It is estimated worldwide that one out of every seven couples has problems conceiving, including 9 million people in the United States. There are many causes of infertility, most of which are treatable by medical and alternative therapies. Research shows that approximately 60% of cases are due to female infertility, and 40% are due to male infertility, although many cases are unexplained, or due to combined factors from both partners.
Infertility is defined as the inability to conceive after one year of active trying if the female is under age 35, or after six months of active trying if the female is age 35 or older. There are two types of infertility:
Primary infertility: The couple has never been able to conceive; approximately 40% of infertile couples.
Secondary infertility: The couple was able to conceive, whether the pregnancy was carried to term or resulted in a miscarriage; approximately 60% of infertile couples.
Treatment of infertility with Chinese medicine
Chinese medicine, including acupuncture, herbs, dietary and nutritional therapy, stress reduction techniques, and reproductive organ massage, provides safe and effective treatment for the majority of causes of male and female infertility. The use of Chinese medicine greatly improves the outcome of assisted reproductive technologies such as in vitro fertilization (IVF) and intrauterine insemination (IUI), while providing an alternative to these treatments for those who desire natural conception. A number of different treatment options are prescribed, depending on the specific presentation involved for each patient:
Acupuncture improves natural fertility rates, as well as conception rates when used in conjunction with assisted reproduction. A 2002 study of fertility and sterility reported that acupuncture treatments performed before and after IVF transfer increased the success rate from 26.3% to 42.5%. Further research has shown that acupuncture during pregnancy improves the overall live birth rates, as well as the conception rates. Due to acupuncture’s profound effect on the endocrine system, it is effective for treating any hormonal imbalance associated with infertility. Research shows improved blood flow to the reproductive system through the uterine arteries after acupuncture treatments. This increase in blood flow may over time enhance egg quality, thickness of the endometrium (uterine lining), and implantation rates, and reduce the chance of miscarriage. Other effects of acupuncture that relate to fertility treatment include stimulation of ovulation, immune system balance, reduced stress and cortisol levels, reduced side effects of medications used with assisted reproduction, and decreased contraction of the uterus post-IVF or IUI.
Herbal formulas are prescribed to help enhance egg quality and sperm parameters and to improve implantation rates and prevent miscarraige. They are also useful to control many of the underlying causes of infertility, including endometriosis, polycystic ovarian syndrome (PCOS), fibroids, follicle-stimulating hormone (FSH), poor egg quality, blocked Fallopian tubes, and immune system imbalance. Much research has been published on the effect of herbs on these individual disorders.
Massage and physical therapy can be used to correct structural imbalances caused by fibroids, endometriosis, blocked Fallopian tubes, scar tissue from prior surgeries, and adhesions restricting function and mobility of the reproductive organs caused by trauma or injury. Reproductive organ massage is also effective in improving blood flow to the reproductive system. In a 2004 peer-reviewed study, manual physical therapy was shown to improve natural and IVF pregnancy rates in infertile women. In a 2008 study it was shown to open and return function to blocked Fallopian tubes.
Nutritional and dietary therapy improve pregnancy rates and can be used by both male and female partners to enhance fertility. Numerous research articles have shown that the use of nutritional supplements prior to and during pregnancy improves the health of both mother and baby. Certain foods and supplements regulate hormone balance, and contain factors beneficial to egg and sperm health and development; they are prescribed according to the needs of the individual patient.
Mind-body techniques such as meditation, yoga, and qigong excercises are often useful for patients struggling with infertility as they reduce stress and cortisol levels and allow the body to prioritize reproduction.
Therapy and support groups can be helpful to deal with the psychological stress and feeling of isolation experienced by many fertility patients. A 2000 Harvard Medical School study showed higher pregnancy rates in patients attending support groups and cognitive behavioral therapy.
Diagnostic testing may be recommended depending on individual needs and may include semen analysis and blood hormone tests for such factors as FSH, estradiol, progesterone, thyroid panel, etc. Saliva testing to map the hormones throughout the menstrual cycle or to test cortisol levels and adrenal function may be indicated. Basal body temperature (BBT) charting, monitoring of cervical mucus, or use of ovulation predictor kits may also be useful.
Possible causes of infertility
There are many causes of infertility, the most common of which are the following:
- Being over- or underweight
- Exposure to environmental toxins
- Problems with ovulation
- Cervical/uterine factors
- Fallopian tube blockage
- Immunology factors or inflammatory factors, both specific and non-specific
- Pelvic inflammatory disease
- Polycystic ovarian syndrome (PCOS)
- Ovarian cysts
- Premature ovarian failure (POF)
- Uterine fibroid tumors
- Endocrine imbalances
- Luteal phase defect (LPD)
- Elevated levels of follicle-stimulating hormone (FSH)
- Thyroid disease
- Birth defects — impaired fetal development due to mother taking diethylstilbestrol (DES)
- Age-related factors
- Unexplained infertility
- Male-associated infertility
- Tuberculosis (TB)
- Previous tubal ligation
- Previous vasectomy
- Adrenal disease
- Genetic factors in either partner causing recurrent miscarriage or infertility
- Kallmann syndrome
Western treatment of infertility
The great majority of infertility cases are treatable with medical intervention, and are generally treated by a Reproductive Endocrinologist or Ob/Gyn. Underlying conditions contributing to infertility are sometimes addressed before beginning treatment, and are sometimes overridden by the treatment itself. The use of medications, surgery or assisted reproductive technology such as IUI or IVF are the most commonly used therapies.