Fertility Kitchen

As an homage to Pride Month, my last few posts were about LGBT parenting options. Today I want to delve more into the choice of using donor eggs. There are multiple circumstances in which using donor eggs is the best (or only) solution for growing your family. Although, it can be a difficult paradigm shift, using someone else's eggs and/or sperm doesn't translate into it not being your child. Once you go through a pregnancy with your baby in your belly and give birth, the bond is the same. In many cases it's the best way to get lucky children in the hands of wonderful parents.

The New York Times recently published an article stating that roughly 6,000 children are born each year via egg donation. (And a million living adults are the biological children of sperm donors!) This was an informative article, but I felt that it portrayed children conceived by egg or sperm donor as being inherently fraught with angst about the means to their conception, which has not been my direct experience while seeing many families make this choice. As you continue your own evaluation, you can check the article out for some fodder in order to consider all the angles.

In my years of working with couples dedicated to trying anything to form a family, my experience with children who originated from the thoughtful choice of egg donation, has been very positive. The patients who visit me seeking help in getting pregnant are usually extremely mature, emotionally-grounded adults who understand the gravity of bringing a child into the world and are ready to commit their lives to raising their children... by whatever means those children come about. In this scenario, everyone benefits.

Laurel Fertility Care is a local San Francisco fertility clinic with, in my opinion, an outstanding egg donation service by virtue of caring and informed physicians as well as diverse donors.

Should you want more help exploring this topic, I highly recommend seeking out a therapist who can counsel you on the emotional grey areas of choosing egg donation.

I recently heard the phrase "gayby" for the first time. Granted, I'm not always in the know, despite being a specialist in fertility acupuncture, but I love good lingo. So, I was happy to incorporate this one into my repertoire.

Here at Acupuncture Kitchen, we—alongside the greater San Francisco area—are celebrating Pride Month. I thought I'd kick it off with a post about pregnancy options for all of our patients who are building their families as either single mothers or fathers, or two-mother/two-father homes. Known as "biological parenthood," infertility clinics are able to give gay and lesbian couples an option over the traditional but more limited option of adoption.

So, here are the main menu items:

For the Ladies: Donor Sperm

The easiest solution is your basic intrauterine insemination (IUI). For a surprisingly low cost (starting at, say, a few hundred dollars), women can research donor demographics and purchase high-quality sperm alongside an IUI. Sperm can also be donated by a friend, but anonymously-purchased sperm has the advantage of not carrying emotional ties and not having to sort out long-term arrangements. If you decide to go this route, a clinic I particularly recommend is Pacific Reproductive Services (a lesbian owned sperm bank).

For Everyone: A Gestational Surrogate

Gay men or lesbians who aren't going to carry their own child have the option of hiring a surrogate to be impregnated via in-vitro fertilization (IVF). IVF, like IUI, can use either anonymous or known donor sperm and/or donor eggs (sometimes from one of the partner's eggs).

For Couples:

A uniquely San Francisco-style parenting option is for couples to agree to raise a child together. In this swinging scenario, one of the lesbians would be inseminated with the sperm of one of the gay men. The two couples then share parenting responsibilities and hope for one (really) big happy family.

There are various clinics in San Francisco that specialize in helping couples of all genders get their baby project in motion. I work most closely with Laurel Fertility Care and founded an Eastern clinic inside of this Western clinic so that patients seeking impregnation can supplement their treatments with acupuncture on-site. In fact, all of the acupuncturists here at Acupuncture Kitchen are on-call whenever one of our patients at Laurel is due for their embryo transplant. We show up and stick a few needles in you in spots that are well-known to increase the chances of successful implantation.

(If you'd like to read the scientific jargon about ACU/IVF, click here.)

Just for kicks, I got the following statistics from the Partners Task Force for Gay & Lesbian Couples (www.buddybuddy.com). This web site lists even more statistics and also some great breakdowns of state-by-state laws on parenting options for gays and lesbians.

• The American Bar Association, Family Law Section estimates that there are four million gay and lesbian parents raising 8-10 million children.
• The American Civil Liberties Union estimates that eight-to-13 million children are being raised by gay or lesbian American parents.
• Lambda Legal Defense & Education Fund estimates there are from six-to-10 million lesbian and gay parents who are mothers and fathers to an estimated six-to-14 million children.
• The National Adoption Information Clearinghouse estimates there are 1.5-to-5 million lesbian mothers and 1-to-3 million homosexual fathers. As of 1990, 6-14 million children were being raised in homosexual households.

Last week, I talked about the immense and incontrovertible benefits of breastfeeding versus formula.

With all that said, breastfeeding does present its challenges and, for many reasons, it's not an option for everyone.

I occasionally see clients who are having trouble with breast feeding—either with producing milk or with helping baby get the milk—and fortunately there are wonderful ways to treat these sorts of issues with Chinese Medicine, and particularly with herbal remedies.

Persistence and experimentation are also important elements in getting the hang of this activity that seems so natural, yet can feel quite awkward (if not downright painful) at first.

Figuring out the right timing

There are a lot of conflicting pieces of advice about the strategy of timing your feedings. Some moms choose to feed on demand. Others time their feedings strategically. Remember that you know your baby's needs better than anyone (except, perhaps, your baby). Experiment with different strategies until you find one that feels right for you and your growing family.

Baby doesn't have a good latch

It's best to try breastfeeding within the first few hours after birth. This helps to form an immediate bond between mother and baby. Studies have also shown that babies who are breastfed soon after birth develop better latching technique faster. It's baby's natural instinct to gravitate toward the breast in these early stages, so it's ideal to encourage and facilitate this behavior by allowing the baby to breastfeed right away. Skin-to-skin contact directly after birth is the only time a baby will sometimes crawl (before they're actually of crawling age)... right up to the breast, to latch on their own.

Challenges producing enough milk

This is where Chinese Medicine can be very helpful. Acupuncture and particularly Chinese herbs can be invaluable in helping kick start your body's milk supply. I (or another qualified acupuncturist) can work with you to develop a formula specifically for your body.

From the point of view of Chinese medicine, insufficient milk supply is generally due to deficient or stagnant qi—basically, mom is sapped and doesn't have enough energy or nutrients to supply milk. An acupuncturist will stimulate points that tonify your energy and help build your blood supply. They may also use herbal therapy and moxibustion to enhance these effects.

Western medicine and Chinese medicine both attribute milk blockage to over-activity in the nervous system (in other words, stress and anxiety). This is something else that acupuncture can address by relaxing, nurturing, and reassuring the mom. Sometimes, simply taking action to take better care of oneself can be the first step to stimulating milk production.

Painful or infected breasts or nipples

An acupuncturist should be able to relieve painful breasts with certain pressure points, and even show you how to stimulate these pressure points yourself in order to soothe painful breasts at home. Always keep an eye out for mastitis and infection, and get appropriate treatment if those pop up.

Resources

In San Francisco, we have access to some great resources for helping with breastfeeding issues.

1. Natural Resources

2. Le Leche League

3. Day One

There are a lot of conflicting strategies and opinions about how to breast feed (timed feeding versus feeding-on-demand being the primary argument), but remember that—just like your own body—you know your baby's needs better than anyone. Utilize strategies in conjunction with intuition and experimentation to discover what will work best for you and your growing family.

I trust that each woman makes the decision that is right for her and her baby, but I would be remiss if I didn't promote my bias toward breastfeeding. If breastfeeding (or providing your baby with breast milk) is an option for you, there is no comparable way of imparting nutrition and nurturing to your little one.

All mammals produce milk, and every mammal's milk is designed specifically for its particular young. In the case of humans, our breast milk contains the exact formulation of nutritional requirements that our babies need in its ratio of proteins, lactose, vitamins, minerals, and water. (Incidentally, this is called "the biological specificity of milk.") Food scientists have done their best to replicate this formula with, well, "formula", but there is no substitute for the real thing.

The Scientific Facts

Breast milk is specifically manufactured by your body to help your baby grow in the following areas:

1. Breast milk is integral to developing a strong, healthy immune system and preventing infection. This is probably the most well known fact about breastfeeding. Breastfed children build stronger immune systems faster and generally respond better to vaccinations. Within the first year of life, there are approximately 400 species of bacteria that establish themselves in the human gut. Breastfed infants have a lower rate of morbidity than formula-fed infants. Breast milk enhances the colonization of Bifidobacterium Bifidum, which may also inhibit the colonization and growth of pathogens during this vulnerable time. Citation: "Oligosaccharides in Human Milk and Bacterial Colonization," Newburg DS, J Pediatr Gastroenterol Nutr, March 2000;30:S8-S17.
2. Breast milk is good for the brain. Again, human breast milk is specifically designed for what we need. In our case (versus other mammals) a fast-maturing brain is vital to a healthy being. We humans are known for our brains, and our milk is designed with just the right nutrients to enhance brainpower. One of these important nutrients is Taurine, an amino acid that the body cannot otherwise manufacture. Breast milk also contains Omega-6. This fatty acid helps the brain transmit messages throughout the body—um, you get the message.
3. Breast milk keeps your baby's body growing at just the right pace. Believe it or not, human breast milk is actually low in protein compared to many other mammals, and this is on purpose. Our bodies are meant to grow relatively slowly in relation to our brains, so that we can take advantage of the early bonding process with our mothers by being carried and nurtured for a prolonged amount of time. This is a crucial element of how we learn to exist in social relationship with other humans.
4. Breast milk boosts vision. Science has proven that the vision of breastfed infants develops faster than that of formula-fed babies. This finding is remarkable particularly in premature infants. The current thinking is that this is because of the presence of DHA in breast milk (in addition to the aforementioned Taurine). DHA is one of the prime structural components of the retina... yet another reason that breastfed babies have a healthier outlook on life.
5. Breast milk ensures a healthy amount of attention from the mother. There's no way around bonding with your baby when it's literally attached to your body for a large part of the day!

Next week I'll post a follow-up post on The Challenges of Breastfeeding, with some herbal medicine tips to get around those tricky first few weeks.

Evening primrose oil is known in natural medicine circles to facilitate labor induction because it contains prostoglandins which help to ripen the cervix. Once you have reached your full term, try the following for stimulating labor:

Take 2-500mg capsules 2 times per day and insert one capsule at night as a vaginal suppository starting 3 weeks prior to your due date.

It’s best to try natural remedies such as this under the supervision of your doctor, acupuncturist, or midwife.

I see many patients through the process of becoming pregnant at my acupuncture clinic, Acupuncture Kitchen. I continue to see many of them through a healthy (or, less often, a tricky) pregnancy. Occasionally, a patient will come to me for labor induction at the end of their pregnancy.

Chinese medicine can be excellent at inducing labor and is a safe, alternative method of preparing the body for birth in lieu of typical Western induction drugs like Misoprostol and Pitocin. These drugs—while proven to safely induce labor without health risks to the baby, for the most part—can cause a cascade of intervention events during birth.

Because they speed up labor, pharmaceutical labor-inducing drugs cause a higher risk of increased bleeding, hemorrhaging, and vaginal tearing.

Doesn't sound pleasant, does it?

While Western drugs sometimes do become necessary, it's a good idea to first try to induce labor with the less invasive techniques of acupuncture and Chinese herbs.

What Science Says

Acupuncture is widely thought to help reduce the need for medical intervention in post-term pregnancies.

"In a randomized, controlled trial involving 56 nulliparous women (women who had not previously given birth) carrying a single fetus, at 39.6 weeks or greater, with a Bishop Score of less than 7 [a pre-labor scoring system used to predict whether an induction of labor may be successful] treatment of acupuncture was found to reduce the mean time to delivery (21 hours sooner), increase the likelihood of going into labor spontaneously (70% vs. 50%), and decrease the likelihood of delivering by cesarean section, as compared to subjects who did not receive acupuncture and only received standard medical care."

"A randomized controlled trial of acupuncture for initiation of labor in nulliparous women," Harper TC, Coeytaux RR, J Matern Fetal Neonatal Med, 2006; 19(8): 465-70. (Address: Department of Obstetrics and Gynecology, University of North Carolina, NC, USA).

More Inventive Ways to Induce Labor

Incidentally, those in the alternative medicine know have come up with a whole list of labor-inducing "wives tales." Some of these are more valid than others, although they are all pretty interesting:

• Essential oils such as oregano and basil (Some say that eating these herbs toward the end of a pregnancy can also be effective.)
• Sex (It's true. Semen contains prostaglandins, which, theoretically, cause the cervix to soften.)
• Red raspberry leaf tea (referred to as a uterine "tonic"—in other words, it helps tone the uterus)
• This one, while it sounds the most farfetched, is actually widely recommended by midwives in the know: stimulating your nipples! This causes the body to naturally produce oxytocin, the hormone that stimulates uterine contractions. Warning: the nipples must be stimulated for quite a while for this to work. Ouch.
• A midwife or Chinese medical professional can often recommend other herbs and tonics known to stimulate uterine contractions and induce labor.

As with any medical advice, it's important that you follow these suggestions with the go ahead and care of a licensed medical professional.