Infertility Causes & TCM Treatment

Having a child is not always easy, with about one in 6 Australian couples currently struggling with infertility. Acupuncture treatments and herbal preparations have assisted many couples achieve conception and pregnancy. Infertility, usually defined as the failure to conceive after 1 year of unprotected intercourse or the inability to achieve a live birth, can be caused by male or female factors, and about 22% of cases are unexplained. There are a number of causes for infertility and failed IVF cycles that will briefly be discussed below.

  • Repeated embryo implantation failure
  • Natural Killer Cells
  • Poor responders to FSH stimulation
  • Poor quality follicles
  • Premature Ovarian Failure
  • Diminished Ovarian reserve
  • High FSH
  • Luteal Phase defect
  • Thin endometrial Lining
  • Male factor infertility
  • Endometriosis

Repeated embryo implantation failure

A client who has repeated implantation failure may choose to see us for a 3 month preparation as above or see us during a natural cycle FET (frozen embryo transfer). In the later we suggest Acupuncture bi-weekly before transfer and pre/post Acupuncture on the day of the transfer.

Some examples of conditions this treatment may be useful in;

  • Repeated IVF transfers will no success
  • Repeated miscarriages with no known reason
  • Older women at risk of miscarriage

From a Chinese medicine perspective a woman, who has responded well to the ovary stimulation and retrieved a good number of quality follicles, however has had several transfers with no success suggests that her endometrial lining is thin or poor quality.

 

Natural Killer Cells

Immune cells in the uterus are important in the early detection and elimination of foreign cells, such as infections or cancer. These immune cells are normally present in every person as part of their immune system. Women who have fertility problems, specifically miscarriage or unsuccessful IVF are more likely to have higher levels of activity of these ‘Natural Killer cells’ [NK cells] than other women. Investigating an approach known as the Bondi or Colorado Protocol, this research offers experimental immune therapy for women who test positive to high levels of natural killer (NK) cells in the blood or uterus.

 

Poor responders to FSH stimulation

This treatment is aimed at clients who have had 1 or more IVF stimulations with poor response and little to no follicles collected. We highly recommend that this client have 3 months preparation before the next cycle treatment includes regular Acupuncture, Chinese herbal medicine, vitamins and dietary changes. Most of these clients are at low risk of hyperstimulation so we sometimes continue Chinese herbal medicine right through the stimulation. However we do avoid particular highly estrogenic herbs.

Some examples of conditions where this treatment can be useful in;

  • Multiple IVF stimulations with very small amounts or no follicles collected
  • Multiple IVF stimulations with decreasing amounts of follicles collected
  • Age related infertility

From a Chinese medicine prospective a woman with few follicles collected suggests that her fertility energy called ‘Jing’ has been depleted.

 

Poor quality Follicles

This treatment is aimed at women who have a large amount of follicles collected however few of the follicles are of maturity, poor quality and or do not survive. Again in we recommend 3 months preparation before the next IVF stimulation cycles begins. Treatment includes; regular Acupuncture, Chinese herbal medicine, vitamins and dietary changes.

From a Chinese medicine prospective a woman who has many follicles collected however none to transfer suggests that her ovaries lack the ‘Qi’ and blood circulation to nourish and develop the follicles.

 

Premature Ovarian Failure (POF),

Premature Ovarian Failure (POF), or Primary Ovarian Insufficiency,(POI) is the loss of ovarian function before the age of 40. In women aged 40 years or older, the physiologic decline of ovarian function because of aging is called perimenopause or menopausal transition.

Clinical researches show the most common patterns of disharmony of POF in Chinese Medicine are Kidney and Liver Yin deficiency, followed by Kidney and blood deficiency. Acupuncture increases blood flow to the pelvic cavity to nourish the ovaries(more blood flow means more hormone and nutrients can reach the potential follicles) and to improve egg’s quantity and quality. Acupuncture regulate the Hypothalamus-Pituitary-Ovarian axis and this improves ovarian function creating more follicles and maturing eggs .

Acupuncture can also relax the body and reduce stress levels. There are many studies that show the effectiveness of acupuncture in regulating ovulation, reducing elevated FSH, and from my clinical experience, significantly increases AMH level(indication of ovarian reserve).

 

Diminished Ovarian Reserve

Reduced egg supply, and or difficulty in egg development or recruitment, generally a sign of advanced maternal age. This condition is synonymous with premature ovarian failure, although this patient population is most often of younger maternal age.

Generally determined by high follicle stimulating hormone (FSH) levels, a low antral follicle count (AFC), and changes in a woman’s menstrual cycle.

Both Chinese and naturopathic medicine treat diminished ovarian reserve, generally with acupuncture, herbal therapy, supplements and vitamins, lifestyle counsel, current accepted fertility diet recommendations, and self massage techniques. When committed to fully, 3-12 months (depending on presentation of condition) of an individualized treatment plan deeply nourishes a woman’s reproductive essence and optimizes her chances of conceiving with her own eggs either naturally of via IVF.

With this diagnosis, coupled with advanced maternal age, many women pause at the thought of waiting 3-12 months to attempt another IVF cycle. This is understandable. But, if these months are spent wisely, a ‘turning back of the biological clock’ effect takes place and moves the woman into a better circumstance as far as her reproductive potential is concerned.

That said, whatever a woman’s choice may be as far as treatment options and protocols, the IVF Acupuncture Group doctors fully support that choice and will treat to the best of their abilities to optimize the given scenario.

 

High FSH

Want to try IVF but have high FSH?
Diagnosed as Pre-matured menopause?

Acupuncture and Chinese herbal medicine may help reduce your FSH and achieve pregnancy. Many of our clients are told that they have high Follicle Stimulating Hormone (FSH), or they are diagnosed are pre-matured menopause.
High FSH is linked to poor egg quality and conception rates, both stand-alone or in IUI/IVF cycle. They are told not able to conceive naturally or if they choose to do IVF, their IVF specialist won’t be able to help them unless their FSH level are below 12, because their ovaries will have no or less response to the IVF drugs.

The reason that you have high FSH is because your ovaries are not responding adequately to its hormonal message from the pituitary gland. Acupuncture and Chinese herbal medicine can improve blood flow to your ovaries, and provide more nutrients to your ovaries, consequently improve your ovaries’ response to pituitary gland, and ovulation happens.

In our clinic we have treated many women who have high FSH with acupuncture and Chinese herbal medicine. Generally after a few weeks’ treatment, FSH level can be lowered below 12, or under 10. Many associated symptoms can also be improved a lot, such as abdominal discomfort (pain in the ovaries, cramping), hot flushes, fatigue and emotional instability. Many patients achieved pregnancy after the treatment either naturally or through IVF.

 

Luteal Phase Defect

A luteal phase defect is when the uterus does not adequately respond to progesterone to hold the typical 14-day luteal phase. Progesterone output from the corpus luteum may be adequate, but the tissues are unresponsive. Thus, progesterone administration rarely cures luteal phase defect. At ties, the uterine lining does not exhibit the proteins that are necessary for implantation to occur. Sometimes, the immune system reacts against an implanting embryo, and lowers the response to progesterone. Occasionally, the endometrium thins and sheds before menstruation, which does not allow an implanting embryo to remain.

Chinese medicine views the luteal phase of the menstrual cycle energetically. We see that the kidney essence must be adequate to produce progesterone and hold the heating aspect of the menstrual cycle. Spleen qi must be able to “hold” the energies that allow implantation. The qi and blood must be unobstructed, without excess heat or dampness.

 

Thin Endometrial Lining

One of the major causes of infertility and IVF failure is a thin uterine lining. Evidence-based acupuncture treatment to increase blood flow is essential to improving fertility and implantation, and reducing chances of miscarriage.

Generally, acupuncture treatments to improve uterine lining are administered 2-5 times per week during the gonadotropic stimulation phase of an IVF cycle.

It should be noted that stress, lack of exercise, not enough rest, lack of joy, and certain foods all can inhibit blood flow to the uterus and ovaries.

The following are a few Dietary principles you can implement during menstruation to help promote healthy blood flow to the uterus, increase your fertility, and reduce the chances of miscarriage;

  • avoid sour food when bleeding (yogurt, vinegar, pickles, grapefruit, currants, and green apples.
  • eat more blood nourishing foods when bleeding such as eggs, carrots, spinach, dates, & goji berries.
  • consume more blood invigorating foods when bleeding such as fish, ginger, cinnamon, and turmeric.

Male factor infertility

The quality and quantity of sperm can be an issue even when ICSI is being used. We suggest a combined Acupuncture, vitamins and Chinese herbal treatment for a minimum of 3 months prior to IVF. Acupuncture session weekly.

 

Endometriosis

Endometriosis is the abnormal location of uterine tissue outside of the uterus. It is a fairly common condition affecting up to 10 % of women between age16 and 50, and is believed to be the cause of infertility in 30-50% of all infertile women. The cause of endometriosis is still unclear. From a Chinese medicine perspective endometriosis is blood stasis. Blood stasis is blood that coagulates or congeals, brought about either by blocked energy in the pathways of the body or by insufficient energy to push the blood through the vessels. Blocked or insufficient energy may be due to emotional trauma, severe stress, constitutional weakness, surgical history, and/or exposure to cold: either cold temperatures or the habitual consumption of cold foods especially during menstruation. Signs of blood stasis include stabbing pain that is fixed in one place, frequent or heavy bleeding, bleeding with dark purple clots. Chronic stagnation causes clots, which can have a tendency to manifest themselves as masses or lumps. Endometriosis, fibroids and ovarian cysts are all examples of blood stasis in women.