Traditional Chinese Medicine & Female Infertility

Although the views of Traditional Chinese Medicine (TCM) and female infertility are very much in line with Western views and the causes of female infertility; the treatment of female infertility is treated in a very different way to Western methods of treatment. Before any form or treatment is recommended a Chinese doctor will gather all relevant details of the patients history, he will then look at the tongue and take the pulse, from the signs he observes he will then have a clearer picture of where the problem lies.

Traditional Chinese Medicine also has at its disposal Western diagnostic tools which allow not only to pinpoint the ovulatory event itself, but also all the steps leading up to it. For example, a vaginal ultrasound can track the progress of a follicle from the very first signs of stimulation by the follicle-stimulating hormone (FSH), right up to its full size at maturity when the egg will be released. The ultrasound also reveals the readiness (i.e. thickness) of the lining of the uterus to receive a fertilized egg. Blood tests can track ovulation by measuring:

• Oestrogen levels, which increase as the follicle grows
• FSH, which stimulates follicle growth
• The progesterone produced by the corpus luteum after the egg has been released.
• Luteinising hormone (LH), which heralds the imminent release of the egg

The main causes of female infertility is due to:

• Inadequate luteal phase –  Meaning the time period calculated from the day after ovulation through to the remainder of the monthly cycle.
• Polycystic ovaries -  Small cysts on the ovaries can cause an imbalance of woman’s female sex hormones which cause changes in the menstrual cycle resulting in infertility.
• Tube blockages – When the fallopian tubes become blocked
• Oligomenorrhoea – Abnormal bleeding and menstrual cycles that occur more than thirty five days apart
• Endometriosis – Where the cells multiply abnormally outside of the uterine cavity, most commonly on the ovaries

Although these disease labels do not usually translate directly into specific TCM categories of infertility, these symptoms in a female patient are easily analyzed and categorized and is the starting point for a Chinese doctor that enables him to form a plan of treatment.

In Chinese traditional medicine you will find in most fertility clinics  nearly all prescriptions are to treat the kidneys. If there is functional infertility, then by definition the Kidney Yin and Yang are depleted or not functioning correctly.

Categories of functional female infertility

• Problems related to ovulation – Kidney Yin deficiency or Heart Qi stagnation, either of these two patterns can be complicated by Liver Qi stagnation, Phlegm-Damp or Blood stagnation)
  
• Problems of embryo implantation – Kidney Yang deficiency (possibly complicated with Liver Qi stagnation, Phlegm-Damp or Blood stagnation).

We know there is no ovulation if:

• there are no periods
• Irregularity of periods
• The BBT chart shows no biphasic pattern
• Blood tests show low estrogen/progesterone levels or high FSH levels

We know there is ‘poor’ ovulation if:

• The BBT chart shows a small rise in temperature
• The temperature rise is very short-lived
• Blood tests taken in the middle of the luteal phase show low levels of progesterone
• there is spotting in the luteal phase.

We suspect problems with implantation if:

• There is poor ovulation
• There are fibroids or other physical barriers to implantation
• The uterine lining is inadequate and periods are very scanty or dark or clotted
• We have eliminated everything else and pregnancy is still not occurring.

Kidney Jing deficiency

Signs and symptoms – Kidney Jing deficiency will be the diagnosis if there are, in addition to any of the above symptoms, the following:

• Obvious developmental disorders in the reproductive organs or
• Little development of secondary sexual signs such as breast development

or

• Under-functioning ovaries, even if the ovaries appear normal
• Puberty may be late and ovulation may be erratic; sometimes the only sign
• Inability of the ovaries to respond to fertility drugs
• Pulse – The pulse will usually be weak and thready
• Tongue – The tongue is usually pale

Kidney Yin deficiency

Signs and symptoms.

This is an increasingly common diagnosis of infertility. Kidney Yin deficiency occurs especially in older women and usually arises out of depletion of resources – working (and playing) too hard without allowing the time and deep rest needed for replenishing body and soul.

A woman who is Yin deficient may complain of some or several of the following symptoms:

• Restlessness or anxiety
• Difficulty getting good-quality sleep
• flushing easily
• Frequently needing to drink fluid

Video on Chinese Acupuncture and female fertility

TREATMENT DURING PREGNANCY

The diagnosis must be made with extreme caution and accuracy, this means examining all aspects of the menstrual cycle and the patients constitution taken into consideration. One or two prescriptions may be prescribed which can be taken for half or all of the cycle with certain additions made at key times. Additions may include blood moving formula to be taken during the period, or a damp clearing formula or Blood moving formula before ovulation, or a Shen calming formula during the follicular phase. Medications may be in pill form, although these are generally not as strong in action as herbs which are decocted or taken as teas made from granules.

Once a positive pregnancy test is announced the patient and practitioner must decide whether treatment should be continued. Pregnant patients must be very cautious of taking medicines of any kind, including herbal medicines. Early pregnancy is a most vulnerable time for the rapidly growing fetus and many pregnant women instinctively reject many foods and flavours. In fact, it is thought that morning sickness evolved from exactly this need to be very cautious of eating plant materials which contain small amounts of toxic chemicals designed to repel insects and animals. The body will therefore be wary of herbal substances and, where morning sickness is pronounced, will reject them outright.

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