|Infertility and AOM|
One of the cruelest ironies that I encounter in my practice is that while teens and young adults constantly worry about getting pregnant, many couples have trouble conceiving once they are finally emotionally and financially able to have children. Women between the ages of 25 and 29 on average have a natural infertility rate of 8.9%. By the time women are between the ages of 30 to 34 that percentage jumps to 14.6% and by age 40 the rate is 29%.(1) Conventional medicine offers a variety of treatments ranging from simple artificial insemination to more complicated rounds of in vitro fertilization (IVF). However, not only are treatments such as IVF emotionally draining, they are also very costly, setting back hopeful young couples tens of thousands of dollars. Despite the high price tag, according to a 2000 Centers for Disease Control study, IVF results in pregnancy only about 30% of the time. Furthermore, 17% of those pregnancies end in induced abortion, miscarriage, or stillbirth. Fertility was a serious concern for the ancient Chinese. In a culture that venerates ancestors production of healthy heirs was essential. As a result, Chinese medicine has treated infertility for thousands of years using a variety of therapies. Today, Traditional Chinese Medicine (TCM) is more than a simple collection of folk remedies. It is, as it has been for centuries, a professional system of medicine that is the product of over 3,000 years of clinical experience by China's brightest scholars. In the United States TCM is a professional medicine licensed in almost every state, and in many of those states physicians of TCM or acupuncture are licensed as primary care providers.
According to TCM, there are many reasons why women, and men, have difficulty with fertility. One of the key issues lies in the Chinese concept of the Kidney. Compared to western medicine, Chinese medicine sometimes has a very different view of internal organs. While this may seem odd, it is important to remember that Chinese medicine refers not only to the actual organ, but also the Channel and all other body functions associated with that organ from a classical perspective. In Chinese medicine then, the Kidney and Kidney Channel are thought to be responsible for growth, development, and reproduction. The Kidney represents our constitution and inherited energy from our parents. The Kidney also represents the deepest stores of energy we use throughout life - sort of like our core battery. Thus, Chinese medicine believes that one of the major causes of infertility in both women and men is weakness of the Kidney system. When the Kidney is weakened by, for example, aging, constitution, or lifestyle (such as overwork), there will be a lessened ability to conceive. Of course Chinese medicine recognizes other impediments to normal conception. For example, some women may have scar tissue from surgeries or uterine fibroids that hinder conception or implantation of an embryo. Men may have poor sperm count from a history of infections. Whatever the cause, Chinese medicine views each person and each case as a unique situation. Treatment must be tailored to each individual - ten women with the same diagnosis of infertility may receive ten different treatments by traditional Chinese physicians. This individualization is one of the defining hallmarks of Chinese medicine.
What treatments are available?
Traditional Chinese Medicine, also known as Oriental Medicine, is one of the world's oldest and complete systems of medicine. Unlike many other indigenous or folk medicines, TCM was a medical system practiced by the most literate and brightest of Chinese scholar-physicians for at least the last 3,000 years. Furthermore, Chinese doctors wrote about what they treated and how they treated it. This means that we have close to 3,000 years of accumulated written evidence on the use of Oriental Medicine in a wide variety of diseases.
Practitioners of TCM, when properly trained, utilize a wide variety of treatment methods. In China, the birthplace of Oriental Medicine, all practitioners of Oriental Medicine are fully trained in both acupuncture and Chinese herbal medicine, as well as dietary, lifestyle, and exercise counseling. Unfortunately, there are relatively few practitioners in the United States who practice Oriental Medicine as a complete system - many practice only acupuncture, which actually is just one modality of TCM. The treatments commonly used for the treatment of fertility include acupuncture, Chinese herbal therapies, and other modalities that look at diet and lifestyle. While some may be interested or familiar with only acupuncture, the best results come from a combination of several therapies. In Asia, Chinese herbal medicine is considered the most important and most effective therapy for treating infertility.
So how long does this take?
In general, when we talk about treating any condition related to menstruation or fertility in women, the standard course of treatment will take at the least three months of consistent treatment. This is especially true with couples who are still trying to conceive naturally. Unfortunately, one or two treatments of acupuncture, or one week on herbs, will do very little to enhance fertility. Women who undergo IVF or artificial insemination however may still benefit from fewer treatments, although again, one or two treatments are not going to do it. The protocol used in this office for patients undergoing IVF treatments is to have them begin weekly treatments as soon as possible before the actual transfer and usually the patient should expect to have at the very least one month of regular treatments. Beginning about one month before embryo transfer acupuncture is done twice weekly. Then, the actual day of the transfer we treat the mother-to-be both before and after the procedure to try to ensure optimal conditions for embryo implantation. Some women elect to pursue Chinese herbal therapies along side IVF treatments. Some western doctors feel comfortable with this and some do not, so it is a personal decision that varies patient to patient. According to Chinese doctors acupuncture may increase IVF success rates by up to 35%. However, when acupuncture and Chinese herbal therapies are combined and performed by a fully licensed and trained practitioner, the success rates can be increased by as much as 60%. (2)
And what about the men?
Issues with male fertility can also treated with both acupuncture and herbs. In my experience however, men are less willing to be treated leaving the burden to their female partner. Sometimes when there are problems with sperm quality fertility specialists will inject a single sperm into an egg cell during an IVF round (a process known as intracytoplasmic sperm injection). Couples then are led to believe that even with poor sperm, an ideal and healthy pregnancy can still be achieved. Many men decide against TCM treatment because this procedure gives then an "easy out" so to speak. Oriental Medicine believes that by far the best results come when both the male and female partners receive treatment of some sort - either acupuncture or herbs, or both. The couples that consistently get pregnant in a shorter period of time are those where both partners receive some sort of TCM treatment.
Please also remember that the mind is a tremendous tool for wellbeing. In my experience some sort of relaxation therapy is one of the best treatments for infertility, especially in younger women where nothing seems to actually be wrong. A moderate diet and lifestyle are extremely important as well. If you are interested in TCM treatment either as a primary or adjunct therapy for fertility issues the good news is that TCM professionals can be found almost everywhere today. A fully trained practitioner of Oriental Medicine will have professional training in both acupuncture and Chinese herbal medicine, having graduated from a 3 or 4-year program in Oriental Medicine following a 4-year bachelor's degree. To ensure you have a completely trained professional, be sure they maintain a valid state license to practice acupuncture and are also nationally certified in both acupuncture and Chinese herbology (designated Dipl. Ac. and Dipl. C.H. respectively). In 2004 the national certifying commission also instituted a comprehensive national certification in Oriental Medicine (designated Dipl. O.M.). People with the credential Dipl. O.M. demonstrate the highest and most advanced level of competency and training in acupuncture, Chinese herbal medicine, western biomedical sciences, diet, exercise and other Oriental Medicine therapies.
For more information about treatment please contact our office .