A Lot of Work and Little Bit of Miracle—Nurturing Hope with Integrative Fertility

Anyone facing subfertility or infertility knows how wracking a process it can be.  As an acupuncturist I have had the honor to support couples in every stage of family building. With her blessing, I am sharing my twin sister’s story of advanced maternal age and male factor. I share their struggles to inform and inspire anyone needing company or inspiration. Fair warning—their journey was a long one!

My sister and her husband faced struggles familiar to those longing for a family.  Through both my patients’ and her experience, I have come to believe that hope is an essential ingredient in the mix of medical and holistic plans in the journey from ‘infertile’ to baby.  While there are no guarantees, I think perseverance in the journey to heal and become fertile plays an important role.   

Infertility runs in our family.  My twin sister and I were the result of a Clomid conception.  After 4 years of trying, our mother took this drug (which stimulates more than one egg to release) and finally--voila!  Two for the price of one!  

Fast forward 37 years, my sister and her husband began trying for a baby.  Newly married, they did what couples ready to try do--pull the goalie!  Having been in practice as an acupuncturist for a decade already, I secretly worried about her short cycles, but didn’t want to transfer worry unnecessarily.  Six months later and no action, I encouraged her to get a fertility work up. Her OB-GYN prescribed Clomid.  

A few rounds of that drug didn’t lead to conception.  She tends to run toward Heat patterns from a Chinese medicine perspective and Clomid can worsen Heat in the body. So I wasn’t surprised that this didn’t do the trick.  It also doesn’t address issues related to egg quality.
I encouraged her to get further workup and see a brilliant group of fertility practitioners at the Lotus Center for Integrative Medicine.  Improving reproductive function means healing and supporting the whole body.  She and I had talked about nutrition, but in an ad hoc way. They gave her a good sound nutrition plan, expert herbal medicine and regular acupuncture.  They counseled her to give up inflammatory foods, focus on high intake of organic vegetables, pasture raised meats, high quality fats, and organic fruits. She got to work overhauling her diet and building the commitment to stick to it.  She reduced and eventually gave up her much loved wine and coffee.  She worked on sleep.  They told her she could have a healthy baby. 
At one point in their work, one of the acupuncturists detected an energetic quality in her pulse that made him suspect an infection in the lower abdomen.  Soon thereafter she and her husband both tested positive for an organism called ureaplasma that infects the urinary tract of both males and females. 

Meanwhile her husband got a work up and issues were identified. This man dug in and got to work.  He too changed his diet, (giving up long-treasured sodas, processed foods and increasing veggie/antioxidant intake), researched and took supplements and vitamins, committed to regular exercise, did research on fertility clinics’ records.  He was completely engaged. 
She noticed some nice changes with diet upgrade--less bloating, less puffiness.  This was a welcome benefit--and one signal that inflammation was decreasing.

Based on age and length of trying, they began assisted fertility treatments in tandem with Chinese medicine.  Already diagnosed with low ovarian reserve, and male subfertility--another issue arose for the couple.  They were both carriers of the cystic fibrosis gene.  That translated into an additional 25% of their embryos that would carry this disease. This is not good news when you are facing diminished ovarian reserve.  Additional and expensive testing on their embryos was required.  Cells from each embryo had to be flown to 2 different highly specialized labs in 2 different states to ‘pass’!

They went forward, despite discouraging numbers.  Another issue arose.  The doctor identified uterine polyps in her uterus that could interfere with implantation.  Delays and a painful procedure ensued, but it “fixed” this issue.  They were ready to move forward with an egg retrieval. 

The drug protocols were exhausting and expensive but after their first two retrievals they had one good quality embryo and one medium quality. 

Finally the big moment approached--embryo transfer!  This is when all the drugs, poking, and prodding pay off. Fertility doctors place the embryo into the woman’s uterus.  The doctor was so confident in this embryo’s quality, she gave them an 80% chance of conception!  I thought that sounded high, but apparently their doctor thought this embryo looked that good.  After the procedure, the notorious two week wait ensued, with every twinge analyzed for what it could mean.

The day of the blood test.  Huge disappointment.  Not pregnant.  

It’s moments like these you can feel like you’ve gone 12 rounds in the ring.  Knocked down, unsure of the way forward.  Does it make sense to continue financial, physical and emotional investments?
In their post-transfer meeting the fertility doctor shared what she learned from the failed transfer.  They had relative certainty the cells of the embryo were healthy, so “implantation failure” was the top suspect.  Was it something about the uterine environment that prevented implantation? 

My sister wasn’t ready to give up. At age 40, she began thorough post-transfer testing to determine possible reasons for this failure.  An additional small polyp was discovered.  She also went through two rounds of the ERA test (Endometrial Receptivity Array), which tests for the (hopefully) ideal window for an individual woman of implantation.  They got second and third opinions. 

Fortuitously, her husband’s new job around this time provided fertility coverage.  This crucial turn of events allowed them to continue treatment, daunting as that prospect felt.

Fertility doctor #3 put another piece of the puzzle together.  She identified what she thought was a partial blockage in her fallopian tube. (This could also have been what her acupuncturist was detecting in the pulse.)

She also wanted to thoroughly vet the uterine lining issue. In an additional procedure, this doctor collaborated with a uterine disorder specialist. They discovered a few areas of scar tissue, and a small septum, or wedge of extra tissue at the top of her uterus. This spot is often where the doctor aims when implanting an embryo.  This could have been a reason that the previous embryo did not take.  The doctor corrected both the scar tissue and the septum.  Here science and surgery, building on the findings of previous doctors and interventions solved another barrier to having a baby.

But alas, further retrievals to get that one healthy embryo were unsuccessful. 

Age 41. They went back to a fertility doctor who was very lifestyle focused.  She highly encouraged both of them to increase veggie intake to prepare for another retrieval.  Interventions, ultrasounds, drugs, nutrition, herbs, supplements and regular acupuncture all continued.  

My sister’s spirit was suffering, however.  She needed a larger framework to keep going. At the recommendation of her RE she saw another wise spirit-based acupuncturist --one who specialized in mind-body practices and meditation to deal with the ongoing stress and sense of loss.  She offered invaluable support, coaching her on meditation and mindset.  When the sprint becomes a marathon, we must tend to our spirits to remain hopeful. Dr. Alice Domar’s work has contributed greatly to the understanding of stress in women’s health and fertility care.

They continued trying for that magic formula: 1 healthy egg + 1 healthy sperm = 1 healthy embryo.  Some months revealed promising egg counts, some months were disappointing.  So many drugs, so many procedures, so much dedication to being healthy, and still no baby. They decided to see the “best of the best.”  A consult and initial treatment at the most famous fertility clinic in the country, CCRM, resulted in a canceled cycle (i.e. her eggs didn't respond to the drugs which means there’s not much to retrieve).  Another defeat.   

I quite honestly don’t know how they kept going.  Somehow, between them, they kept up hope and followed the intuition to go back to the veggie-loving RE.  They had two more cycles with her.   

Here’s where it gets interesting. The second-to-last retrieval was right after a vacation in which they ate ALL the gluten, ALL the dairy, drank ALL the wine and coffee and had ALL the sugar.  They were ready to jump far off the anti-inflammatory wagon.  It was fun!  It was also a big departure from the nutrition foundation they had established. 

The retrieval was soon after this trip and it did not go well.  My theory is that her eggs that were stimulated for this cycle and likely his sperm were poorly affected by the inflammatory swing in their diet and sleeplessness on long flights.  They came out with zero embryos for their efforts. 

Again, I felt so deeply for her.  I just wanted her to not take hyper-stimulating medications, not do injections and not subject herself to so much surveillance.  I wanted peace for her. 

Time passed. Family gatherings became riddled with tension between the child-full and the childless. 

They kept hope alive, though, buoyed by their RE’s tentative encouragement, and the support of her two acupuncturists, their strong background in healthy lifestyle and of course, their insurance benefits.   They decided on a final retrieval. 

I couldn’t believe it--I was so worried.  We were almost 43!  Many RE clinics refuse to treat women at this age with their own eggs--they only will work with couples who opt for donor eggs due to low odds.  

This time, though she and her husband were on a MISSION.  In preparation for their transfer they both ate veggie-rich meals for breakfast, lunch, and dinner supplemented by healthy fats and high quality protein.  Almost 100% homemade.  Zero processed foods, Zero ANYTHING that wasn’t grown by the earth. 100% adherence to supplementation.  He also went for his first few acupuncture sessions. 

After another round of rigorous drugs and retrieval (her 7th!)--a glimmer of hope!!  They got a high-quality embryo that passed 2 rounds of genetic testing with flying colors!  A boy.

This retrieval occurred on February 28, 2019 shortly before our 43rd birthday. Finally the 1 healthy egg + 1 healthy sperm = 1 healthy embryo equation came true!  Correlation can never be causation, but I can’t help but wonder what impact their intense focus on 100% whole foods made in those particular gametes becoming a robust embryo. 

NOW for the final step in the family equation.  Will that healthy embryo implant and become a healthy baby? 

More setbacks. She was plagued by UTI’s and E.coli in the uterus (unusual) in the following months.  Likely brought on by too many vaginal ultrasounds. Treated by antibiotics and followed quickly by yeast infections.  More worry.  Will her uterine environment be ok?  I see these strings of infections as evidence that her uterine and vaginal microbiome are disrupted and I worry about a replay of their first transfer.  

Three UTIs and yeast infections later, her doctor decides on a “mock transfer” protocol, taking all the hormones, but NOT actually implanting the embryo. Rather, she took a sample of uterine lining to determine the optimal time window for transfer. She undergoes two of these procedures and it takes the better part of a year.  It’s all been going on for so LONG. Her doctor hints that a surrogate would be wise. She and her husband think and wait through the infections and procedures.  Meditations, prayers, tears. 

She feels in her heart she wants to carry this baby. 

In late 2019, they finally get the all-clear from their doctor to move ahead with the transfer.  One grueling drug protocol later she is ready.  One year to the day of their successful retrieval, February 28th 2020, her doctor transferred that boy embryo into her uterus.  This small synergy of timing seems more than accidental, and some part of me feels that things may be operating on a larger scale over which we have no control and little awareness.  Especially when it comes to ushering new life into this world.  (This is one reason I encourage women to use guided imagery to connect with their intuition and direct their body’s resources.)

Their one precious embryo hatching before transfer!

I was beside myself during the wait.  We talked about every little cramp or sensation she experienced in that two week wait. 

Finally, the day of the test delivered the news that left us all dumbstruck.  After SEVEN years of trying--A POSITIVE PREGNANCY TEST!  She and I turned 44 years old two days after the positive test.  

The combination of their perseverance, incredible advances in reproductive science, individualized holistic health plans, detective work around “unexplained” issues AND access through insurance coverage made the miracle possible.

I am always honest with my patients and never peddle false hope.  Not every woman at 43 will have this happy outcome, or any age for that matter. Nor is it financially or emotionally possible for many people to pursue this much treatment. But through years of practice, I have seen firsthand that changing the biochemical mix that bathes and matures our eggs can make a difference in reproductive status. Surprise, surprise, the same goes for men!  Men make a new batch of sperm every 90 days and plenty of evidence suggests that he can upgrade the quality and quantity of his reproductive cells with a good lifestyle plan.  

She had a great pregnancy.  Their son thrived and they were both healthy at every prenatal visit.  I do hope their various struggles can give you hope and ideas wherever you are on your journey.