Fertility-Pregnancy Blog Series

This is the 2^nd blog in our fertility/pregnancy blog series. Continuing from the first one, which discussed menstruation, this one will be about infertility issues for women.  We will discuss the possible causes of infertility and how we use TCM to treat these issues. Our future blog will cover infertility involving male factor issues.

Infertility can arise from many different causes and disorders. Some women experience more than one cause at a time, as one symptom can cause another symptom, which ultimately may result in infertility. We will list disorders with descriptions of each except for PCOS (please see our blog from September 11, 2011 for details) and Endometriosis (please see our blog from March 22, 2011 for details). The following are possible causes:

Menstrual Disorders
 including:

• Irregular menses-
menses that is early, late, short, or long; it can also be bleeding in between regular cycles (“breakthrough bleeding”)
• Amenorrhea-the absence of menstruation; primary amenorrhea is the failure of menses to occur by age 16; secondary amenorrhea is the absence of menstruation for 6 or more months (for a woman after menarche)
• Oligomenorrhea-after a woman’s menstrual cycle has been established, oligomenorrhea is defined as
infrequent menstruation, occurring at intervals of more than every 35 days; usually a woman will have 4-9 menses/year
• Menorrahgia-abnormally heavy and/or prolonged menses; there may also be heavy pain associated with the excessive bleeding
• PCOS (Polycystic Ovarian Syndrome)-please see our former blog for these details
• Endometriosis- please see our former blog for these details
• Luteal Phase Defect-the failure of the endometrium (uterine lining) to develop properly during the luteal phase of the menstrual cycle; this may lead to difficulty with implantation
• Asherman's Syndrome-an acquired uterine condition where adhesions (scar tissue) form inside the uterus; this usually results from a D&C procedure
• Premature Ovarian Failure-when the ovaries stop working before age 40; there may be absence of menses and pre-menopause-like symptoms
• PID (Pelvic Inflammatory Disease)-an infection of the pelvic organs including the uterus, ovaries, fallopian tubes, and cervix; this is due to an STD
• Uterine Fibroids-noncancerous growths in the uterus, that usually occur in childbearing years; sometimes fibroids develop without any symptoms
• Tubal Disease-the fallopian tubes become blocked or damaged which may result from scar tissue, infections, and tubal ligation; this blockage/damage prevents the egg from descending correctly for conception and implantation
• Unexplained infertility-some cases are seen to be caused by autoimmune disorders

All of the above listed disorders have some disproportion of hormones-rather it be estrogen, FSH, or a combination of hormones.

In TCM, we are make our diagnosis of any infertility issue according to the meridian and it’s energy that is out of balance. We also look at specific fluids in the body that may be excessive or deficient, which can be related to infertility issues. When our qi (our energy) is not moving smoothly through our channels or if it is insufficient, then we may see symptoms arise in our body. All of the disorders listed above are due to either an imbalance of our qi and/or fluids in the body. The disorders can also be the result of a physiological abnormality, such as a blocked fallopian tube.

In our TCM treatments, we will diagnose which channel to be treated. We use acupuncture and herbs to do this, along with moxibustion and various modalities. With infertility, we tend to see imbalance often arising in our “kidney channel” energies. This is true for both women and men. An example is we see a deficiency of kidney energy when a woman is diagnosed with “premature ovarian failure”. The kidney energy plays a major role in regular menstrual cycles and reproduction. Without the normal amount of this kidney energy, the reproductive organs along with the hypothalamus and pituitary cannot function correctly each month to lead to a healthy conception. Another example is that with fibroids. From a TCM perspective, fibroids can be due to a stagnation of “phlegm”. Phlegm is a fluid in the body that causes slow movement and can form into nodules (fibroids). Phlegm can be caused by several factors including diet and lifestyle choices.

Unexplained infertility is one that is frustrating and difficult for patients and practitioners as not to be able to give a clear reason for an infertility case. TCM does a wonderful job at treating these types of cases because we look at the energy imbalance of the body and treat the root and branch of a disorder. TCM treatments are ALWAYS treating the entire mind, body, and spirit-because all our connected. An emotion we have in our minds can easily have an effect on our physical body-and vice versa. Infertility usually takes an emotional toll on us for many reasons. The amount of time we go through to even reach a diagnosis of infertility is quite a bit, depending on a woman’s age and medical history. The constant stress and worry over becoming pregnant can begin to have an effect on how our bodies physically function. By holding onto stressful and anxious emotions, this can create barriers in our physical systems. For example, the anxious feelings may lead to insomnia, which can have an adverse effect on conception. If our bodies are not having adequate and quality rest each night, it cannot function at it’s optimal level-which is vital in all aspects for a healthy conception.

As TCM practitioners, we choose the acupuncture points that are best to treat each channel that is out of balance. Specific points in the body have a direct effect on our hormones, therefore, resulting in a decrease in symptoms and a return to overall health. Along with acupuncture treatments, we recommend a wide variety of herbal formulas to treat specific illnesses. For a woman with amenorrhea, we may recommend the classic Chinese herbal formula “Si Wu Tang” which supplements and nourishes the blood. Another formula that is commonly used for infertility is “Xiao Yao Wan” which is used to course the qi through the body efficiently. Many times these classic Chinese herbal formulas are modified to distinctly treat a woman’s various symptoms.

Infertility involves so many factors that must be determined and identified in order to make the correct diagnosis. With a diagnosis and thorough treatment plan, infertility issues can safely and effectively be treated with TCM.

Caroline Jung, L.Ac, MSOM