By Beth Heller, MS

The word “diet” can mean “food or drink regularly consumed,” or “a regimen of eating and drinking sparsely so as to reduce one’s weight.” The latter definition is one that inspires fear in the hearts of many who have tried unsuccessfully to lose weight by “going on a diet.”One of the most common questions we get at Pulling Down the Moon is “how do general diet programs like Weight Watchers stack up for fertility?”   How diet impacts fertility was also the subject of a daylong symposium at the most recent meeting of the American Society for Reproductive Medicine.  Clearly, overweight is a challenge to fertility and can also block women from access to advanced medical fertility treatments like IVF.  But are diets the answer?

How Do Diets Measure Up?

In our view, for a diet to be fertility-friendly it must a) help women to attain and maintain a healthy weight for fertility b) target the specific ways in which overweight negatively impacts fertility:  poor blood sugar regulation, inflammation and the negative hormonal impact of excess body fat  c) eliminate overly-processed foods and encourage the consumption of minimally processed foods.  So how do “diets” stack up?

A) Help women to attain and maintain a healthy weight for fertility

While it may sound ridiculous, dieting does not seem to be the best way to lose weight.  An extensive 2007 review of weight-loss programs published in American Psychologist concluded that:

Dieters were not able to maintain their weight losses in the long term, and there was not consistent evidence that the diets resulted in significant improvements in their health. In the few cases in which health benefits were shown, it could not be demonstrated that they resulted from dieting, rather than exercise, medication use, or other lifestyle changes. It appears that dieters who manage to sustain a weight loss are the rare exception, rather than the rule. Dieters who gain back more weight than they lost may very well be the norm, rather than an unlucky minority.

Even well established programs like Weight Watchers struggle when we take a closer look at success and maintenance.  There is recent clinical data suggesting that Weight Watchers may be more effective than other diet programs at helping people lose weight and keep it off.   A 2008 study published in The British Journal of Nutrition reported looked at a sample of 976 “lifetime members”(defined as people who met and maintained their goal weight for at least 6 weeks) to see how many remained below their goal weight at 1 (26%), 2 (20.5%) and 5 (16%) years after they successfully completed the program.  On the surface this sounds encouraging but a closer look reveals this study has significant biases that make it next to impossible to generalize the findings.  Only about 6% of people who try Weight Watchers successfully attain and maintain their goal weight and meet the criteria to become lifetime members.  This study looked only at their most successful dieters and only 16% of that already small minority kept the weight off for 5 years.

The other problem with assessing the efficacy of WW is that we do not know what’s happening to the other 94% people who try the program and fail.  Are they experiencing the clinically relevant negative effects of dieting, including gaining back more than the weight they lost after a failed diet?

With these numbers in mind, there is a very good chance that many women who are told they need to lose weight in order to increase their odds of pregnancy have already failed at Weight Watchers.  Diets, it seems, are not the answer.

B) Provide ample amounts of nutrients that are important for good nutrition function and target the specific ways in which overweight negatively impacts fertility:  poor blood sugar regulation, inflammation and the negative hormonal impact of excess body fat

Major components of commercial diet programs – eating “low fat,” using artificial sweeteners, mass-prepared processed foods to support portion control and optimize convenience and emphasis on low fat dairy and “diet” foods – fly in the face of what we believe lie at the heart of healthy eating in general.  For women to find true success and optimal health they need to “un-learn” many of the dieting habits they have picked up over the years.  This means that frozen processed diet meals are out, as are the sugar-free and low-fat processed snacks.  Diet soda and artificial sweeteners are another crutch that needs to be discarded.  These overly processed food products may conveniently cut calories and “soothe the sweet tooth” (unfortunately artificial sweeteners may actually sharpen a sweet tooth in the long term) but they do not address the underlying causes of infertility – inflammation and poor blood sugar control – associated with overweight.

You can review a head-to-head comparison of a “healthy” low-fat diet versus a fertility-friendly menu in our blog A Tale of Two Diets to learn more about our contention that many of the “healthy” eating habits that have become conventional diet wisdom are simply wrong.   In our estimation an ideal fertility-friendly diet contains about 10% more fat and 10% less carbohydrates than a “typical” healthy diet.  The fats come from foods that naturally have fat in nature – full fat dairy in small amounts, fats from nuts, seeds and oils, as well as fats from grass raised meats and fish in small quantities.  Many of the fat-soluble nutrients and essential oils needed for optimal health are found in these natural fats.

C) Discourage overly processed foods and encourage the consumption of minimally processed foods.

We all seek convenience in our meal preparation but often to the detriment of the food we put in our bodies.  While Jenny Craig, Nutrisystem and Weight Watchers all provide recipes, they  also do a brisk trade in maximally processed meals and snack foods, none of which we feel we could endorse as fertility-friendly.  Processed, packaged in potentially toxic plastics and “fortified” with added vitamins and minerals – they aren’t true foods.  Read the ingredients of any of them for a tongue-twisting array of chemicals, preservatives and colorings.

Furthermore, we encourage women who are trying to conceive to eat organic and hormone-free as much as possible. The cardboard, plastic and Styrofoam packaging that wrap up convenience foods and snack-size packs are not good for our environment, either, and may be contributing to the chemical stew that is negatively impacting fertility in the first place.

What’s the Solution?

As we mentioned above, most women who have been told they need to lose weight in order to conceive or undergo IVF have likely tried dieting in almost every form possible and do not want to try another one.  So what to do?

Our answer lies in the concept of “nourishing up.” Nourishing up is the process of learning how to feed our bodies with real food that includes healthy fats and does not rely on processed low fat, sugar free or diet foods.  With nourishment come satiety, great digestion and optimal nutrition.  In obese and overweight women weight loss is not the goal of nourishing up but it is almost always a by-product.

Our therapeutic intervention for overweight and obesity, First Line Therapy for Fertility, introduces women to highly nutritious and satisfying eating guidelines based on the Mediterranean dietary pattern, which several studies have associated with potential protection against infertility (3, 4).  This dietary pattern emphasizes low-glycemic load, minimally processed foods and healthy oils from vegetable and fish sources.  Refined sugars and treats play a minimal role in this dietary pattern as do “diet foods” like processed low-fat dairy, and sugar free or fat free foods.  First Line Therapy has been shown to promote weight loss as well as improve markers of metabolic syndrome, such as decreasing LDL (bad) cholesterol, in women (5).

Dietitians who have received additional training in fertility nutrition and are up to speed on ART treatments lead the FLTF Program.  We educate women about Fertility Go (eat lots every day), Whoa (okay in moderation) and No (let’s skip these) foods, making it easy for women to customize their program to optimize sources of essential fertility nutrients (iron, omega-3 fats, B-vitamins and antioxidants).   In addition there is education and emphasis on foods and supplements that limit inflammation, which is implicated in many different infertility conditions including endometriosis, Polycystic Ovarian Syndrome (PCOS) and poor egg quality. With FLTF, we will help women choose foods that will nourish their bodies with the vitamins and minerals needed to maximize their fertility and help them feel satisfied, while at the same time helping them achieve a healthy weight.

Currently we have two groups of 5 women, one group in Chicago and one in DC Metro, who are participating in the FLTF program.  Stay tuned to our site for more information about their progress, to share their stories, challenges and successes, and to learn more about First Line Therapy for Fertility.

Sources

1.  Mann et al.  Medicare’s search for effective obesity treatments:  diets are not the answer. American Psychologist (2007), 62: pp 220 –233.

2.  Lowe et al. Weight-loss maintenance 1, 2 and 5 years after successful completion of a weight-loss programme.  British Journal of Nutrition (2008), 99: pp 925-930.

3.  Toledo et al. Dietary patterns and difficulty conceiving: a nested case–control study.  Fertility & Sterility (2011), 96: 1149-53.

4.  Vujkovich et al. The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment increases the chance of pregnancy.  Fertility & Sterility (2010), 94: pp 2096-101.

5.  Jones et al. A Mediterranean-style low-glycemic-load diet improves variables of metabolic syndrome in women, and addition of a phytochemical-rich medical food enhances benefits on lipoprotein metabolism.  Journal of Clinical Lipidology (2011) , 5: pp. 188-96.

Cathleen McCauley L.M.T.

By Cathy McCauley, LMT, NCTMB

Spring has officially sprung and a multitude of signs show the season is upon us. Take a walk through your neighborhood and you see crocuses blooming and green buds taking shape. The earth is fertile and bursting with life.

With spring here, it’s the time for rejuvenation and cleansing. The longer days bring a renewed boost of energy. With spring, you receive the opportunity to release any stagnation that has accumulated during the winter and start fresh in mind and body. You can look ahead and make plans for the coming year.

A Chinese proverb says, “Make your whole year’s plans in the spring, and your day’s plans early in the morning.”  The proverb comes from the fact that farmers sow their seeds in early spring to ensure a good harvest and highlights the importance of being proactive.  Applying this concept to fertility, you can see the importance of starting early in taking care of your reproductive health. When you begin to pay attention to your bodies’ rhythms, cycles, signs and symptoms, your chances can increase in creating a fertile environment.

If you haven’t been as proactive about fertility as you’d like, spring is the perfect time to make plans for the future. It might be time to talk to your doctor about a fertility blood work up to determine what’s really going on with your hormones. You could make an appointment with a nutritionist to overhaul your eating habits to be more fertility friendly or take a yoga class to learn some breathing and relaxation techniques for stress reduction.

Click here to learn about the Fertility Awareness Check-Up available from Fertility Centers of Illinois for just $90

Also, the concept of spring cleaning our bodies can become an important ritual. You need to clear out the toxins and rejuvenate any stagnate energy in the body to boost immunity and increase fertility health. Since spring is the time for new beginnings, it’s a good opportunity to experience something new. Acupuncture helps balance the energy in the body and stabilize the organs and bodily functions. Reiki, a gentle form of vibrational energy healing, helps restore harmony in the body, mind and soul and clears emotional blockages. Fertility massage focuses on opening up the abdominal and reproductive organs to promote the immune system and assist in blood flow. Massage also greatly reduces tension and helps you feel great.

In the spring, people begin to feel better as the temperatures increase, the sunlight shines and the world turns green. Pour some of that warmth and light into your reproductive health to invigorate and rejuvenate your personal fertility journey.

We’re here to guide you along your path and hope to see you soon!

Embrace and enhance your fertility journey with our Fully Fertile Holiday Package! This gift includes Pulling Down the Moon’s own book Fully Fertile, our new Fully Fertile Companion Yoga DVD, a Universal Fertility Intention Bracelet from SheBeads, our Nourish ARTea blend and one box of 100 tea filters.

Fully Fertile  &  Companion DVD

Pulling Down the Moon Co-Founders Tami Quinn and Beth Heller created a holistic 12-week program for optimal fertility. Newly revised and updated.

After writing our book, Fully Fertile, we had lots of requests for a companion DVD that would allow the reader to move with ease from the written text and photographs into the yoga practice. All you’ll need is your yoga mat to begin this 12-week do-it-yourself in home fertility program that includes both the book and the companion yoga DVD.

ARTeas Nourish with 100 Hemp Fiber, Biodegradable Tea Filters

What better way to nurture yourself than with a warm, comforting cup of herbal tea? Pulling Down the Moon’s exclusive ARTeas are caffeine-free, fertility-friendly, and absolutely delicious.

Nourish is a fortifying blend of partridge berry, raspberry leaves and blueberry may help strengthen and support a woman’s reproductive system.Nourish tea is recommended prior to stimulation.

Universal Fertility Intention Bracelet

Pulling Down the Moon announces a special partnership with renown bead maker and founder of She Beads, Sandy Rueve. She Beads are individually hand-rolled, clay bead jewelry sold at high end retailers all over the world.  Sandy has now birthed a new line of jewelry called, “Intention Beads.”  Working with nationally acclaimed astrologist, Barbara Schermer, Sandy has created give Fertility Intention Bracelets, all created during an astrologically auspicious time to conceive.

Each bracelet is unique, colorful and adorned with silver and Swarovski crystals making it not only meaningful as a good luck charm but also an elegant part of your jewelry collection long after you’ve manifested your intention.
Since bracelets are hand crafted and meant to be unique, colors will vary by bracelet.  Be surprised by receiving the bracelet you are meant to have.  You won’t be disappointed.

Click here for more information.

Karisa Grudi, one of our licensed acupuncturists at Pulling Down the Moon Shady Grove, sat down with us to discuss a little bit about the German Protocol and why it is so important for women who have embryo transfers:

Q. Karisa, can you give us an idea of what the German Protocol is?

A. The German Protocol is a series of two acupuncture treatments that are performed on the day of IVF transfer.  The treatments are scheduled before and after the embryo transfer on the same day.  The German Protocol is based off of a study that was performed in Germany, 2006.  In the study of 160 participants, one group received IVF transfer only while the second group received IVF transfer with two acupuncture treatments (before and after transfer).  The pregnancy results showed 42% in the acupuncture group compared to 26% in the control group.

Q. How does this particular type of acupuncture help increase a couple’s chances of conceiving?

A. In the German study, a select number of acupuncture points were used to help with the efficacy of pregnancy.   Those same points from the study are used in the clinic.  Certain points on the leg have a direct connection to the uterus and ovaries.  Those points help to bring blood flow locally to the uterus to help lessen contractions associated with the actual implantation of the embryo.  Points are also selected to decrease stress and help relax the body and mind.  In addition, points are selected on the ear to further help with relaxation, uterine blood flow and endocrine functioning.

Q. Is it helpful for all types of cycles in which an embryo transfer is taking place?

A. Yes, it is definitely helpful for all IVF cycles, including those with donor egg and/or donor sperm.  Again, the focus is the same on the day of IVF transfer – to bring blood flow locally to the uterus, to help relax the body and mind, and to help with endocrine functioning.

At Pulling Down the Moon Shady Grove, Karisa and our other licensed acupuncturists strive to provide everyone with individualized care, whatever their circumstances may be. The German Protocol is just one of the many ways acupuncture can help you on your journey. We hope you will join us!

Featured Products and Services:

Pregnancy Prep Program

Click here to learn more about our Pregnancy Prep Program, supplements to support optimal nutrition for women who are trying to conceive.

Lisa Espinosa, Reiki Master

By: Lisa Espinosa, M.Ed., Reiki Master

“I took this class to help me find peace and relaxation during my fertility,” commented Martha*, a student in my meditation class. “It helped me find both, but even more importantly, helped me realize how important it was to not lose myself on this journey.”

Martha’s comment reflects one of the main purpose’s of the meditation class I teach: to help women re-connect with themselves, and “not loose themselves on this journey.”  In this class I help you experience an hour of peace and relaxation. And I share tools that you can integrate into your everyday life to help you navigate the stress that is common during the fertility journey.

During the class, I guide women through an hour of relaxing and nurturing meditation, integrated with Reiki healing energy.  The combination of meditation and Reiki really enhances the experience for my students. As one of my students, Jill, shared:

“I got so much from the class. It is wonderful for learning ways to release stress and take care of yourself whether you are going through treatments or taking a break. Lisa’s guidance through the meditations were gentle and helped me get the most of each meditation. The Reiki was a great bonus. I could feel the energy each time. It was fantastic!”

During the class I play soothing music as I guide my students to shift from rushing, stress, and worry to a place of peace, and centeredness. I use different meditation techniques, such as visualization and mantra. I also incorporate a chakra meditation, in which students connect with each chakra (the seven energy centers of our body which can often get clogged and congested) and begin to notice which of their chakras might need some balancing. Throughout the class I gently do Reiki by laying my hands on different areas of my students’ bodies, such as tight shoulders, or achy backs, as well as any chakras students identified that need some balancing. During the last meditation, women lie down as I spend a few moments on each student doing Reiki on an area that is in need of more healing. My clients enjoy having this hour to themselves. As Sharron, wrote:

“I enjoyed the hour to focus on myself without disruptions, to think about the week ahead and focus on what I want to achieve and (sometimes) reflect on the past week. It has been a wonderful prep for a stressful IVF cycle. It calms me during the period and keeps me busy at the same time.”

For the next few weeks this class will be a drop-in class, and will return to a 5-week enrollment class in November.  I invite all of you to take this opportunity to give it a try. There is no experience necessary, and both fertility and pre-natal clients are welcome.  If you have any questions please contact me at lisae@pullingdownthemoon.com.

* all names have been changed

by Alice D. Domar, Ph.D from the Domar Center Blog

Dr. Alice Domar is a renown researcher in the field of Mind/Body Medicine for fertility and offers her ground-breaking Mind/Body Fertility Program at Boston IVF and the Executive Director at the Domar Center for Mind/Body Health.

When I read about the results of a new research study, I don’t tend to think too much about the amount of hard work it takes to carry out a research project, which is sort of odd given that is all I think about when I am the one conducting research!  I tend to focus on what the conclusions of the research are, and what this implies for patient care.

Earlier this week, the results of my most recent research were released and have been widely reported in the media. The actual paper is being published in the June 1 issue of Fertility and Sterility, but it is available online now and Reuters picked up the story late last week and it was in the New York Times on Tuesday.

The study included a randomized, controlled design. We recruited 143 Boston IVF patients who had just been advised by their physician to move onto IVF treatment. Half were randomized to participate in our ten session mind/body program and the other half received routine care.  Unfortunately, the women assigned to the mind/body program began their first IVF cycle right away (they didn’t want to wait for the next mind/body group to start), so only nine percent of them had done even half of their mind/body sessions.  For the first IVF cycle, both groups had a clinical pregnancy rate of 43%. However, for the second IVF cycle, when 76% of the mind/body patients had participated in at least half the program, the clinical pregnancy rate was 52%, compared to 20% in the control group, a statistically significant difference.

So to apply my general thoughts about research to my own work, what are the conclusions of this research and what are the implications for patients?  The conclusions are two-fold. First of all, there was no placebo effect. In other words, even though all the mind/body patients knew they were assigned to attend a group, that knowledge had no impact on their first cycle. So knowing you are going to learn relaxation and stress management skills, but not actually yet having a chance to learn them, does not have an impact on conception.  Second, this is another in a series of studies which have demonstrated that women with infertility who learn a variety of skills designed to lower stress, improve lifestyle habits, and decrease isolation experience significantly higher pregnancy rates than women who do not learn such skills.

And what do I say to all those ignorant folks out there who think that this study reinforces the evil myth of “just relax and you will get pregnant”?  I tell them that they have obviously never participated in a mind/body program! Women who attend a mind/body are doing so much more than just relaxing. There has actually never been a study simply on the impact of relaxation techniques on fertility, but the program is far more intensive and comprehensive than just relaxation techniques.

In terms of implications for patient care, if I were about to embark on any infertility treatment, especially one as intensive as IVF, I would do everything in my power to learn ways to lower my stress level. There is no downside to feeling less depressed and anxious, and the advantages include better quality of life, possibly feeling more able to continue with treatment if a first cycle isn’t successful and higher rates of conception.  If you have access to a mind/body infertility program, go for it (check out www.domarcenter.com for more info).

Spring is a powerful symbol of fertility, rebirth and renewal.  In our upcoming book The Infertility Cleanse, we spend a fair amount of time writing about the role of symbols in health and healing.  Warning:  this is one of those places where what we do at Pulling Down the Moon moves into the more mystical realm.  As you read the rest of this blog I will ask that you put your skeptical mind temporarily on “pause.”

To understand how symbols can help us to heal and to thrive, let’s understand a few basic concepts.

1. Symbols are images that describe a thought or belief.  Symbols can be personal (something in your life that means something specific to you) or they can also be societal or universal.  Symbols tend to gain power when the “resonate” for more than one person, i.e.  when they evoke the same thought or belief in more than one person.  However, your own personal symbols can be very powerful as well because they have meaning that is uniquely understood by you and can be very specific.

2.  If we look closely at symbols we will often find that it’s difficult to describe them in words.  The experience of trying to put a symbol into words is similar to trying to describe a vivid dream soon after waking.  Words cannot truly capture the power of the dream images and often the act of putting a dream into words drains the “power” one initially felt in dreaming.

3.  Finally, symbols act most powerfully by conveying a feeling state.   For example, to non-car aficionados, the Porsche logo says “power” or “money.”  But witness the power of Porsche for car lovers who have invested the Porsche symbol with a lot of energy.  For these folks the mere thought of owning or driving a Porsche can evoke a visceral feeling of speed or mastery.  Remember the hormone-happy  Tom Cruise character in Risky Business (Porsche – there is no substitute)?

Amazingly, brain science is beginning to shed some light on why symbols can evoke visceral reactions.   Apparently, the different hemispheres of our brain process sensory input differently.  Our left hemisphere is oriented toward linear reasoning and serves to organize sensory input in order, choosing details and constructing a reality that is based on a perceived “past” and projected into an imagined “future.”  The left brain thinks in words and numbers.  The right hemisphere of the brain thinks in pictures and is engaged primarily in the present moment.  It experiences, but doesn’t organize, sensory input.  Time does not exist for the right brain.   Nor does separation of Self from Other (for a striking depiction of right/left brain hemisphere function watch this video of neuro-scientist Jill Bolte Taylor).

This piece of neuro-science is very interesting from the yoga perspective.  In yoga, our aim is to create a state of whole-ness (yoga means union) that is experienced by our witnessing consciousness (we call this Awareness). We start with yoga postures that integrate the different parts of the physical body through balance, strength and stretching.  Yoga breath work (pranayama) brings awareness to our breathing and creates shifts in our state-of-mind.  Finally, meditation trains the mind to let go of the “chatter” that is primarily generated by the detail- and time-obsessed left brain and gives equal attention to the whole-ness of sensory input generated by the right brain.   Meditation does not aim to annihilate the left brain or glorify the right brain – it creates whole-ness and transcendence by unifying input from both brain hemispheres and allowing it to reside in a welcoming awareness.

While this is all well-and-good from a sit around and talk philosophy kind of way, what’s it got to do with symbols, healing and fertility?

Good question.  Fundamentally, we live in a left-hemisphere-driven  world that feel like the only “real” world.  We have lost the ability to connect with the right brain and the “Now-ness” it imparts to us.   However, the Now is enormously important.  Everything that ever happens happens in the Now.  New thoughts and new solutions arise in the Now, positive change happens in the Now, and healing, too, must also arise in the Now.  If we’re obsessed with negative thoughts and beliefs, the Now is a bummer.  If we’re open to positive thoughts and input the Now can be quite lovely.

Meditating on a symbol is like striking a tuning fork for the “Now” our right brain is experiencing.  Since the right brain thinks in pictures and symbols, a symbol can create a shift in the quality of the right brain awareness.   A positive or inspiring symbol can create  a positive and inspiring Now.  Take for example a simple meditation on Spring.  Spring is a powerful symbol of fertility and renewal.  The feeling you get when you “experience” Spring is visceral.  There’s a churning aliveness that feels as if it’s even making our hair grow!  We can use meditation on the symbol of Spring to bring these qualities into the “Now” of our lives.   If you don’t believe me, try the following simple meditation.

• Sit quietly, with a straight spine on the floor or in a chair.  Close your eyes and tune into your breath, simply feeling the inhales and exhales as pure sensation.
• When you begin to feel still, call to mind an image that symbolizes Spring - this could be a tulip, a leaf-bud or any image that calls to your heart and mind the energy of Spring
• As you hold the image/symbol in your mind’s eye allow the feeling of Spring to arise – the newness, the sense that winter is over, the sense of fertility and expectation, the smell of damp earth and green things growing.
• Rest in that feeling state for as long as you can – working up to 15 minutes.
• Upon coming back from your meditation, bring the feeling state of Spring back with you and practice holding this energized state as you move through your day.

This last part of the meditation is the most important.  Symbols can help us stay attuned to this happy (higher) vibration.  I use symbols in this way every day.  In my home I have a simple altar (actually it’s a shelf) where I place symbols that have a powerful personal meaning for me.  Whenever I am quietly going about my business at home, I light the candle and welcome the vibration of the inspiring symbols to permeate my “Now.”  Throughout my day I will often visualize lighting that candle and accessing these symbols in times of stress or need.