An Integrative Prescription for Fertility Support


cans affected by infertility, the cause is unknown, according to Resolve, The National Infertility Association. However, we know that for many couples formal treatments such as intrauterine insemination (IUI) or in vitro fertilization (IVF) can be a successful course of treatment leading to a healthy pregnancy.


In addition to formal fertility treatment, I recommend


fter working in reproductive endocrinology for over 11 years, here is what I know: fertility treatment works. That said, when I work with patients my prescription for fertility success is not limited to Western medicine. I encourage them to have a peaceful lifestyle and to build a support team within the fertility practice, at home and beyond through services such as acupuncture, counsel- ing and nutrition.


A It is important to support patients’ emotional, mental and


physical well being while undergoing infertility treatment as a complement to advanced medicine. Fertility treatment is different for each patient, but a typical experience includes diagnostics and a fertility treatment plan. In addition, patients are encouraged to improve their overall health through stress reduction, exercise, and nutrition. Patients come to a fertility practice seeking answers. To determine a diagnosis, we monitor the woman’s menstrual cycle to determine if she is ovulating. We perform tests on both partners to evaluate overall health status as well as to identify any problems that may be the cause of infertil- ity. Sometimes we find basic obstacles such as uterine or anatomical factors, ovulatory dysfunction or tubal disease. Lastly, we obtain a semen analysis from our male patients, if appropriate. For nearly 20 percent of the 7.3 million Ameri-


12 January 2011


my patients look into adjunct services to reduce stress and improve their overall mental and physical health. Reducing stress is a key factor in a successful treatment. For years we have known this intuitively and anecdotally, and a recent British study found more evidence to support the hypothesis. In the study “Stress reduces conception probabilities across the fertile window: evidence in support of relaxation,” which was published in Fertility and Sterility this past summer, researchers found that patients with high saliva levels of the enzyme alpha-amylase – a biological indicator of stress – took longer to become pregnant. Stress reduction is possible through multiple ways: relaxation techniques including yoga, meditation, maintaining strong, supportive personal relation- ships, confidence in your medical team, regular physical activity, and even a balanced diet. Ironically, while patients frequently come into our of- fices needing to better manage their stress, fertility treatment brings with it additional pressures, including requiring extra time for appointments, needing more open communication with a partner and, of course, anxiety wondering about the results. Fertility treatment induces and involves a myriad of emotions – frustration, guilt, anger, disappointment – that should not be bottled up. Patients – both male and female – need to have a network of people to honestly share their experience with. It is common for patients to feel isolated because they hide their infertility from friends and family or they encounter insensitivity from the misinformed. I have found that peer support groups and counseling with a mental health professional, either individually or as a couple, can be extremely beneficial. Patients need to be honest with their partners about the experience, as well as have open discussions about expectations and what patients will do in their path to creating a family, such as using donor eggs.


Beyond a patient’s personal relationships, their fertility team can be instrumental in reducing stress through positive support. I recommend patients seek out a fertility practice that will partner with them to make decisions about their fertility treatment plan. Ideally, each patient’s fertility team should include a primary doctor and nurse, as well as a patient coordinator, and a financial point person. Patients need a point person for their questions, whether they want to know more about administering their medication, understand the science behind a treatment plan or clarify their insur- ance coverage and benefits. We pride ourselves on being accessible, and part of that is giving patients access to their team. When a patient emails or calls, they know they will get answers.


Another important factor to stress reduction is physical


activity. During treatment and throughout their lives, patients benefit from low impact exercise. Something as simple as a nightly walk can get the heart rate up and clear the mind!


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