“Do I really have to give up coffee now that I’m trying to get pregnant?” Patients ask me this question a lot and here’s how I usually answer it. If you’re trying to get your body healthy in order to conceive it makes sense to limit your coffee intake to one cup a day. However if getting pregnant is proving to be struggle or you are suffering from infertility it’s best to cut coffee out altogether.

I understand the allure of coffee. I love a cup of coffee myself and I’m similar to my patients in that I’m an over-scheduled New Yorker and I appreciate the energy lift coffee can give me. However even as I guiltily sip my latte, I know that this caffeine boost is false energy and no replacement for proper rest and good nutrition.

We all know that caffeine can increase stress and anxiety levels but for women trying to conceive, coffee has other consequences as well. Caffeine can decrease the flow of blood to the uterus, which can interfere with implantation. Too much caffeine can increase the risk of blood clotting and miscarriage.

Knowing that caffeine can cause fertility problems some of my patients switch to decaffeinated coffee in order to enhance their fertility. However, all coffee, be it regular or decaf, is acidic and can make the body and cervical mucus too acidic and so hamper conception. Several studies have shown that coffee (even decaffeinated coffee) can diminish fertility. One Dutch study showed that 4 cups of decaf or regular coffee a day lowered a woman’s chance of having a baby by 25%. Some studies have linked coffee to miscarriage and some have linked it to low sperm count.

So the message is clear. If you’re trying to conceive and nothing’s working, it may be time to ditch your daily cup of Joe.

Here’s the advice we give our YinOva patients who are trying to limit their coffee intake.

• If you are suffering physical symptoms due to coffee withdrawal, acupuncture can help. Caffeine constricts the blood vessels in the brain and decreases circulation. If you suddenly cut out coffee, the increase in circulation both to your brain and your digestive system can lead to headaches as well as constipation or loose stools. An acupuncture treatment can treat both these symptoms well and so help you navigate your first coffee-free week.

• Herbal tonics such a astragalus or ginseng can help give your body a boost as you adjust to living without caffeine.

• Try drinking black tea. Even though tea contains some caffeine it does not seem to have the same adverse effect on fertility as coffee. In fact some studies have shown that tea may even help fertility. Researchers at Kaiser Permanente Medical Care Program of Northern California in Oakland found that women who drink tea, even caffeinated black tea, have increased fertility.  Black tea contains some caffeine so it can give you a bit of a boost, however the caffeine content is much less than coffee making it a great alternative.

• Go green. Not only does green tea contain even less caffeine (about 1/3 of the amount) but it also boasts numerous health benefits.

• Herbal teas are also worth considering. Experiment with different teas at different times of the day. A soothing cup of chamomile at night or a bright tasting mint tea first thing in the morning.

• Take a coffee-free break! Coffee drinkers enjoy the rituals around their regular cups of coffee as much as the coffee itself. So try to find a replacement for making a cup of coffee in the morning. Buy a pretty tea pot and sip tea from a china cup. If popping out to your favorite coffee shop is a wonderful break in your day, know that you don’t have to give this up along with the coffee. Give yourself permission to take a coffee-free break and go out and buy some tea or even a bottle of water.

Today’s blog was written by YinOva acupuncturist Amanda Silver. Amanda has over a decade of experience as an acupuncturist and herbalist and is a popular practitioner here at the YinOva Center where she is known for her practical, common sense advice on all matters related to OB/GYN.

Spring is a great time to do a cleanse, but some cleanses aren’t particularly safe when you are trying to get pregnant. A lot of popular cleanses today involve fasting or just drinking juices/water, which can be draining to the vital energies needed to get pregnant. Chinese Medicine generally advises against strict fasting and recommends eating a very clean diet of fresh fruit and vegetables and lean organic protein.

Here are some guidelines for a safe cleanse when trying to become pregnant:

• Avoid sugar, including all “fake sugars”. This can be difficult, but I have noticed that it gets easier after the 3^rd day. So hang in there!
• Eat mostly vegetables, organic when possible.
• Eat a variety of grains, not just wheat. Try whole grains, such as brown rice, oats, buckwheat, millet and rye. These foods are high in B vitamins, which the liver needs to support its metabolic processes. Whole grains also bind excess hormones and toxins to carry them through the bowel for excretion.
• Drink water. Try to drink half your body weight in ounces. So if you weigh 140 lbs drink 70 oz or about 9 x 8oz glasses a day.
• Cut out caffeine and alcohol.  Always a good rule when trying to get pregnant.
• Meditate and breathe. These relaxation techniques help to reduce stress hormones. For more information about mediation see this YinOva blog article

“Is there anything I can do to make it more likely that my baby is a girl?”.

This was a question that one of my patients asked me a couple of weeks ago. She already has a little boy and, although she’d be happy with another boy, she would dearly love a baby girl. She is not alone. A recent survey showed that almost 80% of couples do have a gender preference when trying to conceive a child. Obviously a healthy baby is the priority and for many of my patients, who have struggled with infertility, a healthy baby is all they dream of. But if you do want to tip the scales in one direction there are some (far from foolproof) things you can do.

The first thing to understand, if you want to influence the gender of your child, is how nature selects the sex of a baby. This is determined by the sperm. Each sperm contains one chromosome, an X for a girl and a Y for a boy. Nature has organized it so that there are slightly more male sperm than female – for every 100 female sperm there are 110 male ones. The ovum or eggs also only contain one chromosome but this is always an X. So if the sperm is carrying an X chromosome and it is combined with the X in the egg, the fetus will be a XX or girl. If the sperm is carrying a Y chromosome and it is combined with the X in the egg, then the fetus will be a XY or boy.

Next we need to look at how the X and Y sperm differ. Y (boy) sperm are smaller and weaker than X (girl) sperm but they are speedier and can move faster than their female counterparts. Bearing in mind that the X (girl) sperm are tougher (and I know we’ll get comments about THAT in the YinOva waiting room next week!) anything that makes it harder to conceive is more likely to result in a girl. Conversely, bearing in mind that Y (boy) sperm are speedier, anything that makes timing more accurate so that the fastest sperm reach the egg, is more likely to result in a boy. The areas where we can have some influence and affect the gender of an as-yet unconceived child are the timing of intercourse, sexual position and vaginal environment.

Timing intercourse to influence gender

If you have sex right at or near the time the egg is released, then the speedier Y (boy) sperm will make it to the egg quickly and you will most likely have a boy. If the sperm are released two or three days prior to when the egg is released the Y (boy) sperm will die off and there will be more X sperm left waiting for the egg to appear and fertilization will most likely produce a girl.

Sexual Positions and their effect on gender

Again remember that the X (girl) sperm are hardier so anything that makes it more difficult for the sperm to reach the egg favors them. The missionary position is the most beneficial position when it comes to conception and so is (slightly) more likely to result in a Y (boy) sperm reaching the egg first. Other positions that are shallower will give a small benefit to the X (girl) sperm.

Vaginal PH and it’s effect on gender outcome

The quicker but weaker Y (boy) sperm thrive in an alkaline environment whereas an acidic PH will give the X (girl) sperm a bit of an edge since the environment will be too harsh for the Y (boy) sperm. So you may want to try to create an acidic PH to conceive a girl baby. With this in mind some have found that a diet high in calcium and magnesium can favor a girl and a diet high in potassium and sodium can favor a boy. Having an orgasm can effect the vaginal PH as it creates an alkaline environment that is more favorable to boys.

There are some other, unproven, methods that some of my patients have told me about over the years. One is Lydia Pinkham’s Herbal Compound. This is a Victorian fertility tonic which is thought to help women conceive a girl, because it creates an acidic environment in the vagina. Another is the Chinese Conception chart which was first discovered in a royal tomb near Beijing more than 700 years ago. The chart cross-references the baby’s month of conception and the mother’s age to predict gender. Some studies claim the chart is more than 90% accurate and I have to admit that our YinOva mothers that have used it have had success. You can find an explanation of the chart here.

Jill Blakeway is the coauthor of Making Babies: A Proven Three Month Program for Maximum Fertility and the Clinic Director of the YinOva Center in New York City. A former Professor of Traditional Chinese Medicine, she specializes in using acupuncture and Chinese herbs to treat women and children.

As many of you have pointed out to me morning sickness is a bit of a misnomer because in real life a wave of nausea or vomiting can strike pregnant women at any time of the day or night. Between 60% and 80% of pregnant women experience some nausea and vomiting although for most women this dissipates by the end of the first trimester. Just under 2% of women suffer from a more severe version of morning sickness known as hyperemesis gravidarium, which causes vomiting so severe that it leads to weight loss and dehydration. This kind of severe morning sickness may even warrant a stay in the hospital and treatment with IVF fluids and anti-emetic medications.

You should always follow your OB’s advice about morning sickness but here is the advice we give our YinOva Center patients.

• Come in for acupuncture. Acupuncture has proved useful in controlling morning sickness in clinical trials such as this one. The point we use, P6, is a gentle, safe, well tested, natural way of addressing this annoying symptom.
• Ask us to place a magnet on P6 for you before you go home. We send our patients out of the office with a small magnet on the point for nausea and vomiting. This prolongs the effects of the treatment and works the same way as using Sea Bands. We like the seabands and encourage their use but we prefer to use magnets because we can help you by placing them in the exact spot necessary for maximum effect.
• Morning sickness seems to get worse in response to changes in blood sugar so eating small, regular meals throughout the day can be really helpful. When I was pregnant with Emma, I never went anywhere without a small pack of crackers in my bag so that I could nibble on them when I started to get queasy.
• Some of our patients swear by a slice of dry toast before they get out of bed in the morning.
• Don’t overeat.
• Avoid fluids at mealtimes but drink lots of fluids at other times to avoid dehydration.
• Take your prenatal vitamin with food.
• Some of our patients have found that sucking on a hard candy is helpful and some have recommended Preggie Popsfor the same reason.
• Ginger is used in Chinese herbology for morning sickness and so we recommend brewing up some ginger tea. We have a product at our center which is a combination of ginger syrup and honey which is very popular with pregnant patients. You simply add hot water to make a natural, good tasting, soothing ginger and honey tea.
• Avoid rich, greasy or fried foods.
• Ask your doctor about taking extra vitamin B6 (pyridoxine) on top of your prenatal vitamin. The dose recommended for easing nausea and vomiting is 25mg twice a day and many of our patients have found this really helpful. You should be careful not to take more vitamin B6 than your doctor recommends because too much can lead to nerve damage and numbness and may not be safe for your developing baby.
• Inhaling Peppermint Essential Oil can help some women.
• Likewise 2 – 3 cups of Peppermint Tea a day can help to settle your stomach.
• The following homeopathic remedies have also worked for some of our patients. For morning sickness with irritability,Nux Vomica 6C. For inability to keep anything down but nausea not relieved by vomiting, Ipecacuanha 6c and for evening sickness and tearfulness, Pulsatilla 6c.

If your symptoms are severe you should contact your doctor and this is particularly true if you have been unable to keep anything down for more than 24 hours, if you are vomiting blood or if you have lost more than 2lbs in weight.

Related articles on the YinOva Blog
Turning a Breech Baby – A Patient’s Story
Using Acupuncture to Treat Pelvic Girdle Pain in Pregnancy
Can Acupuncture help to turn a breech baby?
Exercise during pregnancy
New Research – A high fiber diet reduces the risk of pre-eclampsia during pregnancy
Acupuncture During Pregnancy
The Early Signs of Pregnancy
Ten Things You Should Avoid During Pregnancy
Foods to eat and foods to avoid during pregnancy

Today’s blog entry is written by YinOva Acupuncturist and Clinical Herbalist, Liz Carlson.

Preparing for baby often means making changes in your everyday life- some easier than others. Let’s face it: adding a prenatal vitamin or staying mindful of eating healthy, unsaturated fats are relatively simple tasks compared to letting go of your beloved daily cup (or three) of that rich, dark and ever so addicting…coffee. There is plenty of evidence that drinking coffee can reduce your fertility and heavy coffee consumption can be particularly damaging. This study found that women who drink four 8oz cups of coffee a day reduce their fertility by 26%. At The YinOva Center we ask women who are trying to conceive to reduce their coffee intake but we are only too aware that this can be difficult even for the most disciplined.

Like any drug, caffeine is addictive so when your body shows signs of physical withdrawal such as headaches and irritability, your will power can take a back seat. Our bodies respond best to kindness, so rather than quit cold turkey, it is better for most to ween and here are a few tips how:

• As you cut back, try black tea instead. Researchers at Kaiser Permanente Medical Care Program of Northern California in Oakland found that women who drink tea, even caffeinated black tea, have increased fertility. All tea comes from one plant and it is the processing of the leaves that give us the variety of types. Black tea is simply the matured leaf that is more oxidized and therefore has developed chemical properties that yield higher caffeine content. Although the content is highest amongst all the teas, it is much less than coffee and therefore is a great place to start as you cut back. Add some milk, honey or even some spices and there you have a treat that rivals the creamy and rich characteristics of your old cup of joe.
• Go green. Not only does green tea contain even less caffeine (about 1/3 of the amount) but it also boasts numerous health benefits. Green tea is rich in anti-oxidants, that keep you beautiful inside and out
• Herbal tea is worth a shot. There are some herbal teas that mirror the characteristics of black tea and some even mimic coffee. Barley tea, also known as Kukicha, if steeped long enough, leaves behind a dark and substance that again can be dressed up with all the fix-ins. Have fun with tea. For exciting and exotic choices of all varieties, I love to visit McNulty’s Rare Tea and Coffee on Christopher Street.
• Take a break. Often times we are as in love with the ritual of getting coffee as we are with drinking it. It’s a such a relief to get up from your desk, go outside for some fresh air and waltz on over to your favorite coffee shop. This is not something that you have to give up! Take a break. Go get some tea, some water or nothing at all but continue to give yourself the permission to “take a coffee break” sans coffee. You will find that after the initial withdrawal of caffeine, this is just as satisfying as often it’s not just the caffeine your body was craving but a much needed escape from sitting in front of the computer.
• Get some acupuncture. When you come in for acupuncture, let your practicioner know about any side effects you are feeling from caffeine withdrawal. Acupuncture can help rid of headaches and many bothersome symptoms as well as encourage your body to detox more efficiently.

Good luck!

Liz

Related articles on The YinOva Blog
Foods for Fertility
Five Healthy Ways to Start your Day
Fertility and Fats
Foods to Eat and Foods to Avoid during Pregnancy

Liz Carlson M.Sc. L.Ac. © October 2008
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Many of our patients are surprised to find out how much their weight can impact their ability to conceive. In fact an estimated 12% of all infertility issues are weight related and maintaining a healthy body mass index (BMI) is one of the most helpful things you can do to enhance your fertility.

So what is a healthy BMI? Doctors tell us that a BMI between 19 and 25 ideal. (BMI is calculated by calculating your weight in pounds and dividing it by your height in inches, then dividing it by your height in inches again, then multiplying the result by 703. Example: 140 pounds, divided by 67 inches, divided by 67 inches, multiplied by 703 gives you a BMI of 22.)

If you are chronically malnourished or underweight your body may go into survival mode and you may produce less estrogen. This means that you are not able to build a follicle and may ovulate erratically or not at all. Low estrogen levels also lead to reduced fertile cervical mucus which can also be a problem for women trying to conceive. We all know that women who are suffering from anorexia nervosa often don’t have periods but did you know that you only need to be 10% underweight to adversely affect your hormones? The good news for most women is that they don’t need to put on lots of weight in order to get pregnant. For many of my patients it’s as little as 2 or 3 pounds which can make all the difference.

In Chinese medicine underweight women fall into a category we refer to as yin deficiency. Yin is the Chinese term for those aspects of your body that are about substance and nourishment. Women who are yin deficient exhibit signs of estrogen depletion such as hot flashes, insomnia, light periods and reduced cervical fluid. At The YinOva Center we will give you Chinese herbs that supplement yin as well as helping you to change your diet. Specifically we ask our underweight patients to increase their consumption of healthy fats such as those found in olive oil, avocados, nuts, seeds and oily fish. We also suggest that you increase your consumption of plant estrogens by eating some soy products and flax seeds.

In overweight women infertility is usually related to erratic ovulation. Fat cells release estrogen which inhibits FSH (follicle stimulating hormone) production which can prevent ovulation. In Chinese medicine these women are classified as yang deficient with yang referring to all the aspects of your body’s function that relate to movement, activity and transformation. Women who are yang deficient have slower metabolisms than other women. At The YinOva center we will give you Chinese herbs that tonify yang and help you to plan a sensible weight loss regimen. We will also ask you to limit your intake of plant estrogens found in tofu and soy milk. The good news is that you don’t need to slim down to a size 2. Clinical research has shown that 60% women who lose just 5-10% of their overall bodyweight resume regular ovulation.

You’ll find some helpful articles on this blog including one on foods for fertility and article on fertility and fats and some health recipes such as this one. But please also feel free to ask us for help. You’ll find us a non-judgmental bunch when it comes to weight. As women, many of us here at The YinOva Center have struggled with our own weight. Some of us have been too thin and some, myself included, have been overweight. We are happy to share with you what has worked for us.

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As some of you know I was on the CBS Early Show this week talking about foods that enhance fertility. You can watch the piece here if you missed it. It was a blustery day out there on the plaza and the segment was quite brief so I wanted to use this blog to give you more information about diet and fertility. Here is the advice we give our patients who are trying to conceive.

Eat as much unprocessed, seasonal organic food as you can

This means eating food that hasn’t been made in a factory. In Chinese medicine we believe food contains qi so an ear of corn receives energy from the sun, which it uses to grow and passes on to you when you eat it. By the time it’s been broken down and extruded into a cornflake it’s lost some of that energy. Even if you prefer a more grounded explanation than this, processed foods contain less nutrients and more chemicals than foods that are in their natural state.

I know that organic food can be expensive and that most of us can’t afford an exclusively organic diet. But eating as much organic food as you can helps you to avoid pesticides and agricultural chemicals some of which can disrupt your hormones.

Fill your plate with colorful fruits, veggies and leafy greens

• Yellow and orange vegetables contain lots of beta carotene, an antioxidant, which has been shown to maintain hormone balance and prevent miscarriage.
• Red vegetables such as tomatoes contain lycopene, a carotenoid, which has been shown to increase sperm counts
• Leafy green vegetables contain folic acid which is important for preventing birth defects and is a vital ingredient for healthy sperm and eggs.
• Cruciferous vegetables such as broccoli and cabbage contain a phytonutrient called DIM which helps with estrogen metabolism and prevents fibroids and endometriosis. In fact a 2004 study in Italy that found that women who ate the most fruits and veggies had the lowest rates of endometriosis

Fats

A lot of people don’t realize that you do need some fat in your diet in order to create certain hormones. Sometimes at The YinOva Center we see people on low fat diets who have hormone deficiencies. So it’s important to include healthy sources of fat in your diet such as olive oil nuts, seeds, avocado and oily fish. I have a more detailed blog article on fats and fertility, including fats to avoid, which you can read here.

Whole Grains

Here in the US we are in the habit of refining grains for the sake of convenience; refined grains cook quicker and keep longer in the cupboard. However the refining process strips 17 key nutrients from grains. Among those lost are several that boost fertility, such as antioxidants, B vitamins and iron.

You can find some whole grain recipes on this blog including one for banana bread and one for blueberry pancakes.

Protein

Some people, especially vegetarians, don’t get enough protein which is unfortunate because the amino acids in protein are vital for egg and sperm production, and for making LH and FSH which are important fertility hormones. Animal studies link inadequate protein intake with poor quality eggs, and there’s no reason to assume humans would be any different.

You can get your protein from meat, fish, eggs and dairy products, of course, but there are plenty of vegetarian sources of protein too, including beans, lentils, brown rice, quinoa and other whole grains, nuts and seeds (especially sunflower seeds)

That being said there are also people who seem to get too much protein. People who follow special high protein diets like the Atkins diet often get too much animal protein and those people benefit from replacing some of the animal products they are eating with vegetable proteins. One of the largest long term studies of women’s health ever undertaken demonstrated that women who got more of their protein from plants and less from animal sources had fewer ovulatory fertility problems.

Water

Sometime it is something as simple as dehydration that is keeping a couple from getting pregnant. So make sure you drink 6 – 8 oz of water a day. Women who are dehydrated produce less of the fertile cervical fluid needed at ovulation and men who are dehydrated have lower semen volume.

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This morning I have been exchanging emails with a patient who is newly pregnant. She and her husband have been trying to conceive for several years and they are thrilled to have finally achieved their goal. I am so happy for them and feel very privileged to have played a small part in their journey. As I thought about how Chinese medicine had helped this couple I was struck by how humbling it is to practice fertility medicine. Although my patient benefited from The YinOva Center’s fertility program and made much progress with regular acupuncture and Chinese herbs, the true star of the show was, as always, mother nature.

This was brought home to by some amazing pictures of ovulation actually occurring that were published in the June 11, 2008 edition of the New Scientist magazine. The pictures were captured by accident by a gynecologist, Dr Jacques Donnez, during an operation on a 45-year old woman at the Catholic University of Louvain (UCL) in Brussels, Belgium. The photograph below shows the whole process, which was described in the New Scientist article like this, “shortly before the egg is released, enzymes break down the tissue in the mature follicle, a fluid-filled sac on the surface of the ovary that contains the egg. This prompts the formation of a reddish protrusion, and after a while a hole appears, from which the egg emerges, surrounded by support cells. It then enters a Fallopian tube, which carries it to the uterus.”

Captured on film - the moment of ovulation

Obviously the above picture has been magnified. The egg is really the size of a tiny dot.

These pictures give us new information about the process of ovulation. Previously we had assumed that the egg bursts forth in a small explosion but what Dr. Donnez observed took 15 minutes and was more of a slow ballet.

In Chinese medicine ovulation is seen as the transition from yin to yang. Yin governing growth and yang being the force behind transformation. It takes nourishing yin to grow a follicle and all the energetic force of yang to make that follicle open and release an egg. Acupuncture has been shown to promote blood flow and help to induce ovulation or promote a smooth ovulation. You can read about the clinical trials that showed this in one of my previous blog entries.

But to me, what these pictures show is that women’s bodies need very little help to accomplish this miracle, because we are extraordinarily well designed.

“Can acupuncture really help make me more fertile and, if so, how does it work?”

This is a question patients ask me all the time and I understand why. It seems so improbable that tiny hair-like needles could have such a profound effect. At The YinOva Center most of our patients find out about us because they were referred by a friend or by their doctor. They have heard stories about how acupuncture has helped other people to conceive a baby. However it’s good to have more than anecdotal evidence about why something works and fortunately these days there is a growing body of clinical data that begins to explain acupuncture’s effect on the reproductive system.

Acupuncture can help women to to ovulate.

Some of the women I treat are not able to get pregnant because they are not ovulating. There can be lots of reasons why someone isn’t ovulating and I always advise these women to have a western medical workup but often all they need is regular acupuncture and sometimes a specially tailored herbal formula.

It turns out that acupuncture can have a powerful effect on the ovaries. Dr. Jin Yu of Shanghai Medical University in China was able to get rabbits to ovulate with acupuncture alone. Apparently rabbits do not ovulate until they become sexually active (who knew!), but Dr. Yu was able to take non-ovulating rabbits and affect them using just a few acupuncture needles so that their reproductive systems woke up. Dr. Yu is a well-known fertility expert in China and a professor of Gynecology. Her book, which is probably a bit too technical for most people’s taste, is available at amazon.com.

Her follow-up study which involved inducing ovulation in women with electro-acupuncture is here.

In another study patients with Polycystic Ovarian Syndrome were helped to ovulate. You can read the study here

Acupuncture can increase blood flow in the pelvic region improving the blood supply to the reproductive organs, improving the quality of the uterine lining and nourishing the developing follicle. Acupuncture seems to relax the blood vessels in the pelvis leading to increased blood flow, which in turn leads to eggs that are better nourished and a thicker endometrial lining. Dr. Susan Emmons, a Professor of Gynecology and Obstetrics at Oregon Health Sciences University was able to use acupuncture to increase the number of follicles in women undergoing IVF. Her research is available here.

Another study looked at how acupuncture can increase blood flow in the uterine arteries.

Acupuncture can influence the hormones that positively affect fertility — A literature review by Dr. Raymond Chang and well-respected reproductive endocrinologists Dr. Zev Rosenwax and Dr. Pak Chung concluded that there was compelling evidence that acupuncture increases levels of hormones in the brain that enhance fertility. You can read it here.

It also seems that acupuncture has a normalizing effect on reproductive hormones as explained in this study here, which discusses the effect of acupuncture on the Hypothalamic-Pituitary-Ovarian Axis and concludes that acupuncture can regulate abnormal HPOA function.

Acupuncture can reduce the effects of stress on the body and lower stress related hormones that can impede fertility. The same study we talked about above also examined previous studies on the effect of acupuncture on depression and stress related illnesses. It concluded that acupuncture is a viable option to relieve stress in women that are undergoing fertility treatment. This is particularly important because it is known that stress plays a very important role in failure to conceive. A study that was published in Fertility and Sterility in 2001 looked at the state of mind of women going through IVF. It concluded that the women who were most stressed and worried about the procedure were likely to have 20% fewer eggs available for retrieval and a fertilization rate that was 19% less than more optimistic women. You can read an abstract of the article here.

Acupuncture dramatically improves pregnancy rates in women undergoing IVF — A study in Germany that was published here in the USA divided 180 women who were having IVF into two groups of 80 women. One group had IVF with acupuncture and one group had IVF without acupuncture. The group that had acupuncture had a pregnancy rate of 42.5% versus the group that had no acupuncture that had a pregnancy rate of 26.3%. That’s almost a 50% better outcome in the acupuncture group. You can read the study here

Other studies back up these findings such as this one and this one.

Acupuncture can increase fertile cervical mucus — In order to conceive naturally it is important to have enough egg white cervical mucus at ovulation. This provides sperm with a medium that they can swim in. Patients often tell me that they notice an increase in the amount of fertile cervical mucus at ovulation after starting a course of acupuncture treatment.

Although many aspects of Chinese Medicine remain mysterious there is no doubting its value in helping women get pregnant. Chinese women have known this for many generations but as an acupuncturist I am delighted that researchers are beginning to study this phenomenon and uncover such positive results.

You can read more about our work enhancing fertility at The YinOva Center and download some useful files here

Fertility and Fats:

Fats to eat and fats to avoid when you’re trying to conceive.

You’ve probably read recent news reports about fats and fertility. I know my patients have and many of them are asking me for help in deciding which fats to eat and what to cut out.

One recent study said that women who eat low-fat dairy foods may have a higher risk of infertility than those who treat themselves to full-fat ice cream or cheese. Another found that getting just 2% of total calories from trans fats instead of healthier mono-unsaturated fats was associated with a doubled risk of infertility.

So what are all these fats and what should we be doing about them?

Trans Fats

Here in New York City trans fats have been in the news since city health officials have tried to outlaw them in restaurants. The first thing to understand is that there are two types of trans fat. One is found naturally in very small amounts in animal products and one is made artificially. It is the latter one that we should be avoiding. Food manufacturers make these trans fats by adding hydrogen to oil so that it remains solid at room temperature. They don’t do this so that foods taste better. They do it so that food will last longer on the shelves. Because these trans fats raise your LDL, which is your bad cholesterol, and lower your HDL, which is your good cholesterol, there isn’t much reason to eat them. Add to that the Harvard study that found that women with ovulation-related fertility problems tended to eat more trans fats than fertile women and you can see why at the YinOva Center we tell our patients to cut them out altogether.

You can avoid trans fats if you cut out factory produced fried foods, baked goods and stick margarines. If you see the words hydrogenated or partially hydrogenated on a food label consider it a trans fat red flag.

Saturated Fat

So far, so good. The fact that trans fats are a no-no is an open and shut case. Not so with saturated fats. Saturated fats are found in animal products such as fatty cuts of meat, whole milk, cream, butter and lard. They are known to raise LDL, bad cholesterol, and many of us have made the switch to low fat dairy products and lean cuts of meat for the sake of our hearts and our figures. The American Heart Association recommends that just 7% of your daily calories comes from saturated fat.

All this seemed like good advice until a recent study published in the journal, Human Reproduction, found that eating low fat dairy food every day can reduce a woman’s fertility by affecting ovulation. The study showed that women who ate more than two portions a day of low fat dairy foods were 85 per cent more likely to be infertile due to ovulatory disorders than those who only ate it less than once a week.

Conversely they found that women who ate full-fat dairy foods, including ice cream, more than once per day had a 25 per cent reduced risk of infertility due to ovulatory disorders compared to those who ate full-fat dairy foods only once a week.

Previous studies have suggested that dairy foods can interfere with ovulation, but few of them have been on humans and they are inconsistent.

So what to do? At the YinOva Center we thought about this long and hard before we decided what advice to give our patients. On the one hand we want them to have the fertility benefits of full fat dairy products but on the other hand obesity also lowers fertility so we didn’t want to give them carte blanche to hit the Haagen Daz with a vengeance. We settled for telling them to have one full fat dairy product a day – such as a full fat yogurt or a small glass of whole milk. In a nutshell our advice is go easy on the saturated fats but don’t cut them out altogether.

Polyunsaturated Fats

These are “good fats”. They help reduce blood cholesterol and some of them such as omega 3 fatty acids have a host of benefits such as reducing inflammation and lowering blood pressure. They have also been shown to improve mood and at the YinOva Center we prescribe omega 3 supplements to people who are depressed or anxious.

This category of fats is where the essential fatty acids that you read so much about fit in. They are called essential because we can’t make them ourselves and have to consume them. EFAs are long-chain polyunsaturated fatty acids derived from linolenic, linoleic, and oleic acids. There are two types of EFAs: Omega-3 and Omega-6. Omega-9 is necessary but it isn’t classified as an essential fatty acid because our body’s can manufacture it if we have enough of the other two essential fatty acids.

Essential fatty acids are a vital component of every human cell and the body needs them to balance hormones, insulate nerve cells, keep the skin and arteries supple, and keep itself warm. They are important to women who are trying to conceive for their ability to balance hormones and resource follicles. They are equally important once you are pregnant to nourish a developing embryo. In fact a British study found that many pregnant women had been discouraged from eating fish because of fears about mercury contamination but that children of women with low omega 3 intake in pregnancy were more likely to have a low IQ and suffer from social problems in childhood.

Polyunsaturated fats are found in vegetable oils, nuts and seeds.

Omega 3 fatty acids are found in fatty fish such as salmon, herring, sardines and mackerel and also in walnuts and flax seeds. Eggs also contain omega 3 especially the ones that you can now buy that are from chickens that have been fed greens rather than corn. Grass-fed, as opposed to, grain-fed beef also contains omega 3 fatty acids as do dairy products from grass fed cows.

Omega 6 fatty acids are found in flaxseed oil, flaxseeds, hempseed oil, hempseeds, grapeseed oil, pumpkin seeds, pine nuts, pistachio nuts, sunflower seeds (raw), olive oil, olives, evening primrose oil, black currant seed oil and chicken.

Omega 9 is found in olive oil (extra virgin or virgin), olives, avocados, almonds, peanuts, sesame oil, pecans, pistachio nuts, cashews, hazelnuts and macadamia nuts.

Heating essential fatty acids destroys their nutritional benefits so try to use raw nuts rather than roasted and don’t cook with flax seed oil but use it as a salad dressing or sprinkle ground flax seeds on your morning cereal. Whole flax seeds are hard to digest and tend to pass through your digestive system whole, which means that you don’t get much benefit from them.

At the YinOva Center we suggest that women trying to conceive take an essential fatty acid supplement and we have one available in the office for you. If you buy your EFA supplement from a health food store check that it has been tested for mercury and other contaminants.

Mono-saturated fats

These also help lower blood cholesterol levels. You can find them in olives, olive oil, avocados and canola oil. They are a healthy choice and should be eaten in moderation.

So here are our recommendations for our patients who are trying to have a baby:

• Two thirds of the fat you eat should be either polyunsaturated or mono-unsaturated.
• Special attention should be paid to essential fatty acids and you should consider taking a supplement that contains omega 3 and omega 6 from a reputable company.
• We should all lay off the trans fats…completely.
• Anyone trying to get pregnant should limit but not cut out their saturated fat.

Patient’s often ask me what the early signs of pregnancy are. It is useful to look out for them even though they can be a little confusing. Realistically, the only conclusive way of knowing that you are pregnant is a positive pregnancy test however the signs outlined below may give you a hint.

These are the symptoms I tell my patients to look out for.

Digestive Changes

Feeling nauseous or vomiting is one of the most common signs of early pregnancy. Gas, constipation or abdominal bloating are also common because digestion slows down in pregnant women.

Breast Tenderness

Extreme breast tenderness or itchy nipples are also a sign of early pregnancy.

Mild Spotting

As the fertilized egg implants into the uterine lining this can cause some very light bleeding. Women experience this as very light spotting a few days after ovulation. Heavy bleeding could be a sign of something more serious and should be flagged up to your health care provider.

Cramping

This feels like a mild menstrual cramp and is often the first sign of pregnancy for many women

Extreme Fatigue

In early pregnancy a lot of your body’s energy is diverted to the developing fetus. My pregnant patients are often surprised to feel as tired as they do.

If you are feeling these symptoms regularly but your pregnancy tests are negative you may be experiencing chemical pregnancies. If you are a patient at The YinOva Center we would like to know about this as this effects the treatment plan we draw up for you. We also advise you to tell your OB/GYN or RE as it will help them with their diagnosis.

You can find out more about our work with women trying to conceive here and with pregnant women here.

When I was expecting my daughter I vividly remember bursting into tears in the middle of a supermarket. Partly this mild hysteria was due to my pregnancy hormones but I also felt overwhelmed by all the conflicting advice and seemingly dire warnings given to pregnant women about food. It seemed as if the advice kept changing and I was so confused that I could not think of anything I wanted to eat.

I have been thinking about this recently because so many of my patients are newly pregnant and have been asking me for help with their diet.

It is important to consult your OB/GYN about this topic and my advice is not meant to take the place of your doctor’s suggestions. However here is what I tell my patients about what to eat and what not to eat when they are pregnant.

What to Eat

All pregnant women should take a daily pre-natal vitamin containing at least 400mcgs of folic acid to prevent birth defects of the brain and spinal cord

Try to achieve a healthy balance of nourishing foods including:

• Lean meat or fish – see below for advice about which fish to eat.
• Fresh fruit and vegetables, especially citrus fruits and dark green vegetables, which contain folic acid.
• Carbohydrates such as bread, pasta, grains, potatoes and cereals.
• Milk and other dairy produce such as yoghurt and cheese. See below for more advice about which cheeses to avoid.
• Plenty of water as pregnant women can become dehydrated easily.

In Chinese medicine we believe that food contains qi or energy and that foods that have been heavily processed in a factory have been deprived of much of that energy and so are less nutritious. Consequently I ask my patients to eat as many whole unprocessed foods as possible and not rely too heavily on frozen meals and pre-packaged snacks. However it is important to remember that not all food preparation methods are detrimental. Pasteurization makes foods much safer and at The YinOva Center we caution our patients against drinking un-pasteurized milk or juice during their pregnancy because of the risks of contamination.

What Not to Eat

• Fish is one of those controversial foods about which there is conflicting advice. On the one hand pregnant women have been told to avoid it because of mercury toxicity and on the other hand a recent article in the British medical journal The Lancet found that the children of mothers who had eaten lots of fish during pregnancy had better communication and social skills. You can find a BBC report about this here and here. Confusion like this is what reduced me to a sobbing mess during my own pregnancy. Here is what we tell our own expectant moms at The YinOva Center.
  • There is no doubt that mercury toxicity in fish is a serious problem. Scientists have found that mercury can be transferred to the growing fetus and cause health problems. Fish with the highest concentrations of mercury are swordfish, shark, marlin, king mackerel and tile fish and these should be avoided by pregnant women. Tuna can be high in mercury, but is also are a good source of nutrition. If you decide to eat tuna while you’re pregnant, eat one serving or less a week. One serving is a 6 oz fillet or one can.
  • Fish that are low in mercury are shrimp, salmon, pollock and catfish and you can safely eat 2 servings or 12 oz of these fish a week. This way you will get the health benefits of eating fish without exposing your baby to too much mercury. Incidentally the scientists believe that the reason that fish seems to improve your baby’s intelligence is because it contains omega 3 fatty acids which are important in brain development. Because of this at The YinOva Center we tell Mom’s who are worried to add a high quality omega 3 supplement to their diet. The one we prefer is called Orthomolecular Fish Oil and we have plenty in stock should you need to buy some.
  • In spite of the controversy about whether to eat fish or not all pregnant women should avoid raw fish, especially raw shellfish because of the risk of parasites. You should also avoid smoked seafood unless it has been cooked for instance having smoked salmon in a creamy pasta sauce would be fine. Canned smoked fish is also OK.
  • Don’t eat liver and liver products while pregnant, as they contain high levels of vitamin A, which can lead to birth defects.
  • Don’t eat hot dogs, deli meats (such as turkey, ham, salami and bologna), refrigerated pates or meat spreads because of the risk of listeria which can cause miscarriage or premature birth. Canned pate’s are safe however. For the same reason you should avoid soft cheeses made with un-pasteurized milk. Examples are brie, camembert, feta, roquefort, queso blanco, and queso fresco. There is also a slight risk of listeria from the kind of ready-to-eat pre-packaged meals you can get from the supermarket so these should be served piping hot to make sure all the bugs have been killed.
  • All meat, poultry and seafood should be cooked thoroughly all to kill bacteria. Likewise you should wash all fruit and vegetables before eating, to avoid infection with toxoplasmosis, an organism that can affect your baby. Its best to avoid sprouted grains and beans such as alfalfa, clover and mung bean sprouts.
  • Don’t eat raw or lightly cooked eggs because of the risk of salmonella.
  • Unless prescribed by a qualified herbalist you should avoid herbal supplements and teas.
  • Limit coffee to one cup a day and avoid alcohol all together.

You can find out more about how we help pregnant women at The YinOva Center here

In the USA it is estimated that 20% of couples are suffering from infertility at any given time. This number has increased steadily over the last 50 years, which has lead researchers to blame everything from increased maternal age to toxic overload. However 10% of all infertile couples will not be able to find out why they cannot conceive. The medical profession is left to shrug its collective shoulders and explain to these people that they are something of a mystery. They are offered assisted reproductive techniques but without a clear idea of what is being fixed, the outcome remains uncertain.

As a practitioner of Chinese Medicine I am trained in a medical philosophy that emphasizes the interconnectedness of everyone and everything. We are taught to look for patterns of dysfunction rather than specific symptoms. In fact no symptom can make sense in Chinese medical diagnosis except in relation to the whole person. This way of seeing bodies extends to the wider environment so that the same laws that are at play in our bodies are also the laws that govern our relationship with the world. I, like most of my patients, have been brought up in the West in a way that reinforced my belief in my individuality and uniqueness. It does not come naturally to any of us to see ourselves as a small cog in a much larger machine.

But by examining unexplained infertility through the prism of Chinese medical theory it has occurred to me that our bodies may be obeying a larger evolutionary imperative. We know that birth rates decrease in times of war and famine as the human race protects itself from having to share scarcer resources with a growing population. Obviously we are not experiencing a famine and all the patients I treat have enough to eat but many of them are on such strict weight-loss diets and exercise regimes that their bodies feel like they are starving and wisely choose not to bring more children into a world where food seems to be in short supply.

Likewise, most of us are not actually living in a war zone but many of my patients’ bodies behave as if they are. You have only to look at local news coverage to see how stories are sensationalized and skewed to provoke the most fear. Our personal communication devices beep endlessly, our cell phones ring and our bosses expect us to get back to them at the double. The advances in communications technology have not freed up our time, as predicted, but enslaved us to them. In our deepest sub-conscious this endless vigilance, this inability to switch off feels like danger and our bodies take evasive action by reducing our ability to conceive.

I have several wonderful, accomplished and resourceful patients who are not able to switch their Blackberries off whilst I give them an acupuncture treatment. They hire me to help them calm down then lie on my table trying to feel “Zen” whilst emailing colleagues and talking on their cell. More than anything I want them to feel free and unencumbered and I cannot help but feel that they would be more likely to get pregnant if their bodies understood that there was enough space in their lives for a baby. Obviously these are the extreme cases but most of us are over-scheduled and lacking in balance.

We all know that animals in zoos have trouble getting pregnant. They unconsciously evaluate the lack of space and limited resources and their bodies respond by allowing less of them to be born. Zoo vets are experts at all kinds of assisted reproductive techniques from insemination to IVF as they encourage these animals to reproduce in defiance of nature. After many years of working with women who are infertile I believe that our heavily scheduled lives make it harder for us to conceive hence the dramatic increase in medical interventions such as IVF. Like the zoo vets our reproductive endocrinologists are being called upon to defy evolution and help us to breed in captivity.

So if no-one can come up with a reason why you are having trouble getting pregnant, I suggest looking at your life and asking yourself how much of what you experience gives your body the impression that you are too unsafe, too under-resourced and too busy to look after a baby. Try to reverse those messages. Let your body know that you are fundamentally safe, that there is enough to eat and that when you do have a child you will be able to drop everything and play with building bricks on the floor for half an hour. Many patients who have followed this advice have found that their bodies were indeed tapped into a larger evolutionary web and that slowing down was all it took to become a Mom.

You can read more about how we prepare women for conception at The YinOva Center by clicking here.

Some of my patients tell me that they feel pregnant towards the end of some cycles but then get a negative pregnancy test. Others briefly show a positive result on a home pregnancy test but then get their period.

I encourage my patients to look out for the early warning signs of pregnancy because they can give us information you can read what these signs are here. Some women are conceiving regularly but their pregnancies are not continuing. These women experience some of the signs of early pregnancy but their period comes on time or just a few days late. This is known as a chemical pregnancy and is surprisingly common. In fact it is estimated that 50%– 60% of conceptions fail in the early stages often without the woman knowing she was pregnant.

Recognizing that this is happening gives both your doctor and your acupuncturist important information. Your doctor will look at your progesterone levels to see if they are dropping when they shouldn’t. She will also examine your uterine lining to make sure it is thick enough and that there are no obstructions such as fibroids. A good doctor will also look for infections such as urea plasma, which may be causing a pregnancy to fail at the beginning. Many of the causes of a chemical pregnancy can be sorted out however it is important to remember that a large number of chemical pregnancies are due to chromosomal problems in the fetus and therefore cannot be prevented.

In Chinese medicine there are also a number of explanations for a chemical pregnancy. I use TCM diagnosis to work out whether my patient has weak yang, dropping qi, blood stagnation or heat in the blood.

Patients with weak yang have poor circulation and run a bit colder. Often their progesterone levels are not as high as they should be and I give them yang tonic herbs, which do not supplement progesterone directly, but help the body to make more of this hormone over time.

Patients with dropping qi are often tired and have periods that are very heavy to start with. Sometimes they spot before their period. I give them an acupuncture treatment in their luteal phase that raises qi and also give them an herbal formula.

Patients with blood stagnation have blood that does not flow smoothly causing their uterine lining to be lumpy and making it hard for a fetus to implant. These patients are hard to treat with herbs because the herbs that move blood in the uterus are contraindicated in pregnancy. I usually give blood-moving herbs during the period to help develop a healthy endometrial lining later in the cycle. If the dense tissue has become a fibroid or polyps I usually send the patient to their GYN to find out if these needs to be removed.

Heat in the blood correlates to an infection in conventional medicine. I give the patient herbs to help with this but also refer them to their GYN for detailed testing and possibly some antibiotics.

As my patients know I am an enthusiastic advocate of a combined approach when it comes to getting pregnant. So I always encourage women to consult their doctor and take advantage of the best that both conventional and Chinese medicine has to offer.

So if you suspect that you may have been briefly pregnant do not worry that you’re feelings will be dismissed. A good health care practitioner will take you seriously and work with you to help you find a solution.

You can read about how we prepare women for conception in our practice here