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The Official Website of  IVF PreparationIf you have to resort to Reproductive Endocrinology, Hormonal treatment, IVF – How to Increase Your Chances for Success Let’s start out with the cold, stark fact that most people do not conceive with IVF. Far more are unsuccessful than successful. The majority of women find hope through The Fertile Soul after multiple failed IVF procedures. We have treated women who have gone through as many as 27 IVFs without success. IVF clinics get to manipulate their success rates by closing the door to more mature women, canceling cycles, and offering donor egg so they may pad their statistics success rates. We have treated two women with only one ovary and one fallopian tube (on opposite sides) who became pregnant naturally in preparation for IVF. When you are in balance, your own body’s wisdom is allowed to participate in helping you conceive – naturally or assisted. When Should One Resort to ART (Assisted Reproductive Technology)? The focus at The Fertile Soul is, first and foremost, to help women restore balance to their bodies so they can become pregnant without assisted technology. However, complete resolution of severe, long-term tubal obstruction (for example) using only massage, acupuncture, and herbal therapy is sometimes difficult. Yes, improvements can be made, but full resolution in your timeframe may not be possible. In such cases ART (Assisted Reproductive Technology) procedures are the only option for women who wish to give birth to their own genetic offspring. Yet, we don’t want you to become one of the statistics who does not become pregnant with IVF. When you are in balance beforehand, you are more likely to be successful with IVF. When you are imbalanced beforehand, you will likely not be successful with IVF. We will try to acquaint you with how best to support the procedures of Western medicine’s assisted reproductive techniques while maintaining your health and wellbeing. The principles and practices of The Fertile Soul Method ™ can help you prepare your body for ART, support you physically and mentally during and after the procedures, and mitigate some of the difficult side effects caused by some of the medications. Learn More about Assisted Reproductive Technology: What is Art? | How the Fertile Soul Method ™ can Improve the Success of ART | Choosing an ART Clinic | Questions about your procedure Let’s look at a typical medically assisted cycle: Typically a woman’s hormonal responses are suppressed for one cycle prior to the attempted ART procedure. This “down-regulation” provides a clean slate and is supposed to help ensure that the eggs produced for ART are as healthy as possible. The ART cycle begins by stimulating a woman’s ovaries to produce several dominant follicles at a time, using drugs like Pergonal, Repronex, Humegon, Follistim, Bravelle, or Gonal-F. The eggs in the follicles are encouraged to mature through ovary-stimulating medications known as gonadotropins. Once the follicles have reached maturity, a shot of human chorionic gonadotropin (hCG) initiates the final ripening of the eggs, which are either ovulated or aspirated with a needle guided by vaginal ultrasound approximately twenty-four to thirty-six hours later. Afterwards, women receive progesterone injections to ensure adequate development of the uterine lining to support successful embryo implantation.
That describes an ideal IVF scenario. However, it leaves out all the side effects and symptoms of the hormonal medications, the discomfort of the surgical procedures—and the level of success a woman can expect. For instance, 10 to 20 percent of ART cycles have to be cancelled either because a woman has not produced enough eggs or because her ovaries have become over-stimulated, affecting the quality of eggs available for retrieval. Even when eggs are produced, retrieved, and fertilized, overall success rates for IVF procedures are around 28 percent in women under thirty, about 8 percent for women age thirty-nine, and 3 percent for women age forty-four. On average, women go through seven cycles of IVF before they either conceive or quit. Therefore, anything you can do to increase your chances of success will definitely be worthwhile. How the Fertile Soul Method ™ can Improve the Success of ART Procedures Fortunately, TCM (Traditional Chinese Medicine) has been shown time and again to help women embarking on ART procedures improve their chances for conceiving and carrying healthy children to term. The Fertile Soul Method can improve the outcome of ART even in women with mechanical and anatomical obstructive factors. Indeed, as you may read from the stories in The Infertility Cure, many of Dr. Lewis’ patients get pregnant during the TCM treatment. But they MUST become balanced before they embark on assisted reproductive technology or they will not end up with the child they so desire. Our goal is not to get you pregnant, but to help you have a healthy child in your healthy body, mind, and soul. Many of our patients get pregnant during their treatments with The Fertile Soul are undergoing in preparation for a reproductive procedure. Once the underlying pattern that had been preventing pregnancy was addressed, conception occurred naturally. However, if you are currently preparing for an ART procedure or are already under treatment by a reproductive endocrinologist, it’s very important you consult your doctor before adding anything to your health care regimen. Your reproductive endocrinologist is “driving the ship,” so to speak: he or she has to know what is going on so they can drive it correctly. Any TCM treatment you choose will have an effect on your hormones and your reproductive system, while hopefully increasing your fertility. However, such treatments may necessitate changes in what your reproductive endocrinologist is prescribing. For your wellbeing as well as your relationship with your doctor, let your medical team know what else you are doing. We prefer our Fertile Soul patients start their TCM treatment three months before their ART cycle, especially if there are hormonal, age, or implantation factors. That usually gives us enough time to restore adequate balance to the body’s energies and organs so that the ART will produce the best possible response. (This often gives patients enough time to get pregnant naturally.) However, in most cases we will tell patients to stop their herbs when they start their ART cycle. After all, if the soil is well prepared you don’t have to keep giving it fertilizer every single day. If a woman is at the point where she’s in good balanced health before the ART, hopefully she won’t even need the procedure. But if she does, it’s important for her to go through it with a good conscience and good medical guidelines. Acupuncture
One Chinese study tested the temperature of the skin on the hand to gauge the effect of acupuncture on anovulatory patients who had hyperactive sympathetic nervous systems indicating high levels of physical stress, which can depress LH secretion. (Hand skin temperature is used frequently in biofeedback experiments. An increase in hand skin temperature has been shown to indicate a decrease in the “fight or flight” stress response.) The study showed that in anovulatory patients acupuncture calms the hyperactive sympathetic nervous system and regulates the function of the hypothalamic–pituitary–ovarian (HPO) axis. Ovulation was induced when functions in the HPO axis were normalized. We use the general stress points to lower your stress levels. You can gauge its effectiveness using the same methods as described in the Chinese study: by measuring changes in hand skin temperature. Biodots (heat-sensitive adhesive strips that change color as hand skin temperature increases) are a very inexpensive form of biofeedback monitoring. As you stimulate your acupressure points or do any of the breathing and meditative techniques described earlier, put a biodot onto your hand to see if you can increase the heat to your hands. An increase in hand skin temperature tells you that your sympathetic nervous system response is being calmed, and so is the rest of your body. To improve blood flow to the uterus and ovaries before retrieval, a Swedish study used electroacupuncture on points on the low back and legs (see medical articles section) biweekly prior to retrieval. We suggest a specific pre-transfer protocol (see medical articles section) on the day of embryo retrieval to regulate the liver and improve blood flow, and calm the spirit and uterus (making the uterus non-reactive to the catheter, and therefore more receptive). This is done only the day before and day of transfer. Herbal Treatments Before or During ART Depending upon your reasons for undergoing ART, there are different herbal preparations you may use—always, of course, basing treatment on the underlying pattern of imbalance. For example, if you fall under the category of anovulation due to Liver Qi stagnation, then we recommend certain dietary guidelines and herbal preparations to help resolve stagnated Liver Qi. You also would perform the meditations to alleviate stress.
If your reproductive endocrinologist will allow the use of herbs during your hormonal cycle, our treatment method is to support the Yin during the follicular phase when the follicles are developing. The uterine lining may also be helped with Blood-tonifying herbs like Angelica (Dang Gui). Certain herbs that harmonize the Qi, like Xiang Fu, can be used during the follicular phase as well for those who have severe Liver Qi stagnation, and will help the body handle the stress of the procedure successfully. Xiang Fu also helps to support the production of estrogen. Fluid retention can be an annoying side effect of hormonal medications as well as a threat to the ART procedure. Sometimes a woman develops a condition where fluid accumulates in the uterus prior to embryo transfer, inhibiting implantation. TCM can help resolve excess fluid accumulation through acupressure and herbs. Diet and Lifestyle Everybody who has been through a cycle of hormonal stimulation knows how difficult this process can be. Numerous visits to the clinic, daily injections, suffering through the side effects, hoping for a good response to the medication, anticipating a smooth insemination, praying implantation is successful, and the dreaded waiting for a positive or negative blood test… almost every aspect of the process is out of your control, and the stress is enormous. It has been well documented that stress negatively effects the outcome of ART. A recent study published by the American Society of Reproductive Medicine’s journal, Fertility and Sterility, reported that stress impairs the success rate in IVF cycles up to 93 percent. Putting an embryo, which has been developing in an artificial laboratory setting, into the uterus changes its environment; and a change in the environment produces heightened stress. Therefore, you want the surroundings in which your embryo will hopefully find its home for the next nine months to be free of the toxic results of stress and tension. Even though ART procedures create enormous hormonal and emotional stress, for the sake of your embryo you need to lower your tension level as much as possible. You can use the principles of TCM to lower stress levels through diet and lifestyle. Begin with the following suggestions:
Another method that has been proven to improve response dramatically is to increase blood flow to the uterus and ovaries. A study in the Journal of Human Reproduction reported that supplementing with 16 grams daily of oral L-arginine (taken from day 1 of the menstrual cycle until the dominant follicle reached over 17 mm in diameter) improved hormonal response. Another European study stated that giving “poor responder” patients 80 mg per day of oral dehydroepiandrosterone (DHEA) for two months improved patients’ response to ovarian stimulation. Another way to improve uterine blood flow is through massage and exercise. Before and during hormonal stimulation, I recommend that you perform exercises that directly increase blood flow to the pelvic organs. We teach and perform the femoral massage, ovarian massage and uterine massages at retreat and workshop. Our Fertile Soul practitioners will also teach these techniques to you in the Fertile Soul locations. You also may find that the Qi Gong breathing and soaking your feet in warm Epson salt water helps you relax while directing energy to your pelvic area. Visualization and meditation are powerful techniques to align body, mind, and spirit. I particularly like the following meditation. Not only is it a wonderful respite from the stress and strain of life but it also connects you to the ultimate purpose of all these treatments: to prepare your body to accept and nurture a child. Meditation with Visualization Do as much of this exercise as you wish. Read through all of it first; then practice each section, adding to it each time you perform the meditation until the meditation is complete. You may leave the meditation whenever it doesn’t feel comfortable, or join it again at any part of the visualization. Lay down, on your back, with your eyes closed. Relax and breathe deeply. Notice any areas of tension you feel in your body from your head to your neck, down your arms and hands, through your torso, down your abdomen, buttocks, thighs, calves, and feet. Tense the tight areas in your body even more, one by one. Breathe in, inhaling deeply down into your lower abdomen. Push your diaphragm down and your stomach out as you breathe in. Focus your attention on the tension in your body, then tighten the muscles in the area even more, and relax them fully as you exhale. Exhale completely, deflating your abdomen when you breathe out. Release the tension in your body through the breath. Keep your focus on the tension, the breath, and the relaxation—nothing more. When the tension in that particular part of your body is gone, move on to the next part. When you feel relaxed throughout your body, and your mind is clear, begin the visualization. Continue breathing deep into your abdomen and relaxing with each exhalation throughout the visualization. In the visualization, a river will be used as a metaphor for your life. A garden will represent the lab where your procedure will be done. Modify these scenes for your own maximum individual comfort. Picture your ideal river scene—the banks of the shore, the background scene, the weather, and the water itself. Are the waters rough or calm? Continue to picture this river scene until the flow of the river feels comfortable and safe. Picture what you are wearing. Is it white and flowing, or is it primitive and beaded? It must feel comforting—this will be your maternal gown. Picture yourself on a raft in the river. You can make the raft rustic or luxurious—whatever you wish. This is your raft, your vessel for this journey. Is it hard or soft? Is it made of pure and untreated materials? You may furnish it with pillows, comforters, or keep it bare and natural. Can you feel the waters of the river through the raft? Let the raft float down the river. Relax and let the waters of life take you down the river. Trust your raft. Trust the water. When you are ready, let your raft float to a cove where the water takes you. Picture the cove with fertile banks. The soil on the banks is dark and rich. They receive water from the river of life. They receive ample sun and adequate shade. The banks of this cove will be your special garden. What else will nourish your garden? Who would you like to be there with you? Who is not allowed? You may wall off your garden, or keep it open to the surroundings. Your garden is a safe place for new beginnings. When your seedling is ready and can no longer receive adequate nourishment from the banks of the shore, you must carefully transplant it. It is now yours. Cradle it, nurture it, breathe into it, talk to it, sing to it. Love it. Bring your seedling onto the raft with you. Make both of you comfortable and safe. When you are ready, carefully launch your raft back into the waters of the cove. Return to the waters of life with your seedling. It now receives all its nourishment from you. On the rest of the journey it will become one with you. You now move on down the river, together. As one. If you choose, you also can invoke the power of prayer as you prepare for your ART procedure. In a number of studies, prayer has been found to dramatically affect medical procedures, including the outcome of ART, even when patients did not know they were the focus of prayer. Whether or not you even believe in God seems to make no difference: prayer seems to open up another dimension of healing, which we cannot explain by our sensory perception. One final reminder: you are creating a healthy environment to welcome and nourish a new life within you. That new life needs every ounce of your support—physical, mental, and emotional. But one of the best ways you can support you and your child is to relax. Do what you need to do in terms of exercise, massage, supplements, diet, and herbs—but also think of the kind of mother you want to be. Remember your goal. Think of holding your sleeping child in your arms. Relax into the love you will share. Then hold that image and love in your heart as you undergo your ART procedure. That is the most welcoming environment you can create in your body and womb. Just as choosing the right doctor is important to your comfort and success with ART, choosing the right clinic is critical. Undoubtedly your gynecologist or reproductive endocrinologist will have a clinic where they typically refer patients, or will be affiliated with a clinic themselves. However, you want to make sure the clinic you choose will give you the best possible results. Different clinics specialize in specific kinds of procedures and conditions. They will have different success rates for different categories of patients. To increase your own odds for success, you need to become a highly-educated consumer and be willing to ask some very pointed questions before you agree to have your procedure done. I always suggest that my patients do as much if not more research on the clinics they choose as they do on their doctors. Since 1992, all ART clinics in the U.S. have been required to report their success rates to the CDC, which publishes these statistics yearly online (www.cdc.gov) and in a pamphlet, ART Success Rates: National Summary and Fertility Clinic Reports. This pamphlet lists the number of ART cycles completed at each clinic, the number of babies born as a result, and the percentage of successful deliveries per egg retrieval and embryo transfer in women using their own eggs as well as those using donated eggs. There is also information on percentage of multiple births and success rates categorized by number of patients treated, age, and diagnosis. These statistics provide an excellent snapshot of the kind of treatments offered and level of success you can expect from a specific clinic. But remember what Mark Twain said: “There are three kinds of lies—lies, damned lies, and statistics.” Some clinics may have higher success rates because they only accept younger women or those who have shown to be good responders. Other clinics may have lower success rates because they are willing to treat more complicated cases of infertility. That’s why it’s important to take a look at the particular data that produced the success rate, and to focus on clinics that treat your particular kind of fertility problem. In addition to comparing statistics I also suggest that women talk to other women who have similar fertility problems and have been treated at that clinic. RESOLVE, the national organization for women experiencing infertility, can provide you with contact information for support groups, chat rooms, and so on. When you have narrowed your search to a few clinics, here are some questions that may help you make your final decision. Questions to Consider in Choosing a Reproductive Clinic
Once you have found the clinic, however, you need to prepare yourself in the best way possible for a successful ART procedure. Most women know they have only a certain window of time in which they can become pregnant, and each failed cycle is a lost opportunity. In addition, with IVF procedures costing $10,000 per cycle and up, financial resources can quickly become a consideration. Therefore, you need to do everything possible to ensure you are hormonally healthy before you begin pursuing pregnancy through ART. The hormonal medications given in ART are designed to increase your production of eggs but are not going to help those eggs be healthy. Remember, getting pregnant isn’t the goal: giving birth is. Miscarriage rates are significantly higher for pregnancies where hormonal stimulation has been used. (Women with mechanical fertility issues like fallopian tube obstruction who use IVF are much more likely to give birth than those with unexplained infertility or ovulatory disorders who account for 25 to 40 percent of those who seek reproductive assistance. I believe this is due to the fact that most women with mechanical fertility issues don’t have hormonal imbalances that affect the quality of their embryos.) The need for hormonal health prior to ART applies to men as well. Conceptions resulting from fathers with sperm issues—low count, morphology, or motility—also have higher rates of miscarriage as well as increased instance of genetic defects. A study in the March 2002 New England Journal of Medicine reported that the risk of birth defects doubles when IVF procedures include intracytoplasmic sperm injection (used when sperm are not healthy enough to penetrate the egg on their own). A woman’s best response to any assisted reproductive technique will depend upon her overall endocrine status the few months preceding the procedure, when the follicles are developing within the ovary. Before you begin ART, you should use any means possible to improve the quality of your eggs, rather than the number of eggs produced per cycle. You must do everything within your means to ensure you are as hormonally healthy as possible before you attempt medical reproductive assistance! Questions about Your Procedure
Finally, here are a few questions to ask during the procedure. They will help you ensure that you are getting the best quality care every step of the way. When You Are in Cycle
Learn More about The Fertile Method ™ Learn more about Fertility Enhancing Retreats. |
Once the eggs have been retrieved, a number of different ART procedures can be done. With in vitro fertilization, the eggs are placed in a Petri dish, allowed to incubate for several hours, and then mixed with the partner’s sperm. (The sperm is washed to eliminate any proteins that might affect the egg negatively and to concentrate the number of healthy sperm present in the sample.) The eggs are checked twelve to eighteen hours later for signs of fertilization, and any fertilized eggs (zygotes) are encouraged to continue development. When the blastomeres (dividing embryos) reach a specific level of development (three to five days later, depending on the parameters set forth by the particular doctor and clinic chosen), the woman is told to come to the clinic with a full bladder (to help ultrasound visualization). Usually between two and five embryos are transferred into the woman’s uterus using a catheter passed through the cervix. (More than one embryo is transferred to raise the chance of conception. However, this is the reason for the 20 to 30 percent rate of multiple births in ART pregnancies.) The woman is kept at the clinic for several hours and then told to go home and rest. She continues her progesterone regimen to support implantation. A blood test is given ten to twelve days later to confirm pregnancy. 
Acupuncture can help improve the outcome of assisted reproductive techniques in three ways. First, it can alleviate the side effects of medical treatments and improve response to hormonal stimulation. Second, acupuncture can improve the blood flow to the uterus and ovaries. Third, it can alleviate some of the tension inherent in these extremely stressful procedures. Numerous studies are being conducted at various IVF clinics which all seem to show that acupuncture improves IVF success rates.
Many women who are undergoing ART, however, are already somewhat deficient in nature, especially if they are older. Hormonal stimulation will deplete the Kidneys, and the Kidneys govern reproduction. Kidney Essence is responsible for underlying egg quality, as well as uterine lining and other measurable responses to hormonal stimulation. Therefore, The Fertile Soul Method ™ insists upon kidney essence tonification for everyone undergoing ART.
In some cases, specific supplements can help you respond better to the hormonal medications of ART procedures. For instance, patients who are diagnosed as “poor responders” (meaning they fail to produce enough hormones or mature eggs in response to the hormonal medications used during their ART protocol) are usually told their only hope is to use donor eggs. If you receive this diagnosis, you may wish to find another reproductive endocrinologist. Some of the more progressive reproductive endocrinologists have found means to enhance responses to hormonal medication even in poor responders. 
Remember, embryo transfer is a delicate procedure. You don’t ever want to do anything that will cause you to look back and have to ask, “Did I do everything within my power to make this happen?” You want to know that you took care of yourself in the best way possible. And that includes asking all the questions you can to find the best possible clinic.