What are the common causes of infertility?

• Ovulation problems

• Tubal causes

• Sperm causes

• Unexplained infertility

• Age-related factors

Some less common causes are: 

• Uterine problems

• Endometriosis

• Previous tubal ligation

• Previous vasectomy

• Various drugs

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Taking the following steps may prevent some cases of female infertility: 

• Avoid excessive exercise

• Avoid smoking

• Control diseases such as diabetes and hypothyroidism

• Follow good [weight management] guidelines

• Get early treatment for sexually transmitted diseases

• Have regular physical examinations to detect early signs of infections or abnormalities

• Limit caffeine and alcohol intake

• Practice stress management

• Use birth control to prevent unwanted pregnancy and abortions.

 

How is the condition diagnosed? 
Diagnosis of infertility begins with a medical history and physical exam. The healthcare provider may order tests, including the following: 

• An endometrial biopsy, which tests the lining of the uterus

• Hormone testing, to measure levels of female hormones

• Laparoscopy, which allows the provider to see the pelvic organs

• Ovulation testing, which detects the release of an egg from the ovary

• Pap smear, to check for signs of infection

• Pelvic exam, to look for abnormalities or infection

• A postcoital test, which is done between 2 and 8 hours after intercourse to determine whether sperm can survive in the cervical mucus

 

What are the conventional medical approaches for this condition? 
Treatment of infertility will depend on the cause. Medical treatment for female infertility may include: 

• Surgery to treat certain problems (e.g., endometriosis)

• Taking antibiotics for sexually transmitted diseases

• Taking medications to cause ovulation, such as clomiphene and menotropins, artificial insemination (placing sperm directly in the cervix or uterus)

• Intracytoplasmic sperm injection (placing individual sperm cells directly inside the woman's eggs)

• In vitro fertilization (fertilizing the egg outside the womb and then returning it to the uterus).

 

What are the side effects of the treatments? 
Following are some of the side effects of medications used to cause ovulation: 

• Abdominal pressure or fullness

• Cysts on the ovaries

• Headaches, hot flashes, mood changes

• Multiple pregnancies, such as twins or triplets

• Ovarian hyperstimulation syndrome, which causes fluid shifts in the body

• Antibiotics may cause allergic reactions, stomach upset, and rash.

• Surgery carries a risk of bleeding, infection, and allergic reaction to anesthesia and other rare but serious complications may be involved.

 

Is there any natural approach to enhance the chance of my pregnancy? 
Depending on the cause of infertility, a natural approach is found to be very valuable. In many cases, the natural approach should be tried first before proceeding to drastic medical interventions, especially if you are in your twenties. The natural approach for female infertility may include:

• Eating a healthy diet

• Exercising in moderation

• Learning about the best time to conceive

• Limiting caffeine and alcohol intake

• Making lifestyle changes, such as smoking cessation

• Receiving a series of acupuncture treatments

 

How does acupuncture work for this condition? 
Functional related infertility is very often related to stress. This may be the reason that infertility seems to be extremely common in women who work in stressful office environments. Acupuncture is very beneficial for decreasing excess tension in the body by balancing the autonomic nervous system. Possible hormonal imbalances and circulatory problems are also addressed by acupuncture. 

What do I need to do prior to my appointment? 
Before your appointment with us it is recommended that you first see your specialist and that your husband and you complete the tests to determine the possible cause of infertility. It is helpful if you bring all the previous medical reports and test results with you for the first consultation. 

Most infertility patients are asked to record their basal body temperature every morning. A properly recorded basal temperature chart can give us a clue whether you are ovulating or not and the degree of hormonal imbalance. You will be asked to continuously record your basal temperature throughout the treatment process in order to evaluate your progress. If you have decided to receive the treatment you may request a basal temperature chart and instructions for recording by phone (510-713-9086) or e-mail. 

Dr.Y.J.Tao and Dr.Ping Wu are professors at the American College of Traditional Chinese Medicine, Department of Acupuncture in San Francisco in California U.S.A. Dr. Tao and Dr. Ping are available for consultation and acupuncture treatment at their clinic.

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ACUPUNCTURE AND FERTILITY TREATMENTS (IVF)

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How can Acupuncture and Herbs help IVF?

• Research shows that acupuncture and herbal medicine improves the function of the ovaries to produce better quality eggs.

• TCM helps to regulate the hormone levels to help produce a larger number of follicles.

• Increased blood flow to the uterus in turn creates a thicker uterine lining. The result is better likelihood of implantation of the embryo to the uterus.

• During implantation of the embryos, acupuncture and herbs can help prevent the uterus from contracting, thereby also preventing the patient from experiencing painful cramps.

• Lessen the side effects of the drugs used in IVF, such as emotional instability, insomnia, palpitations, etc.

• Acupuncture and herbal medicine can strongly strengthen the immune system.

• For males, TCM can improve the quality and quantity of the semen to create better quality embryos.

• Lastly, once the patient does become pregnant, acupuncture and herbs can help to decrease the chances of miscarriage. For women over 40 years old, pregnancies with IVF have an approximate 46% rate of miscarriage after six weeks. This percentage can be greatly reduced with the help of Chinese medicine.

 

Preparing for IVF with Chinese Medicine 
It is best for the preparation to begin three months before IVF treatments begin. In this time, the goal of the TCM practitioner is to improve the function of the ovaries to produce good quality eggs. The treatment method is varied, depending on the patient individual diagnosis and factor of infertility. Some methods used include tonifying the kidneys, spleen, qi, and blood, smoothing the liver qi, and circulating the blood. At ATP Acupuncture clinic, many patients have seen results of decreased FSH levels, resumed regular menstrual cycles, and some even became pregnant naturally! 

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Starting IVF with Chinese Medicine

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STEP ONE - BIRTH CONTROL PILLS 
The first step with IVF is to start taking one month of birth control pills. This is done to give the ovaries a rest and regulate the hormones. This can be thought of as a field on a farm that is not cultivated for a season in order for it to be replenished with nutrients. This helps ensure an even growth of the follicles once the stimulation begins. 
In TCM, the treatment method is circulate the qi and blood by smoothing the liver qi, which ensures the smooth flow of qi throughout the body. When the qi is flowing smoothly so too will the blood. This in turn increases the blood circulation to the ovaries, nourishing them and preparing them to produce good quality eggs. It is important not to over tonify at this time, so that the TCM treatment method is symbiotic to the western medicine treatment.

 

STEP TWO - LUPRON 
The next step is that the patient begins to take Lupron a few days before the end of the birth control pill cycle. Depending on the doctor, the dosage of Lupron varies. The dosage of Lupron is decreased once stimulation of the ovaries begins but is to be taken up to the day before the retrieval of the eggs. There are some side effects associated with Lupron that are similar to menopause symptoms and the severity of these side effects depends upon the dosage. Many patients experience symptoms of anxiety, irritability, sadness, overall emotional instability, palpitations, and headaches. 
The treatment method during this time, is to smooth the liver qi and calm the spirit. This helps to relax the patient and make them more calm and emotionally stable. It is also very helpful with their physical symptoms of palpitations and headaches. Many patients have experienced relief from the side effects of this important drug, Lupron, and are able to go on with the process of IVF. 

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STEP THREE - STIMULATION 
The third step is stimulation of the ovaries to create follicles that will eventually become viable eggs. Two to three days after the period has begun, the ovaries are stimulated with such drugs as Follistim, Gonal-F, and Repronex. These drugs function like the body's hormones, FSH and LH, which help the body produce more follicles. 
During this time, the goal of TCM is to make the ovaries respond well to the drugs and to produce more follicles of good quality. The method used is to tonify the kidneys, spleen, qi and blood, thereby nourishing the ovaries with acupuncture and Chinese herbs. Once the eggs have been retrieved and fertilized in vitro, it is now time to transfer the embryos into the uterus. 

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STEP FOUR - TRANSFER OF EMBRYOS 
In this stage of the process, it is important to receive acupuncture as close to the time of the transfer as possible. This is because acupuncture can help to dilate the cervical opening. This allows for a more easy transfer of the embryos into the uterus. It also helps to relax the patient, thereby relaxing the uterus so that when the transfer is being done, the patient does not experience any pain or cramping. It also helps prevent the uterus from contracting, which better enables the embryo to implant upon the uterus.