Treatment
Infertility
Infertility
Acupuncture Treatment for Infertility
Infertility is an increasing western condition. Currently 1 in 7 couples are considered to have difficulty in conceiving. According to the Merck Manual, 40% of infertility lies with the man, 40% with the woman and 20% to a combination. It is therefore important that infertility is viewed a joint condition.
In western culture, the desire to have children at a later age is also having an effect on conception. Peak fertility occurs at 21-25 for both men and women. By the age of 25 this reduces to a 75% chance of pregnancy within 6 months in women. By 30, this decreases to a 47% chance and by 40 this has reached a 25% chance of conception.
But enough of the bad news! Chinese medicine has been successfully treating infertility for more than 2000 years.
Many people come with recognized conditions which can cause infertility. For women this can include:
- Polycystic ovarian syndrome
- Blocked Fallopian tubes
- Endometriosis
Other causes may involve allergic reactions to male sperm or premature ovarian failure. Many cases of infertility will have an unknown western cause.
Chinese treatment for infertility is based not just on these medical terms but on traditional pattern discrimination. The first step is to look at the menstrual cycle and attempt to regulate it. This may involve changing the length or regularity of the cycle, the heaviness of the period, removing period pains or premenstrual symptoms. See the discussion of the menstrual cycle for further explanation. Making these improvements can improve egg quality, fertile mucus and the endometrium which in turn increase the likelyhood of fertilisation and implantation.
In J&S Chinese Acupuncture Clinic Center, Dr. Shen pays close attention to every detail of the cycle and by studying the subtle changes in symptoms and temperature we can provide a very targetted treatment. Our aims with each treatment depend on where you are in your cycle and what the body needs to be doing at that time.
Acupuncture and herbal medicine do not have to be an alternative to western medicine. Used in conjunction with medication like Clomid or Metfromin or as in the case of IVF, the chances of conception can increase even further.
Endometriosis
Endometriosis is an increasingly diagnosed condition in the west. This is partly because of increased frequency of diagnostic surgery (laparoscopy) but also to deferred child bearing and increasing environmental pollutants.
Endometriosis can take many forms but is often characterized by painful periods with dark menstrual blood and clotting. There may be palpable nodules or masses in the abdomen. Sometimes there is no bothersome symptoms such as pain but a key diagnostic can often be spotting before periods. It can also be indicated by certain patterns in the change of Basal Body Temperature.
Endometriosis is one of the main causes of infertility although the reason for this is uncertain.
Chinese medicine views endometriosis largely as stagnation of blood in the uterus. The blood and endometrium which should be shed cleanly with each period is not done so properly. This leads to the congealing and clotting of the blood in the uterus. As the natural flow is further hindered by this clotting, the endometrial tissue finds its way into areas it shouldn’t causing the problem. For successful and long term treatment, it may be necessary to track the problem back further to find out the cause of this blood stagnation.
Treatment with herbal medicine and acupuncture can be very effective in treating endometriosis for both improving the menstrual cycle and the chances of conceiving.
Acupuncture Treatment for Polycystic Ovaries
Polycystic ovaries is an increasingly common condition where numerous fluid filled cysts grow around the ovary. It is currently estimated that polycystic ovaries can be seen on ultrasound in 25% of women. This can prevent ovulation and make the menstrual cycle irregular (generally tending to be longer). Associated symptoms include excessive hair growth, weight gain and acne as there is imbalance in the male/female hormones in the body. It is also a common cause of infertility.
In Chinese medicine, this condition is often seen as the accumulation of dampness (unresolved fluids in the body) which can be caused by the motive force of the uterus (the kidney yang) being insufficient to resolve this dampness. As the dampness grows, it further weakens the yang, allowing more dampness to form and a vicious circle occurs. By tackling both the symptom (the dampness which shows in the cysts themselves) and the underlying cause, the weakness of kidney yang, effective treatment can be made.
A combination of acupuncture and herbal medicine is often the most effective method of treatment. Severe polycystic ovaries is a difficult and stubborn condition to treat. It may take up to six months of treatment before good progress is made. Dietary and lifestyle factors also play an important role in the treatment of this condition.
Case Study
Susan had been diagnosed with polycystic ovaries 3 years previous. Her menstrual cycle had been erratic for 10 years with her sometimes only having a period every 9 months. She had an increase in weight of 3 stone in the previous 2 years and on observation had increased hair growth. Susan was wishing to improve her cycle to become pregnant. She was currently considering western fertility drugs.
She received acupuncture and herbs for 6 months during which time she had three periods, the most frequent she could remember, her weight stopped increasing and she felt better within herself. Over the next 6 months, her cycle became a more regular 40 days. Susan’s condition continued to improve and at the time of writing she is happily in the late stages of pregnancy.
Acupuncture Treatment for IVF Patients
Acupuncture and to some extent herbal medicine are increasingly being used to assist and improve IVF treatment. While being a traditional therapy, this is one of the best examples of how it can be adapted to new situations. Also it shows how closely and successfully western and eastern medicine can work together.
The success rates for IVF conception to occur are usually between 20-30% depending on the clinic. In a recent study in Germany, a 26% success rate was achieved for women receiving no acupuncture, while a 43% success rate was achieved by those receiving acupuncture. Studies in China and America have achieved similar results. While there have been no European studies, Chinese reports suggest this percentage can be further increased by up to 40-60% with the use of Chinese herbal medicine.
The procedure we follow is:
Preparation treatment for IVF can begin several months prior but even 1 month before can make a difference to the fertilization and treatment at the time can improve implantation success.
We first treat the patient as a case of infertility, make the assessment and try to improve and regulate the menstrual cycle if necessary (eg reduce pain, pms signs or regulate length) and then attempt to nourish the uterus and make the eggs, endometrium and cervical mucus better and stronger.
Then as the IVF approaches, we nourish the uterus and ovaries in order that more good quality follicles can be extracted.
During IVF if possible, we then tend to see people as soon as possible prior to embryo transfer and as soon as possible after. We see people before, to try to invigorate blood flow in the local area in order to make the body more receptive to the embryo. After the transfer, we try to stabilise the hormone level to keep the embryo safe. This also calms and relaxes the uterus so that it does not reject the egg.
After conception has been achieved, we continue with acupuncture and sometimes herbal medicine to reduce the increased risk of miscarriage that occurs with IVF induced pregnancies.
In addition to treating the female partner, we would always advise checking the male partner as good quality, free flowing sperm does make a large impact on the chances of success. Whether you are attempting IVF or ICSI, there is a lot that can be done to help the process.
Acupuncture and Herbal Medicine for Male Infertility
With difficulty in conceiving affecting nearly in 4 couples, male infertility is thought to be the cause in 40% of those cases. This is a very common condition and is dramatically on the increase. Sperm count averaged 113 million in 1940 and in 1990 it was 66 million with 18% of men now considered to have extremely low sperm counts (under20million). The reasons for this appear to be increased exposure to environmental pollutants and the amount of man made oestrogens that are in general circulation.
The diagnosis of male infertility is simpler in Chinese medicine than that of women and normally falls into one of three main categories (or a combination of these). These are as follows:
Constitutional weakness of the sperm. This is where the sperm count may never have been good, motility sluggish and abnormality rate high. Whether hereditary or through some pre-pubescent illness, the testicles never fully functioned. In Chinese medicine this is seen as a reflection of the energy of the kidneys which must be nourished in order to improve sperm quality.
Blockage of sperm pathways. This is where sperm is being produced but through some blockage, they are unable to make it to their destination. In western medicine this may be the case of a varicocele. Chinese medicine views this as a blockage of the flow of qi and blood and herbs that improve circulation in the genitals are used.
Damage caused by heat. Hanging outside of the boy, the testes like to remain cool and are quickly aggravated by heat. Various heating mechanisms can therefore harm sperm production. On a daily basis, the use of alcohol and caffeine are very heating and as such lower sperm counts. Various medications are also known to lower sperm count including those used for epilepsy and chemotherapy. Infections, sexually transmitted diseases or mumps can all have similar effects. In these cases the heat can go on to damage and drain the strength of the kidneys, complicating the issue. Chinese medicine uses herbs to clear any remaining heat and replenish the energy of the kidneys.
Sperm take around 3 months from formation to full maturity. For this reason treatment must always be continued over several months. This also means that herbal medicine is often preferable and the herbs can be taken as a capsule supplement on a daily basis. This provides a subtle method of giving effective treatment , over what is usually at least a six month period.
Acupuncture for High FSH
Follicle stimulating hormone (FSH) is one the key endocrine elements in the menstrual cycle. High FSH levels are generally said in western medicine to be indicators of the menopause and they occur when the pituitary gland, not receiving the correct feedback from the ovaries sends out more of this particular hormone. For patients wishing to embark on IVF, it is often a pre-requisite for the fertility clinics that the FSH reading is below a certain level. This tends to be around 11 or 12 but can vary depending on age and personal circumstance. Many women with high FSH levels are told that there is nothing that the clinics can do for them to help this.
Chinese medicine does not always view high FSH levels as indicative of the start of menopause. They can be, and this would be a diagnosis of deficiency of yin (which is all the fertile, nourishing energy required to make goods eggs). However there are other aspects of the menstrual cycle, such as the circulation of blood in the uterus or the emotional state of the patient through the link between hypothalamus and pituitary gland with the ovaries that can play a part. This is the reason why FSH levels can seemingly fluctuate so much.
Successful treatment with acupuncture and herbs can reduce FSH or stabilize levels to allow IVF treatment to commence or to increase the chances of a natural pregnancy.
Case Study
Jenny was looking to conceive but had a FSH level of 22. She had previously had her fallopian tubes tied and one ovary removed, so an IVF pregnancy would be the only possibility. She also suffered from endometriosis and was generally an anxious person.
From her Chinese diagnosis, which was of yin deficiency, blood stagnation and of unsettled emotions (heart qi stagnation), Jenny had all of the causes of high FSH combining together for the reading. She received acupuncture and herbs for 6 months. In this time her period changed considerably with less pain and signs of clotting in the menstrual blood, there was signs of better ovulation in the that the cervical mucus went back to how it was when she was a teenager and emotionally she was less up and down. Her FSH reading went down to 12 at which time IVF could be recommenced. The case continues….
Coming soon.
Coming soon.
