On Fertility and Yoga

This is my first draft of an article/interview I did for yogasanga.net, an online regional yoga zine.


1) How many years have you been teaching Fertility Yoga classes?

Long enough to see my first group of students give birth to their children! I started teaching "Enhancing Fertility with Hatha Yoga" as a series early last Fall, 2009.  I taught one workshop the summer before that. The series is designed to support a three month cycle, so class meets every other week. There are currently no other hatha yoga classes in town that are specifically geared toward students who are trying to conceive, or who may be undergoing fertility treatments.

There is a wonderful program based out of Chicago called "Pulling Down the Moon," and they have fantastic resources for women who are trying to conceive and want the support of yoga, acupuncture, nutritional guidelines, massage, and other "alternative" or "complementary" approaches to fertility. I strongly recommend their book to my students and to anyone out there who may be trying to get pregnant: "Fully Fertile: A 12-Week Holistic Plan for Optimal Fertility" by Elisabeth Heller, Tami Quinn, and Jeanie Lee Bussell. I found it after I had already started the series, and was gratified to note that the program I had designed for my classes pretty well mirrored the program they recommend, even though they have an entire studio/wellness center dedicated to their fertility students. They are simply essential as a resource.

2) How can yoga support ladies looking to get pregnant?


Probably the greatest gift that yoga can give anyone who is trying to get pregnant is RELAXATION. Yoga can also offer encouragement and specific techniques for calming the mind and soothing the nervous system. When you're trying to get pregnant and it's taking a while, everyone in your world is telling you to "Relax...and it'll happen!" To the point where you're ready to (non-yogically) throttle the next well-meaning relative, co-worker, or lady at the grocery store with a baby on her hip who tells you to "just relax."

In fact, studies have shown that getting the diagnosis of "unexplained infertility" is comparable to being told one has cancer or AIDS; the stress response is THAT high. So what all those kindhearted fertile friends don't realize is that women who are trying to conceive would love nothing more than to be able to relax, but their body chemistry is handling an extra load. It's really tough, and I have nothing but compassion for those of us who have found ourselves in the middle of dealing with our sense of failure, longing, desperation, and hope...that gets dashed every month when the telltale bleeding begins.

Fertility Yoga class can also help by offering support from other like-minded women who understand the struggles, the pain, the hopes and fears. So the shared experience of the kula, the community, comes with the class. Becoming a parent is undeniably a powerful spiritual path. The process of trying to conceive is ALSO a powerful spiritual path, fraught with obstacles and just about any other teaching you can imagine for trying to live a yogic life. 

In one class I led my students through a meditation that took them through the koshas, the different levels of existence, and later one of them said that it helped her to remember she was more than just her body, which is easy to forget when you're undergoing fertility treatments or hoping to get pregnant. It can get very technical.


3) Are there some exercises that you would recommend to do as guidelines to enhance Fertility?


I recommend the program written by my teacher John Friend (founder of Anusara yoga) for enhancing a woman's fertility. There is an entire chapter in "Yoga as Medicine: The Yogic Prescription for Health and Healing" by Timothy McCall that features John's fertility program. He is a master bodyworker, and he has created a whole system of  therapeutics that is based on decades of experience. I sought his guidance while I was trying to get pregnant, about five years ago now, and was given a simple set of exercises that emphasize "The Inner Spiral," which is Anusara parlance, basically, for creating opening through the pelvis and legs. According to John, and to the principles of Ayurveda, "infertility" is a sign of blockage or congestion of prana in the lower channels, from the belly down through the feet. In my opinion, it is key to open those channels energetically and biomechanically, using the breath, herbs, asana, meditation, myofascial release, and so forth.  Many of us have spent a lot of time working on the lower "locks" in the body; in some ways, I believe the fertility enhancement has to include "un-locking" the bandhas so that prana can flow healthily and freely. There is a way to tone the pelvic floor and bring support to the reproductive organs without blocking the flow; also, in my opinion, learning to inner spiral the legs should help relieve the fight or flight muscles in the abdomen and groins, the iliopsoas muscles in particular. This is crucial to relaxation anyway, and helpful in particular when it comes to pranic flow from the heart to the uterus to the legs on down.

So I recommend 1) practicing John's program for enhancing fertility every single day, and if possible, 2) to add at least one ten minute restorative pose.  I would suggest at least ten minutes of supta baddha konasana (reclining bound angle) if time is an issue, adding viparita karani (legs up the wall) to help soothe the kidneys and adrenals and perhaps even help restore hormonal balance; salambha sarvangasana (supported shoulderstand) as directed by Geeta Iyengar for deep calm and for nurturing of the endocrine system; and setu bandhasana (bridge pose) for the therapeutic effects on the reproductive system.

I might also include any poses that emphasize opening the groins, the front body, the lower body. Standing poses. Virasana (hero), supta virasana (reclining hero). Baddha Konasana (cobbler pose). And of course pigeon preparation poses. Hip openers are obviously great for allowing more prana to flow into the belly and legs, and forward bends are fantastic for reducing stress.

But above all, I believe someone who is having a tough time trying to conceive should spend most of their yoga practice time in restorative poses.

There is evidence to suggest that *some* women may have an almost "allergic" response to exercise when it comes to fertility; a significant percentage of women have been shown to have reduced fertility from exercising "too much." This is all based on research by Alice Domar, whose wonderful book "Conquering Infertility" was instrumental in  formulating the program at Pulling Down the Moon, and has been helpful for me and even some of my students for it's scientifically based approach to mind/body medicine and fertility technology. So, like Alice Domar,  I tell everyone who has been trying for a while to STOP exercising -- which is very, very difficult for many women to hear -- for at least three months. At that point, it should be possible to gauge whether or not the extra heat in the body created by exercising has had an impact on one's fertility. When someone comes to my class, I give them permission to reduce their impactful exercise for a few months! So no more heated yoga classes, no more ashtanga or sweaty flow classes...at least not for three full cycles. Especially if someone is taking fertility drugs, something like Clomid, which is heating up the body quite a bit already. Domar's basic guideline is to exercise only to the point of raising the heartrate up to 110 bpm, no higher. My guess is that this would rule out most hot or flow classes.

The principle I'm getting at relates to Ayurveda and to Traditional Chinese Medicine; the idea is that the body, in order to enhance fertility, needs to "cool down" or become more "yin." Less active pitta. So less inner heat buildup, fewer sweaty rigorous classes or practices, lots of cooling and balancing ghee and Love and sweetness.

I also recommend chanting and playing with directing the sound down through the pelvis and legs; chanting "OM" and just directing it down instead of up through the chakras. Mantra is a whole other topic, but it was part of my own fertility practice and it is part of what I offer in my fertility class.

Meditation is essential. Just taking 15-20 minutes out every day to clear out, to center, to simply "be" is so important. Chanting and meditating are techniques for emptying/calming/directing the focus of the mind. Guided meditation is especially good for someone who is trying to get pregnant.

I also recommend pranayama techniques, nadi shodhana in particular, and any practice that involves lengthening the exhalation, which is deeply relaxing.

At some point during my fertility series Jennifer Holt comes in and plays the Tibetan bowls for everyone. So I do practice and believe in the healing power of sound.

And I bring "special guests" in to present to my students. So far I've had Charlotte Jernigan, Ayurvedic doctor; Jennifer with her Tibetan bowls, and Charlotte Westbrook with Maya Abdominal Massage. 

4) Have you done any research with your practice? do you have a rate of success?

I continuously research fertility and its relationship to yoga or complementary medicine, and I haven't found much that is specific to yoga and fertility just yet. 

I am keeping notes, and I suppose eventually I'll have some data after I've taught the series for awhile.

The statistics for improving fertility rates and ivf success rates with acupuncture have been proven; those studies have come out just recently, in fact. We don't have any studies yet to prove the connection between yoga and fertility enhancement, but the Pulling Down the Moon program claims that 75% of their students get pregnant within six months of starting their program. My "success rate" is about that, too.

I have taught three sessions of my fertility series, with 6-8 students in each session. Over half of them have gotten pregnant, since we started last fall. During the very first series we had two sets of twins, both of which were born this May!

The treatments that each of these students have undergone to get pregnant vary, from in vitro to i.u.i. to simple lifestyle changes. There seems to even be some mojo in simply signing up for the class.  It's big. It's the power of Shakti, the creative life force. I've begun making my obeisances to Lakshmi, who is the goddess of fertility, and to Ganesha, the remover of obstacles. It really does come down to the Mystery, no matter how technical the process gets.  We simply cannot control it. Birth, like Death, is on its own clock.

However, I can assure anyone who is trying to get pregnant that acupuncture in combination with yoga will enhance fertility and any assisted reproductive technology they use.


5) What do you tell women that have tried everything and nothing seems to work?


I often quote Alice Domar, who says: "You will be happy again. Life will become joyful again. And somehow, some way, if you want to become a parent, you will."

And I like to remind them of that beautiful quote from the Gita.  "On this path no effort is wasted, no gain is ever reversed; even a little of this practice will shelter you from great sorrow."  When I was trying to get pregnant I thought I was going to explode if I added one more "thing to do" to my list. But hey, improving your diet, quitting caffeine, deeply relaxing, and focusing on self-care have their own rewards.

So far I've mostly gotten students who *have* tried everything, and frankly the options for getting pregnant these days are varied and quite extensive. (And can get very expensive, in every way.) Each student I meet and have had the privilege to work with brings me a goldmine of information to share with the next group of students who walk through the door.

I will say that not everyone who wants it is going to get pregnant. I've had students who took almost ten years of trying before they had success, students who have had more than one failed ivf, more than a few miscarriages, problems with their partners fertility, women using donor sperm, wanting to use donor eggs, deciding it really was time to adopt or give up altogether. I think for some it is extremely important to have done everything they possibly can before they "give up," or take some other course of action, like adoption. But that is not important for everyone. It really is an individualized path, with so many lessons along the way.

I wanted to present my own experience and the experiences I've learned about from other yoga teachers or students as support for anyone who might be going through fertility treatments, whether at the fertility center, with an acupuncturist, with an endocrinologist, whatever.

At first I thought I would "just" teach yoga, but quickly realized these women needed to be able to talk and to share resources. So it has become more like a comprehensive approach to fertility that includes acupuncture, ayurveda, nutrition, herbs, Maya abdominal massage...

I really wanted to present what "worked" for me, at age 43, to have gotten pregnant and given birth to a healthy baby. I am still the oldest first time mom I have ever met. The Bhagavad Gita tells us "No effort is wasted, no gain is ever reversed." So I'm sure for me it was a combination of all the many tools I tried. After TTC for six months, tracking very closely my cycles and my body temperature, without ever getting pregnant,  I sought the help of fertility specialists. I went totally Western medicine. I did several months of diagnostic procedures and testing, I took 3-4 rounds of Clomid and tried intra uterine insemination for several cycles. I had abdominal exploratory surgery. My husband was tested.  We kept ratcheting up our efforts every month with injections, with drugs and procedures, heading toward in vitro fertilization perhaps, but all the while doing acupuncture, until after a few months of all that, I decided to "just relax," and stick to my very customized yoga practice, Maya abdominal massage, and slowly removing items from my very full plate. And then I got pregnant, after nine months of that, plus intensive acupuncture and herbs. It was almost two years into it.

It's important to note that the process of getting to know yourself, your cycles, your body, your whole Self really, is Yoga.  It really is its own reward, even if you don't get the baby at the end of the process. It doesn't always feel that way, but the potential for total transformation is there.

6) What is the role of the partner?


Fantastic question. The role of the partner is, of course, to participate 50-50. A lot of times though, especially in a female/male partnership, there is so much emphasis on the female body that getting the man tested or treated is almost an afterthought. I know that I felt, after a very short time of "trying," that there was something "wrong" with me. So at some point I pretty much demanded that my husband do at least as much as I was doing in terms of testing, supplements, bodywork, meditation...and we worked on it together. Which helped.

As part of the series we teach a workshop, "Enhancing Fertilty for Couples."  We do some partner work, some talk, some breathing exercises, and we tap into my husband's practice of Taoist meditation, of qi gong. He gets to represent the "guy" part of the equation. (Or the partner who isn't the one designated to carry the baby, shall we say.)  I'm always so happy to see the partners. It is more powerful than you'd think. According to Ayurvedic principles, the happiness/love/connection/health of both parents determines the health of the embryo. So I also encourage lots of healthy and even Tantric-influenced lovemaking, and creating a shared vision. It's cliche, but very true that TTC sex can get boring and mechanical.

In the workshop, we also explain some of the technical aspects of the reproductive cycle, and offer some information about how the hormones and perhaps even the treatments might be affecting the woman's body, mind, and emotions. It's simply harder for the male counterpart to understand the rollercoaster of emotion the woman may be on; so I think it is imperative to get everyone on the same page so they can support one another through the cycles of excitement, grief, anticipation, whatever. Really just some simple eyegazing and breathing together can go a long way. There are also supplements and treatments that men can do to increase sperm count, increase motility, whatever the issue may be.