ADVANCED MATERNAL AGE, HIGH FSH, POOR EGG QUALITY
The diagnoses of advanced maternal age, poor egg quality and high FSH all relate to the belief that a woman has a limited lifetime supply of eggs, and their quality deteriorates as she ages. When the pituitary gland receives hormonal messages that the ovaries are not responding as strongly as fertility requires, it emits higher and higher levels of follicle stimulating hormone (FSH) to try to improve the ovaries' response.
Symptoms of this diagnosis include high FSH levels and recurring failed IVFs or miscarriages.
WESTERN MEDICAL TREATMENT
Western doctors often conclude a diagnosis of advanced age or poor egg quality when a reproductive system appears resistant and unresponsive to attempts to force a pregnancy using artificial hormonal stimulation. Other terms frequently used are "poor responders," "Clomid failures," or "IVF failures". The customary Western medical recommendation for the patient with this diagnosis is IVF using donor eggs from a younger woman.
DISCUSSION AND ROOT CAUSES
A CLOSER LOOK AT THE DIAGNOSES
Poor Egg Quality: The fact is, an objective scientific measure of egg quality simply does not exist. "Poor egg quality" is a subjective opinion, not a quantifiable state.
For years science maintained that all of the eggs that a woman was born with would deteriorate by the time she reached about 45 years of age. More recently, scientists have discovered instead that mammalian ovaries have specialized stem cells that make new eggs throughout a woman's life. Scientific knowledge is imperfect, incomplete and evolving. We must learn to heed our inner wisdom at least as much as external wisdom, and become empowered to heal ourselves.
Advanced Maternal Age: The United Nations defines reproductive age to be between the ages of 15 and 49. With respect to the human egg, how old is too old? Perhaps we are asking the wrong question. Remember the psychological argument about nature vs. nurture? Let's rephrase the issue altogether. How can women in their mature reproductive years produce healthy children? The answer is found in the nature vs. nurture discussion. If you nurture the follicle in the 90-120 days before ovulation, it will produce a healthy egg, free of transmutation and the need for medical intervention.
High FSH: Higher FSH is simply the result of the pituitary gland trying to improve the ovaries' response. If you nourish and support your ovaries, they become more responsive to the pituitary gland's hormonal messages, it senses that less FSH is needed, and your levels will drop.
Despite both the high degree of subjectivity and utter relevance of individual circumstances to these diagnoses, we hear time and again from clients whose doctors have told them variations of the following prognoses: "your ovaries are shrunken, black and dead", "your remaining follicles are like the popcorn kernels at the bottom of the bowl that aren't fresh and healthy enough to pop", or "I will eat my shoe" if you ever get pregnant.
We believe most doctors are wholly sincere in their desire to help their patients. When they tell you that you are too old to have a baby, they do so from the perspective of what they know as a result of their Western medical training, and because they wish to help you be "realistic" about your situation and the prospects. At the same time, assisted reproduction is very big business, and interpretation of what constitutes your best interest may be influenced, consciously or unconsciously, by additional considerations, including profits, clinic success statistics and the relative ease of administering certain therapies over others.
The labels and metaphors being used to summarize our reproductive status are at least as much opinion as science and can be profoundly damaging to our psyches. They can and will become self-fulfilling prophecies if we accept them as truth without question and don't acknowledge our own role in our reproductive health.
THE WISDOM OF OUR BIOLOGY
Let's consider what we have come to know about the amazing female reproductive system. First of all, it is perfectly created. The biology of the ovary itself is remarkably intelligent and interactive with the rest of the body. It is, after all, the source of all human life on this planet. Our body knows how to protect it, too. If a little boy gets mumps or a high fever, he may become permanently sterile. Not so for a little girl. Her ovaries, although deep within her body, are protected from their surroundings before the process of meiosis (egg genesis) is initiated.
This natural protective mechanism means that the ovaries may from time to time become temporarily unresponsive in the body's ongoing effort to protect, just as they are inherently fruitful and responsive when the conditions are right. Viewing their function through a narrow scientific lens which renders them functional or not, rather than through the lens of our deep, internal evolutionary wisdom does not acknowledge that our bodies have far more potential than that for which we ever give them credit.
"If we remain obsessed with seeds and eggs, we are married to the fertile reproductive valley of the Mysterious Mother, but not to her immeasurable heart and all-knowing mind."
- Hua Hu Ching
Let's look at the immeasurable heart and all-knowing mind of the Mysterious Mother, that which is capable of bringing life into being. Take off the glasses of the scientific "truths" you have been conditioned to believe and put on the glasses which allow you to see from that internal place where your intuitive wisdom resides.
Whether you have a million egg cells or are continually regenerating germ cells really isn't the issue. What happens to the follicle, the egg's miniature dwelling, as it's cycling through its many phases of receptivity is extremely important to the health and future quality of its residing egg. Look at this diagrammatic representation of the process within the human ovary at every reproductive stage. Puberty initiates this process, which continues until about age 52, the average age of menopause in the U.S.
Each follicle remains pure potential until it reaches its growth phase. Only then will its outcome be determined. Your multitudes of elemental follicles in their initial dormant state have not yet begun the phase of division. Then, by some mysterious ongoing signal which even reproductive science doesn't understand, hundreds of follicles are awakened from their primordial state of rest, about five months before one will be selected for ovulation. At this stage, they remain in a state of biologic perfection until they begin to interact with their environment. Let's follow one active follicle and its residing egg through this miraculous process of folliculogenesis.
About four months before this particular egg's domain is selected to be the lucky ovulatory one, a chamber of fluid appears within the follicle. The follicle quadruples in size and undergoes many stages of proliferation as the fluid-filled chamber expands. Now, hormone-regulating factors within the ovary itself, which is responding to your own internal environment, start to influence the contents of the follicular fluid. The ovary's messages to the follicle, which are affected by blood flow, nourishment and hormonal cues within the body, influence the state of the follicular fluid. Regulatory proteins, hormones and growth factors begin to appear about the time the egg starts to undergo division.
In a perfect, non-stressed milieu, the messages will be clear and the egg will be healthy. However, if any of three factors is substandard, the health of the egg will reflect the state of the rest of your body:
- If your nourishment is poor,
- If your hormonal cues have been interrupted, or
- If your blood flow has been compromised.
The egg's health is determined during the growth phase, when protein synthesis occurs, after the egg starts to communicate and become responsive to hormonal and environmental factors, and three months before it is released.
As you approach menopause, your ovarian blood flow is about five times less than when you were in our reproductive prime. If blood flow to the ovary has been compromised as a result of stress or age, the follicular fluid will contain rising levels of vascular endothelial growth factor, the same chemical found in a damaged heart muscle which signals the body that the organ is asphyxiating and needs more blood flow.
Further, poor diet begins to show its effects the older you become. Fortunately, your system can be very responsive to dietary therapy and nutritional supplements.
As you age, your hormone levels start to fluctuate. The lack of communication between the brain, the pituitary gland and the ovaries makes the follicles resistant, and they quit paying attention to follicle stimulating hormone.
All of these changes are reflected in your follicular fluid, which determines the health of each egg.
CAN YOU TURN BACK THE REPRODUCTIVE CLOCK?
For several years, Dr. Randine and The Fertile Soul have helped women told previously there was no hope to conceive successfully. Women in their forties, women with high FSH-even day 3 FSH levels over 100, women diagnosed with advanced maternal age, and women with poor egg quality have conceived naturally with their own eggs.
How can this be? Western reproductive medicine looks only at the end result of an imbalanced system and not what we can do to support the function of our reproductive biology regardless of our age or our diagnosis.
When Dr. Randine was in medical school studying to be a Western-trained doctor, she did not receive one day of training-one hour even-on reproductive health-just a lot on reproductive diseases and how doctors can try to intervene when it's too late. This is where the problem resides-we don't know how to care for our reproductive systems at any age.
You are not a reproductive failure. Western reproductive medicine has failed you. Time and again we have seen the ancient wisdom of gently balancing Chinese medicine balance the ovaries and reproductive system and produce "healthy" eggs.
Shares Dr. Randine, "In an effort to understand what this process really was, I had to shift my own paradigm. After completing my medical school academic training, I too was told I was infertile. Barren was the label that came to my mind, and panic set in. I could tell that the stress of my terror was worsening my already bleak diagnosis. But, fortunately, I held a kernel of disbelief within that wouldn't accept my doctor's pronouncement. Fortunately, by this time I had gained enough medical knowledge that I realized that since the endocrine system works via feedback, while taking external hormones might force my ovulation, it wouldn't resolve my underlying disorder. After all, if my ovaries weren't producing the right hormones, how could they be producing healthy eggs?!"
"Western reproductive medicine manipulates the follicles during the selection phase only after the quality and health of the residing oocyte has been determined! I knew my reproductive system was not healthy and that I would have to find other methods for addressing the scenario that was unfolding inside my own body."
The following three therapies have contributed to healthy pregnancies in women diagnosed with poor egg quality, advanced maternal age and high FSH.
Increased Blood Flow: Certain acupuncture and acupressure techniques are known to improve blood flow to the ovaries. Better circulation to any organ improves its function, and this is especially true of the ovaries, the follicles and their residing eggs. Fertile Soul programs utilize and teach techniques to improve ovarian and uterine blood flow.
Better Nourishment: Certain dietary supplements like wheat grass, blue-green algae and royal jelly are known to affect the nutritional state of follicular health, and thus the state of the egg. Avoiding sugar, refined carbohydrates, tobacco and coffee also helps the body provide adequate nourishment to the developing eggs. More detailed dietary guidelines are taught through Fertile Soul retreats and nutritional counseling through telephone appointments.
Hormonal Balancing Using Herbal Prescriptions: Our delicate endocrine system operates via feedback, meaning that the hormones don't work appropriately unless the brain senses the right cues from our tissues. Properly-prescribed herbal formulas which address underlying patterns of imbalance can restore natural, balanced hormonal function. By stimulating the body's own reproductive tissues at different parts of the reproductive cycle, herbal medicine offers a gentler, healthier, more organic response to fertility problems. The Fertile Soul recommends herbal formulas that combine herbs in sophisticated synergistic preparations that achieve greater effects than the individual benefits the herbs offer if taken alone. Most of the ingredients in herbal formulas prescribed for fertility challenges have little or no direct hormonal effects, but the effect of the whole formula is to substantially increase hormone levels. This synergy of different herbal combinations is at the heart of many patented Chinese herbal formulas.
When hormone levels are balanced, and when adequate blood flow, oxygenation and nourishment are provided during the follicular growth phase, women are more likely to become pregnant naturally with their own healthy eggs, as happened for Dr. Randine after three months of treatment. Women who choose Western reproductive methods after following this same program also have greater likelihood of success. Traditional Chinese medicine techniques encourage your body to return to a more youthful reproductive condition, and in that state, ovaries produce and release eggs more like they did when you were younger. This treatment route was validated by a clinical study in which the ovaries of menopausal rats were transplanted into the bodies of hormonally youthful rats. Guess what? The ovaries resumed ovulation!
Conceiving a child cannot be a process of struggle, of swimming upstream against all odds, of "forcing" a pregnancy. You can't force a pregnancy. The Fertile Soul can't force a pregnancy. Your reproductive endocrinologist can't create a life without the cooperation of the same universal forces that our bodies respond to. Life is allowed to manifest, which is a process of acceptance. We hear examples of this universal truth all the time. When we let go of our tight hold on control and loosen our grip on the outcome-through resignation, giving up, adoption and even by accepting that getting pregnant naturally is hopeless because we're too old-it ends the struggle. When we finally unclench, lift up our hands and let go, then the space opens up and our reproductive energies become receptive. Only then can Life say, "O.k., now you're ready!"
Women with the symptoms of high FSH, advanced maternal age and old eggs are more likely to experience unsuccessful ART procedures. Further, the healthier the egg and implantation environment, the better the prospects for a healthy, low-risk pregnancy. It is in the interest of every woman trying to conceive to optimize her health.
Forty-four-year-old Hailey desperately wanted another child and went through multiple cycles of hormonal stimulation and inseminations, always only to fail. Despite her doctors telling her there was no hope, that she was just too old, she kept going, kept searching, didn't accept "no" for an answer.
Hailey came to The Fertile Soul for assistance and with our coaching, made dietary adjustments, received acupuncture stimulation and herbal therapy. The final doctor she consulted told her that at her age, he would only help her if she pursued a donor egg in-vitro procedure using another woman's younger eggs.
Hailey decided to give up her quest to have another child, yet she continued her regimen of more healthful living as she felt the changes she was making were helping her to accept her state of heartache better.
Hailey became pregnant naturally. She gave birth to her son at age 45.
It is important for women of all ages to empower themselves and trust their inner wisdom, as Hailey did. There is much that we can do, on our own and with support, to preserve, enhance and increase our fertility at almost every stage of life. We may be able to extend our childbearing years if needed, and we also must learn to celebrate the stages of our lives as they occur, to accept our full potential and also our limitations, and to maintain our health at its highest level for that stage.