Infertility

Compiled by John G. Connor, M.Ac., L.Ac., Edited by Barbara Connor, M.Ac., L.Ac.

TABLE OF CONTENTS
Introduction
Definition and Causes of Infertility
Chinese Medical View of Infertility
Research on how Acupuncture Benefits Fertility
The Use of Chinese Herbs to Aid Fertility
Useful Nutrients
Lifestyle and Dietary Recommendations
References

INTRODUCTION
· Barbara and I get excellent results treating infertility using the combination of acupuncture, craniosacral therapy and hara visceral work.  When indicated we also use certain herbs.  We have written this article in order to help you understand infertility from the Chinese Medical perspective and how we treat it.

DEFINITION AND CAUSES OF INFERTILITY
· Infertility is usually defined as the failure to conceive after a year or more of regular sexual activity during the time of ovulation.  There are a number of causes of infertility, some of which are low sperm count, tight underwear or raised temperature of the scrotum, problems with ovulation, endometriosis, adhesions, uterine fibroids and obstructed fallopian tubes due to scarring.

CHINESE MEDICAL VIEW OF INFERTILITY
· Traditional Chinese Medicine (TCM), with its emphasis more on the functional aspects of health, proves to be a very effective treatment for infertility, often without specifically focusing on infertility itself.

· Endometriosis or scar tissue can pull the fallopian tubes to one side or the uterus backwards.  According to TCM, tubal problems can be due to Phlegm, Damp Phlegm, Blood Stasis or Heat Toxin.  Endometriosis can be due to Qi and Blood Stasis.

· Prolapse of any organ can put pressure on the uterus or fallopian tubes and can be due to Spleen Qi sinking.

· Poor egg quality is due to Kidney Deficiency.  Lack of eggs altogether is due to Jing Deficiency.  If the endometrium itself is deficient, it is due to Blood Deficiency.  If there is no ovulation, which can be caused by polycystic ovaries, it is due to Damp Phlegm and Blood Stasis.  If there are chronic or acute infections, there is the possibility of Heat Toxins or Damp Heat Latent in the Lower Burner.

· It is important to regulate the cycle according to each woman’s rhythm.  For example, if there is a long cycle scenario, it could mean not enough Yang Qi to have progesterone rise at the proper time.  Or if there is a prolonged second phase, it could mean that progesterone is up too long.  This would be due to Qi and Blood Stagnation.

RESEARCH ON HOW ACUPUNCTURE BENEFITS FERTILITY
·  The results of a study published in Asian J Androl 2003 Dec;5(4):345-8 by Gurfinkel et al entitled “Effects of acupuncture and moxa treatment in  patients with semen abnormalities” concluded that the Chinese Traditional Medicine acupuncture and moxa techniques significantly increased the percentage of normal-form sperm in infertile patients with oligoastenoteratozoospermia without apparent cause.

· The results of a study published in J Huazhong Unjiv Sci Technolog Med Sci 2002;22(3):228-30 by Zhang et al entitled “Influence of acupuncture on idiopathic male infertility in assisted reproductive technology” found that acupuncture can improve semen quality and fertilization rates in assisted reproductive technology.

· The results of a study published in Andrologia 2000 Jan;32(1):31-9 by Siterman et al entitled “Does acupuncture treatment affect sperm density in males with very low sperm count: A pilot study.” concluded that acupuncture may be a useful, nontraumatic treatment for males with very poor sperm density, especially those with a history of genital tract inflammation.

· The results of a study published in Arch Androl 1997 Sep-Oct;39(2):155-61 by Siterman et al entitled “Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality” found that patients exhibiting low fertility potential due to reduced sperm activity may benefit from acupuncture treatment.

· The results of a study published in J Tradit Chin Med 1993 Jun;13(2):115-9 by Mo et al entitled “Clinical studies on the mechanism for acupuncture stimulation of ovulation” found that acupuncture may adjust endocrine function of the generative and physiologic axis of women, thus stimulating ovulation.  The results of this research will provide some scientific basis for treating and further studying this disorder.

· The results of a study published in Gynecol Endocrinol 1992 Sep;6(3):171-81 by Gerhand and Postneek entitled “Auricular acupuncture in the treatment of female infertility” found that auricular acupuncture seems to offer a valuable alternative therapy for female infertility due to hormone disorders.

THE USE OF CHINESE HERBS TO AID FERTILITY
· No single herb is considered useful by itself for promoting fertility.  Rather, more than 150 different herbs—usually given in complex formulas comprised of 15 or more ingredients—are used in the treatment of infertility with the purpose of correcting a functional or organic problem.

· Although the outcome for any given individual cannot be predicted, the clinical studies conducted in China indicate that about 70% of all cases of infertility treated by Chinese herbs resulted in pregnancy or restored fertility.  It is estimated that pregnancy can be achieved within six to twelve months with the use of Chinese herbs.

· If one is taking the fertility drug Lupron, which is prescribed to shut down hormone production (as a part of in vitro fertilization treatment), herbs that promote hormonal activity can interfere with it.  So anyone taking Lupron should stop all herbal treatments while taking this drug. (Shima, 2004)

USEFUL NUTRIENTS
· Folic acid supplementation may be beneficial to women.  Food sources include barley, bran, brewer’s yeast, brown rice, cheese, chicken, dates, green leafy vegetables, legumes, lentils, milk, mushrooms, oranges, split peas, root vegetables, salmon, tuna, wheat germ, whole grains and whole wheat.

· PABA (para-aminobenzoic acid) stimulates the pituitary gland and sometimes restores fertility to some women who cannot conceive.  Food sources include molasses, mushrooms, spinach and whole grains.

· Vitamin B6 supplementation may be beneficial to women.  Food sources include brewer’s yeast, carrots, chicken, eggs, fish, peas, spinach, sunflower seeds, walnuts, and wheat germ.

· Vitamin B12 supplementation may be beneficial to men.  Food sources include brewer’s yeast, clams, eggs, herring, mackerel, dairy products, fish, dulse, kelp, kombu, nori, soybeans and soy products.

· Vitamin C supplementation may enhance fertility.  Vitamin C unclumps sperm cells and assists other important minerals like zinc, magnesium, copper and potassium, which are all vital to sperm functioning.  Dosage: 200-1000 mg per day.

· Zinc is essential for sperm production.  Zinc deficiency may be associated with oligospermia, decrease sperm motility and decreased serum testosterone levels.  Food sources include brewer’s yeast, dulse, egg yolks, fish, kelp, lamb, legumes, lima beans, liver, mushrooms, pecans, oysters, poultry, pumpkin seeds, sardines, seafood, soy lecithin, soybeans, sunflower seeds and whole grains.

LIFESTYLE AND DIETARY RECOMMENDATIONS
· Avoid vigorous exercise, hot tubs and saunas, as they may lead to changes in ovulation and reduced sperm count.  A University of Michigan study indicated that intense exercise may result in a drop in the production of hormones involved in potency, fertility and sex drive.

· Avoid all alcohol; it reduces sperm count in men and can prevent implantation of the fertilized egg in women.  Even small amounts of alcohol may cause infertility in certain males.

· Licorice may reduce testosterone levels in men.  For this reason, men with impotence, infertility or decreased libido may wish to avoid this herb. (Armanini & Palermo 1999)   There was a Japanese study published in 2003 involving 18 male patients with type 2 diabetes and chronic hepatitis who were given weekly glycyrrhizin (the active component of licorice), which contained 240-525 mg glycyrrhizic acid, for >1 year and 21 male patients not given glycyrrhizin. Serum concentrations of total and free testosterone were significantly lower in patients given glycyrrhizin than those in patients not given glycyrrhizin.  This study suggests that glycyrrhizin decreased serum testosterone concentrations in male patients with type 2 diabetes and chronic hepatitis.  Reduced serum testosterone concentrations may cause insulin resistance and atherosclerosis, as well as sexual dysfunction and decreased libido in men. (Fukui et al, 2003)

· Although increasing your intake of omega-3 essential fatty acids can increase your chances of conceiving, women who are trying to get pregnant should avoid fish that contains even low levels of mercury.  Ground flaxseed is a much safer way for you to get your omega-3s. (Shima, 2004)

· Do not smoke, and avoid being around cigarette smoke.  Smoking interferes with sperm production and contributes to impotence because of inhibited blood flow.

· Avoid caffeine consumption as it may prevent some women from becoming pregnant.

· Relax.  A study conducted at the University of Washington found that stress may contribute to infertility.  Yoga, tai chi or qi gong are helpful in reducing stress.

· The ulcer medications cimetidine (Tagamet) and ranitidine (Zantac) may decrease sperm count and even produce impotence.

· Strict adherence to a gluten-free diet has enabled some previously sterile men and women to conceive.

· The transdermal use of natural progesterone cream may benefit infertile women.

· The best times to conceive are the 13th, 14th and 15th days before the next menstrual cycle.

REFERENCES
Armanini D, Palermo M., “Reduction of serum testosterone in men by licorice.” N Engl J Med. 1999;341:1158
Balch, James F., M.D., Balch, Phyllis A., C.N.C., Prescription for Nutritional Healing, Garden City Park: Avery Publish Group, 1997
Dharmananda, Subhuti, Ph.D., Chinese Herbs and Fertility, Portland: Institute for Traditional Medicine, July 1996
Flaws, Bob, Endometriosis, Infertility and Traditional Chinese Medicine, Boulder: Blue Poppy Press, Inc., 1989
Fukui M et al, “Glycyrrhizin and Serum Testosterone Concentrations in Male Patients With Type 2 Diabetes”, Diabetes Care, 26:2962, 2003
Kirschmann, Gayla J. and Kirschmann, John D., Nutrition Almanac, New York: McGraw Hill 1996
Maciocia, Giovanni, Obstetrics & Gynecology in Chinese Medicine, New York: Churchill Livingstone 1998
Micleu, Cindy, Acupuncture Therapeutics, OB-Gyn, NIAOM Class Notes, Winter 1995
Ross, Jeremy, Acupuncture Point Combinations, Edinburgh: Churchill Livingstone, 1995
Shima, Miki O.M.D., “About Infertility” Alternative Medicine, Issue 64, Feb. 2004:91-94
Werbach, Melvyn R., M.D., Nutritional Influences on Illness, Tarzana: Third Line Press, 1996

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Compassionate Acupuncture and Healing Arts, providing craniosacral acupuncture, herbal and nutritional medicine in Durham, North Carolina. Phone number 919-309-7753.

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