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Getting a collaborative fertility health team together sooner rather than later can assist you in conceiving more consciously, with greater confidence while knowing you are doing the best for your own health and that of your baby and future family. Choose experienced professionals you can trust. Whether you are just starting to think about making a family, are trying to conceive now or already know you have fertility challenges, they will be there to support you and help you map your way through. A good supportive team with varying points of view can help ensure that potential problems are identified and treated, and nothing gets missed. This is true holistic health care.
Your health team will help you identify and understand any challenges you face and what you can do to overcome them or improve your potential. Learning how to be and stay healthy, how to optimise your fertility and feeling supported in making necessary changes can not only make the path less daunting and less stressful but will also maximise your chances of conceiving. You don’t know what you don’t know, so a team of helpful professionals will ensure you get your needs met and give you the confidence to make a realistic and effective plan for your fertility.
In an ideal world we would recommend getting a collaborative team in place a minimum of four months before trying to conceive. That way you will have support to inspire you to prepare your health and your body for conception and pregnancy. In the real world just start when you can wherever you are on your conception path. If you haven’t already, start now.
Ideally your whole team will be open to communication in all directions. This ensures everyone is informed about what is going on and has the relevant information to provide you with the best possible care. Good complementary health practitioners will write to your GP and/or specialist (with your permission) to keep them informed about treatment. There are times when something we prescribe may have implications for them. It also ensures that if they have any concerns they can be in contact with us to check in. Collaboration between practitioners (naturopaths, acupuncturists, GPs and specialists) really ups the safety element and we believe ensures the best care for our patients. Your medical practitioner may not communicate with natural health practitioners as a standard part of their practice, so if they don’t have an existing relationship with your other practitioners, please do ask that they copy them in on any correspondence they are sending to their medical colleagues and ensure they send copies of all tests at the time of testing. Of course, the same goes both ways for your natural medicine practitioners.
Finding a GP you are comfortable with and who is willing to do some good pre-conception tests is a great place to start. They are likely to do some routine screening checks including measles, mumps, rubella (German measles) and varicella (chickenpox), hepatitis B and C, HIV and syphilis. It is important to know your blood group and make sure your pap smear testing and breast exams are up to date before you are pregnant as well. Ensure that you communicate any other health concerns and discuss the safety of any medication you may be taking (prescribed or otherwise) at this stage, so that appropriate investigation, action or advice may be carried out before you conceive.
We recommend employing the support of a qualified and experienced fertility naturopath for everyone wishing to conceive. Naturopaths will help couples optimise their health prior to conception and ensure they have the healthiest pregnancy possible, and best health outcomes for both mother and child. Naturopaths also work to assist, treat and support couples and individuals with diagnosed fertility issues or those having trouble conceiving.
Supporting your pre-conception health and pregnancy with good food and nutrition is the first important step. There is so much research now indicating the importance of both potential parents’ nutritional health in the months prior to conception affecting the long-term health of the offspring. Getting some professional input at this early stage has huge benefits. Alongside nutrition and diet advice, adequate sunshine, rest, sleep, and regular moderate exercise will all be assessed. A good naturopath will guide you through charting your cycle and identifying your fertile window for conception, ensure appropriate testing has been carried out with your GP and they will also discuss how to reduce your environmental toxin exposure.
If you find a naturopath who is experienced in treating both men and women with fertility issues, as well as pregnancy support, then they can provide you with a wealth of information.
Your experienced naturopath can help you determine which supplements are the best quality, what doses are relevant for you at this stage of your fertility journey and when to take them and stop them. Some supplements will be advisable to continue in pregnancy and others not. For example, some herbs are safe in pregnancy and others are best avoided. We generally recommend no herbal medicine unless prescribed by your qualified and experienced naturopath/herbalist. Some herbs may also interact with medications. This is particularly so if you are undergoing IVF or other hormonal treatment.
Along with general conception preparation, naturopaths will take a detailed case history about your reproductive and general health and may be able to immediately assess a number of areas where they can boost your fertility. They will work with you towards hormonal balance, optimising your cycle and reproductive health, address other acute or chronic health concerns and ensure good nutrition and supplementation for crucial nutrient levels. This work gives the starting cells that will make your baby ‒ your eggs and sperm ‒ all they need for optimal health and function. It is a vital part of any treatment plan for a couple or individual trying to conceive.
TCM and naturopathic approaches are highly compatible and commonly combined in patients with fertility challenges for optimum results.
When you see a TCM practitioner or acupuncturist for a consultation, they will commonly feel your pulse at your wrists and look at your tongue, face and possibly palpate along acupuncture channels (meridians) in your body where appropriate. Combined with a full case history, TCM practitioners determine where the energy is deficient or too full in any particular channels. Along with very effective needling techniques and possibly herbs to correct any imbalance found in any energy channels, they can use certain points to improve the functioning of your ovaries and testicles (don’t worry, the points are not on the testicles!!) and directly affect the quality of the developing eggs and sperm. Sometimes they employ other techniques such as moxibustion (applying heat to the points), laser or electro acupuncture, or cupping and massage too, depending on what is required for your individual needs, TCM diagnosis and health goals.
Perhaps the best thing about acupuncture is that you get to stop, lie down and relax for a good half hour or more. In our practice you are made warm and toasty with blankets and wheat bags, you have eye pillows and headphones and our practitioners play our guided meditations (or music if you prefer) so you get the ultimate relaxation experience.
Your practitioner will also talk with you about your diet and lifestyle from the perspective that may be causing any imbalance, and suggest practical solutions you can work on at home. While ultimately working toward the same outcomes, you can see that TCM practitioners and naturopaths address the issues from very different angles. In our experience, it gets patients to their goals more quickly and in a more holistic way, taking all possibilities into consideration.
Although the understanding of acupuncture is based on an ancient medical theory, thousands of years old, the body of research-based evidence on Chinese herbal medicine and acupuncture for fertility is growing.
There is much more that Chinese medicine and acupuncture has to offer people with fertility problems and there is some research to suggest it has the following reproductive effects.
Acupuncture for women
Acupuncture for men
For both men and women
For Chinese herbal medicine, a meta-analysis of quality research articles suggested that herbal management of female infertility can improve pregnancy rates two-fold within a three to six-month period compared with Western medical fertility drug therapy or IVF. Fertility indicators such as ovulation rates, cervical mucus score, basal body temperature ovulation indicators, and appropriate thickness of the endometrial lining were positively influenced by Chinese herbal medicine, indicating physiological improvements that will support
a viable pregnancy.
Another systematic review comparing Chinese herbal medicine to the medication clomiphine (Clomid), prescribed for women who do not ovulate (anovulation), showed that the herbs had better outcomes for improving ovulation and cervical mucus scores as well as positive pregnancy and reducing miscarriage rates, with no significant adverse effects for the herbal medicine groups.
Assessment of the quality of the menstrual cycle, integral to TCM diagnosis, appears to be fundamental to successful treatment of female infertility, highlighting the importance of an individual approach – there is no “one size fits all” or standard protocols when it comes to natural medicine.
As you can see, a natural medicine team will look at your overall health and not just your reproductive history. This is essential for a comprehensive approach to your fertility. Patients are often surprised about how good they feel after a few weeks or months of treatment, and of course we hope they may also have conceived and be on the way to a healthy baby.
You may need to look to others to help you with health goals on your baby making journey. Having a collaborative preconception and pregnancy care team behind you really helps you walk this journey feeling supported. Maybe a skilled counsellor, osteopath, massage therapist or a personal trainer would be a good person to add to your team. Let’s look at a few reasons why:
If trying to conceive is taking longer than you thought or you are coming across challenges you weren’t expecting with your fertility or perhaps your relationship, then finding a counsellor or psychologist you can work with is an integral part of a collaborative preconception and pregnancy care team to keep you mentally well, your partnership, family and friend relationships intact, help you manage stress and to help build emotional resilience around any treatment.
Osteopathy can ensure your nervous system and blood flow is adequately supplying your reproductive area from a structural point of view, and prepare your body for when you are pregnant and carrying a heavy load. If you experience regular pelvic or lower back or abdominal pain, an osteopathic assessment is highly recommended.
Massage is a wonderful part of a relaxation strategy and could be included as regularly as you like as part of your collaborative preconception and pregnancy care plan. It is particularly great to enjoy a massage at the most stressful parts of your cycle if you are trying to conceive. Around ovulation time to help you feel relaxed and receptive. Also towards the end of the cycle when you may be feeling anxious about getting your period.
Ensure your massage therapist is experienced and understands the potential contra-indications for massage in pregnancy. You can then ask if they know of any fertility massage techniques. These techniques can help improve blood flow to the reproductive area. This is commonly performed as an abdominal massage. Some people also find reflexology to be beneficial, and while there is no research to support it, who wouldn’t love a regular foot massage!
If you have been trying for 6-12 months without a positive pregnancy test, then your doctor may recommend more thorough testing. This may start with some hormonal blood tests to check ovulation, an ultrasound to check the health of your ovaries and uterus, and a semen analysis.
The male investigation (semen analysis)is well worth asking for at this stage where it is often overlooked. If you are over 35 and have been trying for six months or more, we recommend that you request more thorough investigations simply because these tests might take some time. At this stage the doctor may refer you to a gynaecologist or fertility specialist. If you do need assisted reproduction, as statistical success rates do drop with age, it is a good idea not to wait too long before seeking further investigations.
Whether to go to assisted reproduction and/or IVF will be a decision you and your partner need to discuss. If this is something you would consider, please do ensure that a reliable sperm test has been performed (ideally at an IVF or andrology laboratory) before undergoing the many potential (and often much more invasive) female investigations.
It is also worth asking about checking your ovarian reserve at this stage for an indication of how many eggs you have left. Especially if you are 35 or over and have been trying for six months or more. If it is low for your age, then you may want to consider going straight to see a fertility specialist and assess your medical treatment options. Having the rest of your team in place at this stage (naturopath, GP, acupuncturist) will ensure you get comprehensive advice and good interventions early.
Take a deep breath. A referral to a fertility specialist doesn’t signal disaster. Even if something is found to be an issue, often a diagnosis can give direction where you have had none. Not everyone will get a definitive diagnosis, and in our experience many people have complex issues. The medical approach has some good things to offer. Especially in the way of surgical interventions if necessary and, of course, in the IVF process itself. However, there are some clear gaps, especially when it comes to optimising your chances of conception and recovery after any surgical intervention. A combined approach ensures you have all the bases covered. Many fertility specialists are now seeing the benefits for their patients and enjoying collaborating with complementary healthcare providers.
Mandy’s Story
41-year-old Mandy consulted the clinic after being referred by an existing patient. At the time, she had been trying to conceive for six months and all testing had indicated there were no other fertility issues apart from the impact of her age on egg quality.
Mandy and her partner had undergone four unsuccessful IVF cycles. Each IVF cycle had similar results with six eggs being retrieved at egg collection and only two of these fertilising. All embryo transfers had been unsuccessful.
Mandy was also on medication for hypothyroidism. She had blood tests indicating she was low in a number of nutrients (including iron and vitamin D), had slightly high cholesterol, and her thyroid function was less than optimal. Mandy was preparing for her fifth IVF cycle, this is an appropriate preconception time to focus on improving egg quality was discussed. This included taking supplements, making some changes to her diet (primarily cutting out all alcohol, coffee, increasing her water and fish intake) and starting regular exercise and acupuncture.
At her next round of blood tests a few months later, all her nutrients levels had improved. Both Mandy’s cholesterol and thyroid function had normalised (the latter occurred even without a change in her thyroid medication). Overall, her health was much better. Mandy then proceeded with her IVF cycle, which resulted in not only more eggs retrieved (eight eggs) and better fertilisation rates (six fertilised), it also resulted in a positive pregnancy and a beautiful baby girl.
If you do need IVF to help you conceive, attending to as many of the factors of good preconception health care will ensure you have the best chance of successful outcomes.
Embryologists we work with say they can see the difference in the embryos they create when people start taking specific nutrients and change their diet and lifestyle. Fertility specialists say they can see a difference in the quality of the endometrial lining too. Complementary approaches minimise the side-effects like bloating, fluid retention and pain. The nervous system and adrenals become adequately supported too.
Fertility specialists who we work with also comment on the fabulous benefits that collaborative preconception and pregnancy care brings. Specifically of stress reduction techniques, and the nutrients and herbs prescribed. As these support the nervous system when their patients are going through IVF. All this support, increases couples and individuals ability to cope with the ups and downs of their IVF treatment. Rather than a downward spiral in health due to the stress of IVF and the side effects of treatment. Most of our patients feel much better for working positively on their health. They also feel empowered that there are things they can do that can make a real difference.
Build the foundations for good preconception healthFertile Ground practitioners have written a book that has been termed ‘The preconception bible’ – Create a Fertile Life. You will see so much evidence supporting diet and lifestyle modification throughout the pages of this book and it is equally, if not more important, for IVF to do what you can. Egg and sperm quality is of paramount importance during this time. As is the lining of the uterus for implantation and we can make a real difference here.
There is a wealth of scientific evidence to support our collaborative approach to the best outcomes for creating your healthy baby – regardless of if you are trying to conceive naturally or with ART/IVF. Read on through the Create a Fertile Life book to find out more.
Written by Gina Fox, Charmaine Dennis, Rhiannon Hardingham, Tina Jenkins and Milly Dabrowski.