combine these technologies.

TCM looks less at the details and more at the big picture. After all, women’s bodies have been going through this intricate process for millions of years. According to TCM, when the conditions are right and your internal environment is balanced and healthy, your chances of conceiving and carrying a healthy and successful pregnancy to term are great.

What is “unexplained infertility”?

Infertility is defined, in Western medicine, as when a woman has been unable to conceive after a year of unprotected sex. When a doctor can’t find a specific explanation for this, he or she may diagnose unexplained infertility. Twelve percent of couples experiencing fertility challenges are diagnosed with unexplained infertility.²

I see women nearly every day who have spent months conscientiously trying to conceive, feeling hopeful and excited. They’ve also had monthly feelings of disappointment and sadness when they discovered they weren’t pregnant, whereupon most resolutely return to baby-making. But many of the women in my practice admit to going online and diagnosing themselves with unexplained infertility after only a few months of unprotected sex.

Please don’t do this. It has a negative impact on your ability to keep a positive state of mind. I rarely use the word “infertile” in my clinic. In my opinion, this word alone can create a negative environment in your body, mind, and spirit. It’s a word I’ve spent many hours counselling my patients to stop focusing on.

Unfortunately, when a woman hears a diagnosis of infertility, she infers, “I am infertile.” My perspective is that, at that moment in time, that woman’s system is simply saying, “No, not now” to having a baby. Instead of using the words “infertility” or “infertile,” I encourage women to say, “At this time, I am having a challenge with my fertility.”

In my practice, I have seen many women conceive outside of the one-year time frame. The only fertility challenge I diagnosed was that they were out of balance and needed guidance to create a nurturing environment and prepare their soil to receive and nurture their seeds.

How TCM can help

One of the first things I do with patients who’ve been diagnosed as infertile is to help them let go of their negative assumptions. Acupuncture sessions may help them release thoughts and feelings that seem stuck in their minds, while counselling or hypnosis may help them process upsetting experiences they’ve had on their journey to conceive.

What you can do with any TCM practitioner is optimize your chances of creating life by treating underlying imbalances that Western diagnostic tools may not reveal. TCM goes beyond technological diagnoses to look at your overall state of health by inquiring into your lifestyle habits and your physical, emotional, and psychological well-being. The philosophy in Chinese medicine is that you are most likely to conceive naturally when you are more balanced physically, mentally, and emotionally.

Using Chinese medicine, I guide my patients to achieve balance in their overall well-being rather than focusing on the twelve tiny details of implanting an embryo or the specific challenges their body is going through. Throughout this book, I will share with you the same guidance I share with them about eating healthier, engaging in moderate exercise, relaxing, and creating a positive environment in which to grow a baby.

Blending Eastern and Western medicine

Vanessa and I began weekly acupuncture treatments—at the same time as she went to her fertility clinic—to help dissipate and rectify her imbalances. Although her menstrual cycles were regular at twenty-eight days, her other symptoms, according to TCM, reflected imbalances within her cycle.

Western medicine focuses on the numbers associated with menses. It considers a menstrual cycle irregular if it is less than twenty-five or more than thirty-five days; twenty-eight days is considered normal. In TCM, however, we also consider the quality of menses and associated symptoms, like the number of days of blood flow; the thickness, colour, and odour of the blood; and the extent of abdominal pain and bloating, fatigue, and headaches before, during, and after menses.

In TCM, these details reflect a woman’s overall state of health and degree of balance within the environment in which she hopes to grow a baby. The information I gather provides a baseline for the way a woman’s body and reproductive system are functioning. I provide information to help my patient better align her body to receive life. For Vanessa, I did acupuncture at specific sites with the goal of sending a message to her brain to release certain hormones, while inhibiting others to decrease her menstrual symptoms and improve her reproductive balance.

Vanessa chose to monitor her cycle through the fertility clinic. Beginning on the third day of her cycle, the woman returns to the clinic almost daily for blood tests and a transvaginal or intrauterine ultrasound, in which a technician inserts a transducer (phallic-shaped probe) covered with a condom and lube into the vagina and blood tests. The ultrasound counts the number of antral follicles (ovarian follicles that contain eggs) the woman has and tracks their growth, while the blood tests measure hormone levels.

Initially, these tests may be performed every couple of days, increasing to daily as the time for ovulation approaches. The woman may also receive injectable hormones to incite superovulation, which stimulates the ovaries to create more than one egg, increasing the chance of conception. Cycle monitoring and injectable hormones prepare the woman for timed intercourse or IUI. During IUI, a catheter deposits pre-washed sperm (the normal and denser sperm, which is separated by a centrifuge from the semen and less viable sperm) directly into the uterus. (Think of it as the turkey-baster method.)

Vanessa immediately underwent three consecutive rounds of cycle monitoring with injectable hormones, followed by IUI. She conceived after the first IUI, but the pregnancy only lasted a few days. This is termed a chemical pregnancy as there was nothing visible to show she was pregnant. After two more IUI cycles without conceiving, Vanessa was disappointed, but the one positive pregnancy test gave her the courage to have a small uterine polyp (benign growth) removed in case it was a factor in preventing implantation.

After the surgery, Vanessa and Robert decided to try IVF. Although she conceived the first time, it was an ectopic pregnancy, which occurs when the fetus develops outside of the uterus, typically in one of the fallopian tubes. She then had to wait several months before trying IVF again. After the second IVF, she conceived again, but the fetus had trisomy 18, a chromosomal abnormality, and Vanessa miscarried in the second trimester. She waited another six months before trying a third IVF, which was unsuccessful.

Using TCM to balance your life

At this point, nearly four years had passed since Vanessa and Robert first visited the fertility clinic. She’d had several IUI cycles and three IVF treatments, and had taken countless fertility drugs. During this time, Vanessa would come to my clinic for treatment but then disappear for long stretches of time. Often women take breaks from treatment, sometimes to mourn the loss of a baby through miscarriage.

After one of her breaks, Vanessa came to me for a relaxing acupuncture treatment and caught me up on her journey. She felt frustrated, like nothing she did was ever enough, she couldn’t make the right choices, and things were out of her control. She worked hard to control the things she could, such as what she ate and drank.

We talked about how even eating and drinking must happen in balance. Many women I see obsess about their food intake, convinced that eating a spotlessly healthy diet will boost their chances of conception. Vanessa wasn’t giving herself much leeway; at her mother’s birthday she felt bad for not eating any birthday cake. When her mother said one piece wouldn’t kill her, she took a small piece but felt guilty about cheating. Imagine the stress of thinking a single piece of cake could ruin her chances of conceiving, thus wasting all the time, money, and effort they’d already invested. This is just not the way it works!

In Chinese medicine, we believe in living a balanced life. We expect you to eat and drink in order to nourish yourself physically, emotionally, and spiritually. If you have cut gluten, sugar, and dairy out of your diet and feel deprived, I say you are out of balance. Perhaps, instead of depriving yourself, you could consider healthier treats. For example, instead of a Mars Bar, you could buy some organic dark Belgian chocolate and eat with reckless abandon once in a while.

Eating for fertility: What to eat

The following tips will not only create a better environment for conception but will help you grow a healthy baby too:

•In general, pick easy recipes with simple ingredients and choose whole, unprocessed, high-fibre foods.

•Make soups with bone broth, ideally homemade. Bone marrow contains precursor cells for red and white blood cells. In TCM, the marrow is considered Jing essence, or kidney energy, which controls reproductive energy. Some people consider beef bones superior because the marrow is more concentrated, but they must also be cooked longer. With more and more people avoiding red meat, I recommend chicken bones and cartilage. Regardless, all bone marrow is very digestible yet filled with minerals (calcium, magnesium, potassium, and phosphorus), as well as good fats and simple proteins. (See sidebar on page 14 for a recipe for chicken bone broth soup.)

•Eat organic foods where possible to avoid pesticides and additives, which have been shown to cause menstrual irregularity, miscarriage, stillbirths, and developmental defects, as well as reducing fertility and increasing time-to-pregnancy.³

•For lunch and dinner, fill half your plate with cooked vegetables, such as spinach, zucchini, leeks, string beans, lettuce, sugar snap peas, Swiss chard, carrots, alfalfa sprouts, peppers, artichokes, cucumbers, asparagus, dill, avocado, eggplant, bamboo shoots, escarole, sauerkraut, beans, seaweed, beets, onions, cilantro, parsley, garlic, mushrooms, okra, tomatoes, olives, celery, water chestnuts, peas, and ginger root. These vegetables help keep the body alkaline, creating a healthy environment for sperm to thrive.⁴ They also provide lots of nutrients, including vitamins A, C, B6, B12, K, beta carotene, calcium, vitamin E, folate, iron, niacin, copper, magnesium, manganese, phosphorus, potassium, zinc, omega-3 fatty acids, and selenium, all of which are vital to your overall health as well as to making a baby. Veggies are also good sources of dietary fibre, which keeps your bowels healthy and regular.

•In addition to the above vegetables, eat plenty of cruciferous vegetables, such as bok choy, kale, broccoli, Brussels sprouts, cauliflower, cabbage, collard greens, turnips, and radishes. Research has shown cruciferous vegetables help to detoxify carcinogenic cells and reduce oxidative stress. In TCM, these vegetables are believed to help the liver cleanse your body of toxins (which is its primary role in our bodies) and excess hormones (which may accumulate during fertility treatments).

•Eat iodine-rich foods. Eating only cruciferous vegetables can reduce your iodine levels, which are essential to proper thyroid function, and thyroid function is essential to hormone production. You can counteract this by eating dried sea vegetables such as seaweed, wakame, hijiki, dulse, kombu, and kelp. In addition, Himalayan Crystal salts, cod fish, plain yoghurt, boiled eggs, navy beans, cranberries, strawberries, and supplemental iodine can keep your iodine levels healthy.

NOTE: Do not supplement with iodine or eat too much iodine if you have a diagnosis of Hashimoto’s disease, where your body attacks your own thyroid gland, which is responsible for releasing hormones into your body. If in doubt, minimize iodine-containing foods, as an excess can be bad for your health, but consult a health care practitioner with extensive knowledge of supplements.

•Diversify your food intake to maximize nutritional benefits from a variety of different foods.

•Drink one litre of hot water with the freshly squeezed juice of one whole lemon as your first drink of the day. This gently wakes up your stomach, which decreases inflammation,⁵ aids digestion and eases constipation,⁶ eliminates toxins (by virtue of moving your bowels), calms anxiety by acting as a natural antidepressant,⁷ and helps with weight loss.⁸ Lemons also contain ascorbic acid, which protects sperm DNA and prevents oxidative stress.⁹ Think of juicy water-filled cells!

•Buy non-genetically modified foods (non-GMO) so you know they are derived from nature and not saturated with man-made pesticides.

•Eat protein at every meal because proteins are the building blocks of life. Protein sources include:

›Lean organic meats, like skinless chicken.

›Vegetable-based proteins in the form of legumes and nuts, such as chickpeas, lentils, split peas, quinoa, beans, nuts and nut butters (especially walnuts and almonds), sunflower seeds, hemp seeds, sesame seeds, poppy seeds, almond milk, and hemp milk. Eggs are a good source of protein, but make sure they’re from free range, organically fed, antibiotic- and hormone-free chickens.

›Fish. Smaller species are better as they are likely to have absorbed less mercury, lead, and other heavy metals, which can disrupt immune function and subvert the body’s ability to receive an embryo.¹⁰ They can also affect the reproductive system and can be toxic to the growing fetus via the placenta,¹¹ posing a health threat to the developing brain and possibly leading to low birth weight and size.¹²

•Eat plenty of foods containing omega-3 fatty acids. Essential fatty acids (EFA) are naturally anti-inflammatory, and the older we get the more inflammation we tend to have in our bodies (kind of like rusting). The best EFA (DHA and EPA) are found in fish, but it’s important to stick with those with the lowest contaminant levels, such as wild salmon, Arctic char, Atlantic mackerel, sardines, sablefish (black cod), oysters, anchovies, rainbow trout, and mussels. Olive oil, garlic, flax seed, walnuts, dark leafy greens, cabbage, and Brussels sprouts contain another EFA called ALA. The body converts ALA to DHA and EPA, which are vital in pre- and post-natal brain and behavioural development.¹³ As well, one study showed fertile men had higher levels of EFA as compared to infertile men;¹⁴ this is known as a correlation rather than a causal relationship, but there are plenty of reasons for all of us to increase our EFA consumption. As well, for women, EFA appear to help with embryo quality.¹⁵

Chinese herbal chicken bone broth

Start with 1 large whole chicken, about 3 pounds (organic, free-range, hormone- and antibiotic-free). Preheat oven to 350 degrees Fahrenheit. Drizzle chicken with olive oil and rub all over with sea salt and pepper. Into the cavity, insert 1 lemon cut in half, 2 sprigs of thyme, a bay leaf, and some sprigs of rosemary or sage. Roast for about 1 hour. After 30 minutes, baste with cooking fluids and then baste every 10 minutes until done.

In the meantime, fill your largest stock pot with cold filtered water and add the following organic vegetables:

2 large carrots, peeled and cut in half

3 celery stalks

1 tomato cut in half

1 large onion cut in half

2 tbsp of apple cider vinegar

Add the following Chinese herbs, which you can pick up at any Chinese herbal dispensary or Chinese grocery store. Wash them before adding to the stock pot:

•Gou Qi Zi or Goji berries (lycii berry or wolfberry fruit)—a large handful. (Choose the less bright red ones to be sure no colorants have been added.) In TCM, Gou Qi Zi is believed to nourish the blood and kidneys, lower blood sugar, have antioxidant properties, prevent fat build-up in liver cells, and help regenerate liver cells.

•Shan Yao (dioscorea or Chinese wild yam)—3 pieces. In TCM, Shan Yao is believed to nourish digestion, nourish kidney and reproductive energy in men and women, regulate menstruation, lower blood sugar, soothe mood, aid sleep, and benefit overall blood and qi energy.

•Huang Qi (astragalus root)—3 pieces about the size of a tongue depressor. In TCM, Huang Qi is considered an overall tonic that regulates blood sugar and enhances sleep, energy, and libido, as well as the immune system and metabolism.

•Bai Shao Yao (white peony)—2 pieces. In TCM, Bai Shao Yao is thought to nourish the blood, soothe the liver, soothe abdominal cramps, and nourish nutritive (yin) energy. It is used to help with endometriosis, ovarian cysts, and menstrual cramps, and to regulate menstruation.

•Hong Zao (dried Chinese red jujube dates)—3 pieces. In TCM, Hong Zao is believed to calm the nervous system, inhibit cell mutation, protect the liver, improve energy, and have an antihistamine action, which benefits the immune system.

•Fu Ling Poria—3 pieces. In TCM, Fu Ling Poria is believed to aid and strengthen digestion, decrease water retention, reduce stomach acid, calm the heart, soothe the nerves, and sometimes help with insomnia.

When the chicken is cooked, slice off most of the meat for dinner, but cut the leftover meat into bite-sized pieces and store in the fridge. Put all the bones and skin into the stock pot and bring to a boil. Lower to a high simmer so there is minimal bubbling, and cook for 12 hours.

If you need to leave the house, you may need to take it off the stove and store it in the fridge while you’re gone. Alternatively, you may leave it simmering in an electric crock pot for 12 hours.

With a slotted spoon, take out all of the chicken pieces, herbs, and vegetables, and place them in a sieve over a large bowl to collect any stock that drains from them. Discard the pieces from the sieve and strain the rest of the stock through the sieve.

Drink a cup per day. Or cool and pour into separate containers to freeze and use for cooking or as a soup base.

To make chicken soup, heat the stock and boil with 2 peeled and diced carrots, 2 cut celery stalks, and 1 diced onion. Add some parsley and season with salt and pepper to taste. Before serving, add in cut up chicken bits from the roasted chicken.

Eating for fertility: What not to eat

Keeping your body fit to receive an embryo and grow a healthy baby is not only about what you put into your body but also about what you keep out of it. The most important foods to avoid include:

•Sugar, especially refined white sugar, but also fruit juices. Sugar of all kinds can cause blood glucose to spike. This can increase insulin resistance and cause ovulatory issues and impede fertility.¹⁶ Research has shown that sugar is more addictive than cocaine in its effect on the reward centre in the brain—the more you eat, the more you want.¹⁷

•Artificial sweeteners, as they increase inflammation and can negatively affect the growth of eggs, especially for women with polycystic ovarian syndrome (PCOS; see Chapter 6).

•Prepackaged, factory-canned, and boxed foods with long expiration dates, which includes things like commercial chocolate bars, boxed mac-and-cheese, and canned pasta with tomato sauce. Packaged foods are convenient but are also filled with chemical flavourings, colourings, artificial ingredients, preservatives, and fillers. Even the packaging itself is sometimes questionable (for example, plastic contains carcinogens, and there is some concern they may be released when heated).

From a TCM perspective, the above guidelines are common sense for anyone wishing to maintain a healthy inner environment. The following suggestions are more specific to improving fertility.¹⁸

•Fast foods and fried foods that contain excessive trans-fatty acids (TFA), which can potentially increase insulin resistance.¹⁹ This, in turn, can increase weight and impede ovulatory function, decreasing fertility potential. TFA are widely known to be unhealthy fats.

•Gluten-containing foods, which may disrupt hormone function, increase inflammation, tend to be higher on the glycemic index (which lists foods according to their impact on blood sugar), and increases body fat, which can disrupt ovulation.²⁰ A diet with too many foods high on the GI can also increase insulin resistance, which I will discuss more in Chapter 6. If you are sensitive to gluten, a diet high in gluten can cause inflammation and activate autoimmune disorders (see Chapter 7), which can contribute to miscarriage.²¹

•Meats containing growth hormones and antibiotics, which can disrupt your natural hormonal balance.

•Fruits grown with pesticides. Eat organic as much as possible, since toxins can disrupt hormonal balance, but particularly avoid fruits such as peaches, pears, apples, grapes, celery, spinach, and strawberries if they’re not organic. Refer to the most updated list created by the Environmental Working Group (EWG), which ranks pesticide levels on produce tested by the U.S. Department of Agriculture and the U.S. Food and Drug Administration.²²

•Alcohol. If possible, abstain altogether. I often see women who drink moderately, and if they have a negative pregnancy test, they have a drink; that is unlikely to affect their chances of conceiving in the future. However, a Danish study showed that women over thirty who consumed more than one drink per day were more likely to have fertility issues than women who consumed less than one drink per week.²³

•Coffee and caffeine-containing teas and sodas. It’s best to reduce caffeine intake to less than 200 mg per day. Research has shown that two cups of regular coffee or five twelve-ounce cans of caffeinated soda can double risk of miscarriage.²⁴ However, it’s difficult to assess how to keep within that 200-mg limit when another study found that twenty different commercial espresso coffees exceeded the maximum safety limit in just one cup (they contained from 200 to 322 mg per shot).²⁵

•Dairy products, which contain insulin-like growth factor (IGF-1), especially when taken from high-producing milk cattle.²⁶ IGF-1 at high levels can increase insulin resistance, which can in turn affect proper timing of egg maturation, especially for women with PCOS (see Chapter 6).

•GMO soy products. Even for non-GMO soy products, do not exceed sixty grams (that’s three twelve-ounce glasses of soy milk) per day. Soy contains phytoestrogens (plant-based estrogens), which can upset hormonal balance.

Eating for fertility: How and when to eat

There is more to healthy eating than what you physically stick into your mouth. It is just as important to nourish your mental, emotional, and spiritual well-being as to eat a healthy diet. In TCM, this includes how and when you eat (and don’t eat). My aim is to put joy back into your eating experience while boosting your fertility. (NOTE: If you have celiac disease, are lactose intolerant, or have any known food allergies or intolerances, you will want to stay away from whatever you react to.) The following simple guidelines will help you look and feel better inside and out:

•Eat lightly cooked vegetables, as they are readily digestible (partially digested by the cooking process) but not overcooked to the point of losing nutritional value. Steaming or stir-frying vegetables lightly helps your digestion and enables your body to extract nutrients more effectively.

•Chew your food thoroughly. Breaking food down before it goes into the stomach helps the process of digestion.

•Try an eating meditation where you take a bite of your food, chew it well, slowly, and consciously (preferably with your eyes closed), noticing the textures and flavours in your mouth.

•Do not multitask while eating, as you might normally do. Just eat and breathe and notice the calmness that arises as you practice being present during your meal. You may even notice that this style of eating helps your digestion, since normally you may not chew your food as thoroughly and may gobble things down too quickly.

•If you are following a specific dietary regimen, treat yourself once in a while (ten to twenty percent of the time) without worrying about it. If chocolate is your vice, buy organic chocolate and enjoy every morsel. If you love the ritual and taste of coffee, drink a small cup of organic coffee once or twice a week. Make treating yourself a meditative and soulful experience. Ironically, as you begin to eat healthier foods, your taste buds may become more sensitive and, when you give in to a craving, the food may not taste as good as you imagined. That piece of chocolate cake with ice cream may taste sickly sweet and make you feel bloated. The good news is you can make your own treats and control the quality and quantity of the ingredients (like sugars).

•Stop judging what you (or others) are eating. Eating something “bad” does not make you a bad person. This type of self-judgement is tied directly to guilt and shame, both of which can negatively impact your physical, mental, and emotional well-being, and affect the environment into which you hope to grow a baby.

•Share and enjoy food with others. Humans in most cultures have been eating communally since the beginning of time. Sharing food with family, friends, and colleagues affects your natural healing response. It brings more relatedness, laughter, and joy to your life, which leads to physiological, psychological, social, spiritual, and quality-of-life benefits.²⁷

•Eat at regular intervals and do not skip meals; this will help keep your blood sugar levels balanced.

•Prepare and eat home-cooked meals as much as you can. This allows you to control the ingredients in your food. It also enables you to make extra food to freeze in meal-sized containers for when you don’t have time to cook properly. You can also cook fresh vegetables, but make enough for two days. If you find it’s difficult to cook during the week, make several recipes on the weekend that you can eat and freeze. If you need to resort to take-away food sometimes, choose health-conscious establishments, avoid deep-fried foods, and make special requests such as adding more vegetables and decreasing high-carb foods.

NOTE: Often, my patients complain to me about the cost of organic food, yet not too long ago it was considered normal for the average family to spend forty percent of their income on food.²⁸ In 1901, the U.S. Bureau of Labor Statistics, Consumer Expenditure Survey found that families from New York and Massachusetts spent 42.5 percent of income on food.²⁹ Now it seems we want to spend less on food and more on material goods like cell phones and computers. Perhaps it’s not that organic food is too expensive, but that you might consider re-evaluating the cost of your health.

Vanessa’s spontaneous miracle

Having undergone several IUI and IVF cycles, Vanessa and her husband were taking a break from the stress of fertility treatments, although Vanessa was still doing acupuncture at my clinic and eating a balanced diet. She and her husband felt they had exhausted the technological resources in their hometown of Toronto and were researching the Colorado Clinic of Reproductive Medicine (CCRM) in Denver. They thought the CCRM offered more advanced testing than the Toronto clinic she was attending, and Vanessa and Robert met with the fertility doctor to discuss this option.

After the meeting, Vanessa noticed she had some spotting, although her period wasn’t due for five days. She joked with her husband that her ovaries were reacting to the sound of the fertility doctor’s voice and got scared into getting pregnant in order to avoid another IVF. What she didn’t know was that the spotting was implantation bleeding. A few days later, she couldn’t ignore the symptoms anymore; she’d been pregnant so many times that she was completely in tune with her body.

“It was three o’clock in the morning and it sort of hit me,” she told me later. “I got up and did a pregnancy test in the middle of the night. After four years of trying to conceive, I was pregnant with Mia.” What surprised her most was that her husband had been away for work that month and they’d only had intercourse once, well before ovulation.

A woman’s fertile window is about five days before ovulation, and on ovulation day. After ovulation, the window of receptivity to sperm is twelve to twenty-four hours. The idea is to try to have sex before ovulation, allowing the sperm to swim up to and sit in the fallopian tubes, where they can live up to a maximum of seven days ready and waiting for the ovulating egg. This must have been what happened when Vanessa finally became pregnant—the old-fashioned way, with no technology.