In your Forties and Trying-to-Conceive?

Many women are trying-to-conceive while in their forties. Chances for success are limited and even if conception is achieved, the rate of miscarriage is high. The reason it is difficult to conceive is because the woman in her forties has (generally speaking) diminished ovarian reserve and a reduction in egg quality.

After several failed IVF cycles the usual next step is donor egg. Donor egg has between a 60 and 70 percent success rate.

Rate limiting factors may include but are not limited to poor uterine lining, poor sperm quality, and disease (autoimmune attack of the embryo – or poor patency of blood flow not nourishing the embryo or placenta).

Acupuncture and herbal medicine cannot increase ovarian reserve, but it can improve egg, lining and sperm quality in many instances. The mechanism-of-action is improved blood flow- to the ovaries and testes. A “perfect” 10 millimeter lining is not necessarily “perfect”. Many 10 millimeter linings do not have proper blood flow within the lining and this compromises the ability of the lining to maintain an implantation. The eggs of a woman in her forties can always stand to be improved. The sperm in a man in his mid to late forties is often sub-par and may often be improved with acupuncture and herbs.

I don’t, for example, believe that acupuncture and herbal medicine can get one pregnant

The desired and often obtained end result of the inclusion of acupuncture and herbal medicine when trying-to-conceive is an improvement in egg, lining and sperm quality. An IVF-embryo transfer is a ‘mechanical’ procedure: eggs are retrieved, mixed with sperm, embryos develop, and are placed in the uterus and the rest is pure luck.

IVF or IUI has no bearing on improving the chances of conception and an ongoing pregnancy via the mechanism of improving the constituent components of an embryo – egg and sperm. Acupuncture and herbs often fill in this gap. If egg and sperm and lining quality can be improved even a little bit, this may significantly enhance pregnancy outcomes.

Our expectations are not unrealistic. I don’t, for example, believe that acupuncture and herbal medicine can get one pregnant any more than an IVF can get one pregnant, even though pregnancies do occur as a result of both interventions occasionally. Pregnancy occurs as a result of the relative health of the woman who is housing the embryo in addition to the quality of the embryo and uterine lining. Many things can go wrong resulting in failed cycles. So, at the end of the day IUI, IVF, acupuncture and herbal medicine can help a woman conceive but cannot guarantee success. The key is this: you have the power to use additive means which today, more than ever, are at your disposal to help increase the odds of a healthy, ongoing pregnancy. Acupuncture and herbs are just but two. Psychotherapy, diet, exercise, biofeedback, yoga, taichi, and meditation can also be helpful.

Did you know that pregnant women who are highly stressed are more likely to give birth prematurely? This is a fact. Acupuncture, besides it action on the testes and ovaries and lining is also known to help reduce stress.

Repeated Donor Egg Failure

Why is it that some women with “good” lining and access to “good” sperm do not conceive with donor egg transfers? There are several reasons: 1) chromosomally abnormal eggs; 2) undiagnosed poor lining quality; 3) disease (as mentioned above). Most of these cases are considered ‘idiopathic’ meaning that your doctor does not understand why you are not getting pregnant. Idiopathic means ‘no known cause’. That the cause is ‘unknown’ does not mean that there is no cause.

Acupuncture and herbs are probably not necessary for the donor of the egg unless she is older than 35 years old, but realize that even 16 year old girls have some amount of chromosomally abnormal eggs. So if your cycle fails because of a chromosomally abnormal egg it is undoubtedly bad luck and should not typically re-occur.

However, if you have repeated failed donor egg cycles it is probably not a matter of egg quality, but more likely, sperm quality, lining quality or disease. Acupuncture and herbs can help improve lining quality and sperm quality and in some cases even reduce the effect of autoimmune issues or blood clotting issues which may contribute to repeated pregnancy loss. I do firmly believe, however, that the best and most effective way to treat autoimmune disorders or blood clotting disorders which may cause miscarriage is with Western medicine.

Stress and reactive-oxidative-species negatively affect sperm quality. Herbs and acupuncture can successfully reduce both as well as stimulate greater blood flow to the testes improving delivery of hormones, oxygen, electrolytes and nutrients thereat and enhancing the excretion of dead cells. This is the same mechanism-of-action whereby egg quality is improved in the ovary. Acupuncture cannot positively affect a man with no sperm. This is called aspermia. Nor can acupuncture improve sperm count due to genetic abnormalities (micro deletion of the y chromosome) or anatomical abnormalities of the testes (vericocele).



East meets West in Reproductive Medicine – The New Gold Standard

The most intelligent approach for the couple faced with difficulty conceiving and/or staying pregnant is to combine Eastern and Western medicine. These two modalities, though decidedly different, are, nonetheless, complementary and work synergistically. This means that by combining IUI or IVF or donor egg with acupuncture and herbs you should expect better results than when using one of these modalities alone.

In the world, most things manifest in pairs – marriage, night and day, summer and winter, exercise and rest, work and vacation, food and wine, joy and sorrow, etc. This is the yin and yang of life.

The ‘pair’ or yin and yang of reproductive medicine is embraced by recognizing the benefit of pairing Eastern and Western medicine.

What You Need Most when You’re in Your Forties and Trying to Conceive

1. Improved egg quality – acupuncture and herbs often facilitate this.

2. Improved lining quality - acupuncture and herbs often facilitate this.

3. Possibly improved sperm parameters - acupuncture and herbs often facilitate this.

4. Reduced stress - acupuncture and herbs often facilitate this.

5. Hope and Commitment – The Berkley Center for Reproductive Wellness always facilitates this.

Women in their forties are welcome here!