Age 35+ 

How old is too old? What makes women’s eggs less responsive? 

It is not age but hormonal fluctuations. Our hormone levels fluctuate more as we age and our ovaries make the follicles resistant and they quit paying attention to FSH. The blood flow to the ovaries begins to decline precipitously. Acupuncture and acupressure are the only known methods to improve the blood flow to the ovaries. 

If we could encourage our body to return to more youthful levels of hormonal balance and blood flow, then the ovaries would produce and release eggs in the same way they did when we were younger. If we want to become pregnant in our forties, we need to provide more hormonal fuel and blood flow to the remaining thousands of eggs. 

However, rejuvenating the reproductive system takes time. It takes a minimum of three months to maximize the health of the developing follicle and its residing egg. Two specific systems are affected by the aging of a woman’s reproductive system: Kidneys and Spleen. I almost always tonify these two areas in the cases of infertility related to the advanced maternal age, in addition to addressing underlying problems. 

Luteal Phase Defect (LPD)

A luteal phase is the time in a woman’s cycle between ovulation and menstruation. In a pregnant woman, during the luteal phase the fertilized egg will travel from the fallopian tube into the uterus for implantation. The luteal phase is normally 14 days long and on an average it can be anywhere from 10 to 17 days long. If your luteal phase lasts anything under 10 days it is considered a luteal phase defect. If you conceive and you have a luteal phase defect, you may have an early miscarriage because your uterus did not have enough time to be prepared for pregnancy. Going by statistics, the number one reason for a luteal phase defect is low progesterone levels. A slow or low rise in BBT after ovulation might indicate a lack of progesterone production. Horseshoe-shaped curve during luteal phase indicates problem with corpus luteum functioning. 

According to TCM (Traditional Chinese Medicine) there can be many reasons for LPD. However, there are three reasons I most commonly find: Kidney Yang deficiency, Spleen Qi deficiency, and Cold Uterus. My treatment plan is to find the root cause of your LPD and use acupuncture, Chinese herbs, and nutritional supplements to bring your luteal phase back to the normal range. This means your body will produce proper amount of progesterone and your uterus will have a pleasant environment with a proper lining for the embryo to survive. 

Endometriosis 

Infertility affects about 30-40% of women with endometriosis and is a common result with progression of the disease. Around 40% of women diagnosed with endometriosis report no symptoms other than infertility. If tests reveal inflammation as a result of endometriosis, the only treatment is to use GnRH agonists like Lupron to inhibit the release of pituitary hormones depriving the endometrium of hormonal stimulus, which causes unpleasant menopausal symptoms. 

The main TCM pattern discrimination for endometriosis is Blood stasis. Therefore, the treatment principles are to quicken the blood and dispel stasis. In addition, since endometriosis is related to hormonal imbalances such as estrogen dominance, it is important to help the body rid itself of excess estrogen with acupuncture treatments. 

Uterine Fibroids 

Uterine fibroids or myomas seem to be affected by estrogen levels, often growing larger during pregnancy and shrinking after menopause. Just as pregnancy hormones can cause a fibroid to grow, a lack of reproductive hormones can cause it to shrink. Therefore, Lupron is often used to create the condition of pseudomenopause. 

The treatment principle for uterine fibroids in Chinese medicine is to break stagnation and transform stasis. Chinese herbal formulas seem to work more effectively in the cases of uterine fibroids than any other modality. 

Polycystic Ovarian Syndrome (PCOS) 

PCOS is said to affect up to 10% of women of reproductive age and up to 90% of women with irregular menstrual cycles. Two most consistent elements of PCOS are elevated androgen levels and chronic lack of ovulation. With PCOS, if an egg is released it is often later in a woman’s cycle, and it is of poorer quality because of the unhealthy surroundings in which it has been developing. Eggs are meant to develop in an estrogen and progesterone rich environment, not in an androgenic setting. If forced to ovulate with drugs like Clomid, the quality of eggs may be poor. If becoming pregnant, higher risk of miscarriage. The current knowledge of Western reproductive medicine offers few options and little hope for women with PCOS. 

According to the Chinese medicine principles, the most common manifestation of PCOS is Dampness or Phlegm. Phlegm is considered the most resistant imbalance in TCM and takes longer to be removed. However, it is essential to get rid of any phlegm in the body not only for a conception to occur but also to prevent any further complications that phlegm can create to the entire body such as insulin resistance, high lipid levels, etc. Also, I recommend my patients with PCOS take enough time to fix the problem before they try to conceive in order to prevent a miscarriage. 

Premature Ovarian Failure (POF) & Elevated FSH 

Women with POF will have stopped menstruating altogether, or will have shorter cycles characterized by early (or no) ovulation. Estrogen production is reduced, the uterine lining is often too thin for implantation, and the follicles have not had time for their residing egg to fully mature, leaving no chance for conception. 

The treatment of choice for POF is usually estrogen replacement therapy (a version of hormonal replacement therapy). However, this is not an option for women who are attempting to conceive because the estrogen tells the hypothalamus that it doesn’t need to prompt the pituitary to stimulate the ovaries to produce estrogen. The whole hormonal system then goes to sleep. 

Most POF cases present a severe Kidney Yin deficiency accompanied by Liver or Heart Blood deficiency, and Spleen Qi deficiency with empty Heat. Acupuncture and Chinese herbal medicine have been treating this kind of condition very successfully. 

Unexplained Infertility

If you are thinking about trying fertility treatments to help you conceive, you will likely undergo a variety of tests to determine the source of your infertility. However, many couples undergo dozens of tests only to come up with few answers. Known as unexplained infertility, such a situation can often be quite frustrating. Unfortunately, it is quite common and can sometimes hinder the fertility treatment process. 

Up to 30% of all cases of infertility in women and 25% in men are the results of unknown causes. One of the first places we can look to diagnose unexplained infertility is the menstrual flow itself. Irregular and/or abnormal menstrual cycle, which is usually not taken seriously by the Western medicine when you are trying to conceive, often indicates “no consistency” in the quality of your eggs or poor quality. I will utilize acupuncture, Chinese herbal formulas and nutritional supplements to set your menstrual cycle to normal. 

Another main factor that contribute to the unexplained infertility is stress. When we are under stress, the sympathetic nervous system can become hyperstimulated, thus sending less blood to the uterus and ovaries. Acupuncture has been found very effective for relieving stress.

Immunologic Reaction

Sometimes, women’s body produces antisperm cells attacking the sperm. Or, when a woman’s egg becomes fertilized, certain immune components may cause clotting at the placental attachment site, starving the embryo and causing it to abort. The usual treatment for autoimmune fertility disorders is to suppress or override the immune system using drug such as Prednisone, so implantation may occur. These procedures are not only severe, but also can be unpleasant, with long-term side effects.

However, TCM offers a better way. A lot of times, I find my patients with this kind of disorder suffering from Kidney deficiency, Spleen Qi deficiency, Blood stasis, Liver Qi stagnation, or more than likely combination of two or more of those imbalances. Acupuncture and Chinese herbal formula will address those imbalances to regulate and calm down any Immunologic reactions. 

Recurrent Miscarriage

One of the most common reasons for early pregnancy loss is inadequate progesterone production. Progesterone deficiency usually indicates Kidney Yang deficiency, Spleen Qi deficiency, or both. In this case we need to tonify those organs until the placenta takes over its own progesterone production. 

Male-Factor Infertility

Sperm production may be affected by factors such as radiation and other environmental toxins, an undescended testis, trauma-induced or infectious testicular atrophy, drug effects, prolonged fever, and endocrine disorders. 

There is a correlation between Chinese and Western medical pathologies. What Western medicine would call sexual issues, failure to ejaculate, autoimmunity, small testicles, low testosterone levels, low semen volume, low sperm count, low quality sperm, or abnormal motility, Chinese medicine views this as a deficiency of the Kidneys or as a deficiency of Qi and Blood. Abnormal morphology, varicocele, or blockage of ejaculatory ducts correspond to the Chinese medical differentiation of Qi stagnation or Blood stasis. Infections are typically caused by what Chinese medicine labels Damp-Heat pathogens. A lot of times, however, patients present more than one patterns. 

Male infertility factors are easier to diagnose with Western methods than female infertility, but harder to treat. Western medicine has little to offer, as supplementation with testosterone, FSH, LH, or other hormones rarely improves sperm production significantly. 

Chinese medicine can help the body to increase sperm production and quality and to resolve hormonal imbalances that may be affecting a man’s fertility. Also, by increasing blood flow to the pelvic organs using acupuncture and Chinese herbs, we can improve sexual function as well as fertility issues. 

The process of sperm maturation averages 70-90 days. Therefore, it is beneficial that the male receive acupuncture and Chinese herbal medicine for at least three months before trying to make his partner conceive or before any ART (Assisted Reproductive Technologies) procedure.