What Traditional Chinese Medicine can teach us about women’s fertility

Are you trying to get pregnant or thinking about starting your family in the near future? Traditional Chinese Medicine (TCM) teaches us the importance of taking some time to get healthy and ‘on-track’ before getting pregnant, to reduce the chances of failed attempts and early miscarriages, which can take its toll on any couple trying to conceive. I provide a simple intro to some basic TCM theory here.

It is indeed common nowadays for couples to experience trouble conceiving. I have treated many couples at different stages of planning, from those in their 20s trying to get as healthy as possible before trying, to those in their 40s undergoing their third round of IVF. Acupuncture has a role in every pregnancy.

The so called ‘beautiful cycle’…

period-cycle1

Let’s start by looking at the menstrual cycle from a TCM perspective. Keep in mind the yin-yang symbol, left. Day one is the first day of the period. Day one is when the build up of the uterine wall, in the absence of a pregnancy, begins to break down and exit the system. It is the end of the yang cycle in the body, characterised by body heat and fullness, and the beginning of the yin cycle, the cooler phase physiologically, characterised by nourishing processes that build the follicles and blood.

Yang is the warmer, expansive outward force in TCM, yin is the cooler, underlying strength. Yin is the root or the bulb which has the nutrients and yang is the flower or the shoot, both mutually dependent. Where ovulation happens, there is a dramatic change from yin influence in the body to yang and this is represented by a stark rise in body temperature.

What causes the yin phase to change to yang, or the follicular phase into ovulation and the luteal phase, is a complex cascade of hormonal interactions and, in the case of infertility, the internal struggle for the balance of heat and cold, blood and qi (the vital energy). One thing for sure is that the change (from yang to yin around day 14 and yin to yang on day one) can be the catalyst for days of mood swings, pain, nausea and sleep disturbance…for starters!

Charting for victory…

In brief, the TCM view is that by charting temperature changes in the body, analysing the cervical mucous changes and by checking the pulse changes, a good picture of the woman’s overall cycle can be obtained. This should take place over three cycles (three months) prior to trying for a pregnancy. My best advice to couples who are experiencing miscarriage or anovulation early in their efforts to get pregnant, is to consider taking time out to get the cycle in order and reduce stress.

ovulation-temperature-tracking

I help women through temperature charting and try to give insight into the functionality of the cycle. It can be an obsessive phase that drives some people to distraction, but ultimately narrows down a part of the cycle that is failing. If  the body temperatures are too low or high at any point in the cycle we will plan our acupuncture sessions to take place at that time the following month.

How acupuncture works…

How acupuncture is seen to work on a physiological level is to stimulate the nerves in the muscles. Different acupuncture points have been seen to promote different reactions in the brain on fMRI testing and influence various functions in the body. This is very well documented in TCM clinical texts but in the West we are just catching up in the efforts to produce gold standard research. Having needles placed in the body during acupuncture also releases endorphins, the body’s favourite pain-killing and mood enhancing chemicals, therefore it has a helpful role in the treatment of many different health conditions.

In infertility the research shows that the body has an array of different responses to acupuncture. The easiest place to start is to understand is that stress responds to endorphin release and thus it can be helpful in the promotion of ovulation, because the release of the egg can be significantly influenced by stress levels. On a more complex level, acupuncture has been proven in the following research areas

  • regulating fertility hormones – stress and other factors can disrupt the function of the hypothalamic pituitary-ovarian axis (HPOA). Acupuncture promotes the release of beta-endorphin in the brain, which regulates gonadatrophin releasing hormone from the hypothalamus, follicle stimulating hormone from the pituitary gland, and oestrogen and progesterone levels from the ovary (Anderson 2007).
  • increasing blood flow to the reproductive organs (Ho 2009, Anderson 2007), which can improve the thickness of the endometrial lining, so increasing the chances of embryo implantation.
  • increasing egg production (Jin 2009) and improving oocyte quality (Chen 2009), which could increase the chance of fertilisation.
  • enhancing luteal function (Huang 2009)
  • regulating follicle stimulation hormone-receptor expression (Jin 2009).
  • normalising cortisol and prolactin levels on IVF medication days (Magarelli 2008); reducing stress (Anderson 2007)
  • promoting embryo implantation (Liu 2008).

References and further information on these studies here.

When it’s time for IVF

If the above explanation of acupuncture research looks nice and black and white or in any way straightforward, let me correct myself. It is not straightforward! Life is busy, families are demanding and we often put ourselves last on the list of priorities. Acupuncture is not a miracle cure and it certainly doesn’t turn back the body clock.

When it is time for IVF however, acupuncture has been shown to be a very useful treatment in aiding clinical pregnancy rates. IVF offers a 30% chance of a pregnancy, a statistic that can be hard to swallow. Stress and worry about the outcome, the health of the baby and the significant finances involved can put unprecedented pressure on couples, so it is important to build relaxation techniques into your daily routine. Acupuncture is, in my opinion, one of the best relaxation techniques you can choose. My patients across the board report better quality sleep and less anxiety, without the hangover that medication comes with.

The research into acupuncture and it’s role in IVF is impressive, especially for a natural therapy with very little funding behind it by comparison with pharmaceuticals. The link above details some of the most useful evidence that has been published. There are a number of well established protocols for treatment with acupuncture that have been put to the test in the last 20 years. One of the most referenced and repeated studies is the Paulus study (known as the German study), involving 120 women who had treatment on the day of embryo transfer and which showed a statistically significant improvement in pregnancy rates at 42.5%, compared to 26.3% in the non acupuncture group. The authors of the study explained the principle of the treatment was calm the patient and to stimulate the uterus and endocrine system.

So what Chinese Medicine really tells us about fertility is that we need to watch and wait and be patient. It tells us that we can influence our health using natural techniques. It tells us that stress is a major factor in infertility.

I am here to help…

If you are experiencing difficulty getting pregnant or you are going through IVF I am here to help. I am a member of the British Acupuncture Council, the largest organisation of acupuncturists in the UK and Ireland, and I am a member of the specialist group, the Acupuncture Fertility Network. I can be contacted at the Dublin Holistic Centre on 01 6330063 or directly on 085 153 7098. All enquiries are treated as confidential and I offer a free 10 minute telephone call if you wish to discuss your case prior to your consultation.

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