In my last post I discussed the cases of infertility where there is a medical explanation for the condition. Today I am going to concentrate on the surprisingly common situation where a woman can’t conceive despite all medical tests being normal, the so-called unexplained infertility. Unexplained infertility is what we call a basket diagnosis. It is a similar situation in the case of IBS (Irritable Bowel Syndrome) and in Chronic Fatigue Syndrome. In these conditions the Doctors will throw into the basket any patients who manifest with certain complaints without actually understanding the reason for those complaints. As a result, the patients, who can have different causes for their problems, are all put in the one basket. The problem here of course is that when we don’t know the cause of a problem we can’t treat it effectively. Indeed, the only solution modern medicine offers for unexplained infertility is I.V.F. This means, in a way, that medicine is giving up on trying to cure the problem and is bypassing it instead by doing part of the process in a controlled manner outside of the body. IVF is very important and in some cases will be the only solution. However, many of the women who have been diagnosed with unexplained infertility can conceive naturally following a course of treatment with Acupuncture and Chinese Herbs. I have helped many women who have come to me with this diagnosis. Conceiving naturally will save them the unpleasant, expensive and often unsuccessful process of IVF.

So how does Chinese medicine explain and then treat these cases of unexplained infertility? These women have been through a thorough medical testing. It has been established that the hormone levels are correct, ovulation is regular, follicular tubes are open and there are no anatomical abnormalities. What then is the reason for the difficulty in conceiving? Well, the problem here is usually on a more subtle level. The way Chinese Medicine sees the process of conception is a bit like the process of the sprouting of a seed in the ground. You can put a seed in the ground but if the conditions are not right the seed won’t sprout. If the ground is too cold or too hot it won’t sprout; if it is too dry or too wet it won’t sprout; if there are not enough nutrients in the ground it may sprout but it won’t develop and will die or grow poorly. The human reproductive organs are the same. If the uterus is too hot, too cold, too dry, too moist then pregnancy won’t happen. If circulation of blood or energy (Qi) is poor it won’t happen. The environment in which the egg is fertilised then implanted in the uterus and then developed into a healthy baby has to be perfect or at least near to perfect. At the first consultation at the Clinic it is important to establish, in these cases, which of the above problems is the cause of the difficulties. When we establish a diagnosis then treatment is usually successful. The diagnosis will be made through Chinese Medicine methods such as questioning, observation and tongue and pulse diagnosis, but also through a temperature chart. Taking the body temperature morning and putting it in a monthly chart will give me valuable information about the state of the patient’s reproductive system.

I will try now to give you (without boring you with too much Chinese medicine detail) the most common causes of unexplained infertility.

1) Yin deficiency and heat

Yin is the part of energy in the body that keeps us cool and moist. It is therefore essential for fertility to have strong Yin. Examples of symptoms that can indicate the presence of Yin deficiency are: dry mouth at night or first thing in the morning; night heat and poor night sleep. In the context of fertility the uterus lining can get too hot and dry-this will make implantation difficult. Another possible problem when the Yin is low is that cervical mucus may become too thick and that will block the sperm from entering the uterus. The treatment of Yin deficiency in Chinese medicine is with herbs and acupuncture points that nourish the Yin and reduce heat.

2) Yang deficiency and cold

This situation is the opposite one to the Yin deficiency. Here the body is unable to warm itself properly. The patient may feel cold or have cold hands and feet. In bad cases she may feel coldness in the low abdomen, there is often tiredness and low back pain and low libido is common. Lack of warmth in the uterus will limit the blood circulation and will make conceiving difficult. The treatment is with Chinese herbs and acupuncture points that warm the body and tonify the Yang energy.

3) Kidney Qi deficiency

The kidney is the most important organ in the human body in the context of fertility. Energetically it includes the uterus and the ovaries. When the kidney energy (Qi) is weak it is unlikely that pregnancy will occur. Symptoms of weak kidney may include lower back pain, feeling cold or night heat, tiredness and problems with passing water including frequency, urgency or waking at night to urinate.

4) General Qi deficiency

The main symptom here will often be tiredness and palpitations. Shortness of breath is possible as well. When the Qi is low, on top of a weak kidney (see above), we will have problems with the circulation and pregnancy is unlikely.

5) Blood stasis

Blood stasis means a problem with sluggish movement of the blood. In this situation the quality of the womb lining will be poor and therefore implantation and/or maintenance of the embryo will be difficult. Common symptoms resulting from blood stasis are: period pain and passing of blood clots with the period. The treatment here is with acupuncture points and herbs that improve the circulation.

6) Qi stagnation

Here we have a problem with the free flow of Qi. If the Qi is not flowing freely it often affects the blood circulation and the function of the organs. Qi stagnation often occurs due to high emotions, stress or worry. Common symptoms are: irritability, anger, feeling emotional, headache, bad PMS (pre menstrual stress) and period pains particularly in the first days of the period. The treatment of Qi stagnation will aim to relax and restore the free movement of Qi.

As we can see, each of these imbalances will have a negative effect on the woman’s ability to conceive. In reality it is usually not just one of these imbalances on its own but is more likely to be a combination of two or three and sometimes more. In any case, correcting these problems can significantly increase fertility and the chance of a healthy pregnancy. It is about creating an optimal environment for egg fertilisation, implantation and then growth and development of the embryo. That is really what Chinese medicine is all about when it comes to fertility treatment and that is why it is so successful in treating unexplained infertility!

In my next post, which will be the last in the Fertility series, I am going to discuss recurrent miscarriages and I.V.F., considering the Chinese medicine view and how it can help.