Hutchison’s Huddle: Holistic Fertility

The fertility journey can be expensive and with Arizona being one of the poorest states in the country, building your family through assisted reproductive technology might not be feasible. Thankfully, there have been studies done and we’ve seen some success in increasing your chances of getting pregnant using holistic treatments. From Acupuncture to Yoga, there are lots of alternative approaches you can take to support a healthy lifestyle and encourage pregnancy. 

On this week’s Hutchison’s Huddle, Dr. Hutchison shares what he recommends patients try, why they should try it, and his opinions on their effectiveness. Check out his video or read the transcript below. 

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Hi, this is Dr. Scott Hutchison and welcome to Hutchison’s Huddle today, February 25, 2020. So, again, what we’re trying to do here is to use social media for some education and public good. And today our topic is Holistic Fertility and Holistic Fertility Treatments. So please, if you have questions, let us know or if you’re seeing this later down the road and you have other questions, please feel free to give them to–pass this along will answer them in another Huddle down the road. So we’re in Tucson, Arizona, where it is beautiful and sunny this time of year an absolute perfection. So if you ever get the chance to come in the winner or late fall, early spring in Arizona–actually all the way up through about May, all the way through May–pretty much is just just perfect here in Tucson. It is absolutely lovely. But anyway, so let’s get right into it. 

Tucson is a beautiful place to live, but it is the 5th poorest state in the United States apparently. So, for a long, long period of time we have struggled to try to scratch every possible percentage point out of trying to get pregnancy rates as good as they can be because many, many of our patients cannot afford to do unlimited amounts of fertility treatment. It always is particularly galling when you go to fertility meetings and people will stand up and give presentations and say well, our three cycle pregnancy rate for this is this and I’m sitting there thinking you know, my patients can afford to do one maybe two of these, if we’re really fortunate. So long ago, we, you know, tried to really figure out what seemed to make a difference in terms of pregnancies in terms of successful outcome for treatment. Of course with in vitro, you’ve got a lot of variables kind of covered for, so it makes it easier to compare a little bit when you look before and after at certain addition or deletion of certain things that are going on. But there’s been–if you look at a lot of corporate fertility company websites, they will try to make it look like hey, all you gotta do is just write us a big check and we’re going to give you a baby! And so you know, you don’t need to do anything with it. Just pay a lot of money and we’re going to get you a baby! And I’m here to tell you, it ain’t so. I mean, I wish it were that easy, but and I know that that’s the trend in a lot of industries. All you got to do is look at your feed, or open up the paper, look at TV and there’s another car crash where some doofus has bought a car that has some features of self driving like lane assist or automatic braking or automatic following with cruise control, and then they turn it on and then they start dinking with their phone and texting people and then they’re dead. And it’s sort of like you took it a little too far. So I kind of feel like it’s the same way with a lot of our fertility treatment. I mean, it’s really good. Boy, it’s come a long way. But I mean, there’s still–the patient is still somewhat responsible, they’re still in the driver’s seat. 

So the things that we started to figure out years ago–probably 15–around the time we moved into this office and around 2006 we had some really bad cycles where, especially, I can remember two egg donors who had switched from normal diet to vegan diet and nothing against vegan diet, but vegan sometimes in the United States, stands for just like drinking Coke and juice and eating potato chips as long as you’re not eating any animal products, and that just is not a good thing. So it is harder to do. And both of these egg donors had had successful cycles where we’ve gotten good eggs and the people had gotten pregnant, and then they moved away, had been selected again to be donors by some other people, and then they showed up for their egg donor cycles and we were like, Whoa, they’re a lot thinner. And in each case, we had some really bad quality and no good embryos for transfer. So, that started us thinking about it and after that we started changing the way we think of, Oh, you’re, oh, you’re thin, you must be healthy, or you’re thin, you must have good nutrition. And that’s just not the case. So you’ve probably heard me on other ones of these that we really like the Mediterranean type diet, we really like fermented vegetables going down your gullet, and we can talk about that later. But anyway, we also start to incorporate some other things that, you know, trying to look at the whole person and certainly people who are incredibly stressed, heading into a really expensive fertility therapy is never a good idea. And so what we have told people is, if you’re really stressed, just cancel the cycle, do not do it. Now, there some people will be like, Well, my I have a super stressful job, it’s just not going to get any better. So how can I try to deal with that? And there’s really, there’s a few things that depending on the person seem to really help a lot with stress. 

The first is yoga. Yoga, I think is kind of a good just general practice. I would encourage people to do it. I think it’s important, probably is very helpful. You’ve probably heard me talk about how exercise is probably the best prevention for dementia in the future. And I think it’s great exercise and it also tends to make people very calm and encourage kind of a mindfulness approach it, you know, the only downside to it is you got to learn how to do it, and it takes some time. So if you have the time and if you have the inclination, I would encourage you to do yoga a couple times a week is where most people will say it really helps them kind of become more grounded and less worried about frivolous things and will really help their sleep. 

Acupuncture is also very helpful, I think. When you look at the data, and it gets a little iffy, certainly the one randomized study I’m aware of was done in Los Angeles and they made the people drive all over creation and get the acupuncture and then have them drive to the academic fertility center in a hospital for the transfers and that’s just that’s chaos trying to drive across LA in the middle of traffic and then make your embryo transfer on time is, of course, going to be a recipe for disaster and is going to undo probably any of the good that the acupuncture did. Here in Tucson, we’re lucky we don’t have–people aren’t on freeways most of the time, we have one small freeway that goes around part of the city, but the rest of it is surface streets and we have a number of acupuncturists, who were in the central portion of town that are pretty close to us and including one, Della Estrada, who will come to the office here and do the treatments for us before embryo transfer. So that really kind of streamlines it and makes it easier for the patient and much more chill, so they typically will tend to get a lot of relaxation out of it. Again, despite not having really super strong, like, randomized trial data, I think that there probably is some benefit to acupuncture if it makes the person feel calmer and more grounded. I suspect, you know, if you look at some of the research papers on acupuncture that have been done with anesthetize rodents, for example, acupuncture really does a whole lot of things with brain blood flow and inhibition or production of some hormones that are associated with mediation of pain and I suspect that it’s sort of like exercise in that if you exercise regularly and fairly vigorously, you tend to feel better and that is apparently is mediated by release of cannabinoids in the brain that really can help people feel calm and and feel less just generalized discomfort kind of way marijuana does, but don’t smoke pot because it’s really bad for egg quality. But anyway, that may be what the acupuncture is doing. So it may be sort of like actually, you know, a bit like exercise sort of in a pressure point kind of format. I injured my back years ago, and I had Della Estrada, one of our acupuncturists, go ahead and do acupuncture on me. And she had told me for my injury, it wasn’t going to help and for the pain, it really didn’t but I’ll tell you, man, you know, for that particular protocol, you’re lying down, face down and on a like a massage table and I just totally fell asleep for about an hour and I if I weren’t wearing a watch, I wouldn’t have believed that I was asleep for an hour. There’s something significant about acupuncture in terms of what it does to the central nervous system and it’ll be fascinating to know if anybody ever figures it out here in the near future. 

Another thing is massage and massage, I think, is sort of in that same ballpark, where you’re putting pressure on the muscles, and some people may perceive that as extremely relaxing and certainly, my spouse does! And where we have configured our little TV area right now, there’s not a couch and she’s always saying to me, we need to get a couch here so you can do my foot rubs while we’re watching TV again because that’s been she really likes that and a lot of people really like that. And so if massage is something that you enjoy, and you feel like you can find a good massage therapist, I would really encourage you to do that as well as you go through the whole fertility treatment thing. 

Also just making sure that your life is kind of in order, we just really don’t want chaos going on. Fertility treatment is incredibly stressful to the couple in the big picture. I can remember going through that stuff and seeing just how much distress it caused my spouse. And of course then you can’t, as male partner, you can’t really do anything about that. It’s just awful and just very stress-provoking overall. So I like people when they’re going through fertility treatment to really comb their social obligations back, try to comb their work obligations back as best they can, and try to streamline things as well as humanly possible. Some people are really fortunate to have really good bosses, who tend to be very empathetic and or have gone through similar treatment and maybe very helpful. Others are not so lucky and we just try to have to do the best we can But we don’t want people heading into IVF cycles or any other treatment feeling like they have to stress eat or they’re not sleeping very well because so much of how our physiology works including our growth hormone release is mediated with good sleep. And so it’s really hard to get good eggs and good sperm and good embryos if people are just completely distressed and poorly slept and poorly nutrified. So anyway, so those things are all good. 

So in addition to yoga, you can also do if you don’t have the time to spend with something like yoga, I’m a big fan of short, high intensity workouts or HIIT workouts. There’s a free download for your phone that you can do that’s called the Seven Minute Workout. I think it’s fantastic. It just lasts seven minutes. I mean, you’re breathing hard, and it’s over. I would encourage you to do that about you know, four or five times a week if you can. Other people like going for walks, other people like being outside, certainly in Tucson this time of year, the weather’s perfect–there’s you know little wind or rain and it’s just gorgeous and there’s a lot of good walking trails and so a lot of people like that sunlight exposure and I would encourage you if you’ve got sort of a similar situation to take advantage of that because that can be very relaxing and grounding as well.

What else? One of my co-workers, Karina Bacame, is with me today. Karina, what else do you think we should talk about with all this?

Going back to nutrition and again, the fermented vegetables, super important with lactobacillus getting into your gut and then those lactobacillus get up into the uterine cavity. And you probably have heard me talk about it, but everybody used to think that the uterine cavity was sterile because if there’s not pus rolling out of there, it’s really difficult to culture organisms and if you’re just going to place a swab up inside the cervix into the uterine cavity, well, then you’ve contaminated it with going through the cervix. But it was always hard to grow those organisms out like on an auger plate, like you may have done like in science class a long time ago. Some Spanish researchers recently found that you could take tissue out of the uterine lining, and then do a DNA fingerprint test and then figure out what bacteria are actually living in the uterine cavity. And there can be three dozen species up there. But if you don’t have about 60% of them as lactobacillus, it is harder to get pregnant and harder to stay pregnant. So getting those lactobacillus in there is probably helped by eating a lot of fermented food because the main things that are that are fermenting the bacteria–or the fermenting the vegetables are the lactobacilli. I would encourage you to eat different brands in different batches of kimchi, active culture sauerkraut, active culture pickles every day. And mix it up a little bit! And keep in mind it will be it will not be the same every single time. So a lot of food manufacturers like, I love those Vlasic  pickles, but those things are sterile, but by God, you know, you go to the store and that pickle will taste the same today as it did six months ago or six months in the future. The fermented stuff is not that way. And I’ve noticed it–we’ve been fermenting some things–and some batches are better than others and my patients have noticed the same thing. Even getting the commercial varieties, like of sauerkraut which you can now get at Costco. I had a patient said, Yeah, I had it. I loved it. I ran out of it. I went back to Costco, I got another batch and it was mushy and it didn’t taste quite right. And so that’s just going to have–how it’s going to have to be because every ferment is a little bit different. It’s sort of like that old adage, you know, it’s never the same river twice, kind of thing. And so I think you just have to roll with that. If you get a bad batch or something that just doesn’t taste as good to you just pitch it or give it to your husband and or wife and get another batch and try some more. But even if the bacteria don’t live in you forever, and we know that these people have nasty flora sometimes living in their gut, and in the rest of them and on them and it can be very hard to shake loose those freeloader bacteria, but if you’re just loading the system with these lactobacilli even transiently, they appear to push the those pathobiont or unfavorable bacteria out of the picture for a little while. Anyway, but that’s holistic stuff. 

I would also say that for people who are spiritual, I would encourage that as well. I will say that it is important to feel like you have appropriate support. If you are a spiritual person, I think that having mentorship with good people who are kind and loving is really important. Nobody is perfect and certainly we tend to see that people who may be more religious, who are having trouble getting pregnant may go to a place where they say, Well, why is God picking on me? Why is God testing me? Why is God not letting me accomplish what I want to accomplish? And I would just tell you not to go there and to go in a different direction and just worry about what you can worry about and try to be as kind and good to everyone as you can and try to not make yourself feel guilty about whatever shortcomings you’ve had or the the fact that life may have intervened and kept you from trying to conceive before this particular point in time where you’re having trouble. 

Good counseling can also be really, really helpful. So, I mean, having–if you have a good spiritual counselor and certainly around here we have lots of people who are phenomenal. I’ve met rabbis and Latter Day Saint bishops and Catholic priests and Protestant minister and Muslim leaders who are very, very aware of fertility issues and have been very nurturing to their flocks. And I would encourage if you have one those people, it’s very nice to have them help you. But you know, professional therapy can also be helpful. I think that it’s kind of a mistake to use your spouse as a therapist because they’re just not really–that’s really kind of not their job. Also, if you’re female and you’re expecting your male partner to be your therapist, boy, that’s a huge mistake because I think both genders have fundamentally different approaches to problem solving and it can be very frustrating, especially if you’re a young couple and you haven’t been married for very long. I’ve learned over 31 years of marriage that I’m to listen, and I’m not to really give a whole lot of advice. So if you’re lucky with that kind of situation, that’s good, but otherwise, yeah, get maybe more professional help. 

And I think that’s about it for our holistic things. Remember, forgive yourself for things–always really important–and try to do the best you can. And certainly, try to get that nutrition and exercise and sleep all worked out and then try to comb down the social obligations. Also, you know, like this is a good use of social media, but I particularly find social media to be incredibly corrosive sometimes, especially to fertility patients, because people are always looking at other people’s very carefully curated lives and nobody, or very rarely, do I hear about somebody posting something saying, Oh, I’ve just had my third miscarriage or Oh, you know, I’ve had this struggle and struggle and I’ve done four embryo transfers and nothing’s worked and I’m just at the end of my rope, they never do that. They only post pictures of themselves looking beautiful and then holding a baby or looking beautiful being pregnant and it’s just super nasty sometimes for our patients to have to look at that. So if that’s bothering you, I would encourage you to turn off your Facebook feed and just go be very careful about where you go with it, and Instagram as well. All those things, because people are posting potentially things that could really be kind of corrosive to you. 

So anyway, if anybody has any other questions, please let us know and if anybody has questions right now before we finish up, I’d love to hear them. But anyway, tune in, If you already haven’t already, to some of our other Hutchison’s Huddles and with varying great topics like endometriosis, management of polycystic ovary syndrome, other IVF things, and then some of my collaborators on those–there’s a whole bunch of really good doctors who have had conversations with me on that. But yeah, feel free to poke around on there and let us know if you have any other questions and hopefully someday if you’re out of our area and we know that–there’s like 150,000 of you or something that are watching these things–hope you get to Tucson at some point and good luck with your fertility journey. Keep us posted and we’ll talk with you down the road! Next Hutchison’s Huddle is probably going to be in another couple of weeks, I would imagine. Thanks!