Infertility

Treating Infertility in Traditional Chinese Medicine                 Prof. Song Xuan Ke
Introduction
Despite the fact that conventional medicine can perform near miracles for some childless couples, infertility remains a very common problem in Britain and the Western world, affecting as many as one in four women, and about the same number of men. The causes of infertility in most cases are not clear, or are unexplained. The modern therapies such as IVF or IUI over all have a little success, as low as about 20% of success rate. In order to solve this problem, we have to ask why their success rate is so low. The answer is not that the modern therapies are not technologically sound, but that the philosophy underlying the treatment is lacking of proper thought and incorrect, in my opinion, or is simply too mechanical. Too much attention is put on producing the eggs and fertilizing them artificially. No work, or very little work, is done in preparing the patient’s body, or the quality of the eggs. This may result in the failure of the fertilized egg to survive, or the rejection of the embryo by the body. Just as you cannot scatter seeds on rocky ground and hope for a successful harvest, so one must also prepare the body by making the person healthier both physically and mentally. This, achieving the so called harmony of yin and yang, qi and blood, is one of the main aims of Chinese Medicine. So by examining the TCM (Traditional Chinese Medicine) treatment of infertility, it may be possible to tackle this world-wide problem. Over the centuries TCM has certainly played a very important role in maintaining a high population in China. For the past 20 years my personal experience in treating infertility in the West and the tangible results from many thousands of patients have been very encouraging. Therefore I will try to briefly discuss the details of how infertility is treated in TCM.
The basic theory of fertility in TCM
What makes us fertile?
According to TCM theory the reproductive systems of human beings are mainly controlled by kidneys. The quality and quantity of the eggs and sperms are dominated by the kidney essence which is called JING or JING QI. The better the Jing the better the eggs and sperms.
Apart from the Jing’s production of the eggs and sperms, equally important are the planting and carrying of the fertilized eggs. These are the responsibilities of the kidney qi, blood and uterus. The quality of them will determine the whole pregnancy will be successful or not… How can we judge the quality of the kidney, blood and uterus? We will discuss this in the TCM diagnosis section.
What causes infertility?
Anything affecting or weakening the kidney, blood and uterus will cause infertility. The following are the most common causes:
Genetic defects or weakness, such as inherited weak genes.
Over consuming of our qi, blood and jing. Such as working to hard and too long without enough rest; too heavy menstrual bleeding; or too much sexual intercourse.
Emotional stagnation. Such as long term worries or depression.
Improper diet. Such as not eating enough food or lacking a wide range of the food.
Wrong medicine. Many medicines can damage the kidneys.
Directly weakening the reproductive system. The contraceptive pill, if used for too long, will also cause fertility problems. Simply they shut down the ovary (like an engine) If this happens over a long period this will cause the ovaries to shrink because of lack of use.
Wrong (or unnecessary) treatment e.g. D&C performed for too many young girls for unnecessary purpose. It can sometimes damage the lining of the uterus.

How do we diagnose infertility ?
In TCM we pay a lot of attention to women’s menstruation patterns, including the regularity, duration, length of the bleeding, quality and quantity of the blood (i.e. the color, the thickness, the texture, the smell, presence of any clots, and how big these are, etc.), and any complications with menstruation. We also check the whole body, as well as reading the pulse and tongue. From this information we can then assess the quality of the kidney Jing qi, blood and uterus.
According to the patients’ clinical data, particularly the information about the menstrual cycle, we usually divide infertility into the following 5 categories:
Kidney deficiency: scanty menstrual bleeding, thin blood, weak back, tiredness. Feeling too cold or too hot, especially at night.
Liver qi stagnation: painful and irregular menstruation, lots of PMT.
Dampness and phlegm blockage: lacking of menstrual bleeding, but more discharges or mucus, often over weight, and feeling of heaviness of the body.
Blood deficiency: scanty menstrual bleeding with pale blood. Tiredness and sallow complexion.
Blood stagnation: very painful menstruation, with dark clots
How do we treat infertility?
We treat the above 5 categories as follows:
1.Kidney deficiency
Herbal prescription—SU LING ZHU(ren shen, bai zhu, fu ling, bai shao yao, gan cao, dang gui, shu di huang, tu si zi, du zhong, lu jiao, chuan jiao)
Acupuncture—BL23, CV4, SP6, ST36, KI2, KI13.

2. Liver qi stagnation
Herbal prescription—KAI YU ZHONG YU TANG (gang gui, bai zhu, bai shao yao, fu ling, dan pi, xiang fu, tian hua feng)
Acupuncture—CV3,KI14, LR3, KI13, GB34, SP6.
3. Dampness and phlegm stagnation.
Herbal prescription—QI GONG WAN (fa ben xia, cang zhu, xiang fu, sheng qu, fu ling, chen pi, chuang xiong)
Acupuncture—CV3, ST30, ST40,SP6, SP9.
4. Blood deficiency
Herbal prescription—-SI WU TANG (dang gui, chuan xiong, shao yao, shu di huang)
Acupuncture—ST36,CV6,SP6,SP9, BT20
5. Blood stagnation
Herbal prescription—XUE FU ZHU YU TANG (dang gui, sheng di huang, tao ren, hong hua, zhi ke, chi shao yao, chai hu, gang cao, jie geng, chuan xiong, niu xi)
Acupuncture—CV3,ST29, SP6, KI13.
Can TCM work together with modern therapies such as IVF, IUI?
The answer is yes. Nowadays many patients try to have an IVF or IUI treatment together with the TCM treatment. TCM focuses on the body, preparing the body. This includes improving the quality of the eggs and sperms, helping the lining of the uterus, while modern therapies focus on insemination. This kind of “one plus one work” may result in “equals three”. From my personal experience of treating thousands of patients, the following procedures should be followed:

Before the IVF we should tonify the kidney, nourish and move the blood. This will help the body produce better eggs and produce a better lining of the uterus.

During the IVF we should cool the heat and balance liver. This will synchronize the body and the uterus; the internal and external hormones.

After insemination we should nourish and warm the blood, tonify the spleen and kidney. This will assist the embedding and development of the embryo – preventing miscarriages
Furthermore, many clinical trials recently carried out in the West have showed a positive effect in acupuncture treatment with IVF. For example, Dutch and American researchers analysed results from seven clinical trials (selected as eligible from a total of 108), all published since 2002 and carried out in four Western countries. They included data on 1366 women and compared acupuncture given within one day of embryo transfer, with sham acupuncture, or no additional treatment. All except one used a similar acupuncture protocol (based on Paulus et al). The analysis showed that combining real acupuncture with embryo transfer was associated with significant and clinically relevant improvements in clinical pregnancy rate. Women who underwent acupuncture were 65% more likely to have a successful embryo transfer procedure and 91% more likely to have a live birth. (Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ. 2008 Mar 8;336(7643):545-9.)

Summary
The TCM treatment of infertility FOCUSES ON THE ROOT: kidney and blood. The patients’ LIFE STYLE AND DIET changes are also very important. Healthy food and life style and healthy body are the basis of the healthy reproductive system.

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