Bindi Zhu, M.D. (China) Ph.D. and Ileana Bourland, MSOM, Lic.Ac.

The Chinese Medicine Approach to Fertility Bindi Zhu, M.D. (China) Ph.D. and Ileana Bourland, Lic.Ac.

Hello. I'm here today to talk about fertility and how to approach that issue with traditional Chinese medicine. I'll start by telling you one story:

"A couple had been trying to get pregnant for two years. Every morning the wife would take her basal body temperature and count the days to ovulation. Then, on scheduled days, they had an "appointment" to try to get the job done. Unfortunately, even after two years, they hadn't conceived. Finally, they gave up and adopted a beautiful baby girl. They felt so happy - no worry, no stress. Soon after, the wife missed a period and they were unexpectedly pregnant. This story repeats itself time and time again."

Conventional medicine does not have an explanation for this phenomenon. The allopathic medical establishment states that if a woman is having trouble getting pregnant, there must be a structural problem. This is not necessarily the case. Although conventional medical treatment options have been well established and work well for certain disorders, the human body can have functional changes for many different reasons, and not necessarily due to structural issues.

It has been well document that infertility causes stress and stress affects pregnancy. In this vicious cycle, stress causes the body to release certain hormones. These hormones influence the mechanism responsible for normal ovulatory and menstrual cycles through their impact on the hypothalamic-pituitary-ovarian axis. A study by Alice Domar of Harvard's Mind/Body Institute found that stress reduction techniques (such as Qi Gong and acupuncture) can double the pregnancy rates for in vitro fertilization. Our emotional state really has a strong effect on our physical bodies!

Let's talk about the statistics related to fertility. Infertility is defined by conventional medicine as the inability to conceive after one year of unprotected sex for couples in which the female is under age 35 and six months of trying in couples in which the female is over age 35. Eighty-five per cent of couples normally achieve conception within twelve months of unprotected sex. According to the American Society for Reproductive Medicine, 6.1 million women and their partners in the United States experience difficulty in conceiving a child.

What causes infertility? A number of factors in both males and females can cause the condition. In nearly 30% of cases, the cause is associated with the female, another 30% with the male, 30% with both the male and female, and in 10% of cases, the cause is unknown, or idiopathic.

Of those one in six couples that are affected by infertility, many must deal with the medical, physiological, psychological, and financial stresses related to their condition. How many people here are familiar with conventional treatment options.

Today, I want to talk about how traditional Chinese medicine treats infertility; we'll briefly cover conventional treatment options; and then we'll talk about integrating the two.

We'll cover how Chinese medicine can help you achieve a successful pregnancy, including pre-conception care, conception, pregnancy, avoiding miscarriage, and modern medical treatments. When I diagnose a couple, I make a treatment plan that makes the best use of the resources available through conventional and Chinese medicine to determine the cause of infertility, balance the body, and ultimately create an environment where conception is possible.

Traditional Chinese medicine developed thousands of years ago in a sophisticated culture, which pioneered the discovery and orderly, use of medicinal plants and invented a unique therapeutic modality, called acupuncture.

This is a totally different system from western medicine. The ancient Chinese medical doctors concentrated on identifying body functions and their interdependent relationships to each other. Chinese medicine treatment modalities stimulate the body's natural healing potential by treating root causes of dysfunction, rather than just symptoms.

Chinese medicine prepares the body for conception by bringing it back in to balance. This is a key concept in traditional Chinese medicine, balancing the yin and yang of the body. The basis for treatment always starts with a diagnosis according to Chinese medical philosophy, whose foundation lies in identifying constitutional imbalances, presenting symptoms, and determining the proper way to address the imbalance.

Each person is considered an individual in Chinese medicine. For example, each woman with luteal phase defect has her own unique constitution, which must be considered as an individual in order to properly diagnose and treat the problem. In other words, for different couples this might mean fine tuning and regulating the menstrual cycle, raising low sperm count and motility, correcting hormonal imbalances, eliminating immune system incompatibilities, easing tubal obstructions, relieving stress-related dysfunction, reversing ejaculatory defects and correcting erectile dysfunction.

For this reason, Chinese medicine is very effective when dealing with functional problems, whereas conventional medicine is best suited for structural problems. For that reason, more and more women are using traditional Chinese medicine. In China, most women have used traditional Chinese medicine to treat infertility for over a thousand years and the definitive role of Chinese medicine in treatment of female infertility is being established now through scientific research.

The World Health Organization (WHO), the health branch of the United Nations, lists more than 40 conditions for which acupuncture is effective, including infertility.

Conventional medicine describes the neuroendocrine pathway of female fertility as the hypothalamic-pituitary-ovarian axis. In Chinese medicine we describe this axis as a responsibility of the Heart, Liver, Kidney, and Uterus organ systems. These systems are responsible for fertility, pregnancy, and the regulation of the menstrual cycle. Traditional Chinese medicine considers the Kidney the foundation of fertility. Its main functions are to "store essence, dominate human reproduction and development, dominate water metabolism and the reception of qi, produce bone marrow to fill up the brain, dominate bone, manufacture blood, manifest in the hair, open into the ear." Any reason that causes Kidney dysfunction can impact reproduction. Liver qi obstruction, retention of phlegm, congenital Kidney qi deficiency, and stagnation of blood are other syndromes that may contribute to infertility. The treatment principle can be totally different for different people, even with same disease.

The same principle is practiced by certain physicians who use compounding pharmacies to prepare estrogen and progesterone combination for menopausal women. This approach is quite similar to Chinese medicine. Instead of making an educated guess on the appropriate does of hormones, the doctor orders lab tests to find out how much each individual woman actually needs.

Chinese medicine has been successfully used together with in vitro fertilization. Chinese medicine may be used to strengthen and balance one's general health so that in vitro fertilization procedures are more effective.

A study, published in the April, 2002 edition of the medical journal Fertility and Sterility, found that acupuncture increased the chance of becoming pregnant for a significant number of women undergoing in-vitro fertilization (IVF). Acupuncture and herbs support in vitro treatment, especially in keeping the pregnancy, preventing miscarriage, pregnancy becomes easier to achieve and postpartum recuperation happens faster.

The effect of Chinese herbs that tonify the Kidney organ system on fertility has been documented by Guang Zhong Ming at Xu Zhao Hospital and Zhao Lin. In one study, the test group took a formula called "Chu lan san," primarily containing herbs that tonify the Kidney. Sixty-seven percent of that group conceived compared to 34 percent of the control group, who did not use any herbs. Other studies using herbs that tonify the Kidney, such as shen ling pi, gou qi zi, he shou wu, shu di huang, and nu zhen zi, have shown similar results.

Man jing zi (Fructus Viticis or chasteberry), a common Chinese herb used for clearing liver heat, has been shown to restore progesterone balance and increase pregnancy rates in European studies. A recent study of various herbal treatments to correct luteal phase defects in a woman's hormonal cycle produced pregnancy rates from 33 to 56 percent -- far higher than the success with Western therapies.

Traditional Chinese herbal medicine is useful in treating various other conditions related to female infertility, such as ovulatory dysfunction. It can help improve uterine arterial blood flow and, consequently, encourage endometrial thickness, which has a positive effect on egg implantation. A recent study of various herbal treatments to correct luteal phase defects in a woman's hormonal cycle produced pregnancy rates from 33 to 56 percent -- far higher than the success rates achieved with Western therapies. Another study found that 76 percent of women treated with acupuncture and herbs for fallopian tube obstruction were able to conceive.

In the United States the birth control pill has had great popularity for almost fifty years. Lately, medical doctors and scientists have recommended the "mini pill," a low dose birth control pill. What this means, is that women have been taking higher doses of synthetic hormones for fifty years than they actually needed to. The excessive and irregular use of hormonal birth control has created many hormonal imbalances that can result in fertility problems. Chinese women most commonly use the IUD for birth control. They have very low rates of infertility.

In one controlled study comparing the effectiveness of placebo, prednisone and herbal therapy in treating anti-sperm antibody problems found the herbal treatment to be more than twice as effective as the prednisone. As we know, Clomiphene can induce ovulation and increase sperm count, used along with Chinese medicine can minimizes negative side effects and accumulated toxicity from invasive procedures and drug therapies. The Archives of Andrology reported that acupuncture helped increase sperm motility and raised sperm count.

Some Example may help you understand how Chinese medicine work:

• 35 yr old lady, has tried for 3 yrs to get pregnant, all exams are normal, basal body temperature normal, unable to get pregnant. She has a 6 years boy from last married, Her husband has a children from first married, but She had Hot flashes, night sweats, insomnia, according Traditional Chinese Medicine, This is Kidney Yin deficiency, principle of treatment is nourish kidney yin, I have use Liu wie di huang wan which is classic formula and advise to use condom for 3-6 months. She got pregnant; this possible is immunological infertility - reacting to husband's sperm.

• 30 yr old woman, she has suffer from dysmenorrhea since 20, She take birth control pill for long time off and on, She tried to get pregnant for 2 yrs, She complain of stabbing pain at first tow day of period and dark color with clots, mood swing and distention of breast before period, Usually due to cyst problem or birth control pill cause female hormone imbalance. Base on Chinese medicine of differentiation of syndrome, this is live Qi obstruction with stagnant blood, I have use Dan zhi xiao yao san plus wan bu liu xing and xiang fu to regulate Liver Qi and promoting blood. Her period becomes normal and after 3 months, she gets pregnant.

Once the cause of infertility has been determined with conventional medicine, a plan can be customized for the patient with traditional Chinese medicine to fit their unique situation and move them along on the path to conceiving a child.

When evaluating a couple, it is extremely important to consider the couple as a unit in evaluation and treatment, as multiple causes exist for both male and female infertility.

It can be used alone or in conjunction with conventional fertility treatments, such as in vitro fertilization, hormone treatments, and surgery. Some couples do not require such treatments and respond well to the exclusive use of acupuncture, traditional Chinese herbs, and nutritional counseling to achieve conception. We advise you to consult with your physician and partner to determine which path is right for you.

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