Saturday, August 14, 2010

Holistic Herbal Perspectives for Challenges with Fertility

Preparing for pregnancy is the beginning of a new era in a couple’s life. The excitement of expanding a family, the doubts of parenthood, the increased responsibilities of creating life, all can be a random mix of happiness and intense stress.

This article is an introduction to holistic perspectives on infertility. It is impossible to fully address all areas of this subject in a blog post, but I hope it gives readers an idea of how a holistic herbal practitioner might approach a couple who has not conceived.

Most couples conceive within months after consciously making the decision to become pregnant. Failure to conceive after twelve months of regular sexual activity with no use of contraceptives is labeled as infertility.

Standard methods of treatment for infertility can be costly and invasive. Seeking holistic health treatments first is a viable alternative that can often prove successful. Often, a combination of western allopathic medicine and holistic herbal perspectives is most helpful.

Couples experiencing problems with fertility are advised to have some western medicine tests performed to better understand what is limiting conception.

Males can undergo sperm analysis to rule out abnormalities. They may also want to be tested for genito-urinary infections.

Females can have blood work done to evaluate hormones, the endocrine system including the thyroid, and genito-urinary infection screening. Further tests may be necessary but these are a good place to start.

The results of these tests can help pinpoint areas of concern.

The causes and factors of infertility are so varied there are simply no standard herbal treatment plans. Instead, it is the goal of the practitioner to evaluate and assess the couple to create a plan that promotes overall wellness.

The failure to conceive is a symptom of an underlying cause. Couples seeking holistic treatment need to understand that while the end-result may be conception followed by birth, the big picture goal is to create a healthy balance in the entire body.

General Suggestions
My first recommendation for couples seeking conception is to purposefully avoid conception for 4-6 months. This may seem like an odd first suggestion but I feel that these months can then be devoted to creating vibrant health and well-being in both of the parents. Although the desire for a pregnancy as soon as possible can be hard to ignore, taking the time to focus on the health of the parents can result in a happier pregnancy and a healthier baby.

These months can also be taken to cultivate romance in the relationship. The couple can again experience the art of making love without the pressure to conceive.

Women who continue to pursue conception may have to limit beneficial herbs because they are not advised in pregnancy (and therefore can not be ethically given to those actively seeking conception) or they may not fully resolve underlying issues before further stressing the body with the awe-inspiring task of creating life. 

My next suggestion is to monitor the women’s ovulatory cycle. The book, Taking Charge of Your Fertility by Toni Weschler, is a must read for all women whether or not they are seeking pregnancy. It clearly explains how to monitor the women’s basal temperature, the shape and feel of the cervix, and cervical mucosal changes in order to know when and if a woman is ovulating. This alone can help the couple to increase their fertility as well as provide more information about a woman’s cycle and any possible abnormalities.

Another general suggestion for any couple seeking pregnancy is to adopt a pre-conception diet. This is important for both the male and female! While this needs to be tailored specifically to each individual, overall suggestions include:

healthy fats (farm fresh eggs, olive oil, pastured meats including organ meats, coconut oil, raw dairy from healthy animals, olives)
protein (preferably from pastured animals, well sourced fish, fresh nuts)
variety and abundance of vegetables and fruit (organic, nutrient dense)
whole grains and legumes (preferably soaked and fermented before being cooked)

Foods to avoid generally include
any food intolerances specific to that person (common foods are gluten, dairy, soy, corn)
large amounts of sugar (preferably no sugar is eaten)
dairy that is produced in feed lots containing unknown hormones, anti-biotics, etc.
meat from factory farms
processed foods
denatured food
unfermented soy

Each person should be evaluated for nutritional deficiencies. Depending on the person and the deficiency these can be addressed through food or supplements.

Common nutritional deficiencies include
Omega 3s
Vitamin D
Vitamin C
Vitamin E
B Vitamins (Especially important for vegetarian women. B12 deficiency is implicated in miscarriage.)

I especially encourage all couples seeking to conceive to have their vitamin D levels tested to ensure they have adequate levels. My mentor, KP Khalsa, says that vitamin D is the nutritional breakthrough of the century. What we know now vs ten years ago is astounding and research is mounting higher and higher, showing the extreme importance of vitamin D levels for the health of the mom and the health of the developing fetus.

Possible Areas of Concern

A holistic practitioner is interested in increasing the entire health and well-being of an individual. Here are some possible areas and concerns that may be addressed.

Reproductive System Health
Polycystic ovarian disease
PCOD is often implicated in women with fertility challenges. Again, protocols would be tailored to that individual but would frequently include addressing insulin resistance, liver function, and pelvic health.

Endometriosis affects 5 - 10% of women.  The causes can vary and protocols would be tailored to the individual. General suggestions will be around improving liver health and lymphatic health, pelvic decongestants and adaptogens.

Immune health
Imbalances in the immune system can inhibit conception. Treating low-grade infection in the genito-urinary system and addressing any autoimmune factors can be an important factor in fertility health. Important aspects of this are taking immunomodulating herbs, addressing leaky gut syndrome, and avoiding food intolerances.

Endocrine System Health
Disorders within the endocrine system that affect fertility can include hyper or hypo thyroidism, pituitary dysfunction, and signs of adrenal weakness.

Stress is a major factor in fertility. Herbalist, midwife, and Dr. Aviva Romm says, “There is a direct relationship between fertility and stress [and stress] is as much an endocrine experience as an emotional reality.”

Kidney Yang Deficiency
In my practice I often see adrenal fatigue or, in TCM terms, kidney yang deficiency, as an underlying cause of infertility. Kidney yang deficiency is a whole other topic in itself but it is addressed with herbs, lifestyle, and nutritional changes that can help restore balance to these depleted individuals. Adaptogen herbs, nutrient dense foods, healthy sleep habits, regular exercise, and stress management tools are commonly suggested.

Environmental Health
The health of the environment plays a large role in fertility health. Pesticides, heavy metals, xenoestrogens, and radiation have all been implicated in infertility and with miscarriage. An evaluation of the couple’s home and workplace to avoid these toxins is important.

Introduction to bi-phasic formulation
As you can see it’s hard to recommend general herbs for fertility without first understanding the underlying issues that are presenting. Also, not only which herbs you take are important but also when you take them can be important.

I recently took a class on bi-phasic formulation with one of my favorite herbalists (who is also a naturopathic doctor) Robin di Pasquale. Although I haven’t had the opportunity to use this method myself, I thought I would discuss the general theory of it here.

Bi-phasic formulas are issued in two parts. These are be given in accordance of the cycle of  the woman’s menstrual cycle.

The idea is that in the first two weeks of the menstrual cycle (follicular phase) a woman is building estrogen hormones in her body. The last two weeks progesterone is building (luteal phase).

Using a bi-phasic formulation you can then support the woman’s natural cycle. One formula is created for the follicular phase of the cycle and one formula is given for the luteal phase of the cycle. Other considerations may also be present in this formula including liver health, immune support, adrenal support, etc.

Of course all herbs and formulas are created for the individual woman. Besides being important in promoting fertility, bi-phasic formulas can be utilized in a variety of women’s health issues to help bring overall balance and well-being.

Herbal Considerations
I think by now you get the idea that there is no “one herb” to solve infertility issues. Instead addressing what is specifically going on for a particular couple is more successful than blinding pulling an infertility herb out of a hat. Nonetheless as an herbalist I simply must discuss a few herbs that I regularly use for women wishing to conceive.

Asparagus racemosus
Liliaceae family

Shatavari is an Ayurvedic herb that is commonly used for women as a nutritive tonic. It is moistening and building making it a good choice for vata-like conditions. (In Ayurveda, a vata derangement is usually associated with infertility). A food-like substance it can be taken in high doses for extended periods of time. I usually recommend up to ten grams a day taken as a freshly ground powder in ghee or honey. Shatavari is rejuvenating someone from the earth up and it may take several weeks to a month to notice a significant difference.

Milky Oats
Avena sativa
Poaceae family

Another moistening and nutritive tonic, this is a specific trophorestorative for the nervous system. I like both the infusion of the dried milky oat tops as well as the tincture made from the fresh milky oats. I often advise to combine the two preparations. This is for the women (and men) who are high strung and about to fall off their high wire at any moment. This nutritive tonic, like shatavari, re-builds by nourishment bring the body to a better state of health.

Urtica dioica
Urticaceae family

A strong nutritive tonic, nettle is renowned for it’s high vitamin and mineral content. Taken daily as a strong infusion it can help to build blood (high in iron) and restore general health and well-being. Nettle can often be too drying and possibly too cooling for some individuals. Small amounts of marshmallow root and ginger can help to balance this out. 

Dong Quai
Angelica sinensis
Apiaceae family 

Like nettle, dong quai builds the blood and is indicated for women who are pale with low vitality and how may have a dark and scanty menstrual flow. Traditional Chinese Medicine has used this herb for centuries as a female reproductive tonic to regulate the menstrual cycle and address amenorrhea. 

Dealing with fertility obstacles can be an immensely challenging time for a couple. There is no proven get-pregnant-quick protocol as the underlying reasons for infertility are as varied as the people themselves. This article is only a brief look at some of the areas a holistic practitioner would evaluate in order to facilitate increased vitality to the whole being. The following are some additional resources that can help educate people further on this issue.

Botanical Medicine for Women’s Health by Aviva Romm

Taking Charge of your Fertility by Toni Weschler

Preconception diet

Diet and unexplained infertility


This blog post was a part of a blog party on the topic of Fertility hosted by Karen Vaughn of Brooklyn Acupuncture