8. The point is, I am more than a practitioner handing out advice to those struggling with infertility; I have “been there” myself, I know how patients feel, and this knowledge has made me a better and more empathetic TCM practitioner.
You may be tempted, when reading this book, to skip over chapters you think don’t apply to you. For example, if your fertility challenge is rooted in poor ovarian reserve, you may wonder why you should bother with the chapter on PCOS. However, I encourage you to read every chapter, for several reasons.
First, each chapter includes at least one and sometimes two inspirational stories. For women and men with fertility challenges, the pathway to pregnancy can be stressful; you need all the inspiration you can get. Second, many of the sidebars in the book are pertinent to the whole topic of fertility challenges, not just the particular issues addressed in the chapter in which they appear.
Similarly, although each chapter focuses on a particular problem, it also includes information that anyone facing fertility challenges could find helpful. For example, although Chapter 5 focuses on male factor infertility, it includes information about a gender bias in the fertility world that virtually every woman experiences. And through the remarkable story in Chapter 9, I pose the question, “How far would you go?” It’s a question all women, men, and couples should consider early in their fertility journey, and this chapter illustrates why.
Whether you are just thinking about starting a family or have been struggling with fertility challenges for years, Pathways to Pregnancy offers real hope of healing. More than that, it may be useful for your friends, family, co-workers, and employers as they strive to support you in your journey. Finally, it may help those who hope to start a family someday by informing them of what can go wrong and encouraging them to use TCM to be proactive in caring for their own reproductive health.
And it all started with my grandmother. If she had not fallen ill, I might never have taken an interest in Chinese medicine, and I might not be telling you my story now.
By the way, she lived another eight years and died at the age of ninety-four.
1
You Are Not Your Diagnosis
A woman is like a tea bag; you never know how strong it is until it’s in hot water.
ELEANOR ROOSEVELT
Vanessa: Unexplained infertility
Vanessa met her husband, Robert, at thirty-two, married at thirty-four, and started trying to have a baby right away. After six months, they went to her family physician to get a referral to a reproductive endocrinologist (RE). Couples must have tried to conceive for at least a year without success to be referred to a fertility specialist. For some, every passing month feels like an eternity. This must have been the case for Vanessa, who fibbed to her family doctor, telling her they’d actually been trying for a year.
At the same time as Vanessa was seeing the RE, she was coming to my clinic for acupuncture. I encourage my patients to get medical testing if they’re having trouble conceiving because it provides a baseline from which I can help them more naturally align themselves and their environment to support conception. It also allows us to rule out any structural or genetic issues.
Through my TCM examination, I discovered Vanessa had premenstrual symptoms, including several days each month of breast tenderness, back pain, lower abdominal pain, weakness, and moodiness. Like many patients who have visited a fertility clinic, Vanessa was surprised by the depth of my inquiry into all aspects of her health and lifestyle. At the fertility clinic, her diagnosis of unexplained infertility was based solely on her report of not becoming pregnant despite trying for a year and the clinic’s inability to find an explanation. Her RE advised her to begin treatments as soon as possible because she was thirty-five—approaching what fertility clinicians call advanced maternal age.
A jumping-off point
One of the most difficult things I see in my clinic is a woman who is in her mid-thirties, still feeling young and vibrant, yet distressed after a fertility doctor has used terms like “unexplained infertility” and “advanced maternal age.”
I greatly respect fertility specialists; as I discuss in Chapter 8, my own daughter was born through IVF. I’ve experienced the stress of fertility clinics first-hand, as well as the miracle of birth using assisted reproductive technology (ART). The difficult part is healing the emotional impact of a diagnosis on my patient’s body, mind, and spirit.
I have my work cut out for me when a healthy thirty-five-year-old is weeping in my office, having been told to consider intrauterine insemination (IUI) and in vitro fertilization (IVF) before her aging eggs reach their expiration date. My first job in this situation is to shrug off my own anger at a doctor who would say such cold words to a woman who’s come seeking help.
I am not suggesting you ignore your diagnosis, or live in denial of it, but that you think of it as a jumping-off point, an opportunity to become proactive in your fertility journey and overall health. You are a dynamic human being; with a renewed perspective, you and your body can both change. Do not let a doctor’s words stop you. Your pathway to pregnancy may just be different than the one you had planned.
White-coat hypertension
There is a well-known effect called white-coat hypertension or white-coat syndrome. This is when a patient whose blood pressure is normal when monitored at home becomes elevated at the doctor’s office. Just sitting in front of a doctor can cause emotional anxiety and raise your blood pressure. I well remember my heart racing and my palms sweating on my first visit to a fertility clinic.
I tell patients that a blood test captures conditions at a moment in time. During those initial visits, a woman is at her most vulnerable—nervous, anxious, and worried. If her doctor says he doesn’t expect she can get pregnant naturally and she’d better start treatments right away, she may feel sadness, despair, grief, anger, frustration, fear, worry, and anxiety. Worse, she may barely have time to take in this information and process her emotions before feeling pressured to choose her next steps.
I felt all of these emotions over the course of my own fertility treatment, and I want to share with you how important it is to acknowledge, process, and release them. Words from a physician are powerful and can elicit strongly negative emotional, psychological, and physiological impacts. This is called the nocebo effect, Latin for “I shall harm,” a term coined by Walter Kennedy in 1961.1
I see the nocebo effect every day in my clinic. Many patients believe a doctor’s words are the absolute truth, but that diagnosis represents a particular doctor’s beliefs and theories, based on experience, statistics, and research. Without intending to discount these, any doctor’s knowledge of research can be outdated, and their experience is necessarily confined to their own practice.
Over the years, I have seen many women who have undertaken extensive fertility treatments go off on their own, whether to take a break from treatments or stop entirely, and spontaneously conceive. It happens too often to be written off as coincidence.
You have a filter
The first step in hearing your diagnosis in a healthier way is to change the filter through which you hear it. This
