Traditional Chinese Medicine and Infertility
Written by: Chzi Wei Harmony Yuan
July 29, 2015
When most people think of infertility treatments, most don’t think of acupuncture or traditional Chinese medicine as an option. Treatment for infertility is usually viewed as a modern science, involving petri dishes and injections, but the fact of the matter is that it is an age old issue with an age old option of treatment.
Acupuncture is an art originated in Ancient China, characterised by the use of sharpened objects to stimulate certain parts of the body. These points all align on the meridian system, which is an unseen system that channels ‘Qi’, roughly translated as ‘life-force’. Traditional Chinese Medicine (TCM) is a combination of acupuncture, herbs and medicines as well as other practices like moxabustion.
Infertility is defined as the inability to conceive after a period of sexual intercourse without contraception. For women 35 years old and younger, the time period is 1 year. For women over 35 years old, the time period is 6 months. According to Canadian statistics, ~16% of heterosexual couples in Canada experiences infertility. Of that 16%, 30% of the cases originate from problems from the male, 40% is from the female, 20% is a mixture of both while 10% has no determinable cause. [i]
Of the determined cases, infertility in women can be caused by problems with the menstrual cycle, blockages in the fallopian tubes, fibroids or polyps in the uterus, hormonal imbalance or early menopause (menopause before age 40). Infertility in men can be caused by issues in sperm movement and shape, low sperm count, lack of sperm or hormonal balances. Treatments for cancer, like chemotherapy or surgery, tobacco or alcohol use, weight, as well as chronic illnesses like diabetes can also be a contributing factor for infertility in both sexes.
The main method of approach for infertility in western medicine would be ovulation inducing drugs, intrauterine insemination (IUI) or in vitro fertilization (IVF). Both IUI and IVF are usually used in conjunction with ovulation inducing drugs.
The fertility drugs used in Canada are either human hormones (gonadotropins) or other non-human-hormone substances (Clomiphene citrate). The process consists of injecting follicle stimulating hormone (FSH) with or without luteinizing hormone (LH) early in the menstrual cycle. This works directly on the ovaries making multiple follicles (egg containing cysts) mature. When the eggs are matured, Human chorionic gonadotropin (hCG) is injected to release them. Usually close monitoring with ultrasound is recommended. The eggs can then be harvested and combined with the sperm outside of the body in a laboratory before putting the embryos back into the uterus in IVF (surgery is required to remove the eggs). In IUI, a thin tube can carry sperm directly into a woman’s uterus through the vagina.
One of the side effects of using fertility drugs is Ovarianhyperstimulation syndrome (OHSS). Since many follicles are pushed to maturity, the ovaries will become enlarged which can also cause fluid accumulation in the abdomen. In its severe form it can cause nausea, vomiting, rapid weight gain, dehydration, blood clots, kidney dysfunction, fluid collection in chest and abdomen or twisting of an ovary (torsion) or even death. The twisting of an ovary occurs when one of the ovaries is much heavier than usual and twists upon itself, potentially cutting off blood supply. Surgery is needed to untwist the ovary and in worst case scenario, removal of the ovary is required.
Multiple gestation, pregnancies with twins or more, is another common side effect of IUI processes. Up to 30% of IUI pregnancies result in multiple gestation while only 1-2% of natural pregnancies are multiple gestations.[ii] Risk of miscarriage, infant abnormalities and pregnancy related hypertension increases as the number of fetuses increase.
In Traditional Chinese medicine, only one follicle is stimulated to maturity, so there is no risk of the complications you would find in multiple follicle stimulation. TCM can aid in egg production and menstrual regulation, balancing hormones, boosting the immune system to help the body maintain the pregnancy, as well as helping a patient get rid of habits like smoking and drinking which can also lead to infertility.
Studies have shown that when used in conjunction with IVF, acupuncture has a measurable effect on the ability of a woman to get pregnant. In a study group of 80 patients, those who received acupuncture treatments had more success in getting pregnant than women who underwent IVF alone (34 pregnancies with acupuncture compared to 21 pregnancies without). [iii] For patients who visited Dr. Sandra Sourang, so long as the patients were under 35 and there were no physical blockage of any tubes or physical defects that require surgery or acute care, 95% were able to conceive using acupuncture alone.
There are two main ways TCM may help in conceiving. One is through a neuroendocrine effect that impacts the brain and its hormone production which allows for ovulation. This method is natural and without injections of hormones, which also reduces risks of any side effects on the ovaries. Another method is TCM may aid with the lining of the uterus. TCM helps by increasing the blood flow so more nutrients and hormones are available and the lining is more able to sustain an implanted embryo. [iv]
The health of the uterus and its lining is also important in maintaining a pregnancy. Weak lining is often a cause for chronic miscarriages. TCM can work to maintain a healthy uterus lining during pregnancy through maintenance sessions. To ensure a healthy pregnancy, acupuncture is recommended throughout the entire process.
[i]“Fertility.” Government of Canada, Health Canada and the Public Health Agency of Canada. Government of Canada, 4 Feb. 2013. Web. 28 July 2015. <http://healthycanadians.gc.ca/healthy-living-vie-saine/pregnancy-grossesse/fertility-fertilite/fert-eng.php>.
[ii]“ASRM Patient Fact Sheet: Side Effects of Injectable Fertility Drugs (gonadotropins).” American Society for Reproductive Medicine. ASRM, 2012. Web. 28 July 2015. <https://www.asrm.org/FACTSHEET_Side_effects_of_injectable_fertility_drugs_gonadotropins/>.
[iii]Bouchez, Colette. “Infertility Alternatives: Acupuncture, Clomid, IVF Compared.” WebMD. Ed. Dr. BrunildaNazario. WebMD, 13 Oct. 2003. Web. 28 July 2015. <http://www.webmd.com/infertility-and-reproduction/features/ancient-art-of-infertility-treatment?page=2>.
[iv]Bouchez, Colette. “Infertility Alternatives: Acupuncture, Clomid, IVF Compared.” WebMD. Ed. Dr. BrunildaNazario. WebMD, 13 Oct. 2003. Web. 28 July 2015. <http://www.webmd.com/infertility-and-reproduction/features/ancient-art-of-infertility-treatment?page=3>.