radishThis year my wife and I decided that we were going to get serious about our gardening efforts. Don’t get me wrong. We have always been interested in gardening as a means of beautification.  We live in a neighborhood that has gotten pretty worn out by the mass exodus of money and jobs in the post-industrial Rust Belt. The homes on our street are all turn of the century victorians that have only recently been getting the attention they deserve to help maintain and restore them.  We too have been improving our property little by little as money and time become available. When we first moved in, gardening was our best shot at improving and beautifying our little corner of the world, so that is how we got started gardening.

At first we planted any thing that we could get our hands on.  Mostly discarded perennials from friends and neighbors who were thinning their flowers.  Anyone who has a garden with flowering perennials knows that the blessing and the curse is that they keep expanding year after year without replanting. Over the years, we filled our front, then back, then side yard with perennials.  This year we got brave enough to attempt to grow vegetables from seed. More about that later.

My acupuncture practice was also experiencing similar growth.  We started the flower garden and started my acupuncture practice both in the summer on 2010.  Just as the garden grew somewhat organically, so did the acupuncture practice. Early on I treated many high level career people who were suffering from the ravages of stress and anxiety brought about by a fast paced life that I knew all too well.  My first career was as an engineer and management consultant. Like attracts like, and I was no exception.

There were always clients in my practice who were trying to get pregnant, so I cannot say that I did not focus on fertility.  I definitely never saw myself as a “specialist.” Acupuncture is so holistic, that even now I cringe when I hear myself say that I specialize in fertility.  I prefer to say that I “focus” on fertility, and boy did I ever start to focus on fertility. A few years after we started the acupuncture practice, it became definitative that we wanted a child.  As you can imagine. It takes a lot of “focus” on fertility to get a woman pregnant without a man in the picture! I soaked up everything I could on how to make our $3000 per month attempt at pregnancy more likely to succeed.  As I learned more my practice shifted to a mostly fertility practice just as the law of attraction would suggest, and along came our son — the most gratifying aspect of all this learning!

So what is it in a nutshell that makes Chinese Medicine so helpful for augmenting fertility? For that we must return to my garden.   By this time we are moving on to vegetable gardening starting in the spring from seed. There are only two things we have any control over when it comes to gardening success.  The seed and the soil. Okay yes there is light and pests and a multitude of things to try and control, but this is an analogy so bear with me!

We knew we had to start with creating good soil. In addition to urban blight, the post-industrial rust belt is also blessed with lead.  Lots of it — think Flint, Michigan. Buffalo, the city of good neighbors, was no exception. The results of a soil test revealed levels of lead in our soil so high that it was advised that children and pregnant women only touch it wearing gloves.  Ouch!

So if you want veggies (or babies) to grow, you are going to need good soil.  We started by building containers in the areas of our yard with the best light and drainage.  Then we imported soil that had been amended with compost and vermiculite. We filled the containers and worked in even more home compost from our yard and vegetable waste.  Nutrition, nutrition, nutrition! This soil was pretty fabulous if I don’t say so myself. Not perfect – It still needs some work to drain better, but hey you gotta have something to strive for!

Once we got the soil “perfected” we carefully opened the seed packets that we had so gleefully picked out from seed catalogs and websites weeks before.  There was a significant price difference between different suppliers, but it didn’t amount to much in the quantities we were purchasing. We bought based on price.  Seeds are seeds right?

Along with the help of our then 2 year old son, we planted the seeds and waited…  and waited… and waited… Then it happened. Sprouts! In some beds the sprouts were out of control.  We were thinning them every time we were in the garden. Others not so much, and one bed… Almost nothing!  The difference in the seed quality was so apparent knowing that the environment was the same in all of the beds.   Thankfully with a lot of nurturing, we were able to get “enough” out of even the poor quality seeds to get a good shot at some veggies.

So this brings us back to Chinese medicine.  How the heck can such a gentle, natural form of medicine enhance even poor fertility in a human? Seed and soil. Nature is nature.  Even though it takes a long time, egg and sperm quality can improve over time.  Obviously we are not going to change the DNA of the seed in a plant or a human, but that is not necessarily the main reason that egg and sperm (gamete) quality decline over time.

Much of the decline in gamete quality happens as the follicles are dividing.  Eggs are stored in your ovaries as primordial follicles. These have two copies of all of your chromosomes.  Before you can turn these into something that can be fertilized, they need to split in two so that the egg can contribute half the genetic material and the sperm can contributed the other half.  This process is called mitosis. Mitosis is error prone that gets worse with age. One of the major drivers of mitosis is the activity of the mitochondria in your cells.

You may remember the mitochondria from your high school biology.  You probably learned that they are the ”energy storehouses of the cell.”  I visualize them as little border collies herding the chromosomes into place for the cell division.  If the border collies are tired, or old or lazy, they don’t quite get the chromosomes lined up and you end up with an error in cell division that makes that egg turn out to be “poor quality.”  So maybe that seed packet I opened with poor seed quality just had lazy border collies herding it’s genetic material into place. Who knows. The trick is that we want to do everything we can to keep those mitochondria happy and energetic.  

Acupuncture, Chinese herbs, and other nutritional supplements have been shown to improve blood circulation and mitochondrial activity in other cells, and there is every hope that the same applies to the mitochondria in these primordial follicles.  Studies looking at success rates with IVF imply that this is a plausible mechanism for increased success rates, so we always do acupuncture and prescribe herbs or supplements with this in mind. Increasing blood flow and mitochondrial activity is always a goal even if egg quality is not a known issue.  At age 35, it is likely that only 50% of a women’s eggs are genetically normal. That’s part of why it takes longer to get pregnant. For this reason, we always assume the egg quality is at least a part of the fertility picture that needs to be supported. If egg quality is the primary reason that we are not getting (or staying) pregnant, then we are going to need to work on this for at least 3 to 4 months before we start to see change. That is just how long it takes to turn a primordial follicle into a follicle that can be released. Since it takes so long to see improvement, we go ahead and work on the egg quality while we are also amending the soil.  This way, we are hedging our bets. Now that we know we are doing our best for the seed let’s move onto the soil.

The best seeds in the world don’t yield much if you throw them in dry rocky soil and ignore them.  Just as we nurtured the soil in our garden, we must do the same with our soil – the womb. In our garden, we helped transform our barren, lead filled soil into rich, lush, warm, light soaked garden beds.  This too is how Chinese medicine transforms our bodies into being the best soil we can possible be for a growing embryo.

We think of a woman’s cycle as having four distinct seasons.  Each season has a predominant influence that governs it success.  In our soil, we might consider aeration, moisture, drainage, and access to sun. In a woman’s body we are improving blood, yin, qi and yang.  

  • Season one is while we are having our period and is governed by the movement of blood.  
  • Season two is before we ovulate while we are rapidly growing follicles and a new uterine lining.  This is governed by Yin.
  • Season three is around ovulation and is governed by the movement of Qi.
  • Season four is the dreaded two week wait and is governed by Yang.

Most women will have room for improvement in one or more of these areas.  Sometimes it is quite obvious where improvement is needed. Pain, bloating, and symptoms like irregular or scant cycles or PMS may give some clues.  Sometimes the clues are less obvious and are felt during pulse reading or by reading a basal body temperature chart.

Chinese medicine offers many different ways to diagnose the soil quality.  Listening, pulse reading, tongue diagnosis, palpation, and observing all give us important information about the soil and help us create a treatment plan that will focus on improving the blood, yin, qi and yang mentioned above.  Each aspect of the soil is amended as only as little or as much as your specific soil requires.

So there you have it – The want-to-be farmer’s take on how to apply the fertility lessons of nature to our fast-paced, stressful, sometimes divorced from nature lives.  Our goal is to put all of this innate knowledge together and help you make the right lifestyle choices that will support seed quality and best benefit your unique soil needs.   We prescribe the mix of supplements and sometimes herbs that fit you best, and we design acupuncture treatments that are tailored to your unique needs and delivered at the appropriate time (season) in your cycle.

So what does this actually look and feel like when you are a patient?  It means that we are going to coach you a bit in the beginning to make a few changes that are going to also make you feel awesome! It means that we are going to help you sort through some of the supplements that you may or may not want to take. There are so many supplements out there being marketed to you, but in reality you probably need very few. We may prescribe herbs to augment the acupuncture, and we will definitely try to get you on a rockstar prenatal.

In the beginning we are going to want to see you weekly for about 4-5 weeks so that we can see you in every season to really evaluate when, where and how much treatment you actually need.   It helps to get some momentum with weekly acupuncture treatments in the beginning, but we know you have a lot of pressure on your time and money, so we will work to space the treatments out as quickly as possible.   Our goal is to move you to an every other week treatment schedule as soon as possible and eventually less depending on your needs.

For many women these regularly scheduled treatments will do the job with little variation.  For other women, there will be an occasional change in the frequency or timing of treatments to better accommodate treatments goals around ovulation or at certain times in a fertility cycle for those who are also getting medical treatments like IUI or IVF.

Once you do get pregnant, we will only see you every other week in the first trimester and then monthly until you have a baby in your arms.  This too is so much like the garden. All the work is in the spring preparing the soil, planting and weeding. The middle of the growing season is quite easy – mostly watering and a little weeding here and there.  Then comes the harvest. That is a lot of work! Picking, cleaning, and sometimes canning or freezing the harvest. Some women do come a little more frequently at the end of the pregnancy to help with the discomfort or to try and avoid labor induction from a concerned physician.

All of this talk about the seed and the soil may lead you to believe that Chinese medicine fertility  treatment is purely logical and is simply about applying the right treatments or supplements at the right time.  That is where the analogy breaks down. The reality is that trying to get pregnant is a deeply personal and sometimes very challenging experience.  When it is not happening as quickly as you thought it would, it can be one of the most stressful and challenging situations that you may have ever faced. As our journey takes longer and needs more medical attention, it can put strain on your relationship, your family, your job and often your finances.

Many of our patients will tell you that the biggest benefit they get from us has nothing to do with needles and herbs – it is the relationship.  Sometimes our biggest contribution is the support we provide as practitioners who have been down this road before, mindfully, with so many other women on this journey.   It’s what we love most – being a part of this process with you. It is truly the most gratifying work I have ever done personally. Even though the careful attention and nurturing of the seed and the soil is crucial, the real beauty of this practice is the relationship that we develop with you. It is a special kind of love. Thank you for that. Very few people have the privilege of work this beautiful.