The mechanism of human fertility is a wonder. It is very different to most other systems in our body, in the way our systems function and do what they are supposed to do, in an efficient manner, most of the time unless we are ill. Our fertility system however is different. It seems to be not very efficient, almost a bit clumsy and wasteful. For example, a healthy fertile male needs to produce tens of millions of sperm in order to fertilise one egg. A female is born with millions of eggs that reduce in number and quality at a fast pace through life until only a few viable eggs are left when she is in her forties. Even if both male and female are in good shape from the point of view of egg reserves and sperm quality, it is still likely to take up to 6 months of trying before pregnancy will be achieved.

A fertilised egg that has been implanted in the womb and started to develop as a normal pregnancy is not the end of our troubles unfortunately. On average, 25% will miscarry. For those who don’t, there is a long list of possible pregnancy complications such as high blood pressure, diabetes, placental related problems, autoimmune conditions…and the list goes on. It is not a wonder then that so many young people are coming to my clinic seeking help with fertility issues.

As I have stated a few times in the past, Western medicine has a good yet limited understanding of the workings of the human body and of how and why things go wrong. The situation is not different when it comes to fertility. A large proportion of the couples who come to see me with fertility problems have been classified by the doctors as unexplained infertility. That means that medically nothing has been found to explain their difficulties in conceiving. The uterus, fallopian tubes and ovaries are all functioning, the sperm tests are ok yet no pregnancy month after month, year after year. It is an extremely frustrating and upsetting experience, yet not that uncommon.

Despite the lack of medical understanding of these cases the majority of them will achieve a healthy pregnancy after a course of treatment with Acupuncture and Chinese herbs. The reason for this success is that Chinese medicine has a good understanding of the subtle workings of the body and therefore of the subtle reasons stopping a healthy pregnancy. These subtle factors that cause infertility will be the focus of this and following posts.

To try and simplify things I’ll divide the infertility into explained infertility and unexplained infertility. Explained infertility means that there is a medical explanation for the problems. Common examples are anovulating, PCOD, blocked fallopian tubes, autoimmune conditions and male factors. Unexplained means that all medical tests are normal and the doctor can’t find an explanation for the infertility. Today I am going to talk about explained infertility.

1) Anovulation

Anovulation simply means that the ovaries are not releasing eggs on a monthly basis as they do in a normally functioning system.  Of course, if there is no egg then there is  no chance of pregnancy. Anovulation is almost always due to hormonal imbalance. The normal process of a monthly ovulation depends on a specific balance between the female hormones (oestrogen, progesterone, LH and FSH). The blood level of these hormones changes in a very specific manner during the monthly cycle in order to prepare the womb and to trigger ovulation about halfway through the cycle. Any change in this specific hormone pattern can cause a failure to ovulate. This hormone imbalance can happen at any age but is more common in young ladies. In fact, in my experience, it is the most common cause of fertility problems in young women. In some cases the ovulation can be partial which means that in some cycles there will be ovulation and in some not. In these instances we can get a positive ovulation test but the chances of conceiving are still low.

Now, the question we always like to ask in Chinese medicine is “why?” or “what is the reason for the hormone imbalance?”  Medically, the answer is, almost as usual, unknown! Doctors don’t know why a woman’s hormone imbalance occurs. In TCM however, we know that on the subtle level the organ which is responsible for the hormonal balance is the liver. The liver is very sensitive to stress and emotions. If the young lady tends to live a stressful life, or if she is under emotional strain, then there is a reasonable chance that her liver will suffer and, following that, her hormonal balance as well. In some cases these young women won’t see themselves as stressed-they are just doing the “normal” modern day’s practice of working hard, then exercising, then socialising. It may sound ok but for some livers it will be too much. (Our bodies weren’t designed for this pace of life.) There are some other, less common, causes of liver malfunctioning, like blood deficiency for example. But in any case, the important thing is that it is treatable! Chinese medicine (acupuncture and Chinese herbs) is very effective in restoring ovulation through restoring hormone balance. Actually, these cases tend to react quickly to treatment and pregnancy is often achieved within one to three months!

2) PCOD (Polycystic ovary disease).

PCOD sometimes referred to as PCO or PCOS –these are all slight variations of the same condition. In this condition the ovaries produce a large number of cysts. Those cysts tend to produce a large number of the male hormone testosterone. A high level of testosterone in a woman’s body can cause symptoms like excess growth of hair, acne and weight gain, but more importantly for our subject, it causes a great mess in the normal hormone balance and therefore stops ovulation. PCOD in the context of infertility is a complicated version of anovulation. The Chinese Medicine treatment of PCOD is also a bit more complex than the treatment of simple anovulation. In addition to treating the hormone imbalance we need to treat the underlying cause which is the presence of cysts.

Still, despite the complexity of the condition, in my experience the results are often positive. A few of the ladies I treated for PCOD related infertility have achieved healthy pregnancy.

3) Blocked Fallopian Tubes

The fallopian tubes allow the connection between the ovaries and the uterus. When the tubes are blocked it becomes impossible for the egg to travel from the ovaries to the womb and therefore pregnancy is impossible. In cases where the blockage is complete and solid then the only option for pregnancy is through I.V.F. However, in some cases where the blockage is due to the presence of thick fluids or inflammation in the tube it is possible to clear it with a course of Acupuncture and Chinese herbs. It is important to mention here that even if I.V.F. is needed it is advisable to take a course of Acupuncture at the 3 month mark leading to the I.V.F. It is well established that Acupuncture increases the success rate of I.V.F. by about 70%!

4) Auto Immune Conditions

It’s only recently that the role of auto immune conditions in infertility has come to light. It is estimated that about a third of what was considered an unexplained infertility is actually infertility as a result of Auto immune conditions. Auto immune conditions occur when, for some reason, the immune system starts to produce antibodies that, instead of attacking foreign invaders like bacteria or viruses, are attacking our own body organs. In the case of Auto immune infertility the antibodies can be against the sperm, the embryo or the umbilical cord. Other common forms of auto immune infertility are high blood levels of natural killer cells and Antiphospholipid antibodies (causing blood coagulation problems).

The Western medicine treatment for Auto immune infertility is with Immunosuppressants -mainly steroids. The idea here is that suppressing the immune system activity will suppress the unruly activity of producing Auto Antibodies. The Chinese medicine treatment is medicinal mushrooms. The field of regulating the work of our Immune systems with the use of medicinal mushrooms has progressed hugely over the last 10 years, mainly due to the work of Martin Powell from Pure Health and of Dr Trevor Wing from The Women’s Natural Health Practice in Richmond: Martin Powell for finding and establishing the medicinal mushrooms’ amazing ability to regulate and improve the function of a misfiring Immune system and Dr Trevor Wing for excellent clinical trials on hundreds of cases of Immune related infertility that clinically proved the effectiveness of the medicinal mushroom in these cases. These studies proved that the use of medicinal mushrooms like Mesima and Coriolus , Cordyceps and Ganoderma in women with Immune related infertility will significantly increase the chance of achieving healthy pregnancy. These studies clearly show that the medicinal mushrooms are more effective than steroids in these cases and have far fewer side effects.

5) Male Factors

Here we are simply referring to a low quality sperm. One of the mysteries of modern day medicine is the dramatic decrease in human sperm quality over the last 50 years. A few theories have been suggested to explain this phenomenon. The most likely is the usual combination of: environmental factors (toxins), diet and stress. The presence of oestrogen in drinking water and many modern processed foods is also probably an important factor. The important issue here is what can we do when the male has poor sperm? From a Western medicine point of view the answer is absolutely nothing. It may sound surprising but there is no medicine or procedure the doctor can offer to improve sperm quality. The only thing that is on offer in these cases is I.V.F.  Fortunately, in Chinese medicine there is much we can do to help. As usual, it starts with understanding what is causing the problem. Without getting into too much Chinese medicine detail, the main reasons for poor sperm production are too much heat or too many toxins in the man’s reproductive system or weakness of the kidneys or the QI (body energy). After finding out the cause in each individual case, the treatment with Chinese herbs and Acupuncture to correct these causes is usually very effective. Most causes of poor sperm will improve with TCM treatment; however, in some cases, e.g. when the problem is due to defective genes, there is not much we can do.

I hope I have given you a better understanding of this side of fertility problems and of how Chinese medicine can help. In my next post I am going to discuss unexplained fertility. It is a very common situation where a couple can’t achieve healthy pregnancy despite all the medical tests coming back normal. About 50% of my fertility patients belong to this category.

Ilan