In TCM, the two key elements in fertility are ovulation and menstruation. When these are regulated, the chance of conception increases. From a TCM perspective different causes of infertility which can upset the menstrual cycle or ovulation can be a weak constitution, overwork, excessive physical work, sexual activity at an early age, invasion of cold, irregular diet, too little rest from injury or too much menstrual bleeding, emotional disorders such as anxiety, worry or depression, excesses of food or alcohol or too much chilled food (Cochrane, 2011; Maciocia, 2011).
Studies have been done on the mechanisms behind acupuncture for fertility. Response to acupuncture treatment may be “related to the central sympathetic inhibition by the endorphin system, the change in uterine blood flow and motility, and stress reduction” (Ng et al. 1997). Chang et al. (2002) discusses how acupuncture’s effect on GnRH secretion and the menstrual cycle could lead to “hypothesize that acupuncture may influence ovulation and fertility”. In research literature there seems to be a causative link between stress and infertility in both western medicine and TCM – the two approaches are in agreement. The research hypothesizes that TCM affects neuro-endocrinological factors, including cortisol and prolactin hormones and the hypothalamus-pituitary axis (HPA), all of which are thought to have a positive impact on reducing stress levels and therefore increasing the chance of conception.
Treatment with TCM
TCM treatment takes whole systems approach, meaning that body, mind, emotions and spirit are included in the treatment and considered factors in addressing any imbalance. Treatment includes acupuncture, moxabustion (heat treatment) and herbal medicines along with appropriate lifestyle and dietary advice. It is important to note that a positive patient-practitioner relationship has been associated with positive health outcomes.
Appointments are scheduled depending on your menstrual cycle and any other treatment you may be receiving to assist with fertility (i.e. intrauterine insemination, IVF, clomiphene).
There are a multiple of causes of fertility including sperm factors, ovulation disorders, polycystic ovary syndrome (PCOS), fallopian tubal blockage/damage, endometrial-related problems, age, uterus damage and unexplained fertility issues (Stewart, 2011).
Approximately one in six couples ‘are currently struggling with impaired fertility’ (Alfred & Ried, 2011). Infertility, often called ‘subfertility’ is diagnosed after a couple has been having unprotected sex for 1-2 years without getting pregnant and can be caused by male or female factors or be unexplained.
Using western biomedicine, the first line of treatment is to address any underlying medical condition and investigation begins with semen analysis, assessing ovulation, checking for tubal damage and any uterine abnormalities. Diagnostic tests are often carried out to assess gynaecological hormones: follicle stimulating hormone (FSH), oestrogen levels, luteinising hormone (LH) and progesterone and a check via ultrasound or laparoscopy may be needed. It is recommended to reduce alcohol, smoking and body weight to increase the chances of pregnancy (Stewart, 2011). Male factors are involved in 30-50% of subfertility with it being the dominant cause in one third of couples facing difficulties. (Hung Yu Ng, Wing Sze So, Gao, Wong, & Ho, 2008).
References:
Alfred, A., & Ried, K. (2011). Traditional Chinese Medicine: Women’s experiences in the treatment of infertility. Australian Family Physician, 40(9), 718-722.
Chang, R., Chung, P. H., & Rosenwaks, Z. (2002). Role of acupuncture in the treatment of female infertility. Fertility and Sterility, 78(6), 1149-1153.
Cochrane, S., Smith, C. A., & Possamai-Inesedy, A. (2011). Development of a Fertility Acupuncture Protocol: Defining an Acupuncture Treatment Protocol to Support and Treat Women Experiencing Conception Delays. Journal of Alternative & Complementary Medicine, 17(4), 329-337.
Hung Yu Ng, E., Wing Sze So, E., Gao, J., Wong, Y. Y., & Ho, P. C. (2008). The role of acupuncture in the management of subfertility. Fertility and Sterility, 90(1), 1-13.
Maciocia, G. (2011). Obstetrics and Gynecology in Chinese Medicine (2 ed.). China: Churchill Livingstone.
Ng, E. H. Y., Wing Sze So, E., Gao, J., Wong, Y. Y., & Ho, P. C. (1997). The role of acupuncture in the management of subfertility. Fertility and Sterility, 90(1), 1-13.
Stewart, J. A. (2011). Best Practise: Infertility. from http://bestpractice.bmj.com.ezproxy.uws.edu.au/best-practice/monograph/498.html