infertility

INFERTILITY


WESTERN VIEW
  
Description:  Infertility is defined as the inability of a couple to conceive after two years of trying without using contraception. Female infertility accounts for 70% of cases and male sterility for 30%.
                  
Causes -  (Female): The majority of cases (41%) are due to hormonal causes, including failure to ovulate. Other factors include: fallopian tube abnormalities - 32%, uterine factors -16%, cervical factors-47% and no apparent cause, 5%.
 
Investigations - (Female):  Temperature chart will be used to check the woman's ovulation.  The patient need to check her body temperature the first thing in the morning (there is normally a rise in temperature on the 14th day of the cycle, which is the day of ovulation).  Further investigation involves blood tests to measure her female hormone levels, special X-rays that outline the uterus (womb) and fallopian tube. Laparoscopy (a small tube) will be used to put into the lower abdomen to examine the ovaries and uterus.
 
Western Treatment: Initally the couple will be advised to have intercourse during the ovulation period. Fertility drugs (eg. Clomiphene) will be used to promote ovulation; other drugs may also be used to treat endometriosis and antibiotics for infections.  If there is an anatomical abnormality, surgery will be recommended to correct the problem. IVF (in-vitro fertilisation or test-tube babies), GIFT (gamete intra-fallopian transfer) are also methods to help infertility.
 
Causes- (Male): Premature ejaculaton, underscended tested (which fail to work because of overheating), injury to the testicles, mumps infection of the tetes, venereal infections (eg. Syphilis, gonorrhoea), chromosome abnormalities and hormonal disorders.
 
Investigations (Male): Analysis of sperm (quantity, shape and activity of sperm), which is collected and examined in a laboratory within two hours.
 
Western Treatment: Hormone supplements, surgery to correct any abnormality of tests or penis, storage and concentration of sperm (artificial insemination by husband - AIH) or by donor sperm (artificial insemination by donor-AID).
     
Complications:   The success rate for any infertility procedure may be as low as 15% for each attempt, although the overall success rate may be over 50%.

 

 
CHINESE MEDICINE’S LONG HISTORY OF SUCCESS
 
The treatment of infertility and Chinese Medicine goes back over 3000 years, proving itself to be safe and effective, as well as affordable. More women are waiting until their 30’s and 40’s to start their families. Chinese Medicine can greatly improve your chances of getting pregnant. 

 

CAUSES OF INFERTILITY
 
Infertility is defined as the inability of a couple to conceive after two years of trying without using contraception. Female infertility accounts for 70% of cases and male sterility for 30%. The majority of cases (41%) are due to hormonal causes, including failure to ovulate. Other factors include: fallopian tube abnormalities, 32%, uterine factors, 16%, cervical factors, 4.7% and no apparent cause, 5%.
 
CONTRIBUTING FACTORS
 
Chinese medical theory believes that other factors, which cause infertility to couples, include poor diet (including vegetarians); stress, over exercising, chronic infections, the side effects of drugs, alcohol, nicotine, and not getting enough rest. Organic food and hormone free animal products are recommend. Avoid junk food, caffeine, tobacco, fizzy pop, artificial sweeteners, refined carbohydrates and sugar. Reduce raw and cold foods. 
 
 
TRADITIONAL CHINESE VIEWS
 
Infertility tends to arise from one or more of three main causes:
1.  Deficiency syndrome(weakness of kidney energy and liver blood), which prevents the hormonal system from properly influencing the reproductive functions.
2.  Stagnancy syndrome of Qi and blood has the effect of restricting circulation to the reproductive organs.
3.  Heat syndrome may be associated with infection or inflammation.
 
It is recommended to wait 3 months after a miscarriage before trying to conceive. Using acupuncture and herbal medicine will allow your body to heal, and increase your chances of having a successful outcome.
 
 
COMBINING EAST AND WEST 

Combine Chinese Medicine with other treatments and procedures such infertility drugs, artificial insemination, in vitro fertilization, and GIFT is very effective. Several reproductive endocrinologists in the Boulder and Denver area recommend using acupuncture to enhance the success rate of their therapies.

Chinese Medicine works in several ways: to balance hormones, increase thickness of uterine lining, improve egg quality, clear autoimmune factors, improve circulation to the uterus and ovaries, treat obstruction of fallopian tubes, endometriosis, and polycystic ovarian disease.

CLINICAL STUDIES SHOW SUCCESS
 
Clinical studies conducted in China indicate that about 70% of all cases of infertility (male and female) treated by Chinese herbs resulted in pregnancy. (Chinese Herbs and Fertility, Subhuti Dharmananda, Ph.D., Institute for Traditional Medicine.) It is estimated that pregnancy can be achieved within 6 to 12 months. If a woman is over 40, it may take longer.
Researchers in Germany and China found that adding acupuncture to the treatment regime of in vitro fertilization can dramatically improve a woman’s chances of getting pregnant, from 26% to 42%. (Fertility and Sterility, April 2002; 77(4): 721-4)
 
 
TREATMENT

For female patients, treatment consists of weekly or two times per month acupuncture to stimulate ovulation, as well as Chinese herbal prescriptions. Treatment is also available for male patients  if there is a problem with sperm quality, motility, or quantity.
 
HERBAL PRESCRIPTIONS 

Chinese herbs are safe and non-toxic. They are designed to help your body produce the proper level of hormones on its own. 
 
 
FREQUENTLY ASKED QUESTIONS
 
WHEN SHOULD I START TREATMENT?

When possible, its best to start treatment with TCM before you begin trying to conceive or undergo IUI or IVF. There are several reasons for this. Firstly, studies show that it takes about 90 days to influence changes in a woman's menstrual cycle, such as improving ovulation and uterine lining, regulating hormones, regulating any problems with the actual cycle, and addressing situations such as PCOS or endometriosis. Secondly, it takes about 150 days for an egg to grow from a follicle in its resting state into a full-blown egg ready to be released (and follicles are selected from a pool of resting follicles almost a year before ovulation!)So, the sooner the best! 

HOW LONG WILL I NEED TO COME FOR TREATMENTS?

Because it takes 90-150 days to influence change in a woman's menstrual cycle, and because pregnancy does not normally occur in just one cycle of trying even under the best of circumstances , the recommended course of treatment to achieve pregnancy is at least three to six months. This is a general time frame, however - some patients take less time to achieve pregnancy, and some take longer. Length of treatment and success varies for each individual and depends on the underlying fertility issue, among other factors. Success also depends on one's commitment to treatment - a patient who comes regularly for acupuncture, takes their herbs (if prescribed), follows the appropriate self-care measures at home, and makes diet and lifestyle changes will have a much better chance of becoming pregnant than a patient who does not take an active role in their treatment.
 
When you are trying to get pregnant, each passing month can seem like a wasted cycle, and three to six months or more can seem like a very long time. However, studies show that at least three months of preparation with TCM is optimal for a healthy pregnancy and baby. In TCM, no cycle is a "wasted" cycle. Each treatment strengthens your body and brings it closer to optimal reproductive health, a healthy pregnancy, and a healthy baby.
 
DO I NEED TO TAKE HERBS?

Herbal formulas are an important part of TCM fertility treatments. Herbs can help regulate the menstrual cycle and ovulation, thicken the uterine lining, regulate hormones, prevent certain types of miscarriage, and improve overall health. For these reasons, herbs are often recommended for fertility issues.
 
HOW DOES CHINESE MEDICINE WORK WITH IUI AND IVF?

TCM is a wonderful and highly effective compliment to your Western fertility treatments. Acupuncture reduces the stress associated with assisted reproductive technologies (ART), and therefore reduces the negative effects that stress has on the hormones related to reproduction. Acupuncture also strengthens and supports your body so that your Western fertility treatments are more effective. Most impressive are recent studies showing that acupuncture can significantly increase the success rates of ART. This is very important, as the success rates for ART are not generally high. For example, national data indicates that IVF works 33% of the time for women age 30 and under, 29% of the time for women in their mid-30s, and 5-15% of the time for women age 40. On average, women go through three to seven cycles of ART before they either conceive or stop trying. A women's response to ART depends on the state of her endocrine health in the months preceding ART, when follicles are developing in the ovary - this is why it is important to start your TCM treatments in advance of your Western treatments, if possible.
 
The most well known study of acupuncture and ART was a German study published in the April 2002 issue of Fertility and Sterility. This study showed that using acupuncture on the same day as IVF embryo transfer, both before and after the transfer, increased the success rate to 42.5% - the success rate for the group not receiving acupuncture was 26.3%. A more recent study conducted in Denmark in 2006 evaluated the effect of acupuncture on patients undergoing IVF with ICSI. Acupuncture was performed on the same day as embryo transfer, both before and after the transfer. The group receiving acupuncture had significantly higher conception and ongoing pregnancy rates, at 39%, than the group which did not receive acupuncture, whose success rate was 26%.
 
HOW DOES CHINESE MEDICINE TREAT MALE FERTILITY?

Male factors account for approximately 40% of all fertility problems. One reason for this is that the average male sperm count has dropped significantly over the past few generations. For example, the average male sperm count dropped 45% between 1940 and 1990. Semen volume has also dropped, reducing the total number of sperm by 50%. The number of men with low sperm counts has tripled, while the number with high sperm counts has decreased. The reasons for declining sperm counts seems to be our increased exposure to environmental pollutants, increased use of recreational drugs and alcohol, and prescription medications, such as antibiotics. Studies show that although smokers generally have lower sperm counts and more abnormal sperm, once smoking is stopped sperm improve significantly within 6-12 months.
 
In a 2005 study published in Fertility and Sterility, acupuncture was shown to significantly improve several aspects of male fertility. The group that received acupuncture had a 50% improvement in sperm motility, while the group that did not receive acupuncture had only a 32% improvement. The number and percentage of healthy sperm also increased dramatically in the acupuncture group, increasing more than four-fold after 10 sessions of acupuncture. In addition, significant changes in sperm structure and quality were seen in the acupuncture group, with an increase from 22.5% normal shapes to 38.5% normal shapes.
 
Since new sperm generally take 72 days to form, treatment for male factors is usually recommended for a minimum of three months.
 
SHOULD I CONTINUE TREATMENT IF I GET PREGNANT?

Fertility means more than achieving pregnancy - once pregnant, your body needs to be able to nurture and support a pregnancy for nine months. Acupuncture and Chinese herbs has been shown to increase the rate of ongoing pregnancies, especially for those undergoing ART. In addition, well-pregnancy care can help with the common complaints of pregnancy and ensure an easier labour and delivery.