Laughter for Fertility

We all know it is true what they say about laughter being good for the soul. Well, now it seems to be a good medicine, especially for those struggling with fertility.

Humorist Demetri Martin

It may sound like of those 'easier said than done' statements, when you are faced with month after month of heartbreaking disappointment, but bringing a bit of humour into your day to day could make all the difference.

A recent study by Dr Shevach Friedler looked at the stress levels in women undergoing IVF shows a 16% increase in success rates for women who had laughter therapy after an embryo transfer compared to those who  had a 'comedy free' recovery.

This percentage increased to close on 50% once factors such as age, reason for IVF treatment and number of embryos transferred were taken into account.  A good reason as any to take the day off after an embryo transfer and enjoy your favourite comedy, or relax by reading a light hearted, uplifting book.

LOL Cats

Other studies looking at the stress and anxiety levels of those struggling with fertility show that   elevated levels of the stress hormones cortisol, adrenlin, alpha-amalayse and prolactin are likely to play a major role in unexplained infertility. While it can seem flippant to put the cause of infertility down to stress, these hormones effect the female reproductive system at every stage of the cycle.
For example, higher levels of cortisol can disrupt the LH surge inhibiting ovarian function, resulting in untimely release of the egg and a poorly developed corpus luteum. It can also reduce the secretion of oestrogen, limiting cervical mucus production and the development of the endometrial lining.

Poor corpus luteum development can result in lower progesterone levels and consequently luteal phase defects. This interferes with implantation and has been shown to negatively affect immune tolerance in the early stage of pregnancy, an important process responsible for preventing the mothers immune system from rejecting the implanted embryo.
In a different study of American women who had not menstruated for six months or more, for no known reason, were all found to have high levels of urine cortisol levels. Interestingly most of the women reported not to rate themselves as being under stress but researchers noted 'these women have unrealistically high expectations of themselves and and others. They think they can get more done in a day than what is normally possible and their sense of worth depends on  achievement'. After therapy focusing on creating perspective, stress management and self worth 80% of women started menstruating within 5 months compared to  25% of women who did not receive therapy.

These finding go to show that by being kind to yourself and looking at ways of reducing possible stressful situations in your daily life will help improve your natural fertility.

While every day doesn't need to be a super happy, enthusiastic day your stress levels will benefit by giving yourself the time and space to do things that make you happy. Sign up for that class you've been wanting to do, get outside for some exercise, read a good book or watch a comedy. Get offline and meet up with supportive friends for a cup of peppermint, rose or camomile tea. And don't forget your regular acupuncture or massage sessions, they will immediately clear those stress hormones and help brighten your mood.

Ovarian Reserve

How useful is the AMH blood test?

There was a very interesting article in The Age that we though would be good to share. It’s about the anti-mullerian hormone (AMH) blood test and its accuracy. AMH is a hormone produced by the developing follicles on a woman's ovaries. Recently specialists have been using the levels of AMH detected in the blood to give an indication of how many follicles, and consequently eggs are being produced during a monthly cycle. Low levels of AMH (<14pmol/L) indicate fewer developing follicles and fewer eggs. It is also linked to higher FSH levels which can be a problem for those undergoing IVF treatment.

In this article Dr Clarke (the medical director of Sydney based IVF clinic Fertility First) says that the blood test is an unreliable indicator of ovarian reserve due to it being sensitive to a number of factors including having been on the pill.

It makes me happy to read this as we have long believed this test causes undue panic, primarily as its something we have found improves with Chinese Medicine treatment (as do high FSH levels).

Have a read of the article here: http://www.theage.com.au/national/unreliable-fertility-tests-are-misleading-wannabe-mums-20131123-2y2s1.html

If you have been diagnosed with low AMH I would highly recommend asking for an antral follicle count for a more accurate indication of your ovarian reserve.

Plus concentrating on your lifestyle, herbs and acupuncture treatment to improve those results!

Phase Two - The Follicular Phase

Yin Rising

The second phase of the menstrual cycle is all about yin essence in Chinese Medicine. The feminine, cool, moistening energy.
It is when the follicles are growing, oestrogen is being produced and the endometrial lining is slowly thickening, getting ready to receive an embryo in the luteal phase of the cycle.

It is interesting to stop and think about the process that is happening at this point. As we all know women are born with a set number of eggs. These eggs reside in individual ovarian follicles which, when 'initiated', will grow over the course of about a year until they are mature enough to be selected for ovulation. Each menstrual cycle approximately 5-7 follicles are recruited to compete for the honour of being released at ovulation. The first follicle to reach a certain stage of development will become dominant,  the rest die away leaving the dominant follicle to mature and release its egg into a fallopian tube where it will hopefully be met by healthy sperm and create an embryo.

As you get closer to ovulation cervical mucus starts to be produced, reducing the naturally acidic or 'hostile' environment of the cervix, providing a safe pathway up to the fallopian tubes. Cervical mucus is the clear stretchy 'egg white' vaginal discharge many women experience for up to a week before ovulation occurs. It aids in lubrication during intercourse and contains the nutrients  and trace elements needed to keep sperm alive for days while they wait for the egg to enter the fallopian tubes.

If we want good quality eggs at ovulation we must nourish the environment the follicles are developing in. In Chinese Medicine terms this means nourishing the Yin and fluids.

Yin nourishing foods include pork, eggs, honey, tofu, seaweeds, apples, pineapple, kidney beans and black sesame seeds. Blood nourishing foods will also continue to be beneficial at this time so don't forget the bone broths, soups and stews. As we need extra hydration to help produce the slippery cervical mucus soups and stews are fabulous  meal choices.

Here is a link to a ham hock soup that ticks all the boxes for the follicular phase of the cycle:
http://thedesignfiles.net/2013/06/tasty-tuesday-smoked-ham-hock-rye-and-cavolo-nero-soup/

For the vegetarians floridix is a beneficial supplement during the whole of the follicular phase, while spirulina smoothies can be a great addition during these summer months for those with strong digestive systems. Miso soup is another great option, fill it up with plenty of tofu, nori and buckwheat noodles for a nourishing meal.

Heres a bit of a treat recipe from River Cottage. Its an apple crumble with the added goodness of walnuts and almonds: http://www.rivercottage.net/recipes/apple-and-walnut-crumble/
 
Heat tends to dry Yin up, as such anything that creates too much heat in the body is worth avoiding. This includes things like coffee, alcohol, chilli, greasy foods, smoking, emotional and physical stress that is not released and of course 'burning the candle'. So while warmth is super important, heat will reduce the amount of cervical mucus and potential cause an early ovulation with an immature egg.

To sum all this up, if you want your egg to be the best quality it can you need to nourish in the days leading up to ovulation. Look after yourself, do things that make you feel happy 'open the heart' and the rest will follow.

Phase 1 - The Menstrual Flow

Going With The Flow

The menstrual flow speaks volumes about the state of our reproductive health.  It is a concept that is simple to grasp, in fact you would think it was almost an unnecessary statement, however it is something we vary rarely stop to think about.  It varies wildly from woman to woman, and so too do ideas of what is normal.  However, whether it’s a non-event or a debilitating monthly occurrence, the state of the flow gives us an indication of what your fertile health is like. 

Ideally we are looking for a period that is something like this:

·      The flow starts during the night of the 27th day, or the morning of the 28th day (although a cycle between 26 and 30 days is considered normal providing it is regular). 

·      The menstrual blood starts fresh red (the same as if you had cut your hand and were bleeding) at a moderate flow (needing to change a light sanitary napkin/tampon every 4 hours).

·      The flow continues to get heavier until a regular sanitary napkin/ tampon needs to be changed approximately every 3 hours. 

·      The heavy flow is present for 1-2 days then tapers off and finishes cleanly, still fresh red in colour on day 4 or 5.

Clots, pain, bloating, mood changes, sore breasts, changes in bowl movements, headaches or fatigue before, during or after could be considered normal due to the fact that many people have them, but these symptoms are not ideal for optimum menstrual health.

Any deviation from the ideal will show us where we need to focus our attention.  For example, if there are large clots and/or pain, the endometrial lining is unlikely to be smooth, potentially causing implantation issues if you are trying to conceive.  A very light flow can indicate that the lining is too thin, again potentially causing implantation issues; while an extremely heavy flow can indicate a structural problem (eg fibroids) or an energetic imbalance.

During the period, there is a natural tendency to withdraw and take it easy.  Pain and emotions aside, it is the perfect time to sit and meditate, reflecting on the month that has past.  Take a break from your usual exercise routine and do some gentle yoga.  Sakshin Ghatastha www.muktiyoga.com.au and Iyengar yoga both have a lovely menstrual sequence.  It involves sitting on the floor in gentle forward bends and back bends, encouraging the body to open and allowing the blood to flow. Getting into nature with a slow walk through a park, by the creek or ocean can do wonders too.  Just remember to stay warm!  Cold naturally constricts and can cause a world of pain.

In Chinese Medicine there is a great analogy comparing the endometrium to being like a garden bed.  We need to nurture the soil, ensuring that it is rich and fertile, balanced in its nutrients.  Diet, plus our wonderful Chinese herbs and acupuncture, are the best way to achieve this.

At the beginning of the menstrual flow it is important to encourage the blood to flow.  This is where light exercise and acupuncture can be really beneficial.

Eggplant, turmeric, spring onions, leeks and crab are all examples of blood moving foods.

As the blood flow starts to taper off its important to start replenishing blood and fluids.  Organic red meat and soups made from bone stock are the most efficient way to do this.  Slow cooked meals such as osso bucco, lamb shanks and stews are the best option as the meat is easy to digest and the nutrients are “locked into” the sauce.  Here is a link to an aubergine and lamb recipe by Jamie Oliver, perfect for both nourishing and moving blood: http://www.jamieoliver.com/recipes/lamb-recipes/roast-leg-of-lamb-with-aubergines-and-onions.

In addition, here is a link to Sarah Wilson’s recipe for “Bone Broth”. It comes with a long list of why it’s so good for you and a clear and easy “how to”.   If you want to go a little more hard-core Chinese Medicine with this we’d be happy to give you some blood moving and nourishing herbs to put in towards the end of the cooking process, just to give the whole thing even more oomph!

http://www.sarahwilson.com.au/2012/01/how-to-make-bone-broth-and-why-you-should/

If this is a bit much, then chicken stock is a good alternative. (Back to Sarah Wilson again for this one!) http://www.sarahwilson.com.au/2013/04/my-crispy-roast-chicken-5-reasons-why-its-the-smartest-way-to-eat-a-chook/

If you’re not so big on the whole meat thing, then it is even more important to be aware of replenishing your blood energy.  Beetroot is the king vegetable with which to do this.  Tempeh, kidney beans, eggs and seaweeds are also considered good blood nourishing foods, as are any fruits or vegetables that are good sources of iron.  Here is a link to Maggie Beer’s wonderful Beetroot Risotto. She has a bit of bacon in the recipe, but it’s easy to leave out if you want.  I love to serve it with some Meredith’s Goats Cheese and a side of sautéed silver beet.

http://www.maggiebeer.com.au/recipes/beetroot-risotto

Regardless of whether you are trying to conceive or not, having an awareness of your cycle, embracing the monthly flow and looking after your menstrual health will serve you well for years to come - and by this I mean menopause, but that’s for another post! 

Nourishing Life

Nourishing Life, and Fertility

Yang Sheng, in Chinese, means to ‘nourish life’. The principles are based on the preservation of health, not just the treatment of disease. The way we choose to care for our health now will impact not only on the quality of our health in later years but also that of our children, and children’s children, for many generations to come.

At Quiescence we do a lot of work assisting couples to conceive. As a result men’s and women’s health in general has become the dominating focus of our practice, whether you are trying to conceive or not. It has become obvious that optimal health equates to optimal fertility. We feel this concept is especially important because it is this state of health that is carried forward into the future. From a ‘Yang Sheng’ perspective it’s not just about having babies, but also about having healthy, constitutionally strong babies who grow into happy, healthy kids.Over the next few posts we will be writing about the various stages of the menstrual cycle, linking the Chinese Medicine to the western medicine and hopefully giving you a better understanding of how this whole thing works. But for now please, take a second and think about this: How nourishing is my lifestyle really.

• How much of my food comes from a packet? 

• How much exercise am I getting? 

• How much sleep am I getting? 

• How much stress am I under? 

• Is trying to conceive becoming an obsession?

If you're not happy with your answer to any of these questions talk about it with your partner, and with us. If our lives are well nourished then we can support the growth and development of new life, happily and healthily.