Chinese Medicine for Infertility

     In last month?s article, I began to discuss infertility in women, presenting a case of endometriosis-related infertility.  There can be a number of causes for infertility, but endometriosis is the most common cause in the U.S. and China.

     In Chinese medicine, diseases and imbalances are diagnosed as patterns.  A pattern is defined by the signs and symptoms that a person exhibits, and patients will often present more than one pattern.  In the case I discussed last month, the woman had a combined pattern of Congealed Blood (also called Blood Stasis) and Phlegm Accumulation, with the Phlegm Accumulation being the predominant issue.  Her Western-medicine diagnosis was endometriosis.  This month, I will talk about Jean.  Jean also has a Western-medicine diagnosis of endometriosis, but her predominant Chinese medicine pattern is Blood Stasis.

     Chinese medicine believes that Blood travels both in the blood vessels and also in the energy meridians of the body.  It sounds strange to say that blood can circulate in an energy meridian, but Blood has several aspects in Chinese medicine.  There is the physical aspect of blood ? the blood that you see when you cut yourself ? and this physical aspect only circulates in the blood vessels.  There is also the energetic, or functional aspect of blood, which can travel in both blood and energy vessels.  The functional aspect of Blood is as a primary Yin substance in the body.  Blood is called the ?mother of Chi? because it moistens and nourishes every cell.  It also nourishes the feminine principle that exists in every human being.  Ideally, Blood circulates freely through the vessels and meridians, but sometimes it becomes stuck in the meridians of in the tissues, and this is called Congealed Blood or Blood Stasis.  A bruise is a superficial type of Blood Stasis involving the physical aspect of blood.  When Blood is stuck in the meridians, the main symptom people notice is pain, which is usually described as constant, fixed, stabbing pain.  When Blood is stuck in tissues, it often produces lumps, tumors, or masses, which can also be painful.  Endometriosis, uterine fibroids, and ovarian cysts are all examples of Blood Stasis in women.

     Jean is a thirty-five year old patient who originally came to see me for problems related to a car accident.  These injuries cleared up well with acupuncture and Chinese herbal treatment, and Jean began to talk about her infertility issues.  She has a successful career and has been happily married for nine years, but she and her husband are both eager to have children, and they have not been able to.  Jean felt enough pressure about this situation to visit a fertility clinic.  After some diagnostic tests, they told her that she had endometriosis, and that was probably the reason she had not been able to conceive.  The doctor at the clinic decided to try fertility drugs with Jean.  He believed that the endometriosis was a relatively mild condition, and that fertility drugs could override the endometriosis problem.  Unfortunately, the drugs did not work, and at this point, Jean was very hesitant to try this method of fertility treatment again.  She didn?t like the side effects from the drugs, and it is an expensive treatment with no guarantee of results.

     After I began to treat Jean?s Blood Stasis issue with acupuncture and Chinese herbs, her symptoms improved relatively fast.  The patient that I discussed last month, Tanya, had endometriosis based in a pattern of Phlegm Accumulation, and it took quite a while to resolve because it was a severe case.  But Jean?s Blood Stasis pattern was not as serious or as deep-seated.  Even though both of these cases are called endometriosis in Western medicine, they are seen as two different patterns in Chinese medicine, so the acupuncture points that I used and the herbal formulas that the two women took were quite different.  Jean?s response to treatment was wonderful ? her pelvic discomfort lessened, and she became pregnant.  In a few months she will be a first-time mother.

     In China, where both Western-style and traditional Chinese medicine are practiced, gynecologists always recommend their infertility patients to try traditional Chinese medicine first.  It is far less invasive, and there is much less risk from herbal formulas than from potent drugs.

This series of articles is about the traditional Chinese medicine approach to infertility.  Chinese medicine sees people as a whole, taking lifestyle issues such as diet, exercise, and rest into account, and using acupuncture, herbs, and dietary modifications to rebalance the body?s energies.  When unhealthy patterns within the body are cleared up, and when depleted energy is restored, it is often possible for people to conceive.  Western medicine fertility therapy can be very effective, but the emphasis is on powerful drugs that override the body?s natural functioning.

In this article, I will discuss a common problem for older women who want to conceive:  Kidney-energy deficiency.  Pam came to see me when she was 43.  She and her husband had been trying to have a baby for several years, and she had taken fertility drugs without success.  Her doctor tried the highest dose possible of the fertility drug, but she only produced a few, unfertilizable eggs, and the doctor told her she might just be too old to have a child.  Pam and I decided to work together, because there was a chance that Chinese medicine could help her, although even in Chinese medicine theory, age is considered to be a significant factor in fertility.

In the ancient Chinese text, Yellow Emperor?s Classic of Medicine, it says ?When the energy of all the organs is full, the excess energy stored in the kidney is excreted for the purpose of conception.  But [when] the organs have aged and their energies have become depleted, . . .the kidney reservoir becomes empty, marking the end of the power of conception.?  The Kidney is responsible for reproduction, growth, and aging.  When we are conceived, the Kidney Essences of our parents combine to produce a new being.  This is very similar to the Western idea of genetic inheritance.  When we are born, our basic, hereditary constitution is set, giving us our lifetime potential of physical development and aging.  The lifestyle we choose can affect this potential.  If we wear ourselves out with work or stress, or if we eat poor diets or abuse our bodies with alcohol, cigarettes, etc., we will ?use up? our Kidney Essence at a rapid rate, and will therefore age more rapidly than if we follow a balanced and moderate lifestyle.

Pam was in relatively good health when she came to see me, but she was entering her pre-menopausal time, when the Kidney energy normally declines.  Becoming pregnant and carrying a baby to delivery is a very heavy demand on the Kidney?s resources, even for a young woman.  Because Pam saw this effort as her last chance to conceive, she was very dedicated to the treatment.  We started with acupuncture treatments every other day, and she cooked and drank a strong herbal formula on a daily basis.  At the same time, she continued to see her regular doctor, which I encouraged.  After several months of acupuncture and herbs, her doctor tried the fertility drug again, using only half the dose that he had last time, and they harvested twelve good eggs.  The doctor was surprised, and Pam was thrilled.  The only difference was Pam?s use of Chinese medicine.

It is standard practice to stop acupuncture and herbs once a pregnancy starts, as long as everything is going well.  Unfortunately, the first pregnancy did not go well:  the baby died a few weeks after it was implanted.  This often happens when a woman is older, or has deficient energy to start with ? the uterus is too old to nourish the baby.  Pam resumed the acupuncture and herbs and tried again.  When she was pregnant the second time, we continued with the acupuncture and herbs until her fourth month in order to give her extra support and nourishment.  This time she had healthy twin boys.  They are seven months old now, and the parents are very happy.

Pam?s case shows a successful collaboration between Chinese medicine and Western medicine.  In my experience, women do extremely well using these two modalities in conjunction, especially if the Western approach has not worked.  Some women hesitate to try Chinese medicine because they think they will have to give up on their Western treatment.  In China, it is common to use traditional Chinese medicine in combination with Western medicine.  Doctors there have a good idea of what kind of medicine will work best for different conditions, and they use whichever one is most effective for the patient.  I hope that this will eventually be the trend in the American health care system, too.

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