Treating Infertility with Herbal Medicine

Herbal medicine has been used to treat internal disorders including infertility for thousands of years.

               

Practitioners of Chinese herbal medicine rarely use a single herb in treatment. Chinese herbs are formula based; many herbs are mixed together to create the perfect ‘concoction’ specifically designed for the individual patient.

Some formulae contain two herbs and some thirty or more herbs. Each herb has many functions. Each herb has its own flavor, nature, temperature and trophism.  Prescribing the right and the safe herbal medicinals requires training and clinical experience.  Herbal medicine is an extremely complex form of medicine which requires many years of arduous study and clinical experience to master. 

Self medicating with herbal medicine presents a dual dilemma. At best the herbs will be useless, as the key to correct formula prescription is an accurate differential diagnosis which can only be made by a licensed, board certified, experienced practitioner. At the worst case, self prescribing of herbal medicine may prove harmful or fatal.

A good example of this is Ma Huang/Ephedra.  Ma Huang is an herb prescribed on a daily basis by hundreds of TCM practitioners to thousands of patients safely. 

That several people have died as a result of taking Ma Huang has very little to do with the dangerous properties of the herb inasmuch as it has to do with individuals self-medicating.  Aspirin can prove fatal if taken by a hemophiliac.  This is not an indication that Aspirin should be banned or that it is a dangerous drug.   It is totally safe if used appropriately.

Herbal medicine is totally safe if prescribed by a knowledgeable expert. Not only is herbal medicine safe, it is highly effective in treating many pathologies without the concomitant harmful side-effects which often accompany pharmaceutical drugs.   There are greater than one million hospitalizations per year as a result of drug induced side-effects; not so with herbal medicine.

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Infertility

There are many causes of infertility which include but are not limited to elevated FSH levels, PCOS, endometriosis, luteal phase defect, hyperprolactinemia; pituitary adenoma, blocked tubes, uterine anomalies, sperm anomalies, stress, and, infertility which is diagnosed as idiopathic. 

Traditional Chinese Medicine has, for more than three thousand years, successfully treated infertility; and it still does so today.

Nancy is thirty-nine years old and she wants to compete as an Olympic triathalete; she is five feet in height and weighs three hundred and thirty pounds.  Can she compete?  Let’s see.  She asks her best friend, Alice, for a recommendation for a nutritionist. Alice raves about Teresa J., a fabulous nutritionist who “changed her life”. So Nancy makes an appointment with TJ and has a consultation. Nancy listens attentively to TJ, takes notes and leaves TJ’s office full of enthusiasm, commitment and motivation.

Starting the next day Nancy begins implementing the new dietary regimen which TJ has prescribed.  Next, Nancy joins a local health club, hires a personal trainer and works out three to four days per week.  Finally, Nancy joins a meditation group and meditates daily.

What happened?  In twelve months, Nancy lost one hundred and fifty pounds, put on solid muscle, developed a ‘six-pack’ abdomen and can run twenty-five miles per week. She is in the best condition of her life!  Can she now compete in the Olympics? Well, I’m afraid not. To be an Olympic athlete requires a life-time commitment of training and nutritional guidance.  Nancy has, however, become healthier, stronger and happier than ever before!   What if Nancy wanted to get her reproductive system in Olympic condition? 

The proper life-style counseling which includes nutritional changes and perhaps an exercise routine and acupuncture and herbal medicine can get a women’s reproductive system in the best possible condition that it can be in at the present moment.  Your TCM practitioner should be able not only to treat you with acupuncture and the appropriate herbal formula but should also give you guidance regarding diet, exercise and life-style changes which will positively impact your health.

Many women undergo three to five unsuccessful IVF procedures. Often these procedures are unsuccessful for the same reason that Nancy could not even begin to be athletic – overall poor health and specifically, poor reproductive health. 

Women who are over thirty years old need to get their reproductive system in the best condition possible to achieve pregnancy either naturally or via an A.R.T. procedure.

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As we grow older our circulation becomes less patent. In addition to the frequent complaint of cold hands and feet, another effect of inhibited blood flow is that the quantity of blood flow to the uterine lining, ovarian tubes and ovaries is less.  Acupuncture and herbal medicine have a stimulatory effect on the blood circulation.  An example of impeded blood circulation is blood clots in the menstruate. Though in and of itself, menstrual clotting may not be an issue, it does indicate a circulatory dysfunction which can be both a manifestation of an illness (circulatory inhibition) and the cause of an illness (blood stagnation [i.e., endometriosis], causing infertility).

Acupuncture and herbal medicine can be an important aspect of one’s healthcare routine, used to assist in achieving the goal of better health in general and better reproductive health in particular.

Under the care of a licensed and board certified acupuncturist/herbalist who is experienced in treating the infertile person there are no negative or dangerous side-effects associated with acupuncture or herbal medicine; there is only upside potential.   Using acupuncture and herbal medicine as part of the regimen to achieve a healthy reproductive system is a fertile idea.

Traditional Chinese Medicine

Although the goals of  Traditional Chinese Medicine (TCM) and allopathic medicine are the same, their ideas of etiology of disease, disease itself and the process used to regain health  are decidedly different.   The allopathic physician learns that disease must be cured by prescribing medicine which kills bacteria or renders a virus ineffective; at times surgical intervention is a necessity.

There is nothing inherently wrong with this approach. It often works.  The question worth exploring is why TCM succeeds when allopathic medicine fails? What is the mechanism of action of acupuncture and herbal medicine which results in palliation or cure that is not manifest in biomedicine?  It is through this exploration that the unique nature of TCM avails itself.

Though the goal of TCM is to cure a patient, the doctor of TCM attempts to do this not by treating the disease but rather by treating the whole person which takes into account the various attributes of an individual which, when combined, account for an individual being sick or healthy.  A person, according to the tenets of TCM is more than their pathology. To treat just the pathology may yield impressive though temporary results. 

People are not, according to TCM, represented solely by their illness, but by the accumulation of every human interaction engaged in from the moment of birth including the values of and the culture from which the individual develops. The emotional experiences, eating habits, work habits, work and living environment, personal habits and the social milieu are considerations which are important to fully comprehend for the deleterious effects they may have on the individual.

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Though the Western methodology of research of Chinese medicine has not, to date, been arrived at by the Western scientific community, the veracity and efficaciousness of this medical modality is nonetheless proved by its long history of continued success. More than a quarter of the world’s population regularly uses TCM as part of their health care regimen. Chinese medicine is the only form of classical medicine which is regularly and continuously used outside of its country of origin.

TCM is part science, empirical as that may be and part art. It’s practice is, to a greater or lesser degree interpreted and performed by based not only on the facts but also on the experience of the treating doctor. 

The experienced doctor must utilize his or her own interpretive skills, taking into consideration not only what the patient tells and shows, but also what they reveal without meaning too and, what they don’t express during the intake process. The empty spaces can contain more important information than the filled ones.  The tone of the voice, the complexion, the condition of the eyes, the facial expression, the overall demeanor, how one walks, sits, and stands are all observed and utilized by the doctor of Chinese medicine as part of the information required to arrive at a differential diagnosis.  In other words, even before the first words are spoken by the patient, the doctor already has some idea of who this person is.

The doctor must be able to note and sense inconsistencies in an individual that are expressed by the patient even without the patient being cognizant of the chasms which exist between what they verbally express and what their spiritual presentation divulges.

A great doctor is one who can process a mix of factual knowledge of medicine with a personal sensitivity based on experience.  The doctor of TCM specializes not just in inserting needles or prescribing herbal formulae but in being able to divine ‘hidden’ or subtle pathology which may not been seen or understood by practitioners of other types of medicine. In fact, a patient’s main complaint may be only one of several pathologies which are present though the patient herself is only aware of the one which is most important to her at the time of examination.  This ability of divination though quite difficult to master is ascertained without the benefit of modern technology; we rely on the  ‘Four Examinations’.

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This method of diagnosis dates back over three thousand years.  Observing, Listening and Smelling, Questioning and Palpating make up the ‘Four Examinations’. Listening and Smelling are considered to be one of the Four Examinations.  This method of diagnosis, though seemingly quite simple, is far from simplistic. It allows the astute practitioner to arrive at a differential diagnosis.  With the advent of technology, as amazing, necessary and beneficial as it is in relation to medical intervention, there seems to be a direct correlation between advancement in technological wonders with an increasing decrease in doctor sensitivity to the patient.  It is important to always remember that a patient is a person first!

Proper treatment in TCM is more than the elimination of pathological processes. In addition to attacking the pathological factor(s), it is the responsibility of the TCM doctor to support the individual in his or her goal of achieving overall total health which includes the physical-psycho-emotional and spiritual aspects of health.  This paradigmatic approach is an inexorable part of the process of healing. Without it, we are merely chasing the sickness and forgetting about the patient who, though a patient they may be must also be recognized first as a whole person, not just an embodiment of illness.

Pathologies are guests (and we hope temporary ones!) in a home which serves as a gracious host – our physical, emotional and spiritual selves.  TCM first is concerned with strengthening the immune function which includes homeostasis of the physical, emotional and spiritual attributes of the patient, so as to be able to assist the patient in his or her endeavor to do battle and destroy the enemy at the gates (or inside them).

Western Reproductive Medicine and Traditional Chinese Medicine – Things You Should Know

Western reproductive medicine can do the following things: promote follicular development with certain medications, promote ovulation with other medications, perform intra-uterine-insemination, and in-vitro-fertilization. Western reproductive surgeons can also perform often necessary surgeries to create a fertile environment where polyps, fibroids, uterine anomalies and cervical anomalies are present. Without these types of interventions many infertile women would never have children.

Traditional Chinese medicine can often regulate systemic dysfunction naturally. That means that TCM can contribute to helping the PCOS patient ovulate without Clomid or perhaps with a lesser amount of Clomid. In the morbidly obese PCOS patient, weight loss is of paramount importance in increasing the ability to conceive because excess fat stores androgens and converts androgens to estrogen thereby creating a hormonal imbalance that is unlikely to enable conception. Acupuncture and herbal medicine along with exercise and life-style changes can make weight loss and its attendant health benefits possible.

Endometriois

In the endometriosis patient, acupuncture and herbal medicine cannot eradicate endometriosis but it can reduce the inflammatory environment associated with this disease. An interesting example of this is the patient with stage 1 endometriosis who does not present with pelvic distortion but cannot get pregnant. Why not? Her husband’s sperm is fine and other than the endometriosis there are no contributing factors that are contributing to the state of infertility. Even other autoimmune disorders have been ruled out as possible contributing factors. The infertility stems from an inflammatory intrauterine environment that either destroys the embryos or makes the uterine lining inhospitable to an embryo which is trying to implant. Acupuncture and herbal medicine can often regulate this environment by reducing this inflammatory process.


Male factor

Many men have low sperm count as a result of a minor vericocele. Surgeons do not operate on minor vericoceles because the benefit does not exceed this risk. The cause of a vericocele is pooling and stagnating and over-heating of blood in the pampiniform plexus. The pampiniform plexus is the veins in the testicles. The sperm- killing-heat is caused by the pooling and stagnating of blood. Acupuncture and herbs can strongly move qi (energy, metabolism, circulation) and blood in the testicles. As a result of this, the blood is less congealed, the blood flow is more functional and the heat is diminished, contributing to increased sperm count. Even in the face of a major vericocele, the surgical outcomes are successful 50% of the time. This means that even with surgery there is a 50% possibility that the count will remain low. One of the reasons for this is that long term blood stagnation and heat in the testicles causes tissue necrosis (death) and sperm cannot be adequately produced. The determination of success can only be made after the surgery. The recovery time after the surgery is six months.

The reason that this is the case is because the inflammation which is caused by the surgery takes that much time to be reduced. Utilizing acupuncture and herbal medicine after a vericocelectomy shortens recovery time by two months making the total recovery time four months instead of six. Men with any sperm anomaly should refrain from taking hot baths, saunas or riding a bicycle for long periods of time as all of these activities facilitate increased testicular temperature.

What about the patient who wants to do an IVF with her own eggs but her FSH is 18 and her doctor states that donor-egg is the only option? The doctor, essentially, is correct. He or she views this patient as one who either will not respond to gonadal stimulation and therefore produce either no eggs or produce too few to justify the continuation of the IVF cycle. So the reproductive endocrinologist offers the donor egg option with full integrity and with the patient’s best interest in mind. But, here is what I have witnessed on more than a few occasions: I will treat the patient with acupuncture and herbal medicine and her numbers will regulate. Not necessarily to a ‘perfect’ level, but to levels which will facilitate having the reproductive endocrinologist have a ‘second-look’. Subsequently many IVF cycles have been completed with a great many successful outcomes and many failures too. But I choose not to focus too much importance on the failures. It is the successes that would have never occurred had acupuncture and herbal medicine not been utilized on the patient who was told that donor-egg was the only option. In other words, inclusion of TCM has only an upside potential.

Implantation failure

Accounts for a substantial amount of infertility. Almost every patient that I have reports that her lining is “beautiful” according to her reproductive endocrinologist. The scientific truth however is that the morphology of the lining is not analogous to intraendometrial vascularization. This means that even though your lining may be thick it does not mean that there is enough blood flow getting to the lining. This is why sometimes even in the absence of any observable or diagnosable pathology, infertility manifests. Acupuncture and herbal medicine have been shown to increase endometrial vascularization and thereby increasing implantation potential.

The idiopathic patient

Idiopathy means ‘no known cause’. What ‘no known cause’ means is that the limited Western medical diagnostic capabilities available today are only able to diagnose what they can, not what they cannot. In other words, there are many subclinical causes of infertility that have yet to be discovered and which, to date, have no remedies. Over time, this will change. This is by no means meant to be a derisive comment of Western reproductive medicine. IVF has brought thousands of children into the world and created thousands of happy families. These successes would not have been possible in the ‘infertile population’ prior to the advent of this incredible technological breakthrough.

Traditional Chinese medicine, based upon its method of diagnosis does not, as part of its medical vocabulary have a word that is analogous to ‘idiopathic.’ In other words, all cases of infertility can be diagnosed and treated. There are no mysteries or impossible cases.

Each and every case can be, analyzed, differentiated, diagnosed and treated.

TCM can often establish a treatment protocol where Western medicine has none to offer other than donor-egg. TCM uses specific herbal formulas prescribed for a particular patient for a particular disorder, taking into consideration the whole patient as well as their pathology. The whole person is treated, not just their disease. What really does the “whole person” mean? It means that if the patient has a bad marriage, has low libido, chronic headaches, arthritis, depression, anxiety, frustration, a history of surgeries, a history of psycho-emotional trauma, a job she hates, a dying mother, low self-esteem, a smoker, a drinker, a stress eater, etc., etc., these things can contribute to her infertility.

How? Because the mind, spirit and body are inextricably connected. Not convinced? Ok, the why when you are very stressed do you get a headache or a stomach-ache. Why is it that when you are very depressed you have no energy? Why is it that when you pray you feel more empowered? Why is it that when you look better, you feel better and when you feel better you have more energy and when you have more energy you are less likely to get sick and when you are not frequently sick you are not chronically depressed?

Because the mind, spirit and body are inextricably connected. This is why TCM doctors treat the whole person; only treating the disease is like treating a cancer patient with aspirin for their pain.
This is why the best case scenario in the treatment of reproductive disorders (as well as all disorders) is to integrate both methods of medical expertise. The TCM application will help the Western reproductive medical protocol succeed in a shorter period of time. Or TCM may be the difference between success and failure in the Western medical setting; remember, IVF has a 30% success rate which means conversely that it has a 70% failure rate.

Herbs

Many doctors tell their patients not to take herbs. Can you imagine why? Go ahead, let your mind swirl around and try and latch on to one word that sticks. How about ‘dangerous’? DID YOU KNOW: there are more than one million hospitalizations per years as a result of dangerous side-effects caused by pharmaceutical products. But pharma is big business and it has the money and power to squelch the media. When is the last time you heard about someone dying or even being hospitalized as a result of taking herbs? I’ll tell when: NEVER. When is the last time you heard about someone getting sick, or being hospitalized or dying from herbal medicine? I’ll leave that answer to you.

My view is that most Western medicine when prescribed by an expert in his or her field is safe and effective and usually there are no harmful side-effects. Why is it so difficult for Western physicians to say the same thing about herbal medicine? Is it perhaps because if a patient conceives as a result of herbs that a $10,000.00 to $15,000.00 IVF cycle would be cancelled?

Again, I’ll let you answer that question.

Herbal medicine, when prescribed by a Board Certified herbalist is not only safe, but safer than Western drugs. Can herbs “interfere” with Western medicine in an IVF cycle? No. I have been giving herbs to patients while they have been taking Western medicine for ten years. All that’s happened is the production of babies. Can the Western medical establishment be threatened by herbs or acupuncture? I’ll leave that for you to answer.

Here is a medical quiz. If you had a choice of doing something that could improve your chances of conception, would it be:

1. Meditating

2. Praying

3. Yoga

4. Acupuncture

5. Herbal medicine

6. Changing your diet

7. Reducing stress

You’re correct; all of these will help. But can you identify the two things above that have a three-thousand-year-old history of successfully treating infertility? There are only two in the list and only two in the world.

What I find amazing is that every infertile couple is not including acupuncture and herbal medicine as part of their protocol to conceive. Some individuals say they “don’t believe in it.” How can you not believe in something that has been scientifically proven to be effective in countless Western scientific studies?

Non-Believers

I’ve had my share of non believers; they were believers nine months later when they sent me tear-stained letters of gratitude for helping them become parents. Come to my office and see the photos on the walls, the photos of families, the photos of joyous moms and dads, the photos of their smiling cherubs; all sent from non-believers. I can assure that they are all converts now. In fact, a large referral source for me is from former ‘non-believer’ patients.

I am a staunch supporter and firm believer in Western reproductive medicine. But, TCM has been successfully treating infertility for 2930 years longer than Western medicine. And I want parity. Not for my ego or for the validation of the medicine that I so proudly practice but because parity will enable real patient care; better patient care than we presently have; more successful outcomes, more families granted to those who should but cannot have them.

Based upon the information I have provided herewith, it is my conclusion that to not use Traditional Chinese Medicine as part of an assisted-reproductive-medical-protocol is very short-sighted indeed.

Your world is a garden from which you can remove weeds of doubt and replace them with seeds of hope.


mike berkley, L.Ac., FABORM

Doctor of Acupuncture (RI)

Founder and Director, The Berkley Center for Reproductive Wellness