The recent Dutch study revealing a possible link between IVF and borderline ovarian tumors has caused some panic amongst our patients.  I’d like to set everyone’s mind at ease.

This was a large and long term study comparing ovarian cancer rates in nearly 20,000 women who received IVF with about 6,000 infertile women who had not.  Sixty-one women in the IVF group had ovarian tumors. 31 of these were considered “borderline ovarian cancer” and 30 were invasive cancer.  Those who had IVF had about double the likelihood of being diagnosed with ovarian cancer compared to those who did not over the course of the 15-year study, which was published in the Journal of Human Reproduction.

To the casual reader this all sounds very scary but let me break down the facts for you.

• Firstly, borderline ovarian tumors are NOT cancer and the study of 26,000 women found no increase risk of ovarian cancer in women who undergo IVF.  Borderline ovarian tumors are not fatal and may never become malignant, but they usually require surgery.

• Secondly, less than one woman in 100 (0.45 percent of women) will get ovarian cancer by the time they reach the age of 55.  If the results of this study are true, this risk increases to 0.71 percent for women who have IVF treatment.  This is a very small risk increase.  To help put this into perspective, the risk of heart disease is 1 in 5, the risk of being injured in a motor vehicle accident is 1 in 100, and the risk of breast cancer is 1 in 9.  The increased risk of a borderline ovarian tumor is 7 in 1,000.

• There was no additional risk of ovarian cancer for women who had repeated courses of IVF treatment compared with women who had just one treatment.  This might indicate that the hormonal stimulation drugs are not what are causing the increase in borderline tumors.  Some other factor could have accounted for the difference — especially since the risk didn’t continue to rise in those who had higher hormone doses.  Also, women who had been treated with fertility drugs before going on to have IVF treatment did not have a higher risk of a tumor than those who had not.

This study creates a lot of questions that need to be further investigated.  As Jill and Dr. David pointed out, in Making Babies: A Proven 3-Month Program for Maximum Fertility, all medicine is about weighing up risks and benefits and no one should be taking fertility drugs unless it’s absolutely necessary. However, this study reveals that the increased risk of  ovarian cancer associated with IVF is small and, in my opinion, this should not stop someone from using IVF as an option for having a baby.

Ovarian cysts are small fluid-filled sacs that develop in a woman’s ovaries.  Most cysts are harmless, but some may cause problems such as rupturing, bleeding, or pain; and surgery may be required to remove the cyst(s).

In Traditional Chinese Medicine cysts are considered an accumulation of phlegm and/or blood stagnation.  This is predominantly a Yin Pathology where fluid is accumulates due to an overabundance of water and phlegm.  In treating cysts, the main treatment goal is to tonify the kidneys, transform dampness and phlegm and move blood stasis.

Yang energy is required to encourage the break up of cysts.  Yang is the warming and moving aspect of life.  To boost Yang energy and decrease the sinking, heaviness of Yin energy, acupuncture, herbs and dietary therapy are employed.

Acupuncture Therapy

Certain points along the meridians tonify Yang.  There are many ways to do this.  Many treatments are aimed at nourishing the Kidneys especially when the person is susceptible to cold, has back problems, weight gain, phlegm and fatigue.  Others treatments are geared towards raising the Spleen Qi especially if the person has digestive issues, insomnia, bruises easily and feels fatigue.  Additionally, it is important to move blood in order to disperse stagnation.  I often use a heat lamp and castor oil packs on the abdomen to facilitate movement.

Herbal Therapy

Traditional Chinese Herbal formulas are a synergistic interplay of 5-20 herbs.  Some warming herbs include Cinnamon bark and spices such as Tumeric, Cardamom, Cayenne Pepper and Saffron. Some herbs that help eliminate phlegm and dampness include Barley and Orange Peel.

Dietary Therapy

Dietary therapy is an intrinsic element to Traditional Chinese Medicine.  If you are trying to reduce the growth of cysts it is imperative to reduce or eliminate phlegm producing foods such as:

* cheese
* ice cream
* soy
* wheat
* sugar

There are many different types of cysts.  The following list is from the Mayo Clinic:

• Follicular cyst: This type of simple cyst can form when ovulation does not occur or when a mature follicle involutes (collapses on itself).  A follicular cyst usually forms at the time of ovulation and can grow to about 2.3 inches in diameter.  The rupture of this type of cyst can create sharp severe pain on the side of the ovary on which the cyst appears.  This sharp pain occurs in the middle of the menstrual cycle, during ovulation.

• Corpus luteum cyst: This type of functional ovarian cyst occurs after an egg has been released from a follicle.  After this happens, the follicle becomes what is known as a corpus luteum.  If a pregnancy doesn’t occur, the corpus luteum usually breaks down and disappears.  It may, however, fill with fluid or blood and persist on the ovary.  Usually, this cyst is found on only one side and produces no symptoms.

• Hemorrhagic cyst: This type of functional cyst occurs when bleeding occurs within a cyst.

• Dermoid cyst: This is a type of benign tumor sometimes referred to as mature cystic teratoma.  It is an abnormal cyst that usually affects younger women and may grow to 6 inches in diameter.   A dermoid cyst can contain other types of growths of body tissues such as fat and occasionally bone, hair, and cartilage.

• Endometriomas or endometrioid cysts: Part of the condition known as endometriosis, this type of cyst is formed when endometrial tissue (the lining tissue of the uterus) is present on the ovaries.  It affects women during the reproductive years and may cause chronic pelvic pain associated with menstruation.

• Polycystic-appearing ovary: Polycystic-appearing ovary is diagnosed based on its enlarged size – usually twice that of normal – with small cysts present around the outside of the ovary.

Although Traditional Chinese Medicine is highly effective you need to allow time for the treatments to work.  Even if you see an immediate improvement in energy, sleep, mood, etc. it often takes at least three months of regular treatments to change existing patterns of disharmony.

“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.

Endometriosis is one of the leading causes of pelvic pain we see here at the YinOva Center. It can seriously affect a woman’s ability to conceive and can also cause uncomfortable, heavy or irregular periods. Sometimes there are no symptoms associated with endometriosis and it is only discovered when a woman seeks treatment for infertility.

What is endometriosis?

Endometriosis is a condition where the tissue that normally lines the uterus (the endometrium) grows outside the uterus and sticks to various pelvic organs such as the the ovaries, bowel, rectum, bladder and the delicate tissue lining the pelvis. Occasionally, but rarely, this tissue can stray even further and can be found outside the pelvic region in other areas of the body.

This misplaced endometrial tissue behaves just like the uterine lining itself in that it responds to the interplay of hormones during the menstrual cycle. Consequently tissue and blood slough off the endometriosis during the period, just as the uterine lining sloughs off every month. The difference is that the tissue in the pelvic cavity has no means of being discharged, so over time it builds up and can form masses and lesions which can affect organ function. The cyst-like masses are called pseudocysts, and usually appear dark blue to brown, the latter being called “chocolate cysts”.

What are the symptoms of endometriosis?

The primary symptom of endometriosis is pelvic pain often worse during the period. Pain during or after sex is also common, as is pain associated with a bowel movement or urination. Other common symptoms are heavy bleeding during the period or uterine bleeding between periods. Occasionally endometriosis can also cause nausea, bowel movement changes and fatigue. Its worth pointing out that the severity of the symptoms does not reflect the severity of the endometriosis itself. In my career I’ve seen women with very mild endometriosis who have debilitating symptoms and some with very severe endometriosis who have no symptoms whatsoever.

What causes endometriosis?

The cause of endometriosis is unknown, but there are a number of theories. The most likely explanation is that there is a back flow of menstrual blood during the period and endometrial cells travel through the fallopian tubes and into the abdominal cavity. However some researchers have suggested that bits of endometrium are already in the abdominal cavity at birth or that the cells lining the abdominal and pelvic cavities are descended from embryonic cells and have the potential to specialize and become endometrial cells. However, no one knows why these cells would suddenly change and fulfill this potential.

We do know that endometriosis has a genetic link because women with a mother or sister who suffer from endometriosis are 6 times more likely to have the condition themselves. It’s also more common in women who have never given birth or became pregnant for the first time later in life.

How is endometriosis diagnosed?

If your doctor suspects you have endometriosis she may do a pelvic exam and order an ultrasound but the only way she can be absolutely sure is to do a minor surgical procedure called laparoscopy. That way she can look for endometrial implants and may even be able to remove some during the surgery.

How does conventional medicine treat endometriosis?

Conventional treatment for this condition varies depending on the severity of your symptoms, the location of the endometriosis and whether you are trying to get pregnant. Treatment options include medications to relieve pain and inflammation, hormonal therapies to stop the endometriosis from getting worse, surgery and as a last resort hysterectomy.

Can Chinese medicine treat endometriosis?

Yes and no!

Yes…Chinese medicine is a great help when it comes to relieving the uncomfortable symptoms associated with endometriosis.

Yes…Chinese medicine can help limit the proliferation of endometriosis.

No…Chinese medicine does not make current endometriosis disappear (although it may be able to reduce it).

At the YinOva Center we often see fertility patients for whom the endometriosis is getting in the way of a successful conception and a healthy pregnancy. We advise these patients to follow their MD’s advice and if their doctor deems laparoscopic surgery necessary we support them through this process. Then we use Chinese medicine to help with recovery and to slow the rate the endometriosis returns.

It’s often effective to combine Chinese medicine with conventional medical treatment. In Chinese medicine endometriosis is seen as blood stagnation however to treat it properly a good practitioner will also diagnose and treat the root cause of the blood stagnation. The most common patterns we see in our clinic are :-

 
• Qi stagnation with blood stagnation
• Yang deficiency with blood stagnation
• Qi sinking with blood stagnation

There are other, rarer Chinese medical diagnoses associated with endometriosis so it’s always a good idea to meet with a practitioner who specializes in OB/GYN to get a full explanation of your particular case. At the YinOva Center we’re always happy to explain how your particular pattern works, how we came to our diagnosis and what our treatment strategies are designed to achieve.

In 1980 researchers at the Hospital of Obstetrics and Gynecology of the Shanghai First Medical College conducted a clinical trial using Chinese herbs to treat endometriosis. 156 endometriosis sufferers were divided into three groups based on the diagnoses above and then given a herbal formula that addressed blood stagnation as well as their underlying condition. According to the report, 82% of the women saw their symptoms mostly or entirely alleviated, while 18% of the women had either no effect or any beneficial effect was very short term and was lost when the herbs were discontinued.

To me what this research means is that Chinese herbs are effective in the treatment of endometriosis but only if a full diagnosis is made and if treatment is specifically tailored to fit the patient’s individual pattern.

How does acupuncture treat endometriosis?

According to current research acupuncture seems to promote blood circulation and regulate hormones. It also seems to have an anti-inflammatory effect and is effective for pain relief because of it’s effect on blood chemistry and in particular endorphin levels.

In December 2002, The Journal of Traditional Chinese Medicine published a study of 67 women diagnosed who were suffering from dysmenorrhea due to endometriosis. Half of this group received ear acupuncture whilst the other half did not have treatment. In the acupuncture group 81% of the women had less painful periods after receiving the acupuncture treatments.

At the YinOva center we use a combination of ear points and systemic body point aimed at improving blood circulation, clearing inflammation, relieving pain and treating the patient’s underlying condition.

Which Chinese herbs treat endometriosis?

As the study from Shanghai showed herbs are most helpful when they are part of a formula specifically designed by a skilled and trained herbalist to treat a patient’s individual pattern. However some of the herbs most commonly used at our center to treat endometriosis are as follows:-

Stop excessive bleeding

• Pu huang – bulrush
• San qi – pseudoginseng

Reduce pain

• Yan hu suo – corydalis
• Tao ren – persica
• Mo yao – myrrh

Reduce masses

• E zhu – zedoaria
• Zao ci – gleditsea spine
• Mu li – oyster shell
• Xia ku cao – prunella

Moves qi

• Chai hu – bupleurum
• Xiang fu – cyperus
• Chi shao – red peony

Improves blood circulation

• Chuan xiong – cnidium
• Dang gui – Tang kuei
• Dan shen – salvia

Warms

• Gui zhi – cinnamon
• Gan jiang – ginger
• Xu duan – Dipsaci

Relieves Inflammation

• Mu dan pi – moutan
• Zhi zi – gardenia
• Gui ban – turtle shell

How can I help myself?

• Regular acupuncture can improve blood flow, reduce inflammation and decrease pain.
• Chinese herbs prescribed by a board certified herbalist have been shown in clinical trials to reduce the pain associated with endometriosis and may also prevent further proliferation of the tissue.
• Arvigo Mayan Fertility Massage™ is helpful for relieving symptoms and promoting pelvic organ function. You can read more about it here.
• A warm caster oil pack on the lower abdomen brings relief for many of our patients.
• Although we know that the back flow of menstrual blood may not be the whole cause of endometriosis, at the YinOva Center we still feel its important to avoid counter flow of menstrual blood wherever possible. To that end we advise our patients not to do yoga inversions during their period.
• Regular exercise promotes blood flow and in our clinic we have noticed that our endometriosis patients who exercise frequently respond better to treatment and show marked symptomatic improvement.
• As endometrial tissue is affected by estrogen it is helpful to avoid a  condition called “estrogen dominance”. The liver is responsible for metabolizing excess estrogen and so supporting good liver function is an important part of a holistic strategy to treat endometriosis. Because of this we advise our YinOva patients with endometriosis to limit their alcohol consumption and avoid caffeine. You may also want to discuss with your practitioner ways of using liver supporting herbs such as dandelion, milk thistle and burdock root as part of your herbal regimen.
• Many women find that adopting a low fat, high fiber, mostly plant based diet helps relieve some of the symptoms associated with endometriosis.

For further advice about pelvic pain see this YinOva Blog article from our archives about fibroids

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. Our book Making Babies: A Proven 3-Month Program for Maximum Fertility gives more information about this.

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.

BBT Chart

A BBT chart that goes up at ovulation and then goes up again about 4-6 days later, especially if the temperatures stay high.

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.

Women with a common blood type could be twice as likely to suffer from fertility problems, say scientists at Albert Einstein College of Medicine in New York and Yale University. Women with blood group O are at a higher risk of running out of healthy eggs according to research presented this week at the American Society of Reproductive Medicine conference in Denver.

The study examined 560 women, with an average age of 35 who were undergoing fertility treatment, looking at levels of follicle stimulating hormone (FSH). An FSH over 10 iu/L suggests that a woman will have more trouble conceiving than women whose levels are under 10. The study found that women who were blood type O were twice as likely to have an FSH level greater than 10 as those in any other blood group. This was true even when a woman’s age was taken into account and the fact the women came from two different clinics. Meanwhile, those with blood group A were “significantly less likely” to have an FSH level greater than 10 than those who were blood group O.

Group O has neither A nor B antigen so this blood can be given safely to any other group. This is why Group O donors are known as ‘universal donors’. This is not the first study relating blood type to certain medical conditions. Previously scientists have found that people with blood type A or AB are more likely to suffer heart disease and strokes, while those with type O are more at risk from arthritis and certain stomach infections such as E-coli.

Traditional Japanese medicine has a long tradition of grouping people according to blood type, drawing conclusions about personality and making dietary and lifestyle suggestions according to type. This approach was popularized by naturopath Peter D’Adamo in his best selling book Eat Right 4 Your Type: The Individualized Diet Solution to Staying Healthy, Living Longer & Achieving Your Ideal Weight. Although D’Adamo’s book was criticized by many in the scientific community and dismissed as a fad it remains a popular diet amongst many of my patients. Outlined below is a summary of it’s conclusions about each blood type.

• Blood group O is believed by D’Adamo to be the hunter, the earliest human blood group. The diet recommends that this blood group eat a higher protein diet. D’Adamo bases this on the belief that O blood type was the first blood type, originating 30,000 years ago.
• Blood group A is called the cultivator by D’Adamo, who believes it to be a more recently evolved blood type, dating back from the dawn of agriculture, 20,000 years ago. The diet recommends that individuals of blood group A eat a diet emphasizing vegetables and free of red meat, a more vegetarian food intake.
• Blood group B is, according to D’Adamo, the nomad, associated with a strong immune system and a flexible digestive system. The blood type diet claims that people of blood type B are the only ones who can thrive on dairy products and estimates blood type B arrived 10,000 years ago.
• Blood group AB, according to D’Adamo, the enigma, the most recently evolved type, arriving less than 1,000 years ago. In terms of dietary needs, his blood type diet treats this group as an intermediate between blood types A and B.

Based on these classifications the O blood type needs protein rich foods for nourishment. Interestingly in my own book Making Babies: A Proven 3-Month Program for Maximum Fertility, which I wrote with Reproductive Endocrinologist. we make a similar suggestion but arrived at this conclusion through a study of Traditional Chinese Medicine (TCM). In the book we divide people into five basic fertility types. From our observations and using TCM principles we suggested that the dry type (yin deficient) was most likely to suffer from high FSH and premature infertility and we suggest that they eat a yin nourishing diet including plenty of protein.

So what is a woman wishing to conceive supposed to do with this new information about blood type? I have already received emails from patients who are blood type O and are worried about what this news means. My first advice is not to panic. Type O is the most widespread blood type and common sense suggests that it would not have continued to be the largest blood group if type O women routinely have trouble conceiving. It’s important to bear in mind that this research looked at women who were already seeking fertility treatment and not at the majority of type O women who conceive without any problems at all.  What the research may mean from a Chinese medicine perspective is that type O women are more likely to be yin deficient (dry type) and as we noted in our book yin deficient women (dry type) are more likely to suffer from high FSH. In Chinese medicine we would suggest nourishing yin by following the suggestions in Making Babies for the dry type, taking yin nourishing herbs and eating nourishing protein rich foods.

I am often struck by how Western scientific research comes to the same conclusions as traditional Asian medicine but from a different frame of reference. It really is the case that we are all observing the same phenomenon but through our own cultural and societal lenses.

Anne had been a strict dieter since college. Maggie is a yoga teacher and considers herself a healthy eater. Sherrie prides herself on her macrobiotic diet and low body fat. All of these women have something in common. All of them came to the YinOva Center because they were having trouble getting pregnant. Each of these women considered themselves to be a healthy eater and each of them was not getting enough fat to make the hormones necessary to conceive.

As obesity has swept the nation, Americans have got the message that fat is bad but the truth is that whilst saturated fats may harm your heart and trans fats should be eliminated from your diet altogether, healthy fats are vital for your overall wellness as well as your fertility and you do need some dietary fat to make hormones, fight inflammation and facilitate ovulation. I regularly see patients who aren’t eating enough fat and are confused about which fats are bad for them and which fats could be helping them.

Saturated Fats

First, let’s talk about the bad guys. Saturated fats in large quantities are not a good idea. These fats, which are found in animal products, can contribute to insulin resistance, endometriosis, and PCOS. However you don’t need to eliminate them altogether. The kind of animal products that contain saturated fats also contain cholesterol and although cholesterol gets a bad rap you do need some to to make reproductive hormones. So by all means have sensible quantities of fats from animal origin such as a full fat yogurt, eggs or some grass fed beef.

Trans Fats

You can eliminate trans fats altogether. They offer no health benefits and can cause ovulatory dysfunction and poor hormone balance. A large, long-term study by researchers at Harvard Medical School found that women who regularly consumed trans fats were 70% less likely to conceive than women who did not. The good news is that if you are eating only fresh, whole natural foods, you don’t need to worry about trans fats because they are only found in processed foods. So avoid commercially made baked goods, frozen meals and the biggest transgressor of all, stick margarine. Avoid foods which say they contain “partially hydrogenated vegetable oil” as this means that they contain trans fats.

Polyunsaturated fats

Having pruned some of the less healthy fats from your diet you now have room for some beneficial fat. Polyunsaturated fats are considered to be the “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 bodies 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 eggs 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. They have a broad range of fertility benefits including increasing blood flow to the uterus which can help with implantation and thus a health pregnancy.

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. However most Americans get plenty of Omega 6 because it is found in commonly used processed oils.  In fact many of us could be said to be getting too much of a good thing especially when you consider that more important than the exact level of omega 3′s and omega 6′s is the ratio between them. Getting an even amount of each is the best way of supporting hormone balance, which for most of us means focusing on increasing omega 3′s without increasing omega 6.

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.

Monounsaturated fats

Monounsaturated fats are vital for good hormone balance. You can find them in olives, olive oil, avocados and canola oil. They are a healthy choice and should be eaten in moderation.

So if you’ve been limiting fat in your diet for health reasons you may want to reassess and add back some healthy fats. Often this is all it takes for some women struggling with infertility to finally conceive.

So here are our YinOva recommendations regarding fats for 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 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.

Overnight one of my patients “facebooked” me to let me know she’d had her baby – a happy reminder of all the reasons I love my job. Helping couples to conceive is rewarding and interesting work.

When a patient first consults me I ask lots of questions, some of which may seem off-topic, but together they give me a picture of their internal landscape and from there the detective work begins. Sometimes I manage to spot something very simple that may be getting in the way of conceiving and an example of this is a luteal phase defect.

Your luteal phase is the time from ovulation until your period starts. A normal luteal phase should be 14 days which gives a fertilized egg enough time to implant and start to signal to your body that it’s there. A luteal phase lasting less than 12 days is too short for this to happen and the uterine lining begins to slough off before a fertilized egg has had a chance to implant and initiate the hormonal changes necessary to sustain a pregnancy. This is a common endocrine disorder and is present in many of the women I see who are having trouble conceiving. Researchers estimate that more than 1/3 of women who are suffering from early pregnancy loss have a luteal phase disorder.

Another indicator of a luteal phase defect is low progesterone in the second half of the cycle. It’s possible to have a completely normal 14 day luteal phase and still have low progesterone levels which mean that the endometrium can’t develop and function properly and a fertilized egg will have problems implanting and being sustained. A short luteal phase or spotting before your period could be a sign of low progesterone and it is a good idea to contact your doctor for further testing.

In our book Making Babies: A Proven 3-Month Program for Maximum Fertility Dr. David suggested the following tests for women who think they may be suffering from luteal phase defect.

• Testing serial progesterone levels during a single cycle – 7, 9 and 11 days after ovulation.
• Testing prolactin levels – elevated prolactin can lead to inadequate progesterone
• Testing thyroid function – hypothyroidism can lead to low progesterone
• Checking for polycystic ovarian syndrome – low progesterone levels commonly occur in women with PCOS

If progesterone levels are low your doctor may prescribe supplemental progesterone or a follicle stimulating drug in the follicular phase on the grounds that a strong follicular phase can lead to higher progesterone in the luteal phase.

In Chinese medicine we interpret luteal phase defect as an imbalance of the whole cycle, not just the luteal phase. Western medicine recognizes this too which is why doctors sometimes combine intervention in the luteal phase (progesterone supplementation) with support in the follicular phase (clomid). The luteal phase is governed by yang energy, which develops from yin energy which is dominant in the follicular phase. The transformation of yin to yang happens through the movement of qi and blood at ovulation. An interruption in the flow at any point in the cycle can show up as a luteal phase defect. This is where the detective work comes in and as an acupuncturist I try to identify the root cause of the problem as I make my Chinese diagnosis.

• Too little yin in the first half of the cycle can lead to too little yang in the second half of the cycle. This would be termed yin and/or blood deficiency in Chinese medicine.
• Stagnation at ovulation can affect the hormonal transition and thus the transition of yin to yang. This would be termed qi and/or blood stagnation in Chinese medicine
• Too little yang can affect both the hormone transition at ovulation and the quality of the luteal phase. this would be termed yang and/or qi deficiency in Chinese medicine.

Based on these different diagnoses I adapt my acupuncture treatments and create a specially tailored herbal formula for each patient, which along with any treatment suggested by the patient’s doctor can significantly improve or correct a luteal phase defect.

Often all it takes for conception to occur is bit of detective work combined with Eastern and Western medicine working together to correct a small but significant imbalance. Then before I know it I’m waking up to baby pictures on Facebook and the satisfaction of seeing another patient become a Mom.

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

Men make new sperm every day and those sperm come to fruition withing 72 days. This is good news for men who want to give their fertility a boost, because it means that within three months they can

make a big difference to the reproductive health. For more detailed information it is worth checking out our book Making Babies: A Proven 3-Month Program for Maximum Fertility where Dr. David and I give specific advice to men based on their fertility type. Briefly though, here are five simple things men can do that have a big impact on sperm quality and quantity.

1. Keep them cool

It’s important that the testicles are 1- 2 degrees cooler than the rest of the body and so taking hot baths or sitting with a lap top on your knee can be contributing to diminished fertility. Likewise men who sit at a desk all day can become overheated so at the YinOva Center we advise them to get up a move around once an hour to air off their private parts.

2. Eat right

You will find more information in Making Babies about how to eat right for your fertility type but all men can benefit from eating a wide range of colorful fruits and vegetable, whole grains and lean protein. Poor intake of vitamin C and E and the minerals zinc and selenium can affect sperm quality and would-be fathers with borderline sperm counts might want to consider supplementation. Finnish men have some of the highest sperm counts in the world which is thought to be due to the amount of oily fish they eat. For this reason at the YinOva Center we suggest men use a fish oil/omega-3 supplement.

3. Limit your exposure to toxic chemicals.

In Making Babies we discuss how the average sperm count for American men has plummeted over the past few decades. Dr. David and I believe that environmental toxins and the main reason and so advise men to eat as much whole food as possible and to avoid processed foods. I have blogged about this here.

4. Drop some bad habits

Smoking, whilst it does not reduce sperm count, does damage sperm DNA which can lead to a greater chance of miscarriage. Excessive alcohol use can affect hormone levels and lead to atrophy of the semeniferous tubules, loss of sperm cells, and an increase in abnormal sperm. Marijuana use has been shown to reduce sperm and semen volume. If you need help dropping unhealthy habits come on in to the YinOva Center. We are happy to support you.

5. Get checked out for hidden infections.

Infections such as chlamydia or urea plasma can impair fertility and also lead to early miscarriages. Men should ask their doctors for a semen culture to make sure that they are not infected.

Once considered an unusual treatment, acupuncture has become a valued and more mainstream method of enhancing an IVF cycle. As successive studies point to it’s efficacy, couples are more comfortable about adding a course of acupuncture to their IVF protocol. You can read more about how we, at the YinOva Center, treat women who are going through IVF by clicking here.

Many of you are familiar with this German study that looked at 160 women undergoing IVF and split them into two groups. One group combined acupuncture with IVF and one group did not. Interestingly the group that did the acupuncture had a 50% better outcome than the group that did IVF alone. Likewise research published in the British Medical Journal showed that women doing IVF who underwent acupuncture were 65% more likely to have a successful embryo transfer compared with those who underwent a “sham” version of the treatment, or no extra treatment at all. You can read about this study here.

Now some new research may be casting further light on why acupuncture can be so helpful. The study, which you can read here, looks at how acupuncture when given twice a week for about 5 weeks regulates the stress hormones cortisol and prolactin and so improves pregnancy rates.

An IVF cycle can be very stressful. My patients talk about the financial pressure of having so much riding on the outcome of the procedure and how this combined with constant monitoring and taking large doses of stimulating drugs makes them tense and tired. Some studies, like this one by UCSD, have shown that the more stressed a patient is, the poorer the result, because of the way stress interferes with reproductive hormones. The reason this latest acupuncture study is important is that it shows that regular acupuncture treatment can offset the negative effects of stress by regulating stress hormones and so help a patient have the best possible outcome from IVF.

We love helping you have babies here at the YinOva Center and have helped thousands of couples achieve IVF success. Feel free to call and speak to one of our acupuncturists if you want to know more.

Today on the YinOva Blog I asked Fertility Coach, Dania Sander to write about her practice and how she works to support women while they are trying to conceive. Dania does not work at our center but I am big fan of her work. Her coaching can be a great help in moving forward when you feel stuck.

Dania Says: Thank you Jill for this opportunity to share with the readers of your blog, some thoughts and insights on re-wiring the brain to support the fertility journey.

The brain is designed to help us achieve whatever it focuses on – even pregnancy. By the same token, it can work against us when it perceives a threat. David Rock, author of Your Brain at Work and founder and CEO of Results Coaching Systems, talks about threats vs. rewards in our thinking. Our brain recognizes a threat much faster then a reward. It gives these threats a lot of attention and decreases our ability to have insights. By focusing on the perceived threat it prevents us from thinking, acting, or interacting creatively. We go into reactive mode and lose our ability to deal effectively with our problems, with people, and within our community. However, when the brain detects a reward, it triggers our creative thinking and we can feel as though we can achieve our goals, plan our lives in a productive way, stay inspired, be great team players and partners, and take action.

Fertility treatments are often emotionally charged and stressful. This triggers the brain’s stress reaction as it perceives “threats”. Negative thoughts can takeover affecting our perceptions, our behavior, and our ability to make good decisions. All of this inner turmoil can influence the end result.

By applying science of the brain to the fertility process, a coach can help you become aware of your thought processes and adjust your thinking to ensure that stress does not undermine your efforts. You learn how to stop the reaction to threats, or at least shorten their duration, just as you would apply the brakes in your car.

In our coaching sessions we set inspiring goals and move forward with strategies and actions to ensure we achieve them.

• Seek Simplicity: we learn how to reduce complicated thoughts and simplifying them and by that enabling ideas to become manageable.

• Prioritize: What is really important? Prioritizing is important for the brain because if we work on the important tasks first, we won’t become overwhelmed and panicked on our path to parenthood.

• Keep the Big Picture in Mind: The details of the complex fertility treatments can become overwhelming and prevent us from moving forward efficiently during the process. Taking that into account, we take things in chunks. With fewer details to process, there is less drama and we stay goal-oriented.

• Focus is the name of the game: During the fertility process accuracy is key. Following doctors’ instructions precisely is important for success and this demands that we stay extremely focused. We work on concentrating the brain’s attention to prevent a drop in “performance”.

Working with the brain-based approach to coaching and focusing on these elements and others, we help our clients re-wire their thinking and help them create new mental maps that support their efforts today. With that we strengthen their ability to have openness to any thought, which will bring more insights and creative ideas on how to solve problems. Connecting between things that didn’t make sense until that very moment. We help you maximize rewards and minimize threats in your thinking so you can experience yourself achieving your goals and getting rid of patterns that no longer support the new you.

The longer we stay victims of our negative thinking, the longer we will stay in the problem. As a coach I walk hand in hand with my clients on the path of solutions. Often seen that when focused on the solution, the problems get minimal.

The more we learn about the brain, the more we realize that it is easier to meet any challenge – mental or physical – when we put ourselves in the frame of mind to succeed. As your fertility coach I will listen to your concerns without judgment and help you to identify and access your inner strengths – strengths you may not realize you have.

If you want to learn more about how fertility coaching can support your process, please contact me at: info@yourfertilitymatters.com

Whilst moderate exercise helps relieve stress and prepare a body for a healthy pregnancy, spending too much time in the gym can impair a woman’s fertility, according to a new study of 3,000 women published in last month’s edition of Human Reproduction.

In our book, Making Babies, we suggest that women who are trying to conceive do enough exercise to maintain a normal level of fitness and but that they do it in a way that makes them feel good physically and mentally, not drained or exhausted.  This advice is seconded by Sigridur Lara Gudmundsdottir, who led the study, ” we found two groups who experienced an increased risk of infertility. There were those who trained almost every day, and there were those who trained until they were completely exhausted. Those who did both had the highest risk of infertility.”

The researchers believe that high levels of physical activity consume so much energy that the body experiences short periods of time where there simply is not enough energy to maintain all the necessary hormonal mechanisms that make fertilization possible.

This correlates with the way traditional Chinese medicine sees the effects of too much exercise on qi. Qi is the word used to describe the body’s ability to warm, move and make transformations. For thousands of years Chinese doctors have cautioned their patients not to deplete their qi, if they are trying to conceive, because weak qi can lead to failure to ovulate or affect the embryo’s ability to implant.

The key is moderation. Too much exercise depletes qi whilst moderate exercise can help build qi. This is supported by previous research which has shown that moderate physical activity gives women better insulin function and an improved hormonal profile. In this recent study there is no evidence of impaired fertility through moderate amounts of exercise. Gudmundsdottir advises that women who want to conceive should still maintain their fitness but avoid extremes.

‘We believe it is likely that physical activity at a very high or very low level has a negative effect on fertility, while moderate activity is beneficial,’ she said.

Several recent studies have explored the use of acupuncture to treat polycystic ovary syndrome with encouraging results. We see quite a number of women who are suffering from PCOS at the YinOva Center and have found that a combination of acupuncture and Chinese herbs can be really helpful.

PCOS is a complex endocrine and metabolic syndrome that affects 5% – 10% of women of reproductive age and is characterized by small ovarian cysts, irregular menstrual cycles, abnormal hair growth, acne, and metabolic problems leading to weight gain. The cysts associated with PCOS cause a hormone imbalance that means that sufferers have increased male sex hormones. This can disturb ovulation and lead to infertility. Women who suffer from PCOS also have a higher risk of developing hypertension and diabetes and are at an increased risk of heart disease.

A study at Goteborg University in Sweden showed that electro-acupuncture may help some women with PCOS to ovulate. Electro-acupuncture was developed in China as an alternative to manipulating acupuncture needles by hand. It involves the application of a pulsating electrical current to acupuncture needles as a means of stimulating the acupuncture points, .

During the study, one group of women with polycystic ovary syndrome received acupuncture regularly for four months. A second group of women were provided with heart rate monitors and instructed to exercise at least three times a week. A control group was informed about the importance of exercise and a healthy diet, but was given no other specific instructions.

The study showed that activity in the sympathetic nervous system was lower in the women who received acupuncture and in those who took regular exercise than it was in the control group. The acupuncture treatment brought further benefits. “Those who received acupuncture found that their menstruation became more normal. We could also see that their levels of testosterone became significantly lower, and this is an important observation, since elevated testosterone levels are closely connected with the increased activity in the sympathetic nervous system of women”, says Elisabet Stener‑Victorin the lead researcher. 38% of women who received the electro-acupuncture experienced regular ovulation. However, the electro-acupuncture was not effective in the more severe cases (obese, highest waist-to-hip ratio, and highest testosterone and insulin individuals).

What causes PCOS remains a mystery, but we do know that PCOS sufferers have a higher sympathetic nervous system (SNS) activity than other women so it may be that the acupuncture is calming the SNS and thus leading to a reduction in symptoms.

In Chinese medicine PCOS is usually attributed to Kidney Yang Deficiency (poor metabolism) and Damp Accumulation (fluid filled cysts) and has been treated for hundreds of years using a combination of herbs and acupuncture. Some herbs such as zao jiao ci (Spina Gleditsiae Sinensis) have the ability to dissolve the waxy coat around the ovarian cysts and at the YinOva Center we use them as part of a larger formula to reduce cysts. Other herbs such as bu gu zhi (psoralea) and xian mao (circuligo) help metabolic slowdown and insulin resistance and at the YinOva Center we usually combine them with herbs that calm an overactive system such as huang jing (polygonatum) and herbs that balance hormones such as dang gui (tangkuei).

In our book Making Babies we give the following advice to PCOS sufferers

• Lose weight if you need to. Studies have shown that losing just 10% of your body weight can result in normal ovulation in women with PCOS
• Cut down on animal fats and increase essential fatty acids
• Eat a wide range of fruits, vegetables and low fat protein such as chicken, fish and beans.
• Balance your blood sugar by limiting your carbohydrate intake. Don’t cut out carbs altogether, though, as that can lower serotonin levels and leave you feeling depressed. Instead eat healthy carbs such as whole grains.
• Take N-acetyl cysteine (NAC) to help reduce circulating testosterone, cholesterol, plasma triglycerides, low density lipoproteins and insulin.
• Get plenty of anti-oxident nutrients from foods and supplements. They fight inflammation which can exacerbate PCOS.
• Get regular exercise to increase your metabolism. Aim for a half hour of brisk walking a day.
• Practice stress management. Stress stimulates the production of more hormones, including testosterone, which makes PCOS worse. Try yoga meditation or a warm bath.
• See an acupuncturist for help restoring ovulation.
• See an herbalist about creating a formula that reduces cysts and balances hormones.
• Allow at least three months of treatment before trying to conceive. Follicles exposed to excess androgens will be of poor quality and lead to higher risk of miscarriage.