Hard to Conceive

But still, I can't help but wonder what evidence exists for the therapies pulled together in Lewis's program. So once I returned from the retreat, I took a closer look.

• HERBS

The Eastern View Herbs, in use for infertility since 300 B.C., are said to harmonize the endocrine system, which regulates the menstrual cycle. If a woman has, say, low progesterone levels, a Western fertility doctor may prescribe progesterone; an herbalist will prescribe individualized blends of herbs intended to balance that person's entire endocrine system, causing the body to do a better job manufacturing its own progesterone in the right quantities.

After extensive interviews with Lewis before the retreat, I got my herb capsules in the mail -- one custom blend to take pre-ovulation, and another to take after ovulation. I choke down nine capsules a day, three with each meal.

The Western View Many doctors are leery.

"We are really very concerned about our patients' taking herbs," said Bob Stillman, medical director of Shady Grove Fertility, which recently began offering complementary medicine through its clinics but steers clear of herbs. Stillman, a reproductive endocrinologist, said he worries that even the herbalists themselves don't know much about the estrogenic properties in herbs, and too much estrogen in a woman's system may interfere with the drugs prescribed during an IVF cycle.

Others are less worried. "Most physicians don't know anything about herbs and are afraid they will have harmful effects, but that's just paranoid," said Adriane Fugh-Berman, associate professor of physiology and biophysics in Georgetown University's School of Medicine's complementary medicine program. Fugh-Berman, a general practitioner, says the strongest plant estrogen has less than 1 percent the potency of the estrogen produced in the body. Thus, she says, any estrogen derived from herbs is unlikely to have a deleterious effect.

But can herbs have a positive effect? "I think there's something there, but the evidence doesn't exist yet," said Fugh-Berman.

What the Studies Show In the West, large, controlled studies on herbs and infertility don't exist, and the few small studies that exist are hard to find. But in April, a Stanford University School of Medicine study published in the Journal of Reproductive Medicine showed that five of 15 study participants became pregnant after five months on the herb and dietary supplement mix FertilityBlend, which contains the herb chasteberry, the amino acid L-argenine and green tea as well as various vitamins. The study, while very small, was double-blind and placebo-controlled. It was, however, funded by the company that makes FertilityBlend.

In China, where the prescribing of herbs is far more common, studies are more numerous, though none are controlled in the Western sense. In an observational study published in 1994 in the Hubei Journal of Chinese Medicine, 248 of 401 women conceived after three months to one year of treatment with different herb preparations. There was no placebo group against which to compare results.

In another observational study, published in 1995 in Shanxi Chinese Medicine, 107 of 188 previously infertile women became pregnant after three months of herbs, while another 20 conceived after four to six months. Again, there was no placebo group.