TURNING BACK THE REPRODUCTIVE CLOCK: New Science, Old Wisdom:
Regarding the human egg: How old is too old? Perhaps we are asking the wrong question. Remember the psychological argument about nature vs. nurture? Let’s rephrase the topic altogether. How can we help women in their mature reproductive years produce healthy children? I propose that the answer is found in the nature vs. nurture discussion. Nurturing the follicle in the 120 days before ovulation will produce a healthy egg, free of transmutation, free of the need for medical intervention.
Scientists have told us that in about 45 years all the eggs that we’re born with will have deteriorated. Yet, the latest evidence is challenging our previous doctrine. Now, they pronounce, mammalian ovaries may have specialized stem cells that make new eggs throughout the female’s life. And this could, they say, lead to powerful new treatments for infertility. Women who heretofore have been told that their eggs are “too old” to become babies, are renewed with hope, just as they were when cytoplasmic transfer was a promising solution a few years ago. Yet, as scientists and politicians snatched that possibility away from us, we were left once again with the hopeless pronouncement that old eggs have a dismal possibility of propagating. Letting a youthful woman donate her fresh, perfect eggs to replace our shriveled, dying ones has been the only answer for women with “poor quality” eggs. Poor quality eggs mean the ones that won’t act in response to Western medicine’s attempt to force a pregnancy in a reproductive system that seems resistant to artificial hormonal stimulation. They call us “poor responders”, “clomid failures”, or “IVF failures”.
I have been treating poor responders, older women with high FSH, those with premature ovarian failure, poor quality eggs, and yes, even those dismal “IVF failures” for years. Yet because of their successful response, I no longer believe the dogma that our eggs deteriorate, that they go bad, or that we are failures. I believe Western reproductive medicine sometimes fails us. Why? Because when I have been able to embrace a woman whose only desire in life is to become a mother, using the ancient wisdom of Chinese medicine, within a few months of gentle ovarian balancing therapy, her body responds. Her ovaries seem to wake up in reply, somehow liberating “healthy” eggs.
In an effort to understand what this process really was, I had to shift my own paradigm. After completing my medical school academics, I too was told I was infertile. Barren was the word that came to mind, and panic set in. I could tell that this terror was worsening my already bleak diagnosis. But, fortunately, I held a kernel of disbelief within that wouldn’t accept my doctor’s pronouncement. By this time I had enough medical knowledge to realize that since the endocrine system worked via feedback, that taking external hormones may force ovulation, but wouldn’t resolve the underlying disorder. After all, if my ovaries weren’t producing the right hormones, how could they be producing healthy eggs?! That’s what I had to find out on my own. And somehow I knew deep inside that the answer was natural and healthy, if I could just find it.
Let me explain what I have come to know about the amazing female reproductive system. First of all, it is perfectly created. The biology of the ovary itself is remarkably intelligent and interactive with the rest of the body. It is, after all, the source of all human life on this planet. Our body knows how to protect it, too. If a little boy gets mumps or a high fever, he may become permanently sterile. Not so a little girl. Her ovaries, although deep within her body, are protected from their surroundings before the process of meiosis is initiated.
This may make her ovaries temporarily unresponsive, but as her eggs are protected, so are they innately fruitful and responsive when the conditions are right. We have just been viewing them through scientific lenses which have no vision for what our role can be, not through the lenses of our deep, internal sense of knowing we have more potential than we are ever given credit.
“If we remain obsessed with seeds and eggs,
we are married to the fertile reproductive valley of the Mysterious Mother,
but not to her immeasurable heart
and all-knowing mind.”
- Hua Hu Ching
Let’s look at the immeasurable heart and all-knowing mind of the Mysterious Mother, that which is capable of bringing life into being. Take off the glasses of the scientific “truths” you have been commanded to believe, and put on your glasses which allow you to see from that internal place where our intuitive wisdom resides.
Whether we have a million egg cells or continually regenerating germ cells really isn’t the issue. What happens to the follicle, the egg’s miniature dwelling, as it’s cycling through its many phases of receptivity is extremely important to the health and future quality of its residing egg. Look at the following diagrammatic representation of the process within the human ovary at every reproductive stage. Puberty initiates this process, which continues until about age 52, the average age of menopause in the U.S.
Each follicle remains mere potential until it reaches its growth phase. Only NOW will its outcome be determined. Our multitudes of elemental follicles, in their initial dormant state, have not yet begun the phase of division. Then, by some mysterious ongoing signal, which even reproductive science doesn’t understand, hundreds of follicles are awakened from their primordial state of rest, about five months before one will be selected for ovulation. At this stage, they remain in a state of biologic perfection, until they begin to interact with their environment. Let’s follow one active follicle and its residing egg through this miraculous process of folliculogenesis.
About four months before this particular egg’s domain is selected to be the lucky ovulatory one, a chamber of fluid appears within the follicle. The follicle quadruples in size, and undergoes many stages of proliferation as the fluid filled chamber expands. Now hormone regulating factors within the ovary itself (which is responding to our own internal environment) start to influence the contents of the follicular fluid. The ovary’s messages to the follicle, which are affected by blood flow, nourishment, and hormonal cues within the body, influence the state of the follicular fluid. Regulatory proteins, hormones and growth factors begin to appear about the time the egg starts to undergo division. In a perfect, non-stressed milieu, the messages will be clear, and the egg will be healthy. However, if any of three factors are substandard, the health of the egg will reflect the state of the rest of the body:
1) If nourishment is poor,
2) if the hormonal cues have been interrupted, or
3) if the blood flow has been compromised.
The egg’s health is determined during the growth phase, when protein synthesis occurs - after the egg has started to communicate and become responsive to hormonal and environmental factors: 3 months before it is released. This is what determines egg quality!
If blood flow to the ovary has been compromised through stress or age (as we approach menopause the ovarian blood flow is around five times less than when we were in our reproductive prime), the follicular fluid will contain rising levels of vascular endothelial growth factor, the same chemical found in a damaged heart muscle, which signals the body that the organ is asphyxiating and needs more blood flow.
Further, poor diet begins to show its effects the older a woman becomes. This is the time her system can become revved up with nutritional supplements.
And, as a woman ages, her hormone levels start to fluctuate. The lack of communication between the brain, the pituitary gland, and the ovaries makes the follicles resistant, and they quit paying attention to follicle stimulating hormone.
All of these changes are reflected in the follicular fluid, which will determine the health of the egg.
Western reproductive medicine can only manipulate the follicles during the selection phase, after the quality and health of the residing oocyte has been determined! I knew my reproductive system was not healthy. When I was faced with my own fertility challenges, I had to find other methods to improve this scenario which had occurred inside my own body. I found three methods that worked:
1) Blood flow - Fortunately, I found that certain acupuncture and acupressure techniques are known to improve blood flow to the ovaries. Better circulation to any organ improves its function, and this is especially true of the ovaries, the follicles, and their residing eggs. The femoral massage, ovarian massage, and electroacupuncture to the low back dramatically reduce the stress and age induced constriction of the uterine and ovarian blood vessels.
2) Nourishment - Certain dietary supplements like wheat grass, blue-green algae, and royal jelly are known to affect the nutritional state of follicular health, and therefore the state of the egg. Avoiding coffee (tea is O.K., it doesn’t release stress hormones), refined carbohydrates, and for most people – avoiding dairy and hormonally treated animal products will clear out the toxic effects of poor diet.
3) Hormonal balance – our delicate endocrine systems operate via feedback, meaning that the hormones won’t work appropriately unless the brain senses the right cues from our tissues. Properly prescribed herbal formulas, which address the underlying pattern of imbalance, can restore our own hormonal functioning. By stimulating the body’s own reproductive tissues at different parts of the reproductive cycle, herbal medicine is a gentler, healthier, more organic response to fertility problems. Herbal formulas are combined in sophisticated preparations which actually create greater effects than the same herbs would if taken alone. Most of the ingredients in our herbal formulas prescribed for fertility challenges have little or no direct hormonal effects, but the effect of the whole formula will substantially increase hormone levels. This synergy of different herbal combinations is at the base of many of the Chinese patented herbal formulas. These are either unaided or are employed in preparation for assisted reproductive techniques.
When hormone levels are balanced, and when adequate blood flow, oxygenation and nourishment are provided during the follicular growth phase, women become pregnant naturally, with their own healthy eggs, as I did with mine (it took three months). If they opt for Western reproductive methods, the likelihood of success is substantially increased. When we encourage a woman’s body to return to more youthful reproductive condition, then the ovaries produce and release eggs in the same way they did when we were younger. This assumption was confirmed in a recent scientific study where the ovaries of menopausal rats were transplanted into hormonally youthful rats’ bodies. Guess what? The ovaries resumed ovulation!
This isn’t a process of struggle, of swimming upstream against all odds, of “forcing” a pregnancy. You can’t force a pregnancy, I can’t force a pregnancy, and your RE can’t create a life without the cooperation of the same universal forces that our bodies respond to. Life is allowed to manifest, which is a process of acceptance. We hear examples of this universal truth all the time. When we let go of our tight hold, and loosen up our grip on the outcome, (through giving up, through adoption, through being told we’re hopeless, too old, or whatever else ends the struggle), we can finally unclench; we can lift up our hands and let go. Only then does the space open up for our reproductive energies to become receptive. Only then can Life say, “O.K., now you’re ready!”
Hailey was one such woman. This 44 year old desperately wanted a child, and thus went through multiple cycles of hormonal stimulation and inseminations, always to fail. Despite her doctors telling her there was no hope; she was just too old, she kept going, kept searching, not accepting “no” for an answer. She came to see me and began a regimen of dietary adjustment, acupuncture stimulation and herbal therapy. She enrolled in a mind-body wellness program for stress reduction. The last doctor she consulted told her at her age, he would only help her if she considered a donor egg in-vitro procedure, using another woman’s younger eggs. Hailey gave up her quest. Yet she continued on her regime of healthful living, as the combined methods seemed to be allowing her to accept her state of heartache better. Hailey became pregnant naturally. She gave birth to her son during her 45th year.
As in Hailey’s case, it is important for women of all ages to be able to empower themselves and trust their own inner wisdom. There is much that can be done to preserve, enhance, and increase our fertility at almost every stage of life. Yes, we can extend our childbearing years if needed, but we also must learn to celebrate the stages of our lives as they occur, to accept our full potential and also our limitations, and to maintain our health at its highest level no matter what our age or stage in life.
By: Dr. Randine Lewis MSOM, L.Ac. Ph.D