musings & fun / article 4

Yoga Sadhana For Mothers
Ashtanga and Fertility
Philippa’s Story

How long were you practising before trying to conceive?
Five or six days a week for over twelve years. Then, after nearly a year of not having conceived, I started cutting back on my asana practice, just in case the amount of exercise I was doing, was having an impact on my fertility. It’s been over two years now, since trying to conceive.

Was it a daily practice observant of moon days and ladies holidays?
Yes and also if I’m tired, I try to respect my body and only take a gentle asana practice.

Was it easy to conceive?
My doctor in the UK said that it’s probably the stress of living in London and working too hard, that was making my body less receptive to conceiving. She was confident that when my husband and I moved to India, I’d be pregnant within six months. We had all the regular fertility tests in London and everything seemed fine. I now know that the NHS tests are pretty basic and don’t pick up on all fertility problems.

After moving to India, I mentioned to one of my teachers that I was trying to start a family and asked what she recommended in terms of the yoga practice. She told me to carry on with my regular practice, so I did just that for a few more months.

Still no pregnancy, so my husband and I decided that as treatments are move affordable in India, it couldn’t do any harm to seek fertility advice here. I think when seeking medical help, it’s important to do your research and to get a second opinion. Medical Tourism is a growing industry in India, so there are doctors here whose aim is to make money from patients (so may not offer the most cost efficient and pragmatic treatment plan).

First of all I saw an Ayurvedic doctor who assured me that a month of panchakarma and various herbal remedies would ‘cure’ me. I dutifully followed his instructions and embarked on several unctuous treatments, but I really didn’t notice any positive change at all. The oil and herbs that I had to ingest made be pretty nauseated. One thing that did resonate with me though, is that is whatever you imbibe, has a profound effect on the body. I’ve been vegan for about fifteen years and vegetarian before that, so have been aware of the effects of food on my body for quite a while. The main thing that I took away from the panchakarma was to not drink coffee (about the only sin I had left) and to be really mindful about what one puts in one’s system. Many people believe that caffeine can reduce your chances of conceiving and sustaining a pregnancy.

So after exploring traditional Indian medicine, I did the polar opposite and sought the advice from two different allopathic fertility specialists in Mysore. The first one a lady, told me off for being old and said that given my age, my only hope would be to have IVF with a donor egg. This route is incredibly costly, so I felt that it might be prudent to explore other options. I had heaps of tests to check hormone levels and to identify whether there were any internal problems that were causing infertility. My hormone levels were low, but everything else was fine, so she then suggested that I should give IUI a try (the most affordable method of assisted fertility). Intrauterine Insemination is an aided fertility procedure, where you are given hormones to encourage follicles in the ovaries to grow and to help prepare the body for ovulation and implantation. Internal ultrasound scans are performed every other day, to monitor the development of the dominant follicle (that contains an egg). When the follicle is a good size, injectable drugs are given to rupture it (so that the egg is released) and then the insemination procedure happens with the aid of a catheter. It’s not very pleasant. It was around this time that I had a word with my main teacher in Mysore and he told me to practise Suryanamaskar only. The complete opposite of what I had been doing. I think he may have suggested this, as he knows that I have a tendency to over-heat during my practice and of course, this can be detrimental to conceiving and sustaining a pregnancy. Maybe he just wanted me to slow down and to give my body a chance to be still. Interestingly, my hormone levels started rising to a more normal level, so it’s quite possible that my intense asana practice, was effecting my hormone levels and making it difficult for me to conceive. We tried IUI for four or five cycles, but still no pregnancy.

Not having any success with IUI, my husband and I agreed that maybe we should explore other options. In Vitro Fertilisation is a form of deeply aggressive allopathic medial intervention, with the aim of growing several eggs in the ovaries, surgically removing them, creating an embryo in the lab with the husband’s sperm and then surgically placing the embryo back into the womb, in the hope that it will keep growing and implant into the uterine lining. For this, we went to a different IVF specialist in Mysore. The doctor made me have a hysteroscopy, a hysterosalpingogram and many more blood and other tests, to see whether I would be a suitable candidate for IVF. They encouraged healthy eating and being a sensible weight. Apparently it’s difficult to conceive if your fat / muscle ratio is extreme (ie if you’re too fat or too lean). His clinic was busy and very impersonal, but the doctors seemed to be professional, articulate and knowledgeable. Nevertheless I felt like a number, rather than a women who was going through an emotionally challenging time. The nurses were aggressive and bulling, which put me on edge and made the process of IVF extremely traumatic. In the OT room before the egg removal procedures, I felt violated and traumatised. I can hardly believe that I put myself through such an ordeal, so many times, but the motivation of course for undergoing IVF, is the chance that it might work. The potential result could outweigh the adversity of the journey, even though it isn’t the most joyful way of creating a new life. It’s possible that had I undergone IVF in London, my experience might have been less brutal, given that I would have felt culturally more at ease.

The IVF procedure for me, involved having four hormone injections into my belly every day for the first two weeks of each cycle, plus many drugs and internal scans (and that was even before the egg retrievals and embryo transfers). Several months of medical intervention had made me very emotional and quite honestly, I needed to get back to my asana practice. Only taking Suryanamaska wasn’t lifting my spirits and I needed to feel the grace and flow of of the Ashtanga practice again. With hindsight, the asana practice was keeping me balanced and steady. Taking the practice away completely, resulted in my feeling anxious and tense, which is obviously not what you want for IVF to work.

During the first two weeks of each cycle (whist having the injections), I practised the Primary and Intermediate series, but after the embryo transfers, I eased off the asana practice and just focused on meditation, breathing and a few hip and heart opening asanas. Even so, the IVFs didn’t work.

Interestingly the girl on the reception desk at the clinic, was concerned that after the failed IVFs, my ladies’ days only lasted for a day and half. I explained that this was normal for me, but she felt that I should probably have an iron test. It turned out that I was seriously anaemic and was immediately put on an iron drip. It’s conceivable that this could have contributed to the embryos not implanting properly.

After several failed IVF attempts I was pretty deflated and just wanted to get back to my regular daily asana practice and to feel like ‘myself’ again. A year of Assisted Reproductive Technology really took its toll on me physically and emotionally; the drugs caused me to gain over five kilograms in weight and the doctors made me feel like a disappointment. Children are everything in India, so not being able to do the most natural thing for a woman, resulted in my hitting rock bottom.

I spent a couple of months getting my practice back to what I deemed to be a ‘reasonable’ level and came back to the shala. In under a month I was practising the four series that I have been taught. This was quite an epiphany, as it suddenly dawned on me that the asanas don’t go anywhere and it’s OK to relax them for a while (to try to start a family), because they do come back. Guruji used to talk about ‘keeping the faith’. It’s good advice.

Feeling pretty good and healthy again, I felt ready to explore another system of non allopathic medicine to help with getting pregnant. Traditional Chinese Medicine for me, took the form of three months of acupuncture and twice daily concoctions of odd looking boiled herbs. The aim was to cleanse and strengthen my liver, spleen and kidneys, after filling my body with toxic IVF drugs for a year. Although the tea was utterly disgusting, I did feel pretty energised and healthy after just a few days. It was whilst I was researching TCM, that I discovered the potentially harmful side effects of certain allopathic medicines on ovulation. I was diagnosed with osteoarthritis in my big toe joints, about three years ago and saw a couple of specialists in London, who suggested that diclofenac would help manage the pain. I mentioned that I was taking diclofenac to both of my fertility doctors in Mysore, but neither one told me to stop taking the drug. I have now learned that NSAIDS (nonsteroidal anti-inflammatory drugs), can actually stop ovulation from occurring, resulting in something called Luteinized Unruptured Follicle Syndrome. That’s when the egg isn’t released from the dominant follicle and the follicle keeps growing into a cyst. I wonder why the fertility specialists, didn’t tell me about the side effects of the drug that I had been prescribed …

Did you have to make any adjustments in your practice/diet/daily life?
During the last two years I have explored all manner of combinations of asana practice and I think for me, whilst I’m trying to conceive, the middle path is probably the right one. I have a regular practice, but I’m not demanding extreme feats from my body at the moment, neither am I over-heating. My attitude is more relaxed now and I’m experimenting with practising as though I’m pregnant. I’m trusting that if I am meant to conceive, it will happen naturally and it’s up to me to create an encouraging environment for this to flourish.

To cure the Luteinized Unruptured Follicle Syndrome I’m using homeopathic medicine and when possible, I eat organic fresh food. I now take maca root, spirulina, vitamin B complex, calcium and iron supplements. I haven’t taken any allopathic medicine for over six months and hope to stay clear as much as possible.

Did you seek any other forms of spiritual practice and in what way are they helpful?
One thing that my main teacher did tell me to do, was to visit an ancient stone temple called Kukke Subrahmanya (famous for helping women to conceive). My husband and I have been there a couple of times, to do puja and offer a little prayer. Let’s hope the gods smile on us one day! Now that I’m bit older, I’m much more into meditation and can appreciate sitting quietly and being still. Going through IVF is incredibly stressful and the emotions that it evokes, can be quite unsettling. Meditation is very helpful in terms of centreing oneself and focusing the mind. I also enjoy chanting simple mantras and I find pranayama very calming. I read yoga philosophy books, to help me keep the faith and spend as much time in nature as possible. We’ve bought some land in the Western Ghats, which I find incredibly spiritual. Being surrounded by tropical trees, birds, hills, flowers, waterfalls, sunrises and sunsets, fills me with reverence and makes me feel alive and content. There’s nothing like going for walks and practising yoga in nature, to make you feel connected and part of the Universe.

What motivated/ inspired you to keep practising?
Observing my emotional state when I was only practising Suryanamaska, was a catalyst in itself to inspire me to get back to a regular practice. The asana practice makes me happy and without it, life seems a bit harder. Yoga helps me to control my mind, stay focused and it fills me with joy. Having said that, if I’m ever blessed to be with-child, I’d like to think that I’ll trust my instincts with the practice and look forward to relaxing completely, during the first trimester. Surrendering ones practice when you’re not even pregnant is both deflating and perplexing. I imagine that if one becomes blessed with pregnancy, it would be a joyous and selfless act to not practise for three months, knowing that you’re giving the little one inside you, the best chance of developing normally in the womb.

What have you learned?
I think in the end, you have to trust your instincts and believe in your ability to make sensible choices. It’s very challenging to let go of the practice, especially when you’re not even pregnant. Ever since my husband and I began thinking about starting a family, I became really torn in my head about what to do with the asanas. On the one hand it made no sense to continue with the first four series if I wanted to get pregnant, but like so many Ashtangis, I was too attached to the asana practice and got deeply stressed by the idea of not practising to my normal level. Rather than focusing on what yoga is really about and why we do it, I would obsess about the asanas and believed that if I stopped doing the more challenging ones, I’d lose the ability to do them. It’s not true. If I had only trusted my instincts about being relaxed with practice, without berating myself with my conflicting fears, I would have saved myself a lot of heartache and agitation. The yoga practice is about controlling the mind, feeling connected and not letting those nagging demons get the better of you! Now I am older and wiser, my relationship with the yoga practice is very different. It’s a tool for making life a bit easier. The asanas are all equal and you don’t have to practise the Advanced series in order to be peaceful, calm and content. It’s just a state of mind. At the moment, I’m happy as long as I’m doing something.

One very relevant thing to mention is that throughout my life I’ve had long stretches of athletic amenorrhea (that’s when menstruation stops due to excessive exercising / over-heating and having too little body fat). Most recently this happened to me from age thirty seven, until I was nearly forty. I was practising Advanced A and B together and my practice was taking three hours. Although I was exhausted and I hadn’t had a ladies’ day in nearly three years, I ignored the problem. I don’t know what was going through my head. Perhaps I felt that the asana practice was some kind of endurance test and if I gave in, I would be weak. Eventually my teacher allowed me practice Advanced A and B on different days (and my practice became a more manageable two hours in length). Thankfully my ladies’ days came back a couple of months later. It was only then that my husband and I could begin trying to conceive. It’s obvious now that I should have told my teacher about the amenorrhea, soon after it occurred. Women are built very differently from men, so how can a male teacher intuitively know what’s going on in a female student’s body. I think it’s imperative and our responsibility to communicate with our teachers, when something abnormal is occurring physically. The Yoga Sutras do talk about ‘supernatural powers’ in the third pada, but we can’t assume that our yoga teachers are psychic and it’s foolish to suffer in silence.

I mentioned that during the IVF procedures, I discovered that I was seriously anaemic. I still have to watch my iron levels and need to be very mindful about not over-heating. When I practised in the shala after my year of assisted fertility treatment, I eventually had to stop going to the counted Intermediate and Primary classes. This was simply due to the amount of people in the room causing the humidity levels to rocket and thus making me over-heat, feel nauseated and ultimately faint. I find that when I practise on my own, I can control my over-heating problem and from what I have understood from women who have managed to conceive and sustain a pregnancy, keeping the body cool is pretty important.

Obviously I’m very wary of allopathic medicine now, its potential effects on conceiving and indeed on an unborn child. I’d say that if you truly need to take allopathic medicine whilst trying for a baby, during pregnancy and beyond, do heaps of research into potential side effects.

You were given contrasting advice about the asana practice, whilst trying to conceive. What guidance did you receive about what you should / shouldn’t do in your situation?
I have enormous respect for both of my teachers. One of them may have seen me as strong, flexible and healthy and probably thought that I was a bit younger than I actually was. The other knew that I’m about his age and has seen me over-heating for years. It’s a case of horses for courses, I think. We are all different and so are our bodies. What is right for one person might be inappropriate for the next. In my case I experimented with a range of practices from my regular four series practice, down to two series, Primary and half Primary. A friend suggested that I might explore practising as if I’m pregnant, which I’m doing now and am really enjoying. The truth is, we can’t see what’s happening inside our bodies, so it’s hard to know what effect the asanas are having on fertility and every woman is different anyway.

How do you feel about your practice in retrospect and the difficulty to conceive? Do you feel there is a relationship or not?
Well I know that the length and extremity of my practice when it was three hours long, caused my ladies’ days to stop for three years. This was during the time that we would have started trying for a baby, so that caused a considerable delay. I should have been less selfish and thought about creating a welcoming environment for a pregnancy, rather than pushing my body to its physical limit. I do hear about women who managed to get pregnant really easily, whilst practising the Advanced asanas, but maybe they were younger, didn’t have an over-heating problem and had luck on their side. I think it’s important to enjoy a sensible practice though, in order to keep the body fit and the mind calm. I’m indulging myself in a more relaxed practice now and am wallowing in the moving meditation, which certainly feels like the right thing to be doing!

If a woman practising Ashtanga yoga as part of her daily life over many years is having difficulty to conceive what advice would you offer her given your own personal experience?
First of all if her menstrual cycle isn’t regular, that needs to be addressed. It’s probably a good idea to have a few tests to check that there aren’t any medical reasons why she’s not conceiving (low hormone levels, blocked fallopian tubes, or lack of ovulation for example). Her significant other should probably get checked out too. Work out which are her fertile days and plan accordingly. Gain a little weight, if she’s skinny. I’ve read that low body fat to muscle ratio and exercise-related chemicals, can disrupt the functioning of oestrogen and progesterone, which in turn can make it difficult to conceive. I can say that when I first started having tests at the fertility clinic (whilst I was practising through to the fourth series), my hormone levels were too low for conception to occur. Reducing the extremity of my practice and gaining weight, saw my hormone levels rise. I’d say try to adopt a relaxed approach to the asana practice. The asanas come back, so it’s OK to give oneself permission to be more open-minded and free for a few months. During the time when implantation could occur, I think that being gentle with the body and not jumping is a smart idea. Eat a healthy balanced diet with lots of organic fresh food and if any vitamins and minerals aren’t being adequately provided, look at possible supplements. Cut out coffee and if allopathic medicine needs to be taken, find out its effects on ovulation and pregnancy. Try to spend time in nature, meditating, breathing slowly and feeling connected to the Universe. Be positive and happy and if things don’t happen for a while, don’t lose the faith!

EPILOGUE
Within four months of detoxing with TCM to cure the LUFS and practising Ashtanga as if she was pregnant, Philippa did manage to conceive. It was a twin pregnancy, but sadly she miscarried both babies at ten weeks. On a positive note (despite what the doctors said), it was a natural pregnancy, so maybe it could happen again …

Written for ‘Yoga Sadhana For Mothers’ published 2014     yogasadhanaformothers.com