The mind/body approach to fertility is based on the premise that knowledge is power and that a change in perception based on new information is powerful enough to effect subtle changes in your endocrine, immune, and nervous systems. Regardless of what you’ve been told about your fertility, you need to know that your ability to conceive is profoundly influenced by the complex interaction among psychosocial, psychological, and emotional factors, and that you can consciously work with this to enhance your ability to have a baby.

The first thing that’s needed in the area of fertility is a new language. Few labels are more damaging to women (or to men) than the label "infertile." It strikes at the very heart of one’s self-concept and self-esteem and results in a punishing internal dialogue in women who are going through this experience. Many feel inadequate, guilty, and to blame for their condition, which creates a vicious cycle inside them. The word infertility conjures up images of barren, dry, sterile earth that can’t bear fruit. If you currently carry this label, try replacing it with the following: "I am a sensual, sexual, fertile being with a great deal of love and nurturing to give to others—and to receive for myself." Internalizing the feeling that goes along with these words will help you change your self-concept (and physiology). Remember that changing your self-concept is a process, not an event. Give it time.

Here are some other suggestions:

-Step one: Look at the big picture. Know that you’re not alone—millions of women are charting new territory when it comes to balancing personal and professional lives.

-Step two: If you are over thirty-five and trying to get pregnant, examine your programming about your biological clock! The popularity and widespread publicity surrounding assisted reproductive technologies have made it seem as though every woman over the age of thirty-five is apt to have problems conceiving. But this just isn’t true.¹

-Step three: Make the connection between your emotions, your family, and your fertility. The crux of the mind/body approach to fertility is discovering how the messages you internalized from childhood are currently affecting your ability to conceive.

To get started on this, construct an ephistogram. An ephistogram is an emotional and physical family health history that diagrams family patterns. It was developed by Niravi Payne as an adaptation of the genogram used by family therapists. It can help you understand what circumstances, over many decades, may have caused you to experience reproductive problems. "Filling it out," writes Niravi, "is a powerful method for creating new pathways for healing, conceiving and carrying a baby to term."

To create an ephistogram, you use the same diagram you would use when drawing a genealogy, or family tree, except that in addition to the names of your grandparents, parents, aunts, uncles, and siblings, you also put in any illnesses or physical symptoms they had, any emotional patterns you remember, and any reproductive difficulties they may have had. This is like detective work. Remember, for better or for worse, your family served as the model for your current intimate relationships. Ask yourself the following questions about each member of your family tree: What message did I receive from this person about having children? Was it positive? Was it negative? Did I internalize any of it? What did they lead me to believe about the process of conception, pregnancy, labor, and birth? Were there any family secrets, such as miscarriages or pregnancies that were kept hidden?

-Step four: Name your ambivalence. It is perfectly normal to be somewhat ambivalent about having a baby. It is possible to very much want a baby and to be terrified of the process at the same time. After all, it changes your life permanently and in ways that you can’t really plan for. Ambivalence is a problem only when it isn’t acknowledged and worked through.

There are other factors to consider when getting to the root cause of your fertility issues:

Unabated emotional stress results in high adrenaline and cortisol levels. This leads to imbalances in other hormones that are important for optimal fertility including thyroid, progesterone, and estrogen. One of the most tried and true ways to decrease emotional stress and its physiological effects is with guided imagery, meditation, breathing through the nose, and relaxation. A wide number of well-documented modalities are available to help with this.

Mindfulness meditation and techniques such as Herbert Benson’s Relaxation Response²have been successfully used by Alice Domar, Ph.D., to help women heal from the stress of infertility while also increasing conception rates substantially.³ For years, those interested in PMS have batted around the idea of a "menotoxin" present in women around the time of their periods because of this Jekyll-and-Hyde phenomenon and also because skin breakouts were worse premenstrually. A practical guide to Dr. Domar’s program can be found in her books Healing Mind, Healthy Woman (Henry Holt, 1996) and Self-Nurture (Viking, 2000).

Mindfulness and relaxation training are especially important if you’re going through any high-tech medical fertility treatments, since it is clear that unresolved and unexpressed emotional and psychological stress has physiologic consequences that may hamper the effectiveness of fertility treatments.⁴ But when emotional stress is addressed and resolved, pregnancy rates go up. Helpful, guided imagery for enhancing fertility has been created by my colleague Belleruth Naparstek. (See www.healthjourneys.com.)

When people hear the word biological clock we usually think "women." But this simply isn’t true. Fully 40 percent of infertility problems lie with the man, not the woman!

Living in artificial light without going outside into natural sunlight regularly can have adverse consequences on fertility, because light itself is a nutrient. The scientific literature on light and human biocycles is extensive.

Nutrients affect every hormonal interaction in the body, and adequate levels of them are clearly important in human reproduction. For more information, see chapter 17, "Nourishing Ourselves with Food" in Women’s Bodies, Women’s Wisdom.

In order to become pregnant, the fallopian tubes have to be able to pick up an egg and assist its passage to the waiting uterus. This process is dynamic and can be affected by myriad factors, one of the most common being scarring of the tubes from previous pelvic infections that are often the result of sexually transmitted diseases. This can be treated with a variety of techniques including deep tissue massage.

Helpful New Modalities for Enhancing Fertility include:

Though our culture is quick to bring in the big-gun technologies when it comes to fertility enhancement, these are often not necessary. One of most helpful modalities for enhancing fertility is Traditional Chinese Medicine (TCM). I’ve been referring patients to practitioners of acupuncture and herbology for years with great success. It’s the first place I go for any health problem myself!

My colleague Randine Lewis, Ph.D., has dedicated her life to helping women enhance their fertility through the use of TCM. Dr. Lewis, author of The Infertility Cure (Little, Brown, 2004), was in medical school when she began to have fertility problems herself. After exhausting the western medical approach, she discovered the ancient wisdom of Traditional Chinese Medicine. Not only did TCM resolve the imbalances that were leading to her own fertility problems, Dr. Lewis realized that it was the perfect solution for many other women as well.

She eventually dropped out of medical school to pursue training in Traditional Chinese Medicine. Following training in China, she returned to the U.S., where she opened a clinic helping women achieve optimal fertility with a 75 percent success rate. Her fertility enhancement work also supports women who are using assisted reproductive technologies, helping them achieve better outcomes.

Dr. Lewis points out that in Chinese medicine, it takes a disturbed ovarian cycle a full ninety days to regenerate. That’s why she urges her patients to complete her ninety-day program. TCM, like most holistic methods, is aimed at rebalancing the body from the inside out. It’s not a quick fix the way western medicine claims to be. Dr. Lewis offers Fertile Soul Retreats four to six times per year that include personalized evaluation and recommendations.

Pelvic adhesions that interfere with fallopian tube function have long been associated with fertility problems as well as chronic pain. It is estimated that approximately 40 percent of female infertility is associated with scarring of the pelvic organs either from prior surgery or infections. A noninvasive, nonsurgical type of deep tissue massage performed by specially trained physical therapists known as the Wurn Technique (after its founders, Larry and Belinda Wurn—both physical therapists) and Maya abdominal massage (a technique used for centuries by indigenous healers in Central America) has been used to successfully treat infertility as well as other reproductive and pelvic disorders.