Overcoming Infertility and Pregnancy Loss with an Integrative Approach

In Part I of this blog, I discussed a holistic approach to addressing fertility challenges and pregnancy loss. Lifestyle and nutrition are an important foundation for health and fertility. Anyone having fertility challenges would benefit from first addressing dietary and/or lifestyle factors that may hinder fertility. In this section, I'll address nutritional and herbal supplements that can be added to help regulate hormones and optimize fertility. Some supplements benefit both female and male fertility. In general, holistic medicine can take 3-6 months to significantly impact the hormonal system. It can be quite effective when used consistently and given a reasonable amount of time to work.

There are numerous herbal and vitamin supplements that assist reproductive health in various ways. Both Eastern and Western herbs are excellent for boosting fertility. Alternatively, vitamin and mineral supplements may be used to increase nutrients in the diet. Sometimes it's appropr iate to use both Eastern and Western herbs, along with vitamin or mineral supplementation. Each supplement has a different physiological impact on the body, so it's important to know which ones to use and which not to use. Keep in mind that not all supplements on the market are of the same quality, and just because they are herbs or vitamins doesn't mean they are necessarily safe for you. I've included a brief description of each supplement to get you started. A licensed herbalist or natural practitioner can help you decide which are appropriate for your situation and which brands or manufacturers are reliable.

Chinese Herbal Formulas - I recommend consulting a practitioner of Chinese medicine when using Chinese herbs to enhance fertility, since the herbal formulas are matched to each person's unique presentation and often changed according to phases in the menstrual cycle. Herbal formulas work synergistically with acupuncture, which is instrumental in enhancin g fertility, with or without assisted reproductive technology. Chinese herbal formulas contain plant medicine (and sometimes animal products like gelatin) which provides vitamins, minerals, and other nutrients important for preparing the body for pregnancy. Chinese medicine is also helpful in treating underlying conditions affecting fertility.

Nettles (Stinging Nettle) - Nettles has vitamins, iron, & calcium, useful for preconception, pregnancy, and postpartum. It strengthens the kidneys, which are overburdened during pregnancy. Take it as a tea or infusion (steeped overnight).

Chlorophyll - Some studies show that chlorophyll (found in plants) improves the health of blood cells by increasing the uptake of oxygen in the blood. In Chinese medicine we use it to strengthen blood. Chlorophyll can be conveniently taken in liquid form (just be careful as it will stain your clothes).

Chaste tree berry (Vitex) - Chaste tree berry or vitex is often used in Europe to treat disorders of the female reproductive system. It is very useful for conditions associated with high estrogen and low progesterone levels, such as PMS and PCOS (Polycystic Ovarian Syndrome). Chaste tree berry works on the pituitary gland to help regulate the body's hormones, and therefore is said to be safe to use whether estrogen or progesterone dominant. It is excellent for treating pain and discomfort associated with the menstrual cycle. Because it helps the body regulate hormones, it's also a useful fertility herb, particularly for women with irregular menstrual cycles. Chaste tree berry can decrease prolactin levels which is helpful for women who aren't ovulating. It can be taken in capsule form, tincture, or as a tea (often mixed with other fertility herbs). One such tea on the market is called "FertiliTea", which contains several fertility-boosting herbs. If taken as a tea, I recommend drinking at least 3 cups per day to ensure you're getting a high enough dose to impact the hormonal system. Herbal teas are gentle acting but quite effective when used consistently. Furthermore the ritual of drinking tea can be relaxing, nourishing, and empowering for the individual.

Coenzyme Q10 - Coenzyme Q10 is an antioxidant found in the human body. Because it decreases as we age, it's especially useful for boosting fertility in women over the age of 35 and men over the age of 40. A study published in the "Journal of Fertility and Sterility" found that older women taking up to 600 mg of CoQ10 daily experienced an improvement in both egg quality and fertilization rates. Similarly, some studies show that it improves the quality, quantity, and motility of sperm. Supplementation may assist in conception as well as possibly preventing miscarriage due to chromosomal abnormalities (often due to poor quality egg and/or sperm).

Royal Jelly - Royal jelly is a secretion of the worker honeybee that is fed to queen bees before they lay eggs. Queen bees are known to lay up to 2,000 eggs per day. Royal jelly contains trace minerals, enzymes, amino acids, lipids, protein, fatty acids, and vitamins. One Japanese study demonstrated that taking royal jelly for 6 months improved erythropoiesis (or formation of red blood cells), glucose tolerance and mental health. In Chinese medicine, we say it strengthens spleen qi, blood, yin, and kidney jing which are required for vitality and fertility.

N-acetyl cysteine (NAC) - There are studies which support its use as an antioxidant to improve egg quality and prevent miscarriage due to oxidative stress/free radicals or PCOS (Polycystic Ovary Syndrome).

Folate, B6, and B12 - Vitamins B6, B12, and folate are important for healthy blood cells needed to conceive and maintain a pregnancy. They can also decrease elevated homocysteine levels which are connected to early pregnancy loss.

Vitamin E - Studies have demonstrated tha t the use of Vitamin E is associated with improved egg and sperm quality, thicker uterine lining, and decreased risk of miscarriage in women who experience recurrent pregnancy loss. The natural form, d-alpha-tocopherol, should be taken instead of the synthetic version.

Progesterone cream - Some women experience a "luteal phase defect" which can cause problems with conceiving or carrying a pregnancy to term. The "luteal phase" of the menstrual cycle starts right after ovulation and ends just before the period. A defect occurs when the uterine lining is not adequately prepared for an embryo to implant. It's often due to low progesterone levels. Women with low progesterone levels often have a short luteal phase, which is less than 12 days. Progesterone cream may be beneficial for these women. The cream can be started after ovulation and applied until the period comes, or if pregnant it should be continued at least until the 12th week (when the placenta takes over the production of progesterone). It's important that the progesterone not be taken until after ovulation (after the egg has been released). Emerita Pro-gest is a reputable cream available over-the-counter.

Prenatal Multivitamin - Although it's important to receive nutrients from fresh, whole foods, a prenatal vitamin can be helpful for filling gaps in nutrition. It's especially useful for replenishing iron, folate, and B vitamins important for fertility. Selenium and zinc are useful in improving egg and sperm quality and may reduce the chance of chromosomal abnormalities. I recommend using a prenatal vitamin derived from whole foods, rather than synthetic vitamins.

Fish Oil -The essential fatty acids in fish oil can reduce inflammation that hinders conception as well as carrying a pregnancy to term. It is beneficial to take before, during, and after pregnancy, since it also provides important nourishment for the baby's brain. Some studies suggest f ish oil may increase circulation to the uterus since it's a mild blood thinner, and therefore can help blood clotting problems as well. In addition omega-3 fatty acids can improve the quality and quantity of cervical mucous, which assists the sperm in reaching the egg after intercourse. Some studies suggest it may also benefit men's fertility by improving the quality of sperm.

Moxibustion- Moxibustion, or moxa as it's often called, is a form of herbal and heat therapy performed by acupuncturists. It consists of burning an herb called mugwort, which creates an intense heat that warms the body, builds blood, and increases circulation of blood and fluids. Moxibustion is particularly helpful for an individual who feels chilly and experiences the following health challenges: back and/or knee problems, difficulty digesting foods, fatigue, and low libido. It is commonly used for gynecological disorders and can help to regulate the menstrual cycle.

A Note About Baby Aspirin- If you're experiencing recurrent pregnancy loss, you might ask your Reproductive endocrinologist if baby aspirin might help. Its use may increase blood circulation to the pelvis, reduce clotting disorders, and assist implantation of the embryo. Always ask your physician if it's appropriate for your case and how long you should take it. Some individuals on blood thinners or with bleeding disorders should not take baby aspirin.

Whichever path of treatment you and your practitioner decide to take, always consult your physician and let them know about any supplements you're taking. This information is meant to supplement your regular medical care, not replace it.

Nikoo Saleh Kasmai, MS, L.Ac. holds a Master of Science in Acupuncture and Chinese Medicine. She is a trained Birth Doula and specializes in Pregnancy & Labor Support. For more information about acupuncture and Chinese medicine, visit her website at www.guesthouseacupuncture.com.

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