You do not need to be diagnosed with or experience fertility concerns to benefit from Traditional Chinese Medicine (TCM). TCM helps harmonise the system of the body, it prepares the couple to conceive and reduce the possibility of any complications, such as miscarriage.
Infertility concerns arise for couples planning to start a family who have been unsuccessful in conceiving after two years of unprotected regular intercourse. Currently in Australia, infertility affects about 3 million couples who are planning to start a family. 80% of infertility conditions can be diagnosed with Western medicine, the remaining 20% is diagnosed as having no medical cause. In both cases TCM can help couples conceive (Jane Lyttleton, 2004).
In treating fertility, TCM provides a holistic approach. To develop a pattern of diagnosis, observation of the tongue and palpitation of the radial pulse provides detailed information about the internal environment of the body. For a female, lifestyle, energy levels, symptoms during ovulation and menses need to be looked at in great detail. To increase the likelihood of conceiving the cycle duration, menses colour and quality needs to be regulated. For the male, physical symptoms such as sperm production, back pain, weak knees, hair loss, tinnitus and other internal and external environmental factors are assessed.
Polycystic Ovarian Syndrome (PCOS) involves various hormone imbalances and the build-up of immature follicles in the ovaries, affecting the development and release of mature eggs during ovulation. In Traditional Chinese Medicine, when treating PCOS for fertility the primary objective is to clear the blockage and swelling found in the ovaries caused by the build-up of immature follicles (immature eggs and cysts). The accumulation of immature follicles and cysts in the ovaries obstructs the pathway for any fully matured eggs from being released, making ovulation problematic. By clearing the accumulation of immature follicles and cysts, an easier passage can be made for any mature eggs to travel down the fallopian tubes allowing the process of ovulation to occur. A treatment plan of acupuncture and Chinese herbs can enhances ovarian function and promote the balance and nutrients follicles need to develop into healthy and mature eggs.
A systematic review involving 1659 females, reports that Chinese medicine significantly increased frequency of ovulation in women with anovulatory infertility compared to treatment with Clomiphene (Clomid). They observed that pregnancy rates increased and miscarriage rates reduced in women who used Chinese medicine compared with those who used Clomid (The Journal of Alternative and Complementary Medicine, 2012).
ivf and tcm
IVF (In Vitro Fertilisation) is often considered when a couple is unable to fall pregnant. A fertilised egg can be implanted inside the womb of a female. Often the fertilised egg does not implant on the lining of the endometrial wall or hold, drastically lowering the IVF success rate. The key to a successful IVF implantation is to prepare the uterus well before the fertilised egg is implanted. Traditional Chinese Medicine (TCM) prepares the soil (uterus lining) and IVF provides the seed (fertilised egg). The seed needs good, nourishing soil to flourish, just as an embryo needs a strong lining to develop in to a foetus. If the soil does not have the nutrients to sustain a growing embryo a miscarriage or unsuccessful implantation is likely.
Prior to commencing the IVF process, Chinese herbal medicine (CHM) and acupuncture is used to nourish the ovaries and prepare the uterus for the fertilised egg. However, due to lack of research, it’s advised not to combine Chinese herbs with the IVF process, due to possible interactions with many of the Westernised drugs. Acupuncture, on the other hand is an accepted and popular treatment whilst undergoing IVF.
In 2011, a systematic review was conducted by the University of Adelaide (Journal of Complementary Therapies in Medicine), involving 1851 females with fertility issues. The study compared the effects of Chinese herbal medicine (CHM) in comparison to IVF and other Western drugs in the treatment of female infertility. CHM was twice as effective in increasing pregnancy rate over a four month period when compared to Western fertility drugs or IVF.
ivf and acupuncture
Four weeks prior to the egg extraction, acupuncture is administered twice a week to help regulate hormone levels and increase blood flow to the ovaries (or eight weeks prior, once a week). In TCM terms we are nourishing the blood and the production of quality eggs which can be used in the IVF cycle.
The procedure of collecting eggs from the ovaries can cause soreness in the abdomen due to follicles swelling and bleeding. In Western terms we say the blood congeals within the uterus, in TCM the bleeding and swelling is seen as blood and Qi (energy) stagnation. Qi is the commander of blood and if the Qi does not push the blood, the blood will congeal creating bruising, swelling and abdominal pain. After the procedure, acupuncture is used to remove the congealed blood in the uterus, stop the pain and simultaneously support the smooth flow of Qi thus helping the reproductive system recover from the egg extraction.
Once an egg has fertilised and is ready for implantation, it’s highly recommended to receive acupuncture on the same day of the implantation, a treatment before and after the implantation. If logistically this is not possible, as close to the implantation date as possible ie. the day before and after. This is needed to help nourish and strengthen the womb and to allow the implantation to sustain and grow. Acupuncture points are used to nourish blood within the uterus walls, much like the nutrients found in soil that will allow a plant to grow and flower. Developing good soil prior to the seed being inserted for germination is the key to a successful implantation. Because acupuncture has created a healthy lining for the uterus, the uterus will be more likely to accept the fertilised egg.
Around the time of implantation, the body constitution and emotional state of the female must be strong. Acupuncture is also used to calm the mind and strengthen the Qi (immune system, energy levels) to help secure and allow the embryo to grow. Once the implantation is successful, to reduce the chances of miscarriage, acupuncture is continued for a further 12 weeks. The main priority is to administer acupuncture points which calm the mind (Shen), to help prevent stress from consuming one’s energy and to keep the uterus (Bao Mai) closed.
Globally, adequate research has been conducted providing evidence that acupuncture aids the IVF process. Acupuncture has been particularly beneficial for patients who have been identified with having an IVF success rate of about 35% or less. In other words, IVF patients who have been identified as having a lower chance of success, have responded better to acupuncture treatments incomparison to those who have been identified as having a higher success rate with IVF (Human Reproduction Journal, 2010).
It’s important for the male to find out if there are any underlying health issues affecting their quantity, quality and motility of sperm. Out of the approximate 1 in 5 Australian couples experiencing difficulties in conceiving, males contribute to about 40 percent of these cases (Jane Lyttleton, 2004). Aside from assessing the quantity, motility and quality of the sperm, part of TCM diagnosis involves evaluating internal and external environmental factors which play a major role in sperm production.
In order to produce sperm, the scrotum temperature needs to be lower than the body temperature. If there is too much of a temperature rise in the scrotum, sperm making cells within the body will decrease. For example, if a male gets an infection within the reproductive organs the infection generates heat leading to less sperm being produced. Within TCM this is seen as heat affecting the reproductive organs and this heat needs to be expelled out of the body by using acupuncture and cooling Chinese herbs. Other environment factors which produce heat toxins and can cease the production of sperm include men who work with plastics and dyes, take certain antibiotics or heavy consumption of recreational drugs, including alcohol and cigarettes. These heat toxin producing drugs affect not only sperm count but can be the cause of creating abnormal sperm.
In the year 2000, a pilot study was conducted (Journal of Andrologia), after 10 treatments of acupuncture, 7 out of 15 men who had no sperm count actually produced sperm. The positive effects of acupuncture on sperm count measured in this particular research has validated the need to continue researching the positive effects of acupuncture on male infertility.
The quality, motility and production of sperm in TCM is predetermined by our genetical makeup and passed down from our parents. It is called ‘jing’, the essence of life which is stored below our navel and one of its uses is to produce healthy sperm. Jing has limited storage and as a male gets older it depletes and cannot be replaced, hence sperm number and quality is affected. In TCM over indulgence in sexual activity, masturbation and unhealthy dietary habits causes the over use of Jing and thus affecting sperm number and quality. Acupuncture can be used to nurture the Jing and improve the quality of the sperm.
In 2005, a research found that acupuncture improved sperm quality (Journal of Fertility and Sterility). A group of 40 infertile men who had pathological semen analyses were treated with acupuncture twice a week for 5 weeks. The research saw improvement in the ultra-structural integrity of the sperm and the research concluded that males with poor sperm quality can benefit from acupuncture.
Another study in 2002 (Journal of Huazhong University), involved 82 infertile men with pathological semen abnormalities who received acupuncture twice a week over 2 months. After the course of acupuncture treatment the results indicated significantly higher fertilisation rates (66.2%) in comparison to before the treatment (40.2%).
Within TCM, the Kidney has an important connection with the reproductive organs. For the male, if the sperm motility is lazy and cannot get to the female’s egg, the Kidney yang is low and the sperm tail does not have enough drive to get to its destination. Accompanying signs of Kidney yang deficiency include difficulties in sustaining an erection, feeling tired all the time and lower back pain.
Recent research supports the ancient treatment form of acupuncture to increase sperm motility. In 2009, a small randomised clinical trial (Journal of Fertility and Sterility), divided 57 men with extremely low sperm count into 2 even groups, an acupuncture treatment group and placebo acupuncture group. After receiving treatment twice a week for 6 weeks, the men within the acupuncture group detected a significant increase in sperm motility. The research results support that acupuncture is a positive treatment form for male patients with severe oligoasthenozoospermia (combination of reduced sperm motility and low sperm count).