And it all started with my grandmother. If she had not fallen ill, I might never have taken an interest in Chinese medicine, and I might not be telling you my story now.
By the way, she lived another eight years and died at the age of ninety-four.
1
You Are Not Your Diagnosis
A woman is like a tea bag; you never know how strong it is until it’s in hot water.
ELEANOR ROOSEVELT
Vanessa: Unexplained infertility
Vanessa met her husband, Robert, at thirty-two, married at thirty-four, and started trying to have a baby right away. After six months, they went to her family physician to get a referral to a reproductive endocrinologist (RE). Couples must have tried to conceive for at least a year without success to be referred to a fertility specialist. For some, every passing month feels like an eternity. This must have been the case for Vanessa, who fibbed to her family doctor, telling her they’d actually been trying for a year.
At the same time as Vanessa was seeing the RE, she was coming to my clinic for acupuncture. I encourage my patients to get medical testing if they’re having trouble conceiving because it provides a baseline from which I can help them more naturally align themselves and their environment to support conception. It also allows us to rule out any structural or genetic issues.
Through my TCM examination, I discovered Vanessa had premenstrual symptoms, including several days each month of breast tenderness, back pain, lower abdominal pain, weakness, and moodiness. Like many patients who have visited a fertility clinic, Vanessa was surprised by the depth of my inquiry into all aspects of her health and lifestyle. At the fertility clinic, her diagnosis of unexplained infertility was based solely on her report of not becoming pregnant despite trying for a year and the clinic’s inability to find an explanation. Her RE advised her to begin treatments as soon as possible because she was thirty-five—approaching what fertility clinicians call advanced maternal age.
A jumping-off point
One of the most difficult things I see in my clinic is a woman who is in her mid-thirties, still feeling young and vibrant, yet distressed after a fertility doctor has used terms like “unexplained infertility” and “advanced maternal age.”
I greatly respect fertility specialists; as I discuss in Chapter 8, my own daughter was born through IVF. I’ve experienced the stress of fertility clinics first-hand, as well as the miracle of birth using assisted reproductive technology (ART). The difficult part is healing the emotional impact of a diagnosis on my patient’s body, mind, and spirit.
I have my work cut out for me when a healthy thirty-five-year-old is weeping in my office, having been told to consider intrauterine insemination (IUI) and in vitro fertilization (IVF) before her aging eggs reach their expiration date. My first job in this situation is to shrug off my own anger at a doctor who would say such cold words to a woman who’s come seeking help.
I am not suggesting you ignore your diagnosis, or live in denial of it, but that you think of it as a jumping-off point, an opportunity to become proactive in your fertility journey and overall health. You are a dynamic human being; with a renewed perspective, you and your body can both change. Do not let a doctor’s words stop you. Your pathway to pregnancy may just be different than the one you had planned.
White-coat hypertension
There is a well-known effect called white-coat hypertension or white-coat syndrome. This is when a patient whose blood pressure is normal when monitored at home becomes elevated at the doctor’s office. Just sitting in front of a doctor can cause emotional anxiety and raise your blood pressure. I well remember my heart racing and my palms sweating on my first visit to a fertility clinic.
I tell patients that a blood test captures conditions at a moment in time. During those initial visits, a woman is at her most vulnerable—nervous, anxious, and worried. If her doctor says he doesn’t expect she can get pregnant naturally and she’d better start treatments right away, she may feel sadness, despair, grief, anger, frustration, fear, worry, and anxiety. Worse, she may barely have time to take in this information and process her emotions before feeling pressured to choose her next steps.
I felt all of these emotions over the course of my own fertility treatment, and I want to share with you how important it is to acknowledge, process, and release them. Words from a physician are powerful and can elicit strongly negative emotional, psychological, and physiological impacts. This is called the nocebo effect, Latin for “I shall harm,” a term coined by Walter Kennedy in 1961.1
I see the nocebo effect every day in my clinic. Many patients believe a doctor’s words are the absolute truth, but that diagnosis represents a particular doctor’s beliefs and theories, based on experience, statistics, and research. Without intending to discount these, any doctor’s knowledge of research can be outdated, and their experience is necessarily confined to their own practice.
Over the years, I have seen many women who have undertaken extensive fertility treatments go off on their own, whether to take a break from treatments or stop entirely, and spontaneously conceive. It happens too often to be written off as coincidence.
You have a filter
The first step in hearing your diagnosis in a healthier way is to change the filter through which you hear it. This is not simple, and it’s not likely to happen overnight, but you can start by becoming aware that you have a filter and paying attention to its impact on your ability to remain positive. Here are some ways you can change your filter:
•Ask yourself, is your diagnosis the ultimate truth? When I received my diagnosis (see Chapter 8), I acknowledged the condition but refused to live with the label “infertile.” Instead, I opened myself to creative ways of building a family, including IVF, donor eggs, and adoption. At the same time, I continued with my healthy diet, moderate exercise, and positive lifestyle.
•Surround yourself with positive people.
•Be grateful for your overall health.
•If the doctor says you are reproductively old, find examples of women who defy the odds and tell yourself you can be one of them. (I hope you will find yourself in some of the women I describe in this book.)
•Remind yourself that the tests form a baseline picture of your current reproductive health. Focus on what you can do to improve that picture by taking charge of your diet, lifestyle, and stress-management strategies.
•Remember that a diagnosis is usually more opinion than fact; you can always get a second opinion.
Pregnancy really is a miracle
We see pregnancy around us so often that we take it for granted. Few of us realize how many conditions must line up perfectly just to prepare a woman’s body to conceive. Consider this simplified list of requirements for an embryo to become implanted:
1.The brain (hypothalamus, pituitary) must release the right hormones properly to stimulate egg development.
2.An egg of good enough quality must develop to maturity, and it must be chromosomally normal.
3.The brain must release luteinizing hormone (LH) to stimulate final ripening of the egg and ovulation (release of the egg).
4.The follicle in which the egg develops inside the ovary must rupture at time of ovulation and release the egg.
5.The fallopian tube must “pick up” the egg.
6.The sperm must be of good enough quality to survive and swim up the fallopian tube from