March-April 2011 | Features in Bethesda Health

Trying Times

Could holistic treatment be the answer for a woman struggling to conceive? The author sets out to find out.

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“Don’t worry if the candle blows out,” Beth Heller says. “It’s not a sign you’re doomed.”

I’m one of seven women at an all-day “yoga for fertility” workshop at Pulling Down the Moon in Rockville, and Heller has voiced my very fear. Five years have passed without the promise of parenthood, and I’m wondering if I’m destined never to conceive.

Heller places a glass votive with a lit candle in the palm of my hand and steers me toward the window. I’m supposed to let the flame release negative thoughts and carry up a prayer.

I try not to think about all the tests I’ve been through since my husband and I began our quest to start a family. Ron’s sperm was tested a year into the process, and it elicited such high praise from doctors that I joked we should frame the results. My own reproductive report card wasn’t so hot. After another year and a devastating miscarriage, I learned I had a large ovarian cyst that required laparoscopic surgery.

Then the news got worse.

“You have endometriosis,” Dr. Steven Maggid told me as I blinked away the grogginess of anesthesia at Capital Specialty Center in Rockville. “I removed 90 percent of your right ovary.”

Endometriosis is a condition in which tissue similar to the lining of the uterus grows out of place, often in weblike patches on other organs of the body. It creates a hostile environment that can make conception difficult. Although it affects 5.5 million women in the United States, according to the Department of Health and Human Services, those with mild to moderate cases have a good chance of pregnancy after surgery. Mine was “extensive,” but it had spared my fallopian tubes. Maggid cleaned out what he could and told us to keep trying.

We went about it with an industriousness that Ron compared to his favorite sport, golf—we were focused without being so anxious we couldn’t relax. We used an ovulation predictor kit to learn the most auspicious times for me to get pregnant. And I took a small dose of Clomid, a fertility drug designed to boost ovulation.

When that failed, Maggid suggested a specialist. I went to Dominion Fertility in Arlington, Va., where they tested my fallopian tubes to ensure they were open (they were). We signed up for intrauterine insemination, better known as the turkey-baster method. Ron’s sperm sample was “washed,” with the best of the bunch deposited in my uterus through a flexible catheter. Still nothing.

And so I embarked on a quest that would take me to India before bringing me full circle back home.

Our story is not uncommon. More than 7 million couples in the United States (one in six of childbearing years) have trouble conceiving, a number that has risen recently. In 1988, according to the Centers for Disease Control and Prevention (CDC), about 2.3 million U.S. couples struggled with infertility.

“The trend with women today is to get an education, get a job, get on the advancement ladder and delay having a child,” says Dr. Frank Chang, one of about two dozen reproductive endocrinologists associated with the Shady Grove Fertility Center in Rockville.

Many don’t learn until too late that age is the number one factor in fertility. The National Center for Health Statistics reports that in 1970, the average age of a first-time mother in Maryland was 21.6. Today, it’s 26.1. That four-and-a-half-year gap is one of the largest increases in the country.

The night I tossed my birth control and gave my husband a googly-eyed look, giddy with visions of us having a baby, I was sure I’d be pregnant within weeks. I even browsed a maternity shop the next day.

I had spent my 20s and early 30s chasing not one career, but two—first as a lawyer, then as a writer. But at 32 I was a runner and in good shape. I didn’t smoke. I ate oatmeal and spinach and pasture-raised chicken. In fact, I was so health-conscious that I balked during the infertility consultation I scheduled after our failed turkey-baster attempt. The number of drugs…good grief.

The fertility specialist recommended in vitro fertilization (IVF), where the egg and sperm are joined in a laboratory before being transferred to the uterus. He told me that over four to six weeks I would be required to take as many as six different types of hormones through injection, oral medication and vaginal suppository. I was nervous about dumping that much medication into my body. In the end, I decided against it.

Chang maintains that women shouldn’t be concerned about the medication required for IVF. “In the last 20 years [fertility drugs] have been used a lot, and studies have not clearly, consistently demonstrated any association with infertility treatment and cancer,” he says. “Logically, you’d expect to see something occur after awhile.” Nonetheless, I wasn’t comfortable with it. According to the CDC, 57 percent of IVF fails when women use their own eggs. Given my age (by now I was 35) and my endometriosis, my odds of success were even lower.

One look at my brother’s 4-month-old, Noah, and I understood why so many people choose fertility treatments. And yet I believed on some basic level that I could conceive the old-fashioned way. I thought if I improved my health and habits, my womb would be more receptive to pregnancy—that if my mind, body and spirit were in balance, I would have the optimal chance of conceiving naturally.

So in the fall of 2008, three years into my fertility quest, I searched the Internet for a holistic fertility treatment center in the D.C. area. I had heard of The Domar Center for Mind/Body Health in Waltham, Mass., where infertility patients undergo a wide range of holistic healing practices to improve their chances of conception. But all I found locally were a few naturopaths and acupuncturists who would work with fertility patients.

Then I read about a health clinic in Kerala, India, that practices ayurveda, a 5,000-year-old holistic system of medicine. “I doubt chewing on the bark of a South Asian tree will cure endometriosis,” Ron told me.

Dr. Alan DeCherney says the question of lifestyle changes enhancing a woman’s fertility is a hot topic today. DeCherney is head of reproductive and adult endocrinology at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, part of the National Institutes of Health. “There is only [supporting] evidence on acupuncture,” he says. But that doesn’t mean other therapies can’t help. “Infertility is an emotional roller coaster. Any kind of support is helpful,” he says. (Except herbs: “They’re not regulated,” DeCherney says, “and some have estrogen compounds, which are counterproductive to getting pregnant.”) 

Disregarding the naysayers, I left for India three months after learning of the clinic. For 21 days, I practiced yoga, meditation and abdominal massage in a converted house next to a coconut grove, hoping to repair some of the damage done by endometriosis. I took herbs to regulate my menstrual cycle and ate a vegetarian diet to rid my body of excess toxins.

When I returned home, Ron was as optimistic as I was. But a month passed, then two more. We were beginning to lose hope when I learned that a holistic fertility center had opened in Rockville. Continuing our quest seemed right.

Pulling Down the Moon was co-founded by Beth Heller and Tami Quinn, yoga teachers living in Chicago, each of whom had struggled with infertility in the 1990s. Heller began practicing yoga poses to stretch and open the pelvic area and release tension. Over time, her irregular menstrual cycle corrected itself. Quinn enjoyed the meditative aspects of yoga, and used it in combination with “good old-fashioned prayer and trying to eat healthy.” Both took Western fertility medication, but stopped short of IVF. Each has two children today.