Infertility FAQs

Overcome Infertility with Acupuncture and Traditional Chinese Medicine
1. What is Infertility
2. What are the causes of infertility?
3. What are the causes of infertility according to Traditional Chinese Medicine (TCM)?
4. How does Western Medicine treat infertility?
5. How do acupuncture and TCM enhance fertility?
6. What are the advantages of acupuncture and TCM?
7. Can acupuncture and TCM help a woman in her advanced reproductive age?
8. Can acupuncture and TCM lower elevated Follicle Stimulating Hormone (FSH)?
9. How can acupuncture and TCM help a woman with Polycystic Ovarian Syndrome ( PCOS)?
10. Is there any hope for a woman with Premature Ovarian Failure (POF) to have a biologic child?
11. Can acupuncture help a woman who has uterine fibroids or endometriosis conceive?
12. When is it best to start acupuncture treatment?
13. What protocols are involved in the use of acupuncture and TCM?
14. What foods enhance fertility?
15. What other supplements will help increase the chance of pregnancy?
16. What foods I should avoid?



1. What is Infertility

Infertility is a disease of the reproductive system that impairs one of the body’s most basic functions: conception. Reproductive endocrinologists, the doctors specializing in infertility, consider a couple to be infertile if one of the following three conditions is met:

  • The couple has not conceived after 12 months of contraceptive-free intercourse and the female is under the age of 34.*’
  • The couple has not conceived after 6 months of contraceptive-free intercourse and the female is over the age of 35.*
  • The female is incapable of carrying a pregnancy to term

*Note that the declining egg quality of females over 35 years of age accounts for the age-based discrepancy.

 

2. What are the causes of infertility?

Roughly one-third of infertility cases can be attributed to factors affecting the female and about one-third can be attributed to factors that affect the male. The remaining one-third of infertility cases is generally due to a combination of problems between both partners although, among this last group, 20% of cases cannot be explained.

The most common causes of female infertility are as follows:

  • Ovulation disorders due to irregular menstruation, amenorrhea, polycystic ovarian syndrome, or premature ovarian failure.
  • Endocrine imbalances, such as elevated follicle-stimulating hormone (FSH), luteal phase defect, thyroid disease, or hyperprolactinemia.
  • Blocked fallopian tubes, which can occur as a result of pelvic inflammatory disease, endometriosis, or having undergone an ectopic pregnancy.
  • Cervical or uterine factors resulting from uterine fibroid tumors or surgical damage during treatment for cervical dysplasia.
  • Immunological and inflammatory factors, both specific and non-specific. An example would be lupus, which is a chronic autoimmune disease that can affect various parts of the body.
  • Congenital anomalies (birth defects) involving abnormal structure of the genital organs.

The most common causes of male infertility are as follows:

  • Azoospermia, which refers to a complete absence of sperm cells in semen, accounts for 10% to 15% of all cases of male infertility. It may be caused by testicular failure or it may result from damage to some portion (e.g., the epididymis, vas deferents, or ejaculatory duct) of the reproductive delivery system. Obstructive azoospermia is caused by either congenital or acquired problems, the latter of which may be due to infection.
  • Oligospermia, or abnormal sperm production, can be triggered by genetic factors, lifestyle choices (e.g., smoking, alcohol, and certain medications), varicocele (enlargement of the vein in the scrotum that drains the testicles), diabetes, kidney failure, childhood infections (e.g., mumps), and hormonal or chromosomal deficiencies (e.g., insufficient testosterone).
  • In rare cases, infertility in men is caused by a genetic disease, such as cystic fibrosis or chromosomal abnormality.
 

3. What are the causes of infertility according to Traditional Chinese Medicine (TCM)?

According to TCM, infertility is caused by an imbalance in blood and Qi affecting one or more of the organ systems. The three major organ systems involved in fertility are the kidney, the spleen, and the liver. In TCM, there are 6 differentiations of diagnosis for female infertility:Kidney Yin Deficiency, Kidney Yang Deficiency, Spleen Qi and Blood Deficiency, Liver Qi Stagnation and Blood Stasis, Dampness, and Cold uterus.

The kidney controls the release of the ovum and also releases and stores a substance called Jing Qi (body essence), which is necessary for a healthy body, mind, and pregnancy. If an imbalance exists within the kidneys, the body will be insufficiently supplied with Jing Qi, resulting in infertility. If one consumes excessive cold foods or beverages, her kidney Yang will be deficient, and she will not be able to keep her uterus warm to help the embryo’s implantation.

Finally, the liver facilitates the smooth flow and distribution of blood and Qi. It is responsible for transformation in the body, including ovulation. Stagnation in either blood and Qi leads to depression, anxiety, and stress, all of which negatively affect fertility.

 

4. How does Western Medicine treat infertility?

Western Medicine practitioners treat conditions according to the medical diagnosis. For infertility, they generally offer Assisted Reproductive Technology (ART) as a solution. Examples of ART include intrauterine insemination (IUI), in-vitro fertilization (IVF), gamete intro-fallopian transfer (GIFT), and zygote intro-fallopian transfer (ZIFT). About 90% of infertility cases are treatable with medical and alternative therapies.

 

5. How do acupuncture and TCM enhance fertility?

Western Medicine treatments for infertility target only the reproductive organs, while acupuncture and TCM work to strengthen all systems within the body. Among the most positive aspects of acupuncture are the benefits it has on the Hypothalamic-Pituitary-Ovarian Axis, which plays a key role in fertility. Acupuncture helps to reduce anxiety, stress, and cortisol levels and increases blood flow to the uterus and pelvic region which, in turn, improves the uterine lining and relaxes the uterine wall. This increases the chances of successful embryo implantation and fertilization. Finally, acupuncture and TCM also enhance the immune system and normalize all endocrine and hormonal systems that regulate ovulation and the menstrual cycle, which is especially important in women with Polycystic Ovarian Syndrome. Thus, by exerting multiple effects on multiple systems and regions within the body, acupuncture and TCM restore health and balance to the mind, body, and spirit which in turn enhance fertility in both men and women.

Free circulation of blood and Qi throughout the body ensures that every cell, tissue, and organ is properly nourished. Through procedures and treatment regimens that improve the quantity, quality, balance, and flow of blood and Qi, acupuncture and TCM ensure optimal functioning of all organs in the body, thus increasing health and fertility.

In the Chinese tradition, acupuncture and TCM have been effective in treating infertility for over three thousand years. Numerous studies in the past decade have now shown that acupuncture also increases the success rate of conventional Western Medicine infertility treatments. In the April 2002 issue of Fertility and Sterility, for example, a German study showed that using acupuncture pre- and post-IVF increased the success rate by 42.5%, compared with only 26.3% for those who did not incorporate acupuncture into their treatment regimens.

 

6. What are the advantages of acupuncture and TCM?

Acupuncture and TCM offer several advantages in the treatment of infertility. They enable patients to conceive naturally with minimal side effects, thus allowing them to achieve pregnancy without compromising their health. When used in conjunction with such ART procedures as IVF, they help increase the success rate and reduce the side effects of drugs prescribed during ART. Acupuncture and TCM also have the added benefit of improving patients’ overall physical and emotional well-being, thereby reducing the chances of ectopic pregnancies and spontaneous miscarriages.

 

7. Can acupuncture and TCM help a woman in her advanced reproductive age?

We all know that seniors who continue to exercise are able to maintain greater levels of strength, bone mass, and agility. People who eat a healthy diet and have active social lives are sharper and healthier, and retain their faculties at higher levels. Physical decline associated with aging has much less to do with biology and more to do with lack of physical activity, poor diet, and lack of stimulation. The same is true of our reproductive life span, which is only about 40 years (menarche at 12-15 years old to menopause at 46-55 years old). A woman over 37 is defined as “senior reproductive age” and requires “Ovarian Care.”

The concept of ovarian care is similar to skin care, eye care, prostate care, etc. Just as exercise is important for maintaining the optimal health of the lungs and heart, a woman also needs to pay attention to the ovaries in order to maintain beauty and youth, inside and out. This is also very important for preserving fertility. With a regimen of acupuncture treatments and TCM herbal medicines, it is possible to retain good blood flow in the reproductive region, regain balanced hormones, and encourage resting, non-responsive follicles to resume normal communication to the Hypothalamus-Pituitary-Ovary-Uterus Axis when they are ready to grow.

 

8. Can acupuncture and TCM lower elevated Follicle Stimulating Hormone (FSH)?

Yes. High FSH indicates sluggish ovaries, meaning they have become less responsive to FSH. When there is an interruption along the Hypothalamus-Pituitary-Ovary-Uterus axis, the ovaries do not react appropriately to the normal signal from the pituitary gland, so the pituitary gland is constantly secreting an excessive amount of FSH. In turn, the ovaries are not producing enough Estrogen to tell the pituitary gland to stop making FSH.

Acupuncture can help open up the blocked channel and assist the restoration of normal communication between the organs to bring the elevated FSH down to a normal level. However, once one’s ovaries reach the menopause stage, all reserved follicles are depleted, and nothing can bring FSH down.

 

9. How can acupuncture and TCM help a woman with Polycystic Ovarian Syndrome ( PCOS)?

PCOS is a medical disease defined as a disorder of ovulation, affecting the skin, hair, body weight, reproductive system, endocrine system, pancreas, hypothalamus, pituitary gland, and adrenal glands. The primary indication of PCOS is irregular or absent periods, often dating back to menarche. In some cases, women with PCOS can have very long cycles, and don’t ovulate, or ovulate later in the cycle, may have little bleeding or very heavy bleeding. Western medical doctors and scientists have been unable to explain the actual cause of PCOS, and thus have been unable to treat it effectively. Chinese medicine seeks to redress the entire hormonal secretion that produces the changes in a woman’s ovaries seen in PCOS. The most common manifestation of PCOS is dampness or phlegm, associated with Yang Qi deficiency and obstruction. A study done in Europe in the 1990s on anovulatory women with PCOS showed that electro-acupuncture restored ovulation in one-third of the test subjects. Acupuncture also reduces endocrine indicators of PCOS, including LH/FSH rations, mean testosterone concentrations, and beta-endorphin concentrations. Researchers theorized that this improvement was caused by an inhibition of hyperactivity in the sympathetic nervous system. In other words, acupuncture works to restore the entire sympathetic nervous system to health and balance. The result is normalization of the hormonal system directly tied to ovulation and reproduction; then the entire hormonal cascade allowing an egg to develop and be released on schedule. To ensure follicles are healthy and capable of nurturing healthy eggs, it is important to have at least three regular ovulatory cycles before trying to get pregnant. Once the woman with PCOS has re-established at least three cycles, her whole reproductive system will most likely function normally, and pregnancy can occur naturally.

 

10. Is there any hope for a woman with Premature Ovarian Failure (POF) to have a biologic child?

POF is essentially very early menopause, occurring before a woman reaches the age of forty. It is due to either the loss of accelerated eggs; or the follicles themselves becoming less responsive to hormonal stimulation; or a confused immune system; or chromosomal defects; or damage from pelvic surgery, chemotherapy or radiation therapy; or pelvic inflammatory disease(PID). It is one of the more common conditions affecting a woman’s fertility.

Women with POF have stopped menstruation altogether and experience menopausal symptoms, or will have irregular cycles, either very long or very short, characterized by unpredictable ovulation or non-ovulation. The cycle is often accompanied by elevations in FSH, indicating that ovaries are not responding to any signals from hypothalamus-pituitary. The lack of communication causes hormonal “confusion.” The hypothalamus gives the pituitary gland messages to try harder to stimulate the ovaries, but the ovaries are no longer making any hormone to feedback, thus making the FSH high. Elevated FSH is produced to invigorate the ovaries, but the ovaries, whose receptors are down, have become less responsive to this message. Infertility is the result of this condition, and there are additional health implications, like osteoporosis or decreased bone density. Western medicine can not pinpoint its cause and can do little to help it.

Although treatment of POF may be challenging for the acupuncturist, it is also rewarding because Chinese medicine offers one of the most effective ways to address POF, especially POF due to a failure of the Hypothalamus-Pituitary-Ovarian axis. In TCM philosophy, most POF patients have a combination of excess and deficiency causing blood and essence depletion or meridian obstruction. Based on each patient’s condition, treatment is individualized either by fortifying or decongesting with acupuncture and herbal supplements, improving blood flow to the ovaries and uterus.

It is possible to regulate Qi flow along this axis, reestablish the communication among these organs, and by doing so, to lower FSH, improve the immune system, and restore ovulation naturally, with the possible result of a biologic child.

Of course, when a woman’ ovaries reach her reproductive life span, there is nothing that can be done reverse them.

 

11. Can acupuncture help a woman who has uterine fibroids or endometriosis conceive?

In fact, there are quite a few cases in which women become pregnant with either fibroids or endometriosis. Both conditions are characterized by inappropriate tissue growth within the reproductive system. In endometriosis, the endometrial cells migrate in the area outside the uterus. Uterine fibroids are benign tumors found on the inner and outer wall of the uterus, or anywhere else in the pelvic cavity. They cause damage to the reproductive organs and prevent conception. In TCM, they are both considered processes of inhibited, stagnated pelvic blood flow. They form lumpy nodulations within the body caused by hardening static blood. TCM treatment involves acupuncture to open blocked Qi and blood pathways, invigorating the blood and eliminating blood stasis, clearing and softening the indurations. Thus, conception can occur when the body restores the free flow of energy and blood in the reproductive organs.

 

12. When is it best to start acupuncture treatment?

Treatment can start almost anytime, although 3 months of acupuncture and TCM usually provides maximum benefits. Any amount of treatment will help. Some patients become pregnant by natural means after undergoing acupuncture treatments. Other patients undergoing ART turn to acupuncture and TCM to help them prepare physically and emotionally in the 3 months leading up to the time at which they begin receiving stimulation medication.

 

13. What protocols are involved in the use of acupuncture and TCM?

At the Art of Wellness, treatment regimens are tailored to the specific needs of each individual patient. The general procedure for treatment of infertility with acupuncture and TCM, however, involves the following components:

  • Acupuncture treatments 1-2 times each week
  • Herbal supplements taken 2-3 times daily (optional for patients under stimulation medication)
  • Following specific dietary guidelines provided by the practitioner
  • Self-acupressure procedures taught by the practitioner
  • Meditation, Tai-Chi, Qi Gong, or Prenatal Yoga
 

14. What foods enhance fertility?

The Nei jing, Classical of Internal Medicine was compiled over 2000 years ago, possibly the first document describing the dynamic relationship between health and the energies of food, which is known as Chinese dietary therapy. It emphasizes the connection between the human body and the environment. What foods one should eat depend on the season, location, one’s base constitution, emotional and spiritual health, daily work and activity, as well as the food itself and its color, tastes, and energetic properties.

Overall, organic and seasonal locally-grown foods tend to be more nutritient-dense than conventional foods and will help to enhance fertility.

In addition, be sure to eat meats, fish, and eggs from poultry that are free-range and hormone-free. Vegetable products, such as sprouts, nuts, and seeds are a good source of vitamins and minerals. Complex carbohydrates (e.g., whole grains like brown rice, oats, quinoa, barley, and spelt) are another good source of nutrition.

Based on each individual’s condition, there will be specific dietary suggestions from the acupuncturist.

 

15. What other supplements will help increase the chance of pregnancy?

Supplements are by no means a substitute for natural sources of nutrition, but we do recommend the following supplements to increase the chances of pregnancy:

  • Natural, high-potency multivitamins and minerals, containing 400-800 mcg of folic acid and iron
  • Deep sea fish oil, flax seed oil, or omega-3 fatty acids
  • Pure royal jelly, 1/4 teaspoon daily
  • Coenzyme Q-10, 75 mg for woman, 200 mg for men with poor sperm production
  • B-Complex vitamins daily
  • Bee pollen or royal jelly
  • Amino acids L-arginine and L-carnitine for men
  • Zinc, 15 mg for woman, 100 mg for men
  • Selenium, 20 mcg for woman, 150 mcg for man
 

16. What foods I should avoid?

The foods that should be avoided by those suffering from infertility include the following:

  1. Processed foods
  2. Foods containing preservatives and additives, like food coloring, artificial sweeteners, and artificial flavoring
  3. Coffee
  4. Processed or refined sugars
  5. Cold and icy foods and drinks should be avoided, especially during menstruation
  6. Alcohol and drugs

In addition to the aforementioned foods, smoking should be avoided as should chemical and environmental toxins, such as aerosol cans, paints, glues, household cleaners, dyes, and pesticides.

Reference
1. Paulus, W.E., Zhang, M., Strehler, E., El-Danasouri, I., and Karl. S. (2002). Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertility and Sterility, 77 (4), 715-720.

2. Randine Lewis. The Infertility Cure.