8.The sperm must release its DNA of twenty-three chromosomes into the egg to fertilize it.
9.The fertilized egg must undergo cellular division to become an embryo and then continue to divide normally.
10.The embryo must make its way down the fallopian tube into the uterus by the third day of development, where it will have a different environment in which to survive and grow.
11.Once there, the embryo must continue to develop and expand into a blastocyst (a multi-celled embryo) and then hatch out of its shell and implant in the uterus.
12.The endometrial lining of the uterus must be ready for implantation (a complicated, multi-step process of its own).
Western medicine and fertility clinics focus on what might be wrong with any of these details, how they might explain it, and how they might fix it. They test blood levels of reproductive hormones and examine ultrasounds of developing follicles. They administer hormones; perform IUI, IVF, or surgeries; or combine these technologies.
TCM looks less at the details and more at the big picture. After all, women’s bodies have been going through this intricate process for millions of years. According to TCM, when the conditions are right and your internal environment is balanced and healthy, your chances of conceiving and carrying a healthy and successful pregnancy to term are great.
What is “unexplained infertility”?
Infertility is defined, in Western medicine, as when a woman has been unable to conceive after a year of unprotected sex. When a doctor can’t find a specific explanation for this, he or she may diagnose unexplained infertility. Twelve percent of couples experiencing fertility challenges are diagnosed with unexplained infertility.2
I see women nearly every day who have spent months conscientiously trying to conceive, feeling hopeful and excited. They’ve also had monthly feelings of disappointment and sadness when they discovered they weren’t pregnant, whereupon most resolutely return to baby-making. But many of the women in my practice admit to going online and diagnosing themselves with unexplained infertility after only a few months of unprotected sex.
Please don’t do this. It has a negative impact on your ability to keep a positive state of mind. I rarely use the word “infertile” in my clinic. In my opinion, this word alone can create a negative environment in your body, mind, and spirit. It’s a word I’ve spent many hours counselling my patients to stop focusing on.
Unfortunately, when a woman hears a diagnosis of infertility, she infers, “I am infertile.” My perspective is that, at that moment in time, that woman’s system is simply saying, “No, not now” to having a baby. Instead of using the words “infertility” or “infertile,” I encourage women to say, “At this time, I am having a challenge with my fertility.”
In my practice, I have seen many women conceive outside of the one-year time frame. The only fertility challenge I diagnosed was that they were out of balance and needed guidance to create a nurturing environment and prepare their soil to receive and nurture their seeds.
How TCM can help
One of the first things I do with patients who’ve been diagnosed as infertile is to help them let go of their negative assumptions. Acupuncture sessions may help them release thoughts and feelings that seem stuck in their minds, while counselling or hypnosis may help them process upsetting experiences they’ve had on their journey to conceive.
What you can do with any TCM practitioner is optimize your chances of creating life by treating underlying imbalances that Western diagnostic tools may not reveal. TCM goes beyond technological diagnoses to look at your overall state of health by inquiring into your lifestyle habits and your physical, emotional, and psychological well-being. The philosophy in Chinese medicine is that you are most likely to conceive naturally when you are more balanced physically, mentally, and emotionally.
Using Chinese medicine, I guide my patients to achieve balance in their overall well-being rather than focusing on the twelve tiny details of implanting an embryo or the specific challenges their body is going through. Throughout this book, I will share with you the same guidance I share with them about eating healthier, engaging in moderate exercise, relaxing, and creating a positive environment in which to grow a baby.
Blending Eastern and Western medicine
Vanessa and I began weekly acupuncture treatments—at the same time as she went to her fertility clinic—to help dissipate and rectify her imbalances. Although her menstrual cycles were regular at twenty-eight days, her other symptoms, according to TCM, reflected imbalances within her cycle.
Western medicine focuses on the numbers associated with menses. It considers a menstrual cycle irregular if it is less than twenty-five or more than thirty-five days; twenty-eight days is considered normal. In TCM, however, we also consider the quality of menses and associated symptoms, like the number of days of blood flow; the thickness, colour, and odour of the blood; and the extent of abdominal pain and bloating, fatigue, and headaches before, during, and after menses.
In TCM, these details reflect a woman’s overall state of health and degree of balance within the environment in which she hopes to grow a baby. The information I gather provides a baseline for the way a woman’s body and reproductive system are functioning. I provide information to help my patient better align her body to receive life. For Vanessa, I did acupuncture at specific sites with the goal of sending a message to her brain to release certain hormones, while inhibiting others to decrease her menstrual symptoms and improve her reproductive balance.
Vanessa chose to monitor her cycle through the fertility clinic. Beginning on the third day of her cycle, the woman returns to the clinic almost daily for blood tests and a transvaginal or intrauterine ultrasound, in which a technician inserts a transducer (phallic-shaped probe) covered with a condom and lube into the vagina and blood tests. The ultrasound counts the number of antral follicles (ovarian follicles that contain eggs) the woman has and tracks their growth, while the blood tests measure hormone levels.
Initially, these tests may be performed every couple of days, increasing to daily as the time for ovulation approaches. The woman may also receive injectable hormones to incite superovulation, which stimulates the ovaries to create more than one egg, increasing the chance of conception. Cycle monitoring and injectable hormones prepare the woman for timed intercourse or IUI. During IUI, a catheter deposits pre-washed sperm (the normal and denser sperm, which is separated by a centrifuge from the semen and less viable sperm) directly into the uterus. (Think of it as the turkey-baster method.)
Vanessa immediately underwent three consecutive rounds of cycle monitoring with injectable hormones, followed by IUI. She conceived after the first IUI, but the pregnancy only lasted a few days. This is termed a chemical pregnancy as there was nothing visible to show she was pregnant. After two more IUI cycles without conceiving, Vanessa was disappointed, but the one positive pregnancy test gave her the courage to have a small uterine polyp (benign growth) removed in case it was a factor in preventing implantation.
After the surgery, Vanessa and Robert decided to try IVF. Although she conceived the first time, it was an ectopic pregnancy, which occurs when the fetus develops outside of the uterus, typically in one of the fallopian tubes. She then had to wait several months before trying IVF again. After the second IVF, she conceived again, but the fetus had trisomy 18, a chromosomal abnormality, and Vanessa miscarried in the second trimester. She waited another six months before trying a third IVF, which was unsuccessful.
Using TCM to balance your life
At this point, nearly four years had passed since Vanessa and Robert first visited the fertility clinic. She’d had several IUI cycles and three IVF treatments, and had taken countless fertility drugs. During this time, Vanessa would come to my clinic for treatment but then disappear for long stretches of time. Often women