08 May 2008

Herbs for Fertility: Part 2 (The Good Guys)

As we covered in the Supplementing Fertility: Vitamins section, supplementing our diets with herbs, vitamins and minerals allows us to overcome any deficiencies modern life throws at us. This is especially vital when these deficiencies affect our ability to conceive or carry a pregnancy to term.

One of the issues with self-prescribing for fertility is the ability to over-prescribe for yourself.

Often I will see women taking 10 herbs at once, often starting them all at once, because they read a single article and/or saw someone else taking the same combination.

Taking 10 herbs might not be problematic for you, if they are all compatible, but it could be a recipe for disaster!

Taking Herbs

Just because something is 'natural' does not mean it is safe.

Firstly, the first rule of herbs: start small, start slow and do NO harm.

The second rule of herbs: Fresh is best, tincture second, capsules third.

Making your own herbal teas from dried herbs you found in an organic shop (locally produced) is fantastic. It lets you completely measure, 'brew' and take your own herbs in a regime that's right for you.

Secondary to that are tinctures. These are herbs at their finest, require only a few drops per day and last for ages. If you can't find locally produced herbs then always go for the tincture option.

Capsules are always the last option I recommend to people. Capsules often have been sitting around in a plastic bottle and have a long shelf-life. You have no control over the heat it could have been exposed to and often only get the product right before it expires.

Capsules tend to be made from 'lesser' quality herbs and stuffed with things to make them last a long time. However, if you can't find a tincture I'd rather you take a capsule than nothing at all.

Self-Prescribing
Now, let's look at what's available for self-prescribing.

When researching herbs you'll come to find that almost 9 times out of 10 the websites offering advice on herbs are for online stores who stock and sell (and want to sell to you!) herbs.

Some of these stores can be a useful resource but often they are simply copying vital information from other websites and editing the information to sell a product that does wonders with no side effects.

This is why research on herbs is so limited and often very wrong. Anything you put in your body will have a consequence, good or bad, and anyone who tells you otherwise is wrong and not exactly a reputable source.

Your best bet is to spend some time with a naturopath who sells their own herbal mixes and/or professional ONLY brands. But I know naturopaths are often hard to come by and some are very difficult to work with so self-prescribing can be a manageable and easy practice.

Useful Herbs for Fertility

  • Red Clover

  • Red Raspberry Leaf

  • Stinging Nettle

  • Oat Straw

  • Vitex

  • Soy Isoflavone

  • Maca Root

  • False Unicorn Root

  • Spirulina

  • Wobenzyme

  • Evening Primrose Oil

  • Flaxseed Oil

  • Fatty Fish Oils



Why do Women Take Herbs?

For centuries women have taken herbs to regulate their menses, achieve pregnancy and terminate pregnancy. That is the most simple fact of herbal folklore. Somewhere along the line herbal traditions were ended (the Holocaust and the ruin of Native American culture) and pharmaceutical companies began creating, researching and selling drugs to your doctors and society at large.

We've suddenly forgot that there are natural ways to treat the body and that the majority of pharma meds are based on plant (herb) parts. The root, the stalk, the leaves, the blossom -- aspirin in one of the finest examples.

Why do you need to consider herbs? Well, for me I turned to herbs after fertility drugs failed me. Truly. 6 rounds of Clomid, 1 case of OHSS and a miscarriage and I was pretty upset at the lack of 'the dream' I was promised.

We were saving for a house deposit, we had no insurance coverage for fertility drugs and we had run the Clomid gamut. What was next?

Herbs

We knew in my particular case that I have 1 functional ovary (my right ovary) and 1 completely non-functional ovary (my left one). We knew from an in-depth laparoscopy, hysteroscopy and resulting D&C that I had scar tissue all over my uterus.

What we also knew was that my body would ovulate from the right but be over-powered by the cysts forming on the left, rupturing and causing me to take an obscene amount of NSAIDs for the pain. We also learned that the scar tissue could be one of the reasons for the miscarriages.

So, I turned to a yahoo group and set out to learn all these herbal women could teach me.

When Something Isn't Working...

Susan Weed has this beautiful breakdown of what herbs for pregnancy should do.

"Herbs which encourage pregnancy are characterized by their ability to:

a. nourish and tonify the uterus
b. nourish the entire body
c. relax the nervous system
d. establish and balance normal hormonal function
e. balance sexual desire "

If ovulation is delayed or absent it makes sense to work on the body and find out why. However, I've found most women don't care about the whys and just want to be pregnant...now!

Unfortunately for the impatient, the body doesn't work that way. Everyday we put things into our body: caffeine, tea, sugar. Every day we put things on our body: shampoo, lotion, makeup. Add to this the things we inhale, the bugs we are exposed to and all the chemicals our food and clothing are exposed to. These additions, no matter how big or small, cause some sort of physical reaction. It's one of the most basis rules of physics: for every action there is an equal and opposite reaction. And this is absolutely, 100% true for your body.

We all have experienced the reaction that happens when clothing gets stuck in the washer and you find, after putting on your t-shirt, that it's caked in detergent. Your body immediately causes an itching reaction. Red, angry, itchy. It's forcing you to take notice of this problem. This same response is found all throughout the body. We just sometimes don't or can't take notice of these reactions.

Not just external reactions, but it happens inside the body too. Drink too much caffeine and you either get a headache or get jittery. Eat too much sugar and you'll feel your body 'crash' hours later. Eat something too spicy or hot and your gut will act quickly to push those substances out!

We take these bodily reactions for granted and only really pay attention when our body elicits an over reaction, or an 'allergic' reaction.

So many people fail to realize that herbs are drugs. Herbs ARE drugs. Herbs are the basis for so many pharmaceutical drugs already on the market and more and more drugs and herbs are hitting the market.

Think of it this way: Sugar is a drug. Cinnamon is a drug. Chili is a drug. Caffeine is a drug. All come from plants that we take for granted.

Everything you put into your body will have an equal reaction. And this can be a very, very good thing!

Which is why you must always start small, start slow and DO NO Harm.


Red Clover

Red Clover is the most important starting point for women truly looking to treat the entire body and not just try to 'trigger' ovulation. Susan Weed, the wise woman of herbs, recommends this herb as the starting point for all women looking to conceive.

In Herbs For Fertility, Susan writes: "One of the most cherished of the fertility-increasing plants is red clover (Trifolium pratense). Common in fields and along roadsides, it has bright pink (not really red) blossoms from mid-summer into the chilly days of fall. A favorite flower of the honeybees, the tops (blossoms and appending leaves) are harvested on bright sunny days and eaten as is, or dried for medicinal use. The raw blossoms are delicious in salads and nutritious when cooked with grains such as rice or millet.

To make a fertility-enhancing infusion, I take one ounce by weight of the dried blossoms (fresh won't work for this application) and put them in a quart size canning jar. I fill the jar with boiling water, screw on a tight lid, and let it steep at room temperature overnight (or for at least four hours). Dozens of women have told me that they had successful pregnancies after drinking a cup or more (up to four cups) a day of red clover infusion.

It is especially helpful if there is scaring of the fallopian tubes, irregular menses, abnormal cells in the reproductive tract, or "unexplained" infertility. It may take several months for the full effect of this herb to come on and pregnancy may not occurs until you have used it for a year or two. You can improve the taste by including some dried peppermint (a spoonful or two) along with the dried clover blossoms when making your infusion. Treat the father of the child-to-be to some red clover infusion, too!"

Kristen Hart explored the benefits of the little blossom: "Red clover is widely useful as a 'purifying' herb. It helps to rid the body of mucous and aids the body in efficient waste elimination. It’s also a blood booster and has long been used as a gentle cough remedy for children.

It truly shines as a fertility boosting herb because of its nourishing properties. It has large amounts of vitamins and minerals. Most trace minerals are found in red clover blossoms. Calcium and magnesium are abundant and very available - so much so that Susan Weed states it is 'exceedingly absorbable.'

These minerals are useful for supporting the blood and bones, as well as the reproductive system. A gentle red clover tonic makes all these nutrients available to the uterus and other reproductive organs. They also help to relax the reproductive system and allow it to work at maximum efficiency.

Red clover also has an alkalinizing effect on the whole body, which creates a more sperm-friendly environment within your body. Combined with peppermint to make a tasty brew that also stimulates the sex drive it is a perfect drink to prepare for conception."

And, not to be outdone, the little clover was even taken for examination by How Stuff Works.com: "It may be that the isoflavones in red clover have an estrogenic effect when consumed as a staple part of the diet. We still have much to learn about isoflavones, but it seems logical that they may prove useful in conditions associated with very low estrogen levels (menopause, chronic miscarriage, some cases of infertility) and should be avoided in cases of estrogen excess (uterine fibroids, endometriosis, breast cancer). Red clover has been a traditional folk therapy for infertility and chronic miscarriage, both of which can be due to insufficient estrogen."

How Much?

As Susan Weed instructed, it's best to use a proper Mason type jar with screw on lid. I found the complete ounce (1oz = 29g) of Red Clover to be a tad overpowering at first so I used about 1 teaspoon for the entire jar (1 US quart jar = 1.1L).

The most important bit is not to use boiling water. Boil the water and let it cool for a few minutes. Boiling water will ruin the important properties of the plant (the volatile oils) and make the tea very, very bitter.

I started with 1 teaspoon of herb to the water (I have a 1 quart Mason Jar with screw on lid) and drank it after 2 hours of seeping. Not exactly what Ms. Weed 'prescribes' because I did find it challenging to drink. After a few weeks I grew accustomed to the taste and once added with all the other herbs for your regime I learned there are other, much more awful tasting things to drink!

After about a week I could do 2 teaspoons and let it seep for 4 hours. At this stage I would drink half the mixture in one day and drink the rest the following day. I kept the tea in the fridge and found it is MUCH nicer served cold with ice.

(I think the colder temperature masks the real flavour.)

After about 6 weeks in total I upped my mix to 4 teaspoons Red Clover, 1 Tablespoon Mint and would let it sit for 4 hours. I began to drink only 1/3 of the tea cold, with lemon.

Start small, start slow and do NO harm. You can also avoid the hassle of making tea every day (or every other day) by taking a small amount of Red Clover Tincture in warm or cold water. (This is a good idea for busy women or the men in their lives.)

When to Take It

The beautiful thing about Red Clover is that when taken in normal amounts it is a very regulating herb full of trace minerals. This means that it can be taken every single day with no worry about what stage your cycle is entering. Once pregnancy is achieved you may remove the red clover from your daily tea regime. It is not indicated in miscarriage, and is full of those wonderful trace minerals, but is probably best left in the cupboard. It can be eaten raw in salads during pregnancy for those trace minerals.

What Not To Do

There aren't many ways to go wrong with Red Clover but I can imagine trying to drink an ounce of the herb on Day 1 might not exactly be the best bet. If you are used to the herbal taste of dried herbs you might not mind it but it certainly was eye-opening for me. Another mistake would be to try and increase your herb past the 1 ounce recommended by Susan Weed. I know how desperate a woman can feel when trying to conceive but you can set your body backwards by increasing the amount of estrogen in your body too quickly and to an exceeding level.

Red Raspberry Leaf

"Brewed as a tea, red raspberry leaf is one of the safest and commonly used tonic herbs for women wanting to get pregnant or for women who are already pregnant. Red Raspberry Leaf (Rubus idaeus) tones the uterus, improves contractions and decreases constipation. It also contains many vitamins and minerals, including vitamin C and calcium. The alkaloid fragrine is thought to help tone the uterus." (Source)

Linda B. White, M.D. writes in her Wise Use of Herbs and Vitamins during Pregnancy that: "Red Raspberry is a tonic that has been used safely by people in North America and Europe for hundreds of years. Catherine Hunziker, owner of WishGarden Herbs and an instructor at the Rocky Mountain School of Botanical Medicine in Boulder, Colorado, calls it "the best all-around herb for a healthy pregnancy. It's a nourishing, building herb that has an affinity for the reproductive system."

This nutritive herb is rich in calcium, magnesium, iron, phosphorus, potassium, vitamins B, C, and E, and the alkaloid fragarine--the constituent that contributes to the plant's potency as a pregnancy tonic. It increases fertility in men and women (especially when combined with red clover), tones the uterus, eases morning sickness, and assists in plentiful milk production."


How Much?

According to Dr. White, "to make a tea, add one to two tablespoons dried leaf per cup of boiling water and steep ten to 20 minutes. You may want to alternate red raspberry with other nutritive herbs such as nettles or combine it with other nourishing herbs. Motherlove's "Tea for Two" recipe contains red raspberry, red clover (blood cleansing), nettles (nourishing), alfalfa (also nourishing), and spearmint (tastes good and calms the stomach).


If you have a history of miscarriage, some herbalists recommend that you should delay using the common variety of red raspberry (Rubus idaeus) by itself, especially as a tincture, until after the first trimester. You can then drink one to two cups of tea a day every other day. Also, if your previous labor has been under three hours, red raspberry may be contraindicated. Check with your health practitioner."

When to Take It

The beauty of this herb lies in it's ability to be used all throughout pregnancy and before labour. There is some internet lead belief that Red Raspberry Leaf Tea will push you into labour which is completely false. What it will do is support uterine tone and help support the uterus during labour.

What Not To Do

I think it would be almost impossible to physically harm yourself with this herb, however the threat of allergic reaction or the use in women with recurrent miscarriage can always create potential for something to happen.

As always use caution, as you would with any herbal regime.

Stinging Nettle (or just 'Nettle')

Violet Snow calls the Nettle Plant, "the plant that talks back" and she couldn't be more accurate! The first time I heard about Stinging Nettle I laughed a bit to myself about how this so called 'hairy' plant could ignite a fire ant like response in people. I read about how it is picked carefully and laid out to dry in the sun. And I thought it seemed kind of weird that a single plant could be so vicious. Surely they were wrong, right?

Then, about 2 days after buying my first bag of dried Nettle herb I had the unexpected pleasure of grabbing a cluster of Nettle plants bare handed.

It was worse than a jellyfish sting, it was worse than a team of wasps stinging, and it was way worse than fire ants. It took about 16 days for the poison to finally be released from my hand and arm. Ms. Snow calls the Nettle an aggressive plant and I agree with her description.
Linda B. White, M.D. explains: "Nettles are rich in biochelated iron, calcium, and protein, as well as a host of other important nutrients. "It is virtually a pregnancy tonic by itself," says [Rosemary] Gladstar (author of Herbal Healing for Women). The benefits of drinking nettle infusion before and throughout pregnancy include nourishing and strengthening the kidneys, increasing fertility in men and women, nourishing the mother and the fetus, diminishing leg cramps and childbirth pain, preventing hemorrhage after birth, reducing hemorrhoids, and increasing the richness and amount of mother's milk."

"Nettles are a uterine tonic and a general nourisher with the special ability to strengthen the kidneys and adrenal glands. It is an excellent food and tonic for the hormonal system. Nettles is very high in iron and calcium and other minerals, plus it contains substantial amounts of chlorophyll." (Source)

Susan Weed lists Nettle as one of the mega herbs to help reduce birth defects in women over 30 trying to conceive: "Boosting your nutritional status makes birth defects less of a worry. Women who drink 2-4 cups of stinging nettle infusion daily and eat cooked leafy greens as well as lettuce salads are getting the abundant folic acid, calcium, magnesium, and other minerals needed to create a healthy baby. (Tinctures, pills, and teas contain little or none of these important nutrients.)"


How Much

Nettle Tea has to be one of the worst drinking teas I've tried. It took about 9 months of my daily herbal regime before I stopped gagging at the taste of the Nettle. I've read online that it tastes 'green' or like 'dried spinach'. I agree to a certain extent. They would be doing themselves a disservice if they wrote that the herbal tea tastes bitter, grassy, like bark, has a lingering after taste of weeds and can make even the strongest gut weak at the thought of drinking more.

Nettle is such an extremely generous and rich herb that it's well worth forcing yourself to give it a go.

My rule of thumb is 1tsp Mint for 1 tsp Nettle. The mint really does little to help mask the Nettle flavour but it does at least work to help your taste buds recover from the Nettle assault.

I would start with 1/4 of a teaspoon of Nettle in your daily brew and work up a tolerance of 2 teaspoons. I have never managed anything stronger than 2 teaspoons although I can't imagine anything up to 1 tablespoon being harmful. The more herb you use the stronger the taste and I honestly think that's Nature's way of managing how much herb you take.
When to Take It

Nettle can be taken as a tea throughout the cycle and during pregnancy. It has a wealth of vitamins and minerals that make it brilliant for use during pregnancy, however the taste might make consumption during pregnancy difficult.

I have seen Nettle tinctures but these would do very little to supply the body with all the nutrients found in the plant and concentrated extracts of Nettle can be dangerous during pregnancy.

So stick with the tea and add it to your herbal regime.

What Not To Do

"According to Sharol Tilgner, ND, president of Wise Women Herbals in Creswell, Oregon, nettles should be picked prior to flowering to avoid bladder and kidney irritation. Although use as a tonic is considered safe in pregnancy, concentrated extracts of stinging nettles (such as used to treat hay fever) can act as an abortifacient." (Source)

OatStraw

OatStraw is an amazing herb. So few women actually add this herb to their herbal regime but it is one of the most important herbs you can actually add because it works so well for so many intrinsic, systemic issues.

The Amazing Herbal Guru at Local Harvest.org explains:"Oat Straw is rich in calcium and magnesium. It can be used for both physical and nervous fatigue and is helpful for depression. Oatstraw also contains B-complex vitamins, silicia, calcium, flavones, saponins, and Vitamin A.

Oatstraw has been found to be an excellent toner for the whole system. Oat Straw is useful for thyroid and estrogen deficiency, for MS, osteoporosis, appetite loss, anorexia, urinary concerns, colds and chills and to encourage sweating. It's secondary uses are boils, weak bones, bursitis, constipation, gallbladder, kidney problems, liver disorders, pancreatic concerns, rheumatism, and some skin conditions.

This herb increases internal heat, dispels internal chill and strengthens metabolism and circulation, relieves symptoms of depression, prevents and relieves spasms, softens and soothes damaged or inflamed surfaces such as the gastric mucous membranes, strengthens functional activity of the nervous system, helps with the process of assimilating food and has the property of nourishing, and restores, nourishes, and supports the entire body; it exerts a gently strengthening effect on the body."

So, it's not at all related to the menstrual cycle or getting pregnant, so why is it so important?

Let's consider today's diet of processed food, environmental toxins and stress. If you eat a lot of 'white' products (white sugar, white flour, white rice) you might be getting intestinal upset. Turn to oatstraw.

You might feel stressed at the prospect of having children. You want a baby, right? It's the right move, right? Or maybe it's infertility. Why is this not happening!? What are we 'doing' wrong!? Why will my family/friends/neighbours not shut up?!

And with Oatstraw reportedly being loaded with calcium, with one cup containing up to 300 mg, it is the perfect addition to any menstruating woman's herbal regime.

Oatstraw is simply an amazing herb. But it's no quick fix. You can't zap away your nerves with oat straw the way you can with Valium or other benzodiazapines. But, with each cup you ingest, you ARE working away at total health. What you DO does add up, each cup, each herb, each day.

How Much

Follow the lead of the LocalHarvest.org guru: "Oatstraw is not a quick fix herb, it is an herb that can be quite effective if used on a regular basis over time. Every person and every situation is different, but a general guideline could be to drink two to three cups of infusion, three or four times a week. It is slow to act in the system but has a long lasting effect.

Oatstraw may also be added to the bath to help relieve overall nervous body tensions and combines well with Lemon Balm for this purpose."

When to Take It

Oatstraw, as we have seen, is a slow acting herb that works on all systemic areas of the body. Therefore it is safe for all areas of your cycle and into pregnancy.

What Not To Do

I think the worst thing you could do is expect too much too soon. And therefore try to speed up the 'relief' you're seeking and take too much of the herb. Of course there is always an issue with allergies to any botanical plant which is why it should be added, slowly, to an established herbal regime.




Your Herbal Regimeh

Kimberly Gallagher, in her article for Family Herbal Remedies.com, writes that one must embrace herbs

According to Ageless.co.za you should always keep these reminders handy when considering herbal regimes:

* Only use the herbal material if you are 100% sure that it really the herb in question.
* If you are ill or have any health concerns, consult your health practitioner.
* Do not continuously drink the same infusion. At maximum use for 10 days and then skip 5 days.
* Only have one cup of herbal infusion per day, except during acute periods - such as when you have a cold or flu, you can then have it three times a day, but for a maximum of 4 days.
* When you use herbal remedies, be aware that they can be extremely powerful, and should you have any side effects when taking these infusions, immediately stop using the herb and consult your health practitioner right away.

06 May 2008

Herbs For Fertility: Part 1 (The Offenders)

Most websites have simple lists of herbs suggested for women (and men) to take when trying to conceive. And often these same websites make very little mention about the herbs one should not take.

So that's why we're starting this section with The Offenders.

It is wise to check any and every herbal supplement and vitamin + herbal supplements for any of these listed herbs. And if you have any questions please call the manufacturer and/or a herbalist.

Herbs to Avoid When Trying to Conceive

  • Black Cohosh

  • Blue Cohosh

  • Ginseng

  • Pennyroyal

  • Ginger

  • Dong Quai

  • Licorice

  • Fenugreek

  • St. John's Wort

  • Echinacea

  • Gingko Biloba

  • Goldenseal





This is the scary part about online self-prescribing of herbs.

Typing in "Herbs for Fertility" in Google I hit my first site: The Fertility Shop.

The Fertility Shop has a link back partnership with Ovusoft, maker of fertility software and huge message board for women looking for support when trying to conceive.

The very first herb on offer is Black Cohosh.

Black Cohosh
According to their website: "Black cohosh is used primarily for hot flashes and other menopausal symptoms. Black cohosh, a phytoestrogen, is the most promising herbal remedy to treat mood swings, hot flashes and vaginal dryness associated with menopause. Phytoestrogens are non-steroidal, plant-derived substances that bind or activate estrogen receptors in various areas of the body. In post-menopausal women, phytoestrogens typically act as weak estrogens.

An improvement in overall menopausal symptoms, reduction in hot flashes and stimulation of vaginal changes were observed in a series of clinical studies in more than 800 women. Few or no toxic effects were observed."

No where in this blurb does it say you absolutely Must NOT take this herb while trying to conceive. It has been indicated in miscarriage and is used in folklore for at-home terminations.

Debbie Craig at Suite 101 advises: "Black Cohosh and Blue Cohosh - These two herbs should NEVER be taken while trying to conceive or while pregnant. They cause uterine contractions, which can lead to miscarriage during pregnancy. They can be taken, in very small doses and only under the supervision of a Midwife or Herbalist, during the last two weeks of pregnancy. Many 'herbal vitamin' products contain either black or blue cohosh, so always read the ingredient label."

I have used Black Cohosh to successfully treat hot flashes while on large doses of the steroid Prednisone. However you must not ever actively ttc while taking this herb.

Women who feel they are peri-menopausal or close to 40 and are trying to conceive think they can combat these early signs of 'menopause' and take Black Cohosh. I have seen 3 accounts of women doing this on Ovusoft and these women actively miscarried each pregnancy while on this herb.

Blue Cohosh

Please refer back to Black Cohosh as these herbs are related and often combined.

Sister Zeus writes: " Blue Cohosh contains at least two uterine contracting substances, an oxytocic effect, {oxytocin is a hormone produced during childbirth which causes the uterus to contract} and a substance called Caulosaponin which is a unique substance found only in Blue Cohosh which causes the uterus to contract. It is also an estrogenic herb meaning it contains estrogen-like substances and can have estrogen-like side effects (those with estrogen-dependent tumors should not use this herb). If you are not suppose to use the pill, then you should not use this herb unless under the guidance of your herbalist."

This herb is used in folklore to terminate pregnancies and in modern midwifery to encourage labour. This herb has no place in trying to conceive.

Pennyroyal

Kurt Cobain famously sang: "Sit and drink Pennyroyal Tea/ Distill the life that's inside of me". Legend has it that his then girlfriend, Courtney Love, drank a cup of pennyroyal tea to induce an abortion at home.

While there's no certainty to the legend, the truth is this herb is incredibly dangerous, and not only to pregnant women.

Sasalog.com contains this information: "There are two forms of 'pennyroyal', American Pennyroyal (Hedeoma pulegoides) and European Pennyroyal (Mentha pulegium).

Pennyroyal is a well-known abortificant which causes the uterine muscles to contract, it is said to be very effective and is sometimes combined with Blue Cohosh, or mugwort.

If you wish to avoid damaging your unborn child, please stay away from this herb during pregnancy.

The essential oil of pennyroyal should NEVER be used orally/internally. It is a deadly poison. Several women have reportedly died very painful deaths from ingesting small amounts of the essential oil in an attempt to end suspected pregnancy."

Ginseng

According to Medical News Today Ginseng has been found to alter the health and cause abnormalities in rat embryos.

"The researchers tested the effect of various concentrations of a compound called ginsenoside Rb1 on nine-day-old rats.

They found that embryos exposed to more than 30 micrograms per millilitre of ginsenoside Rb1 showed signs of significant developmental abnormalities, including problems with their heart, eyes and limbs.

At the highest dose of 50 micrograms the problems were even more pronounced. The embryos were significantly shorter in body length and had fewer immature muscle cells.

Dr Chan said the study provided strong evidence that ginsenoside was capable of causing malformations in rat embryos - known technically as a teratogenic effect.

It was also possible that lower doses of compound led to more minor developmental problems which would not always be picked up."

Ginseng is offered on most Fertility stores online and should be avoided completely while trying to conceive.

This raises the question: Should men discontinue use of supplements containing ginseng while trying to conceive? How much ginseng does it take to alter the health of sperm?

Dong Quai/Dang Quia/Angelica

Dong Quai is an excellent herb for thinning the blood. When used in menstruating women it can increase bleeding and if taken while menstruating it can cause excessive loss of blood. Dong Quai has two very different effects on the uterus, it has the ability to stimulate contractions and also to relax the uterus thus inhibiting contractions. Which effect you get depends on how you prepare the herb.

For most women, with 'normal' menstrual cycles, Dong Quai would be a herb to avoid. However, for women with established infertility Dong Quai can be a successful addition to your herbal regime, if troubled implantation is an area of diagnosed infertility. I do not recommend women without diagnosed implantation issues to begin this herb.

According to Sister Zeus: "Dong Quai's relaxing effect on the uterus comes from the volatile oils contained in the root. Volatile means that the oils are easily destroyed. When the desire is to capture them, brew a medicinal tea or infusion. "Studies indicate that dang gui hot water extract regulates uterine and intestine contractions, relaxes the uterus and even inhibits spasms."1 The relaxing effect of Dong Quai is useful for dysmenorrhea (painful menstruation).

When the desire is to stimulate strong, coordinated, regular contractions, for aiding in childbirth, stimulating delayed menstruation, and causing miscarriage/abortion, then a decoction, tincture or capsules are used. In these preparations the volatile oils are destroyed or not captured in the process; the simmering of the herb while making a decoction destroys the oils, leaving just the uterine stimulating properties, in a tincture the oils are not extracted into the alcohol, and capsules also seem to have the uterine stimulating properties as well, it is possible that the volatile oils are damaged or destroyed when grinding the root into powder for placement within the capsule."

I believe it is a herb that requires great skill to take and regulate and would not recommend it for many women. However, it seems Dong Quai is indicated for women with clotting issues who are not taking any sort of anti-coagulant therapy, like aspirin.

You must NOT take Dong Quai with any sort of anti-coagulant and it must not be taken during menstruation. It is recommended for women looking to increase their chances of successful implantation. Therefore I would recommend, with great caution, women take this herb after ovulation and cease taking it before menstruation begins. I would recommend taking it from 1dpo to 10dpo and must advise caution not to exceed
the standard dosage. Please, please, please consult a practioner of Traditional Chinese Medicine before starting this herb.

You must not take Dong Quai with warfarin (Coumadin); aspirin; a nonsteroidal anti-inflammatory drug (NSAID) including ibuprofen (Advil, Motrin, Nuprin, others), naproxen (Aleve, Naprosyn, Naprelan, Anaprox, others), ketoprofen (Orudis KT, Orudis), indomethacin (Indocin), etodolac (Lodine), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), tolmetin (Tolectin), and others; ardeparin (Normiflo) and there have been numerous side effects reported. Take care with your sun exposure.

Healthline.com reports the following: "Stop taking dong quai and seek emergency medical attention or notify your doctor immediately if you experience any of the following rare, but possibly serious, side effects:

* an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
* unusual bleeding or bruising;
* a rash or a sunburn; or
* changes in skin color or moles.


Other less serious side effects have not been reported with the use of dong quai, although they may occur. Talk to your doctor, pharmacist, or health care professional about any side effect that seems unusual or that is especially bothersome."

Licorice

Licorice is another controversial herb when it comes to trying to conceive. Licorice can benefit the body in many ways and is a unique herb that has yet to be fully understood. However, recent reports indicate this herb isn't one to take during the conception period and pregnancy.

But anecdotal evidence suggests that licorice can help increase cervical mucous in women who do not produce enough cervical mucous to enable conception. Contrary to this are several websites that include licorice in this warning: "Many of the herbs used for teas, when taken in large or medicinal amounts, can potentially stimulate the uterus and induce miscarriage."

My advise would be to pass on the licorice and find an essential fatty acid and increase your water consumption to increase cervical fluid.

Fenugreek

Again, this is an anecdotally supported herb for increasing cervical fluid because it helps the body stimulate all mucous production. Much like licorice it has some evidence but none has been adequately studied and the safety of the herb during conception and pregnancy is unknown. It is widely used to increase milk supplies for breastfeeding mothers.

VitaminStuff.com reports: "Fenugreek seeds contain diosgenin, a phytoestrogen compound that seems to mimic the effects of the hormone estrogen. Fenugreek has been used for many years as a form of natural hormone replacement therapy for menopausal women. The diosgenin in fenugreek is thought to help increase libido lessening the effects of hot flashes and hormone-induced mood fluctuations; however, fenugreek is also traditionally used to promote weight gain and stimulate breast growth. In fact, fenugreek is often used as an active ingredient in natural breast enlargement supplements, and fenugreek sprouts are said to be particularly effective for breast enlargement."


St. John's Wort

NOTE: If you are taking this herb and trying to get pregnant you must speak with a herbalist. Dropping this herb suddenly can cause withdrawal symptoms and increase incidences of depression and mania.

Babycentre.co.uk reports: "It is currently recommended that St John's Wort should not taken if you are pregnant or breastfeeding. However, if you are already taking St John's Wort for depression it may not be wise to stop suddenly in case you suffer a relapse. Speak to your doctor before deciding what to do. It may be that other medication would be safer.

At present the consensus is that it is probably best to stop taking St John's Wort at least a month before you start trying to get pregnant. This is because there is very little good quality research concerning its use and effect during pregnancy.

There is some evidence from animal studies that St John's Wort increases uterine (womb) muscle tone and so theoretically may lead to an increased risk of premature labour. Some animal studies show lower birth weight in male offspring. Hypericum, the ingredient in St John's Wort, also contains tannic acid, which may interfere with iron absorption. Iron is essential for a mother and baby during pregnancy.

The effect on the baby's central nervous system is unknown, although one study involving 30 breastfeeding women who took St John's Wort showed the babies to be more lethargic, drowsy and to have an increased incidence of colic when compared to a group of mothers not taking the medication."

If you have been taking St. John's Wort, or looking to take it, to help with symptoms of depression please consult your doctor. There is no shame in treating the symptoms of depression or anxiety and there are many, many safe options for pregnancy and breastfeeding.

Echinacea

Echinacea is marketed as a herb you should consume to avoid infection, colds and the flu. However, there is little evidence that the herb is helpful when consumed during a cold, flu or infection. So it makes sense to take the herb before you get ill.

You might find yourself trying to conceive and preventing illness at the same time, so it makes sense to turn your attention to Echinacea.

"Other names that Echinacea goes by include comb flower, hedgehog, snakeroot, scurvy root and American cone flower. This supplement has become popular to use when you have a cold or flu. Its use is to stimulate the immune system." (Source)

Most people recommend women stop all herbal supplements unless working with a naturopath and Echinacea falls into this category. Most people don't realize but Echinacea should be used for no longer than 6 to 8 weeks. If you are taking this herb in a supplement you might be consuming average doses for longer than this period and most sources argue this is setting the patient up for an allergic reaction.

The same holds true for pregnancy. Because the herb Echinacea is noted in allergic reactions there is some arguement that the pregnancy might be exposed to this allergenic substance and the body could react against the pregnancy not the herb.

However, this is all speculation as there are no real herbal studies on Echinacea and pregnancy. So it's probably best to watch your consumption of the herb and avoid it while pregnant. However, minimal exposure to the herb shouldn't affect the body unless you are allergic to the herb.

There is some noted evidence that Echinacea can trigger Lupus flares so it must be avoided by patients with little or no immune system, which is contrary to the publications produced for the herb.

Gingko Biloba

Gingko Biloba has caught recent attention in the past decade as a super herb for brain function. I remember when starting university someone gave me a bottle of gingko biloba as a key to my studies. "The traditional Chinese uses of Ginkgo include the relief of asthma and cough, and to support brain function. Currently, Ginkgo is widely prescribed in Europe for conditions including brain dysfunction, peripheral vascular disease and erectile dysfunction, with more than 10 million prescriptions written worldwide in 1989." (Eclectic Physician

What most people don't realize is that Gingko is a blood thinner and must not be used with ANY drug that is contraindicated for blood thinners. It must be stated that European companies are looking towards Ginko Biloba as a form of contraception because the effect on the reproductive cycle and pregnancy is so pronounced.

In 2001, a US study found that Ginko is extremely toxic to developing fetuses and must not be used, ever, by pregnant women. Ginko is often added to many multi-vitamins as it is a rather 'trendy' herb for increasing brain performance and function.

Goldenseal

Goldenseal is a herb that is used in many different multi-herb preparations. You will most likely find it in digestive, urinary, and cold prevention mixes. "Practitioners promote the use of goldenseal for a wide variety of conditions, including digestive problems (e.g., peptic ulcers, colitis), urinary tract irritation, constipation, poor appetite, bleeding after childbirth, painful menstruation, eczema, itching, ringing in the ears, tuberculosis, cancer, and other ailments. Some claim goldenseal stimulates the immune system and recommend it for colds. Goldenseal has been used on the skin (externally) to treat wounds, herpes sores, and other skin conditions. It is sometimes made into a tea and used as a mouthwash or as a douche." (Source))

Like Echinacea, Goldenseal has a high potential for allergic reactions. And these reactions can be quite severe, even fatal. However, most preparations involve small amounts of Goldenseal unless it is a single ingredient remedy.

Since detox programmes are becoming increasing more popular Goldenseal is finding itself into more and more herbal remedies. This is a rather worrying trend as Goldenseal has a history of being used to induce abortions.

James J Gormley writes: "Patients with central nervous system (CNS) problems, neuro-muscular dysfunction, hypoglycemia, hypertension, and respiratory and/or circulatory problems should avoid goldenseal, unless instructed to use it by a licensed physician; due to traditional use as an abortifacient, pregnant women, and those trying to conceive, should avoid this herb, altogether."

And, if you didn't think that was bad enough, Berberine, one of the active compounds in goldenseal, has a systemic wide effect on the body.

"Berberine is known to reduce sperm motility in bulls, which could cause fertility problems. Based on this information, men who are trying to conceive may wish to avoid goldenseal until human studies are done. In pregnant women, there are concerns that high doses of goldenseal might tighten the womb and cause miscarriage or early labor. Women who are pregnant or breastfeeding should not use goldenseal unless further studies show it to be safe." (Source)

Other offenders include: Borage oil, Comfrey, Elder, Henbane, Horsetail, Motherwort, Nutmeg, Rue, Shepherd's Purse, Uva Ursi, Yarrow

I have not gone into great depth because I don't believe many women come into contact with these herbs unless they are using them for a particular purpose and are already taking these herbs in a specific remedy. You must consult a herbalist if you are taking these remedies and wish to conceive.

25 March 2008

Luteal Phase Defect, Progesterone and Vitamin B6

It seems all young medical students are taught that the average woman's menstrual cycle is a textbook 28 days.

Day 1 means your period is starting. Day 14 means you're ovulating and Day 29 becomes Cycle Day 1. Therefore, all nice and tidily written, the average woman has a 28 day cycle.

Which means she has a 14 day Luteal Phase.

Contrary to the textbooks is the real nature of the menstrual cycle.

Every woman is different. Every cycle of the same woman is vastly different, even if she has a 'normal' pattern of fertility.

Cycle Day 1 starts her period, her bleeding should cease sometime between Cycle Day 5 and Cycle Day 8 and this begins her follicular phase.

This is the most important phase of the entire menstrual cycle. Secondary to that is not ovulation itself, but the luteal phase.

What is the Luteal Phase?

Before ovulation the brain sends chemical signals to the ovaries to begin ripening follicles. One ovary may be dominant for that cycle or both ovaries may begin ripening follicles.

As the body begins pushing more Lutenizing Hormone the follicles slow down with only one follicle continuing to ripen.

The LH hormone peaks and the follicle ruptures, hopefully at the most optimal time, sending the ovum from the follicle and away from the ovary towards the fallopian tube.

But this isn't the end of the follicle. The follicle reseals and begins swelling in size. It becomes a cyst full of fluid and changes to the course of the hormones for the rest of the cycle.

This Corpus Luteum, or yellow body, Cyst produces the progesterone needed to sustain pregnancy and delay the onset of Menses so that the fertilized egg can implant into the uterine lining.

If implantation is not successful the CL Cyst begins to break down, shrinking in size and the uterine lining begins to fall away from the uterus, initiating Menses.

The Luteal Phase

It is imperative the Luteal Phase is of an adequate length to allow time for the ovum to travel down the fallopian tubes, to mix with sperm and create an embryo. The embryo must have time to travel down the tubes into the uterus and penetrate the uterine lining and implant into the uterus wall.

If the Luteal Phase is too short, perfectly normal and healthy embryos may not have sufficient time to implant into the uterus and Menses starts prematurely causing an infertile cycle.

Luteal Phase Defect

Another of fertility's hotly contested spectrum is the Luteal Phase Defect.

Some specialists say that if a perfectly normal embryo was conceived it should have no trouble implanting into the uterine wall anywhere from 2 days past ovulation (on the early side of average) to 8 days past ovulation and that late implantation (anything more than 10 days past ovulation) suggests an abnormal, unhealthy embryo.

Some specialists say that because every woman's body is unique and we all have uniquely shaped uterus that it is perfectly acceptable for an embryo to implant anywhere from 4 to 10 days after ovulation.

Most agree delayed implantation of CD10 onwards is indicative of an unhealthy pregnancy.

So what is Defective?

If we rely on the textbook definition of the Luteal Phase, being 14 days, anything below 14 and anything greater than 14 is defective.

Most specialists now say that up to 16 days post ovulation is 'normal' but only if a woman is showing consistent and acceptable ovulation.

What they don't take into consideration is the length of the follicular phase.

If your follicular phase is 15 days and you ovulate on CD20, you should, naturally, have a longer luteal phase.

Example 1

CD 1 -- period begins
CD 7 -- bleeding stops
CD 20 -- ovulation
CD 35/ CD 1 -- period begins

Total cycle length: 34 days
LP Length: 14 days

Example 2
CD 1 -- period begins
CD 4 -- bleeding stops
CD 13 -- ovulation
CD 25/ CD 1 -- period begins

Total Cycle Length: 24 days
LP Length: 12 days

The Defect

I think it's such a hideous term, defect, and when applied to the menstrual cycle it really isn't appropriate.

I know of several women who jumped to conclusions about the LP Defect and over supplemented Vitamin B6 causing hot flashes and total loss of their menstrual cycle.

If you are noticing strong ovulation and a luteal phase of less than 10 days then I would, without hesitation, begin looking for ways of extending the cycle.

If you are noticing that you don't have strong ovulation and often wonder if you are ovulating at all, I would begin working from the start of the cycle to help the follicular stage and see if this helps extend the LP.

Causes of Luteal Phase Defect

According to Baby Hopes.Com the three main causes of luteal phase defect include poor follicle production, premature demise of the corpus luteum, and failure of the uterine lining to respond to normal levels of progesterone. These problems occur at different times during the cycle but can also be found in conjunction with each other.

1. Poor follicle production occurs in the first half of the cycle. In this case, the woman may not produce a normal level of FSH, or her ovaries do not respond strongly to the FSH, leading to inadequate follicle development. Because the follicle ultimately becomes the corpus luteum, poor follicle formation leads to poor corpus luteum quality. In turn, a poor corpus luteum will produce inadequate progesterone, causing the uterine lining to be adequately prepared for the implantation of a fertilized embryo. Ultimately progesterone levels may drop early and menses will arrive sooner than expected resulting in luteal phase defect.

2. Premature failure of the corpus luteum can occur even when the initial quality of the follicle/corpus luteum is adequate. In some women the corpus luteum sometimes does not persist as long as it should. Here, initial progesterone levels at five to seven days past ovulation may be low; even if they are adequate, the levels drop precipitously soon thereafter, again leading to early onset of menses and hence a luteal phase defect.

3. Failure of the uterine lining to respond can occur even in the presence of adequate follicle development and a corpus luteum that persists for the appropriate length of time. In this condition, the uterine lining does not respond to normal levels of progesterone. Therefore, if an embryo arrives and tries to implant in the uterus, the uterine lining will not be adequately prepared, and the implantation will most likely fail.

Detective Work

It will take some detective work to expose a true Luteal Phase Defect.

1) You must chart your cycle for both temperature and cervical fluid.
2) You must confirm ovulation either through temperature, cervical fluid and opk or with a progesterone blood test from your doctor.
3) You must chart your temperature through your luteal phase.
4) You must have at least 2 cycles with less than 10 days of the luteal phase.

If you are noticing 10 days or more then you do not have the luteal phase 'defect' and just have your own unique LP.

This article from INCIID is a very good page to help explain LPD.

What Can You Do?

I think your first step is to visualize a longer luteal phase. Visualize that the egg travels through the tube, meets the sperm, conceives your precious embryo and rushes, not just travels, but rushes to meet the lining.

It burrows with tremendous force and implants successfully. And I would do this visualization from ovulation until your period begins (unless it doesn't!).

Secondary to the visualizations is supplementation.

Most specialists do not tend to jump on a progesterone supplementation but some do and I believe a woman looking into a LP issue should consider Vitamin B6 (in addition to her normal B complex). Let's look into Vitamin B6 first.

Vitamin B6
Vitamin B6 is also known as pyridoxine, and is water soluble. It can be found in yeast, whole grains, legumes, liver, eggs, cereal, meat and fish. Along with providing the body with reactions of amino acid metabolism, it also has some benefits we can see and feel; it helps to regulate blood sugars, alleviates PMS and morning sickness. It is excreted totally from the body after about 8 hours.

Lori Ramsey, at Suite 101 gives her perspective on using Vitamin B6 to help extend her LP. She write:

"I've read it is recommended to take 100-200 mg of vitamin B6 a day to help with luteal phase defects. However, just 63 mg did the trick for me. Perhaps it would be smart to start out with smaller doses to see if it would work and increase it if it doesn't. Always check with your practitioner or doctor before taking megadoses of any vitamin. Vitamin B6 helps to normalize hormone levels thus normalizing the luteal phase."

What You Should Be Looking For

Vitamin B Complex
Dosage: 1 pill each morning with food.
Comments: Look for a B-50 complex with 50 mcg vitamin B12 and biotin; 400 mcg folic acid; and 50 mg all other B vitamins.
Warnings: High doses of some B vitamins can be toxic and/or cause nerve damage. Vitamin B6 may prevent the drug levodopa from working properly and folic acid and Vitamin B6 have been show to interfere with some anticonvulsants.

Vitamin B6
Dosage: 50 mg a day.
Comments: 200 mg daily over long term may cause nerve damage.
Warnings: When consumed in higher than recommended doses, vitamin B6 has been show to interfere with some anticonvulsants such as carbamazepine, gabapentin, and phenytoin, and the drug Levodopa, used to treat Parkinson's disease. High doses of B6 can cause nerve damage.

Source

Progesterone Supplementation

What is Progesterone?

Kevin Stitch explains progesterone much better than I could:

"Progesterone is a hormone produced by the ovaries that helps maintain a normal menstrual cycle. By preparing the lining of the uterus for implantation by the embryo, Progesterone also plays a critical role in maintaining the early weeks of a pregnancy. At approximately the eighth week of a normal pregnancy, the placenta takes over the role of producing Progesterone for the remainder of the pregnancy. Progesterone helps relax the muscles in the lining of the uterus, and also helps the breasts to develop in preparation for milk production after the birth of a baby."

The only way to test for progesterone is through a simple blood test. Most doctors order this test on CD21, but as we know, not all women would be 7dpo then, when the test is most commonly ordered. Some doctors even call it a CD21 test which shows a blatant lack of respect for you as a patient.

I always advise women to count out 7 dpo and go get the blood test then NOT on CD21 as is most commonly written on your lab sheet. If your numbers come back very low it suggests there was not active ovulation, even if you felt ovulation sensations or had fertile cervical mucous. Most doctors would want to force ovulation and would suggest a medicated cycle, most often starting with Clomid or Femara.

If, however, your test indicates ovulation occurred but your progesterone is very low, supplementation might be offered. A level less than 14 ng/ml indicates that progesterone production in the luteal phase is inadequate.

Supplementation can be in the form of pills, injections or the more popular suppositories. These are taken after ovulation has occurred and either taken about 2 weeks or sometimes until the 10th to 12th week of pregnancy.

There is an over the count (OTC) version called Natural Progesterone Cream or to those in the know, NPC. Some may find an alternative made from Wild Mexican Yam.

What is NPC (Natural Progesterone Cream)?

Dr John R. Lee, M.D, a world class expert on progesterone and women's hormones, noted that a natural hormone program worked better than conventional, mainstream medicine to help women cope with menopause.

Doctors working in reproduction found that this progesterone cream also works well to support the body in the luteal phase.

Micronized progesterone is progesterone run through an ointment mill to reduce the size of the progesterone pieces. In general, smaller progesterone pieces are more effective since they are more easily absorbed.

Natural progesterone has the consistency of powdered sugar. In progesterone that is not micronized, some of the "pieces" can be too large to be absorbed. Also, if pieces of the progesterone are not milled to a smaller, consistent size, this can lead to a grittiness in the progesterone cream.

What are the directions for using NPC natural progesterone body cream?

Suggested Use:

* For best results, use approximately ¼ tsp. of NPC natural progesterone body cream per application (scoop enclosed). Apply once or twice daily for the last 10 to 14 days prior to your period.
* Apply to hairless areas of skin, such as inner wrists, upper arms, behind knees or upper chest. Rotate application areas to avoid saturation.
* Rub in thoroughly.
* For topical use only. Do not exceed the recommended daily usage. Follow all directions.

Who Needs to Supplement Progesterone?

When a woman undergoes an IVF cycle she has the ovum aspirated from the follicles. Therefore her body never accepts that ovulation has occurred and the Corpus Luteum Cyst never forms, so in fact, she has NO real source of progesterone until her body is pregnant and supporting a growing baby.

Therefore she must, absolutely must, supplement progesterone. This progesterone supplementation is absolutely vital to ensure an embryo has the opportunity to implant into the uterus, otherwise her body assumes there has been no fertilization and Menses would begin.

If a woman has shown to have low progesterone during medicated cycles sometimes progesterone will be prescribed, however, it is greatly contested whether low progesterone is a sign of the body lack of ability to produce progesterone or whether the body would miscarry the pregnancy since it does not want to produce progesterone to support the pregnancy.

Some doctors feel the answer lies in getting a stronger ovulation and most patients do note that they have higher progesterone levels during medicated cycles (non IVF).

If you wish to supplement with NPC you MUST discuss this with your doctor.

Does Progesterone Supplementation Prevent Miscarriage?

The short answer is no. Nothing can truly prevent miscarriage.

In some women, however, progesterone supplementation is absolutely vital to ensure an embryo has the opportunity to implant into the uterus.

Dr. Amy writes:

"There is a small group of miscarriages that can be prevented. These miscarriages are causes by a progesterone deficiency (luteal phase defect). Progesterone is needed to support the growth of a pregnancy. In the early weeks of pregnancy, the mother’s body produces the progesterone. By about 8-9 weeks of pregnancy, the placenta usually takes over the production of progesterone. Women who don’t produce enough progesterone in the early weeks of pregnancy may have repeated miscarriages. These miscarriages can be prevented by progesterone supplements...

Measuring progesterone levels at the beginning of pregnancy may show dropping levels of progesterone before a miscarriage. However, it seems more likely that levels drop because the pregnancy is no longer growing, not because the dropping levels cause the miscarriage. Therefore, taking progesterone supplements will not prevent the miscarriage."

Visualization Exercise