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Chinese Herbal Medicine & Infertility

Chinese herbal medicine is a profound and highly sophisticated medical system that dates back 3,000 years. It is still used in hospitals in China today – alongside western medicine – and is an integral part of the Gynaecology and Obstetrics Department. There is overwhelming evidence of its effectiveness in treating infertility and gynaecological conditions, and it is for this reason that it is used as a form of treatment at Blackheath Complementary Health Centre. It has become steadily more recognised by the medical profession in the UK, and an increasing number of gynaecologists now work together with Chinese medical practitioners to support their treatment.

The aim of Chinese herbal medicine is to treat the underlying disharmony that lies at the root of disease and improve wellbeing, rather than simply alleviating the symptoms. It derives its principles from the observation of nature and the cycle of the seasons, and is based on the Taoist principles of Yin and Yang, two opposing qualities that are interdependent and in a constant state of dynamic balance. When the balance becomes undermined due to lifestyle, emotional, dietary, hereditary or climatic factors, toxins or trauma, illness may result.

Like Yin and Yang, the hormones, are in a constant state of dynamic flux. By balancing Yin and Yang, Chinese medicine is able to balance the hormones and treat a number of gynaecological disorders, including infertility.

Numerous studies have demonstrated that Chinese herbal medicine can:

  • lower stress hormones which interfere with ovulation;
  • regulate hormones by stimulating the hypothalamus, the regulatory control centre of all hormone activity;
  • increase endorphin production which, in turn, effects the release of gonadotropin-releasing hormone;
  • promote blood circulation in the uterus, ovaries and testes;
  • improve ovarian function and follicular development;
  • increase fertile mucus; • thicken the lining of the uterus;
  • increase energy production in the cells;
  • boost and balance the immune system; and
  • strengthen the digestive system, nourish the quality of the blood, and improve general health and wellbeing.

Female infertility
Infertility is becoming an increasing problem. Today at least 1 in 6 couples experience problems in conceiving, and 60% of those are due to female infertility. This growing problem can be attributed to nutrition, alcohol, smoking, caffeine, xeno-oestrogens from pesticides and plastics, toxic metals, food additives, household chemicals, radiation, allergies, immunology, genitourinary and other infections and stress.

How does Chinese herbal medicine influence fertility?
Studies indicate that Chinese herbal medicine triggers the release of prostaglandins, which stimulate production of chemicals in the nerve endings, which, in turn, transmit a message to the hypothalamus. Located at the base of the brain, the hypothalamus is the regulatory control centre for all hormone activity. It is of particular interest as regards fertility since it also controls the discharge of gonadotropin-releasing hormones (GnRH), which govern ovulation, menstruation and pregnancy.

Besides balancing hormones, studies have demonstrated that Chinese herbal medicine can reduce stress (which directly effects fertility), improve ovarian function and follicular development, increase fertile mucus, promote uterine and ovarian artery blood flow, and thicken the lining of the uterus, so increasing the chances of successful fertilization and implantation. They can also influence the facility by which the eggs are released and travel down the fallopian tubes.

Chinese herbal medicine can treat infertility due to:

  • Idiopathic or unexplained infertility
  • Stress
  • Polycystic ovarian syndrome (PCOS)
  • Endometriosis
  • High FSH
  • Premature ovarian failure
  • Luteal phase deficiency (LPD)
  • High prolactin levels
  • Other hormonal imbalances
  • Ovarian dysfunction
  • Recurrent miscarriage
  • IVF, ICSI and IUI support
  • Fallopian tube dysfunction
  • Prevention of ectopic pregnancies
  • Lack of fertile mucus
  • Impaired follicular development
  • Impaired ovarian/uterine blood flow
  • Inadequate endometrial lining

Treatment protocol
An initial consultation is carried out to review the patient’s complete medical history, on the basis of which comprehensive pre-conception advice is provided and a unique, customised treatment protocol is drawn up. Lifestyle, general medical history, menstrual, structural, nutritional and emotional health is also examined, and the patient is informed on how to identify the most fertile phase of her cycle. She may additionally be asked to monitor her ovulation by charting her body basal temperature (BBT). The BBT chart helps the practitioner to understand the activity of the hormones regulating the female cycle and guides the practitioner in the treatment protocol.

The practitioner then treats according to the different stages of the cycle – the menstrual phase, follicular phase, ovulatory phase and luteal phase, to balance the hormones, regulate the cycle and enhance the chances of conception.

It takes at least 3 months for immature eggs (oocytes) to mature sufficiently to be released at ovulation, and it takes the same amount of time for sperm to be developed before ejaculation. A period of at least 3 months to prepare for conception should therefore be allowed for.

Combining Chinese herbal medicine with western medical treatments

Chinese herbal medicine does not have to be an alternative to western medicine. Besides increasing the chances of natural conception, it can be used in conjunction with western fertility drugs, such as Clomid or Metformin, whilst counteracting their side effects.It can also be used to successfully prepare both men and women for IUI, IVF, ICSI and other forms of assisted reproductive technique (ART), thus improving success rates, reducing the number of treatment cycles required and alleviating the side effects of the drugs.

Male infertility
Average male sperm count in 1940 was 113 million per ml, while in 1990 it had dropped to 66 million per ml. Furthermore, the volume of semen also dropped, reducing the total number of sperm per ejaculation by 50%! Today 40% of all cases of infertility are thought to be due to male subfertility.

Factors contributing to male Infertility
One of the reasons for the decrease in male fertility appears to be increased exposure to environmental pollutants (pesticides, fungicides, plastics, detergents, lacquers, etc.) and to the amount of man-made oestrogens in the water supply. However, nutrition, alcohol, smoking, caffeine, stress and immune system abnormalities can also be contributory factors, as can tight clothing, excessive cycling and hot baths, which increase scrotal temperature, thus effecting the sperm. A history of urinary infections, sexually transmitted infections (STIs), such as chlamydia or gonorrhea (which can effect sperm morphology), prostatitis (which can lower sperm count and motility) or trauma to the testicles can be additional factors, and systemic disorders such as diabetes or hypertension can lead to erectile dysfunction.

Sperm/ejaculatory abnormalities

Male infertility can be due to:

  • Low sperm volume
  • Low sperm count (oligospermia)
  • Poor sperm motility or movement
  • Poor sperm morphology or deformities (teratozoospermia)
  • Liquefaction problems, i.e. the semen remains too coagulated so that sperm is not released sufficiently after ejaculation. Such problems can indicate male accessory gland disorders (prostate glands and seminal vesicles) or a history of infection.
  • Varicocele or the blockage of sperm pathways, which results from the abnormal dilation of veins within the testes. This causes insufficient drainage of blood from the testes, resulting in excessive pooling of blood and higher intrascrotal temperatures. Varicocele can give rise to poor sperm count and/or poor morphology. A urologist can usually repair a varicocele surgically, but improvement in sperm morphology is seen in only about 50% of cases, and it may take up to 18 months to see an improvement. Varicocele is found in 15% of men, but in up to 40% of men examined for infertility. Although they may be a factor in male infertility, some studies question whether surgery to correct varicocele has a beneficial effect.
  • Problems with the head of the sperm that can prevent it from penetrating the egg (this cannot be identified by a sperm test).
  • Anti-sperm antibodies: sperm autoimmunity is a condition that accounts for 9-36% of male infertility. The immune system produces antibodies as part of the normal defense mechanism against foreign substances and organisms. Sperm are normally protected from exposure to the immune system. However, some men produce sperm antibodies following surgery or trauma to the testicles. In other men, there is no apparent cause for their development. The antibodies attach to the surface of the sperm and reduce their life span, impair sperm motility and ability to penetrate the partner’s cervical mucus. Antibodies located in the sperm head may prevent the sperm from fertilising the egg.
  • Agglutination (which indicates immunological infertility)
  • Presence of other cells and identification of leukocytes (which indicates inflammation/infection)
  • DNA sperm fragmentation (this is not tested for in standard sperm tests)
  • Retrograde ejaculation, where semen doesn’t come out of the penis during ejaculation but enters the bladder, instead. This can be caused by diabetes, certain medications as well as by bladder, prostate or urethral surgery. The World Health Organization (WHO) guidelines for assessing male fertility are:
  • Volume: more than 1.5 ml
  • Count: more than 15 million sperm per ml
  • Motility: more than 50%
  • Morphology: more than 4% normal forms

Treatment of male infertility with western medicine
Western medicine can do very little to improve sperm quality and quantity, and management of male infertility is often unsatisfactory. Clomifene citrate is sometimes prescribed for 3-4 months. This can improve sperm count to some extent although it does not improve sperm motility or morphology and no studies suggest increased fertility.

However, the introduction of introcyoplasmic sperm injections (ICSI) has largely resolved the problem of poor sperm quality in IVF procedures, although it is suggested that there is a higher incidence of birth defects when ICSI is used.

Diagnosis and treatment of male infertility with Chinese herbal medicine

Chinese herbal medicine, however, can offer a significant improvement in sperm count, morphology, motility and liquefaction, and it can also successfully treat varicocele, retrograde ejaculation and anti-sperm antibodies. Research studies show that Chinese herbal medicine affects hormone levels and testicular blood flow, thus promoting the production of healthy sperm. Certain herbs improve liquefaction time by stimulating the secretion of important enzymes into the prostatic fluid.

In Chinese herbal medicine terms, both male and female fertility is dependent on strong Kidney energy. Most cases of male infertility can be diagnosed as Kidney Yin or Yang Deficiency. Many cases appear to be genetic, indicating that a Deficiency of Kidney Jing or Essence is involved. In some cases, there may also be Damp Heat in the genitals or a blockage of the sperm pathways would indicate stagnation of Qi and Blood.

Sperm can take 3 months to form, so treatment should be continued for several months. As in the case of female infertility, the practitioner will devise a natural healthcare plan of herbal medicine and nutrition in order to improve the patient’s overall health and the quality of the sperm. Herbal treatment is especially important, as it is very effective in replenishing the Kidney energy. However, it is particularly important to treat the patient just before their partner is due to ovulate, as there has been a study that suggests that treatment at this time greatly enhances the sperm’s activity.

Miscarriage
Miscarriage is very common. One in seven of known pregnancies miscarry in the first trimester. About 1% of women miscarry in the second trimester. And many more will miscarry before they are even aware they are pregnant.

Causes of miscarriage
Most miscarriages that occur within the first trimester are a result of foetal abnormalities, the risk of which increases with the age of both the parents. After the first trimester, maternal factors, such as uterine abnormalities or cervical incompetence become more common causes of miscarriage.

If a woman has miscarried 3 times, her chance of another miscarriage is increased by 30%, as well as the risk of premature labour. Recurrent miscarriage may be caused by the following conditions:

  • hormonal dysfunction (ovary, placenta, thyroid, 30%)
  • uterine or cervical abnormalities (e.g. fibroids or congenital abnormality of the uterus, 10%)
  • endometrial infections (10%)
  • chromosomal abnormalities of either parent (3%)
  • blood-clotting factors
  • immune factors

Treatment of miscarriage with Chinese herbal medicine

Threatened miscarriage
When a woman is already pregnant and is threatening to miscarry, the miscarriage is inevitable where there are severe foetal abnormalities. No treatment can change the outcome of this event. However, in a few women, the reason for the threatened miscarriage may be due to the physiology of the mother, and timely treatment of Chinese medicine may save the pregnancy.

Post-miscarriage

After a miscarriage has occurred, a short course of Chinese herbs is beneficial to ensure that the uterus is cleaned out to allow for the restoration of the menstrual cycle.

Recurrent miscarriage
Chinese herbal medicine can play a very significant role in the treatment of recurrent miscarriages. Increasing the health of both parents before conception will ensure that the quality of the sperm, the egg and the endometrium are optimized, thereby maximizing the chance of a healthy pregnancy. It is easier to enhance the quality of the sperm, as spermatazoa are constantly reproduced. However, in women, it is still possible to balance the hormones with Chinese herbal medicine in order to influence the nourishment and development of the follicle so that a more mature egg is released and to improve the thickness of the endometrium.

There is also evidence that women with high LH in the first half of their cycle have a greater risk of miscarriage, though it is not yet understood why. Chinese herbal medicine is effective in balancing the hormones and lowering LH in the follicular phase of the cycle.

The quality and condition of the endometrium can effect the implantation and early growth of the foetus. The tube or uterus may have excess fluid –understood as Damp in Chinese herbal medicine – which can impede the movement of the embryo though the tubes and its implantation in the uterus. This can be treated by Chinese medicine. Or the endometrial lining might not provide an even surface in which to implant – a condition often diagnosed as Blood Stagnation in Chinese herbal medicine. This condition is best treated during the period to ensure a complete discharge of the old endometrium and the smooth growth of fresh endometrial tissue

Studies demonstrate that Chinese herbal medicine can play a significant role in the prevention of recurrent miscarriages. Research from Japan shows that women whose recurrent miscarriages are immune-related benefit from Chinese herbal medicine prior to their next pregnancy. Furthermore, a study from Shanghai suggests that, for women with a history of recurrent miscarriages and who are threatening to miscarry again, the pregnancy can be saved with correct and timely treatment.

Preparing for IVF
Chinese herbal medicine is increasingly being used to assist and enhance success rates of IVF treatment. The success rates for IVF are somewhere in the region of 20-30%, depending on the clinic and the methods used. In a recent study in Germany, a 26% success rate was achieved for women receiving no acupuncture, while a 43% success rate was achieved by those receiving acupuncture, a 40% increase (Paulus and others, 2002). Other studies in China suggest that this percentage can be further increased by up to 60% with the additional use of Chinese herbal medicine.

Pre-IVF: Treatment to prepare for IVF should ideally start at least 3-4 months prior to commencing the IVF cycle although even 1 month prior to treatment can make a significant difference to improving the success rate. The general aim of the treatment is to bring the patient to optimum health prior to conception in order to maximize the chances of success. Using a combination of herbs and nutrition, the practitioner can relieve stress, regulate the menstrual cycle, improve egg quality, balance the hormones, improve blood flow, nourish the endometrium and improve fertile mucus, as appropriate. A diagnosis is made following the principles of Chinese medicine as well as incorporating results from the BBT chart and other western medical test results.

During IVF: When the woman starts her hormone regime for IVF, support is mainly given with acupuncture but Chinese herbal medicine can also be used as an ancillary treatment. Point selection varies according to the stage of treatment i.e. down-regulation or stimulation. Treatment with Chinese medicine aids down-regulation and can also help relieve some of the side effects of the medication (e.g. headaches, hot flushes or mood swings). Treatment during the stimulation phase is used to promote the development of the follicles. At all stages, treatment is given to increase the thickness and blood supply of the endometrium and to relieve anxiety during this stressful time.

Embryo transfer: The patient should have treatment just prior to embryo transfer, and just after. Prior to transfer, the aim of the treatment is to invigorate blood supply to the uterus and to help dilate slightly the cervical opening in order to make transfer of the embryo into the uterus more easy so that when the transfer is being performed, the patient is less likely to experience cramping and uterine contractions, thus helping the embryo implantation. After transfer, it is important to assist blood circulation in the uterus, relax the uterus, nourish the embryo and stabilise the hormones in order to encourage implantation of the embryo.

Chinese herbal medicine can also be helpful in relieving the effects of ovarian hyperstimulation syndrome (OHS).

Pregnancy
Chinese herbal medicine is an ideal form of treatment during pregnancy, as it offers gentle, drug-free relief for a wide range of problems often associated with pregnancy such as miscarriage and morning sickness. It can also be used to prepare for labour, induce labour and to turn breech babies.

Chinese herbal medicine can offer support at every stage of the pregnancy from conception right through to birth.

Breech presentation
Moxa can be used very effectively to turn breech or posterior-facing babies, avoiding other more invasive methods. The optimum time for turning a breech baby is 34 weeks, but it can be successful as late as 38 weeks.

Pre-birth
Pre-birth treatment given once a week 3 or 4 times prior to the due date is very effective to prepare the body for labour. It promotes cervical maturation and dilation, helps relax the ligaments, ensures the smooth flow of energy in the pelvic region (stagnation may hinder labour), boosts general energy levels and calms the mind. By doing so, it increases the likelihood of an efficient labour, reduces labour time and helps to minimize the need for medical intervention.

Chinese herbal medicine to induce labour
Chinese herbal medicine can also be used to induce labour where the woman is overdue, avoiding the use of medical induction which can lead to a difficult labour. It is effective in promoting dilation of the cervix, stimulating contractions, helping the baby’s head to engage, shortening labour time, reducing the need of medical intervention and in alleviating pain.

List of complaints during pregnancy Chinese herbal medicine can treat:

  • Morning sickness
  • Back ache
  • Sciatica
  • Symphysis pubis pain
  • Rib pain
  • Anxiety
  • Depression
  • Insomnia
  • Constipation
  • Heartburn or acid reflux
  • Carpal tunnel syndrome
  • Fatigue
  • High blood pressure or hypertension
  • Swelling or oedema
  • Breech presentation
  • Preparation for labour
  • Labour induction
  • Post-natal care

Post-natal care
Pregnancy and labour can leave a woman exhausted and depleted, and care is needed to recover her reserves and build up her strength.Chinese herbal medicine can be used to both boost her energy and aid her recovery. If the mother is breast-feeding, promoting the health of the mother will also promote the health of her newborn baby.

Chinese herbal medicine can also be used for specific problems associated with post-partum:

  • Post-natal depression
  • Mastitis
  • Insufficient breast-milk production or lactation
  • Fatigue
  • Night sweats
  • Backache

 

To book an appointment
Please contact the centre reception on

020 8293 5380 / 5405

info@healingpath.co.uk

SESSION TIMES

Thursday 5.30pm-9.30pm

PRICES

1st appt: £50 - 1 hour
Follow-ups: £30 - 30 mins

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