by Beth Heller, M.S.

Recurrent Pregnancy Loss (RPL) is one of the most frustrating fertility challenges a woman can experience.   One loss is devastating enough but the cycle of  expectation and disappointment that accompanies RPL can create feelings of despair.  But from both a medical and a holistic perspective, though, couples who experience RPL have plenty of reason to be hopeful.

“In practice we will initiate a work-up for RPL after two losses in a row,” says Reproductive Endocrinologist Dr. Christopher Sipe of Fertility Centers of Illinois.   A medical work-up is important since common conditions such as hyper/hypothyroid, PCOS, luteal phase defect , infection and diabetes can cause RPL.  Once there is a better understanding of the causes of miscarriage, steps can be taken to choose a treatment plan that will optimize the chance of a healthy pregnancy.

There are also holistic strategies for addressing potential root causes of miscarriage.

1.   Acupuncture and Traditional Chinese Medicine

From the Traditional Chinese Medicine perspective much of miscarriage prevention occurs in the months leading up to pregnancy. Regular fertility acupuncture treatment prior to conception can help to manage stress, potentially regulate the menstrual cycle and improve the uterine environment  by increasing blood flow – key elements promoting a healthy uterine environment and pregnancy.   In cases of  threatened abortion, several studies show that treatment with TCM herbs has been shown to be beneficial and may relate to an impact on endocrine hormones and abnormal maternal-fetal immune interaction.  While herbs are NOT appropriate during a medicated fertility cycle,  woman who are not using ART may wish to explore acupuncture and herbal therapy.  However, if you choose to consider this route, we recommend that you check with your OB before beginning any herbal regimen and ALWAYS work with a licensed TCM practitioner who specializes in fertility and pregnancy.

2.  Nutritional Support

Studies have linked conditions like hyper/hypothyroid, obesity, PCOS and oxidative stress to early pregnancy loss and each of these conditions has a nutrition connection.  Assuring that a woman’s diet is rich in antioxidant nutrients like Vitamin A, C, E and selenium can reduce oxidative stress.   In some cases, food allergy or intolerance may be causing gastro-intestinal inflammation which in turn may negatively impact the uterine environment or impair the absorption of nutrients that are vital to reproductive function, as in the case of celiac disease.  RPL is also more prevalent in women with  diabetes and PCOS. Working with a nutritionist to learn how to eat an anti-inflammatory diet that is rich in antioxidant nutrients, and supports good blood sugar regulation and  GI function not only supports overall fertility but may address root causes of pregnancy loss.

3.  Stress Reduction

Giving yourself time to grieve, finding community and surrounding yourself with positive people can make a huge difference for a woman who has experienced RPL and is “trying again.”  Researchers hypothesize a link between stress and poor pregnancy outcomes , so techniques like support groups, yoga and meditation not only help you feel better but may help you stay pregnant.

If you would like more information about holistic support for miscarriage or would like to meet with a Pulling Down the Moon Patient Advocate to discuss your particular experience, please call us at 312-321-0004 (Chicago-Area) or 301-610-7755 (DC Metro) or email us at info@pullingdownthemoon.com.

We feel so much better when we are able to love.  Reserarch shows that people in community tend to live longer and enjoy better health than those who live in isolation.  Yet fertility challenges can be deeply isolating. This simple meditation can open and energize the heart center, rekindling our ability to give and receive love:

Bring your awareness to the heart center and notice any sensation there.  Perhaps there’s a sense of constriction, or alternatively, a feeling of warmth and expansion.  Observe without judging.

The meditation continues in three phases:

May I dwell in the awakened heart.
As you repeat these words silently to yourself, feel your heart center waking up.  Visualize a wheel of the brightest green glowing in your chest.  Sit with this phrase for several minutes, breathing into the heart, feeling it wake and glow with a fertile, radiant green light.

May I attend to what clouds the heart.
As you repeat this phrase, you may want to silently chant it on the exhale and “see” the clouds of your pain, disappointment, loss and anger dissolving in the radiant green glow of the heart.  Sit with this phrase for several minutes, until you feel that the heart is unobstructed and bright.

May my awakened heart be extended to all beings.
As you now silently repeat this phrase, feel the radiant light of your heart extending out beyond your body, wrapping the world in a huge loving hug.  Rest for a few minutes and allow a free give and take – offering the world this love and receiving love in return.

To end the meditation, join your hands in front of your heart in a gesture of reverence and gently bow to your own loving heart.

By Breea Johnson, MS RD

Women with PCOS (polycystic ovary syndrome) may endure a lot to get pregnant – from utilizing medications to induce ovulation to undergoing IVF – all while experiencing the typical PCOS symptoms. But, does PCOS also impact miscarriage rates? Pregnancy loss rates amongst women with PCOS have been reported to be as high as 30% to 50%, but some research has shown that information to be conflicting. In a recent study, women with PCOS were found to have a 2-fold increase of miscarriage loss after undergoing ART (IVF or IUI) (Chason et al, 2010).  While not the 30-50%  reported previously, the rate found by Chason et al.  is pretty substantial considering the general reproductive population has about an 11% miscarriage rate.  PCOS has also been found in approximately 40% to 80% of women with recurrent miscarriages (Palomba et al, 2009).

Insulin levels also seem to play a factor in miscarriage, as studies have shown that Metformin has positive effects on reducing miscarriage rates in women with PCOS.  In a study comparing three groups of women with PCOS on Metformin, all rates of miscarriage decreased while on Metformin but the groups that stopped at 8 weeks and 12 weeks had a statistically significant drop in miscarriage rates while the group that stopped immediately after a positive pregnancy diagnosis did not have a statistically significant drop (from roughly 20-40% down to 4-8%). However, a meta-analysis of randomized controlled trials showed that preconception intake of Metformin did not have a beneficial effect on reducing miscarriage rates in women with PCOS (Palomba et al, 2009). The research is still very limited in this area.

Factors in women with PCOS that may be contributing to increased miscarriage rates include higher Lutenizing Hormone (LH) levels which can be increased by elevated insulin. Elevated testosterone levels, obesity, insulin levels and infertility treatments are also factors that may be involved (Palomba et al, 2009). Many of these altered hormone levels seen frequently with PCOS are greatly affected by diet and lifestyle and may be improved through working with a nutritionist.  Acupuncture has also been used to minimize the chance of miscarriage.  Please call Pulling Down the Moon at (312) 321-0004 or visit our website at www.pullingdownthemoon.com for more information.

Chason et al. A Diagnosis of Polycsytic Ovary Syndrome (PCOS) is associated with an increased likelihood of pregnancy loss with Assisted Reproduction.  October 2010.

Palomba et al. Effect of preconceptional metformin on abortion risk in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Fertility Sterility. 2009.

by Pamela Policastro, L.Ac.

Miscarriage is the result of many possible factors during pregnancy.  These include genetic factors, environmental factors, circulatory factors, and immunologic factors.  Many of these conditions are a result of subtle imbalance within a very delicate internal environment.  Since acupuncture is used to bring the body back to balance, it is able to contribute to the prevention of miscarriage.  There are benefits to having acupuncture during each trimester of pregnancy.

During the first trimester acupuncture is used  to help prevent miscarriage and provide a stabilizing effect on the pregnancy, balance the endocrine system,  and regulate hormones.  Acupuncture helps to minimize nausea, morning sickness, fatigue, migraines, bleeding and spotting.

During the second trimester , acupuncture is used to regulate the digestive, nervous, and endocrine systems, all of which are necessary to maintain a healthy pregnancy.  Acupuncture helps to alleviate heart burn, hemorrhoids, edema, elevated blood pressure, and stress.

During the third trimester, acupuncture is used to regulate to musculoskeletal system to provide relief from sciatica, backache, pubic and joint pain, and carpel tunnel syndrome.  Treatment during this trimester also encourages the proper positioning of the baby for birth and helps normalize labor.  Research shows that women who use acupuncture experience shorter labor times with fewer complications, reduced rate of caesarean, and less need for the use of oxytocin, pain medications and epidurals.

By Breea Johnson, MS RD LDN

Going through a loss can have a huge impact on our nutrition. We know that the mind and body are intertwined, with an even closer connection between the brain and the gut (otherwise known as the digestive system). Do you ever notice when you are nervous you feel it in your stomach? Or when you drink alcohol you feel it in your brain? Dealing with a loss can affect appetite; foods you typically like may seem tasteless and just trying to eat three meals a day may seem challenging. But the connection between what we eat and how it makes us feel and think is also perpetually linked. The brain is the most complex organ, as everyone knows, and it requires proper nutrition to function well.  Beyond nutritious sources of protein, carbohydrates and fat, the brain needs the complete spectrum of vitamins and minerals to properly function and for brain cells to communicate effectively. Most vital are neurotransmitters (i.e. dopamine and serotonin) which are made of amino acids—found in protein foods (meat, fish, dairy, beans, nuts, seeds, whole grains) which makes protein essential in improving mental performance. While the comfort foods may be calling your name – be sure to add some protein to keep you thinking clearly and feeling healthy.