Specializing in Fertility, Gynaecology and Obstetrics
Conditions treated with Acupuncture and Chinese Herbal MedicineInfertility and Chinese Medicine,
Infertility is commonly defined as an inability to conceive after 1-2 years of trying. In approximately 60% of cases the difficulty is with the woman and 40%, the man. Infertility also refers to repeated miscarriages.
In order for a woman to conceive, she must ovulate. The egg must travel through the fallopian tube towards the uterus and a man's sperm must fertilise the egg along the way. Finally the fertilised egg must implant into the wall of the uterus. Some of the main causes of infertility in women are; endometriosis (where parts of the uterine wall are deposited in the abdomen outside the uterus itself), ovulation problems, poor egg quality, polycystic ovary syndrome, and fallopian tube blockages. In men problems may be caused by low sperm count or sperm abnormalities. However, in many cases the infertility is unexplained, with no underlying problems that can be identified.
CHINESE MEDICINE AND INFERTILITY: In a recent study, Chinese herbal medicine has been shown to result in a high success rate of pregnancy in infertile couples (Journal of Chinese Medicine 2006; 80; 20-8). It has shown improvements in the size and number of eggs and in the thickness of the uterine wall, all of which could help to explain its success. Chinese medicine may be used on its own or in combination with IVF or other forms of assisted reproduction.
Chinese medicine treatment is tailored to you as an individual. The practitioner will take note of your medical history, the characteristics of your menstrual cycle and your general health. This information will be used to assess the nature of the underlying imbalance, and to choose a herbal formula (a combination of herbs), which will then be modified during the course of treatment.
The aim of treatment will be, where appropriate, to regulate the cycle and support ovulation or implantation. The medicine may be prescribed as a tea or in pill form. In addition your practitioner may recommend lifestyle and dietary changes. A minimum of three months' treatment can be expected in the case of unexplained infertility. Although with underlying problems such as endometriosis treatment tends to be longer, improvement may be seen in other changes, such as a reduction in the severity of peiod pain.
"Infertility" leaflets (above information) made by the RCHM are available in the clinic. For further information, please visit www.rchm.co.uk
The 'egg factor':Using Chinese herbal medicine to improve fertility in a 45-year old woman (Heese I 2006)
Abstract: Advanced female age is an important factor in low pregnancy outcome. In the following case study, a course of Chinese herbal medicine improved ovarian and uterine function in a 45-year old woman who had a very low response rate during her two IVF cycles and who was advised to opt for donor eggs for her next IVF attempt. She conceived naturally after five months of taking Chinese herbs and is now successfully into her second trimester.
Introduction: Advanced female age is an important factor in low pregnancy outcomes. As a woman progresses through her reproductive years, her ovarian reserve diminishes, with an approximately 50% decrese in fertility rates in women attempting pregnancy at the age of 40 onwards, and a two-to-three-fold increased risk of miscarriage.
Chinese medicine and reproduction: Chinese medicine can effectively improve ovarian and uterine function and other fertility markers, and thus optimise the chances of conception and pregnancy. Whilst it cannot turn back time and improve egg quality in an older woman, it may - by improving the growth of the dominant follicle within an ovary that functions more effectively through treatment - improve the environment an egg matures in, and thus indirectly influence its maturity and quality. Chinese medicine also improves the thickness of the endometrial lining (and thus the endometrial receptivity to an embryo), increasisng the chances of a successful conception and pregnancy. Research as well as clinical experience has shown that both Chinese herbal medicine and acupuncture can improve ovarian and uterine blood flow, regulate the endocrine hormones FSH & LH, increase oestrogen and progesterone and normalise both the follicular and luteal phases of the menstrual cycle.
Reference: Heese I (2006), The 'egg factor': Using Chinese herbal medicine to improve fertility in a 45-year old woman, Journal of Chinese Medicine, No.82
The different approaches of IVF and TCM
Jane Lyttleton (2004) on "Treatment of Infertility with Chinese Medicine" says that "IVF is essentially a numbers game - it increases the odds of success by increasing the numbers of eggs produced. The technique does not aim to affect the quality of the egg: rather it aims to increase the quantity of eggs. In the hope that in a large number at least one will have what it takes. The thickness of the lining of the uterus is the only other parameter measured. The general health of the couple, in the absence of major pathology, is of minor concern. Whether the male partner has enough motile sperm is even becoming less important now in the days of ICSI.
In contrast, Chinese medicine considers the overall health of the person (with special emphasis on Kidney Qi) who is making the gametes, based on the supposition that this will translate into healthier gametes. We know that the greatest determinant of a viable pregnancy is a viable embryo, which in turn depends largely on the fusion of healthy and compatible gametes. Unlike IVF, TCM treatment is not a numbers game. Treatment with Chinese medicine on its own does not usually increase the number of eggs ovulated. While it cannot change the genetic make-up of the egg, TCM is thought to influence how well the eggs are nourished and stimulated to grow and the facility with which they are released and travel down the fallopian tubes. In addition, TCM treatment improves endometrium thickness and quality. Chinese medicine can also influence the number, motility and genetic quality of sperm.
Unlike the IVF treatment regimen, TCM has an endless number of variations - as numerous as the patients themselves. The skill of the TCM infertility specialist is in the correct diagnosis of subtle patterns of dysfunction, the correct prescription of herbs and their doses, the correct timing of the medicine and the technical skill involved in applying acupuncture.
Where TCM treatment of infertility is holistic, time tested and generally slow acting with few side effects and little risk, IVF is specialised, experimental and quick to get results but not without risks to mother and baby" (Lyttleton 2004).
"With both Chinese herbs and acupuncture in preparation for and support throughout the IVF procedure, increases IVF pregnancy success rate to 60%" (Lifang Liang 2003)
Lifang Liang (2003) states that "A recent German study found that using acupuncture with IVF achieved a 42% clinical pregnancy rate in the test group, compared to 26% in the control group that did not receive acupuncture. This study involved giving acupuncture for just one day, shortly before and after the trasfer of embryos. My clinical experience is that this rate increases to at least 60% with broader support of both Chinese herbs and acupuncture in preparation for and support throughout the IVF procedure. As well, both of these modalities can significantly reduce the risk of miscarriage by supporting the female during her entire pregnancy.
A large number of patients who have tried IVF several times and were unsuccessful have soon become pregnant after Chinese medicine treatments. In clinical observation, the ultrasound shows that, after acupuncture, the color of women's ovaries change from cloudy to bright and clear. The follicles usually double in number, the lining of the uterus becomes thicker, and the number of embryos increases significantly. Patients experience less side effects from the Western drugs and feel more at ease and happy. For male patients, it is my experience that the semen quality significantly improves and the sperm number greatly increases. In brief, Chinese medicine can help to improve the success rate of IVF in a number of ways:
1. Improve the function of the ovaries to produce better quality eggs
2. Regulate the hormones to produce a larger number of follicles
3. Increase blood flow to the uterus and increase the thickness of the uterine
lining
4. Relax the patient and decrease their stress
5. Prevent the uterus from contracting
6. Lessen the side effects of drugs used in IVF
7. Strengthen the immune system
8. Improve semen to create better quality and quantity of embryos
9. Decrease chances of miscarriage"
Diane Cridennda and Paul Magarelli have been researching and publishing integrated research into the effects of combining TCM with ART and have found many useful results exemplifying the role Acupuncture contributes in the success of In Vitro Fertilization as follows:
They have over 815 IVF study cycles in their database and consistently their results reveal a 12-15% improvement in Take Home babies if their patients received Acupuncture along with their IVF.
Their study shows miscarriages were 15-50% fewer when IVF patients were treated with Acupucnture.
Their clinical pregnancy rate improvements associated with the addition of Acupuncture were over 20% on average.
For full details of the Magarelli/Cridennda studies, please log on to:
Diane and Dr Magarelli's Articles
"Can complementary therapies help you conceive?"
Given the high profile of in vitro fertilisation (IVF)and other assisted conception techniques, it is easy to forget that most of the time, they do not work. Among women under 35, the success rate for IVF is a meagre 28.2 per cent, a figure that plummets to 10 per cent in the over-forties. With private IVF treatment costing upward to £4000 - only about 25 percent of cycles are NHS-funded - it is unsurprising that patients are keen to maximise their chances and are increasingly turning to complementary therapies. 'We are always being asked by patients if there is anything they can do to improve their chances of success,' says Zita West, a midwife and fertility expert. 'Lifestyle factors such as exercise, diet, smoking and stress can have a huge impact.' A few years ago, most IVF consultants would have laughed in the face of any patient bold enough to air views like these. Today referrals from doctors to complementary practitioners have become almost commonplace. 'There is a lot of interest in alternative approaches,' concedes Stuart Lavery, director of the IVF unit at Hammersmith Hospital in west London. 'Conventional medical approaches, specifically IVF, are not that successful and everybody is desperate for anything that can help.'
The single most important factor in determining whether a woman becomes pregnant is the quality of her embryos. And the herbalist and acupuncturist Michael McIntyre, the chairman of the European Herbal Practitioners Association, believes that complementary therapies can have a profound impact here. 'They can help to rebalance the body, maximise the ability of the eggs to mature in the first phase of a woman's cycle and hlep the endometrium to support the fertilised egg in the second phase,' he says. Michael Dooley is a well-regarded gynaecologist who has come to believe passionately in the integrated approach to infertility treatment. His 10-point 'Fit for Fertility' programme includes diet, exercise, stress-reduction and a lifestyle review, and the clinics where he practises in Dorset and London offer more than a dozen different therapies. Given the financial, physical and emotional cost of assisted conception and the success of complementary medicine in treating both male and female infertility, some clinics now suggest that patients start with natural approaches, which are much cheaper and less invasive.
from 'Telegraph Magazine', by Barbara Lantin, October 2006
Useful websites for Acupuncture related research/articles on Infertility:
The Acupuncture Fertility Network------I am a member of AFN
Diane and Dr Magarelli's Articles
Acupuncture related research recently published in Medical Journals
References:
Lyttleton, J. (2004). Treatment of infertility with Chinese medicine. London: Churchill Livingston.
Lifang Liang (2003). Acupuncture and IVF. Boulder, USA: Blue Poppy Press