Infertility is one of the most common gynecological reasons that women come into the clinic. Probably because there has been quite a bit of research showing that acupuncture and Chinese medicine significantly increases the chances of becoming pregnant. While a significant amount of the causes of infertility are related to male pathology, this paper will only address female infertility.
According to Western Medicine
Simply stated, infertility is defined as the inability to become pregnant for one year after one year of unprotected intercourse for women under the age of 35 and 6 months of unprotected intercourse for those over the age of 35. But there are different kinds of infertility: primary infertility occurs in women who have never conceived, while secondary infertility occurs if there has been a conception in the woman’s past. Infecundity is the ability to conceive but the inability to carry the baby to delivery. According to the CDC, 7.4% of reproductive couples are infertile, while 11.8% have impaired fecundity. And causes of infertility are varied, here is a general idea:
And here is a graph on female only causes of infertility.
Depending on the type of infertility, there are different Artificial Reproductive Technologies (ART) available.
- IVF: In-Vitro Fertilization is the fertilization of the egg by the sperm outside of the body. In Vitro, literally translated from Latin, means in glass. The fertilized egg is then implanted into the uterus.
- GIFT: Gamete Intrafallopian tube Transfer is when the eggs are removed from the ovaries and are placed in the fallopian tubes along with the sperm.
- ZIFT: Zygote Intrafallopian tube Transfer is when the eggs are removed from the ovaries and fertilized in vitro and finally placed in the fallopian tubes.
- ICSI: Intracytoplasmic Sperm Injection is the process in an in vitro fertilization in which the sperm is injected into the egg.
The success rate of these procedures shows that only about 20% of women carry a child to term. That along with risks of multiple pregnancies, ovarian cancer (due to some medications), and Ovary Hyperstimulation Syndrome (due to hCG treatments).
Studies have shown that combining ART and Chinese Medicine can increase the changes of holding and carrying a baby to term up to 60%!
According to Chinese Medicine
The definitions of infertility with Chinese Medicine are similar, some sources site 1 year of unprotected sex without pregnancy, while other sources site up to 2 years. Causes include: Kidney Yin and/or Yang deficiency, Liver Qi stagnation, Phlegm-Dampness accumulation, damp heat accumulation, Blood stasis, Blood deficiency, or a combination of these.
The main treatment principal is to regulate the menstrual cycle and then to treat any other associated disorder(s). A Kidney deficiency is often the root cause. Blood obstruction in the uterus is also a common cause, especially for those with endometriosis or paratubal and peritoneal factors. Damp heat is often associated with endometriosis or infections of the ovaries, tubes, uterus, cervix or vagina. Kidney deficiency along with phlegm obstruction is usually associated with infertility due to polycystic ovarian syndrome (PCOS), and a Liver dysfunction is usually seen in those with hyperprolactinemia or a luteal phase defect.
Basic Treatment includes acupuncture for the differentiations and herbs. Acupuncture includes points with regards to differentiation: RN 3, RN 4, Extra Zi Gong Xue, KI 3, KI 6, KI 13, KI 14, SP 6, SP 8, ST 27, ST 28, ST 36,LV3, UB 23. Each point has specific actions and functions and should be used only with a qualified practitioner. It should also be noted that herbal prescriptions are usually modified to suit each particular person, thus the formulas listed are guidelines only. Also, different formulas may be used at different times during the menstrual cycle.
- Kidney Yang deficiency: modified Yu Lin Zhu
- Kidney Yin deficiency: modified Yang Jing Zhong Yu Tang + Er Zhi Wan
- Liver Qi Stagnation: modified Kai Yu Zhong Yu Tang, or modified Xiao Yao San
- Phlegm-Damp accumulation: modified Cang Fu Dao Tan Tang
- Damp Heat accumulation: modified Jie Du Huo Xue Tang + Hong Teng Bai Jiang San
- Blood Stasis: modified Shao Fu Zhu Yu Tang
- Blood Deficiency: modified Wen Tu Yu Lin Tang + Gui Pi Tang
This is just a basic outline of the treatments for infertility, please contact us if you would like to see a workshop for more information on how Chinese medicine can help infertility or how to treat infertility effectively.
Caroline Prodoehl, R.TCMP
References:
http://www.cdc.gov/nchs/fastats/fertile.htm
Fertility, Family Planning, and Reproductive Health of U.S. Women: Data from the 2002 National Survey of Family Growth, tables 67, 69, 97
Wikipedia Definitions: IVF. GIFT. ZIFT, ICSI
Wang, Yuxiang (2010). Integrated Gynecology Course Notes. Toronto School of Traditional Chinese Medicine.
A. Siu, A. Breous, T. Matano & C. Prodoehl (2010). Infertility Presentation: Integrated Gynecology. Toronto School of Traditional Chinese Medicine.