Acupuncture, Traditional Chinese Medicine (TCM) and Fertility

Today we have a guest post from Laura Erlich.

Laura Erlich, MTOM, LAc, co-founded LA Herbs and Acupuncture in 2007.  Her areas of specialty include women’s health, fertility enhancement (with or without ART), conscious conception, prenatal and post-partum care, gynecological disorders and menopause. Ask Laura your questions on Facebook! http://www.facebook.com/pages/Laura-Erlich-MTOM-LAc-Doula-of-La-Herbs-and-Acupuncture/163573970364246

With so many women and their partners waiting until later in life to start families, itʼs no wonder that both holistic and allopathic treatments for fertility are on the rise. Traditional Chinese Medicine (TCM), which encompasses acupuncture, herbs, nutrition and lifestyle recommendations, has been widely acknowledged for itʼs impact on both the male and female reproductive systems.

TCM can be used as a stand alone method to help prepare the body for pregnancy and encourage the development of healthy follicles (eggs) and sperm, or in conjunction with Western treatments, such as IUI and IVF.

When selecting an acupuncturist for conception preparation, or integrative infertility treatments, it is important to choose a practitioner who specializes in this area. While treating infertility is within the scope of all licensed acupuncturists, not all possess the advanced training necessary to treat alongside reproductive endocrinologists (fertility specialists), which is vital to a successful outcome. Knowing how to alter treatments and herbal protocols based on the phase of the menstrual cycle, medications the patient might be taking, or procedures they may be recovering from or preparing for, is an essential component of TCM fertility care.

Some of the ways that TCM can enhance fertility include: stress reduction/ nervous system balancing, hormone regulation, which includes regulating the menstrual cycle, increased follicle count and reduction of FSH levels (for IVF), and the treatment or management of such conditions as endometriosis and PCOS. In men, TCM can help to increase sperm count, motility and morphology. Letʼs take a closer look at each of
these areas:

Stress and the nervous system

Our nervous system, which is comprised of the brain, spinal cord and peripheral nerves, is responsible for everything that takes place in our body. Without the direction of the brain, we would not be able to breathe, have a heartbeat or function on any physical level. The hypothalamus, part of the mid-brain, is responsible for regulating all of the bodyʼs systems, which it does by sending signals to the pituitary gland, which in turn tells different parts of the body what to do. You may hear this referred to as an ʻaxisʼ, such as the Hypothalamus-pituitary-ovarian axis (HPOA), or the hypothalamus-pituitaryadrenal
axis (HPAA).

The HPA axis is a feedback loop which triggers the brain to release stress hormones into the bloodstream when we are under threat. It is a system designed with the most primal need in mind: SURVIVAL. The problem in our modern society is that the perception of a threat is often relentless, from pressure at work, to financial worries, family dilemmas, even traffic, all lead to the sometimes relentless release of these
hormones into our blood stream. In the short-term, these hormones, which include cortisol, adrenalin and epinephrine, are very useful, because without them, we would not be able to escape danger quickly enough to survive. In the long run, however, they can be damaging to the body, because in the presence of these stress hormones, our reproductive hormones go on the back burner. This function is, once again, set in place for our survival. It is simply not in the best interest of our bodies to reproduce during times of prolonged distress.

TCM is able to act on the nervous system in several ways. The insertion of fine, sterile needles along certain energy lines (meridians) in the body, initiates the release of endorphins, which are the antidote to stress hormones. Regular visits to the acupuncturist will allow the brain to come out of itʼs relentless state of stress and begin to “turn on” the “rest and relax” part of the nervous system, or the parasympathetic nervous system. It is from this place of relaxation, or reduced stress, that the body can begin to turn itʼs attention to things like reproduction and healing.

Hormone Regulation

Once the body is able to begin to unwind from the effects of ongoing stress, many systems that were once underperforming will simply regulate themselves. For example, this is why we often see couples become pregnant right after theyʼve adopted a child. Depending on a womanʼs age, and the severity of the condition causing infertility, a short period of acupuncture, gentle herbal tonification and dietary modifications may be all she needs to conceive on her own.

As an integrative practitioner myself, I am of the belief that any woman over the age of 35 who is trying to conceive for a period of 6 months, should consider a workup with a fertility specialist. Although it will cost a bit out of pocket, I have found time and again that women who try and go through their regular OB/GYN for this type of workup often end up, after months of frustration, turning to a fertility specialist and spending the money after all. This kind of baseline workup allows both the doctor and the
acupuncturist to target treatments to the specific needs of the individual. Some of the things that one should consider when seeing a fertility specialist include: blood work on day 2 or 3 of the menstrual cycle to check FSH, Estradiol and LH, an ultrasound to measure the number of follicles present in the antral part of the ovary, a hysterosalpingogram (HSG), to make sure that the uterine cavity is free of fibroids or scar tissue, and that the fallopian tubes are open, and a day 21 progesterone test to make sure that levels are high enough to support pregnancy. Your doctor may, of course, wish to run other tests, but these are some of the most common, and most important baseline tests.

An acupuncturist will use other means for diagnosing the individual, including tongue and pulse diagnosis, but it is always helpful to have western diagnosis to corroborate a treatment plan. Once a diagnosis (both eastern and western) is established, the acupuncturist will begin using herbs and acupuncture to correct the imbalances in the system that may be causing infertility. Herbal medicine is a very important part of the TCM practitioners tool chest, and they shouldnʼt be a shied away from by fertility patients. All of the herbs that come into the US are inspected by the FDA, and most acupuncturists are careful to use pharmaceutical grade herbs that are free of heavy metals and pesticides. Nevertheless, herbs are a form of medicine, and one should never self-prescribe, or take herbs from anyone other than a licensed individual who specializes in their area of need, to avoid any adverse reactions.

For the older patient, the pressure of time can feel very overwhelming. It is important to note that as your body unwinds from ongoing stressors, and as the acupuncture and herbs work to correct the bodyʼs hormonal imbalances and bring more blood flow to the reproductive organs, that oneʼs “reproductive” age actually begins to reverse itself. Through TCM, one becomes reproductively younger. This is not to say that every woman who receives TCM treatments will conceive on her own, however, agreeing to 3-6 months of treatment prior to utilizing assisted reproductive technologies like IVF, can dramatically increase the odds of pregnancy and live birth.

For women who suffer from specific conditions, such as PCOS and endometriosis, working with a TCM fertility specialist can help to regulate the symptoms that come along with these conditions. Some examples are regulation of blood sugar and ovulatory frequency for the PCOS patient, and a reduction in painful menstruation and heavy bleeding for the endometriosis patient. While these conditions, depending on severity, may still require western medical intervention, they can be dramatically assisted by TCM.

Male Infertility

Roughly 1/3 of all infertility cases are attributed to male factor infertility. Just like women, menʼs reproductive health is affected by high stress levels, which can in turn be positively impacted by TCM treatments. Spermatogenesis, or sperm production, is process that takes place over about 90 days. Therefore, a 3 month period of herbal medicine, acupuncture and other lifestyle modifications to reduce stress levels can help improve sperm count and quality.

Self Care

Finally, it is important to touch on the importance of self care and itʼs role in the healing process. Changing oneʼs body, whether for the purpose of conception, or healing from dis-ease, requires changes in oneʼs daily life and practices. Of vital importance is finding time for peace and relaxation every day. There is no more time for excuses about being too busy or too tired for self care. If having a child is your priority, then parenthood begins now, with your thoughts, your dietary choices, your sleep and your relationships. Take time to clear out old resentments and grudges. Make peace with those around you, and shed yourself of relationships, both personal and professional, that arenʼt working for you anymore. Take 30 seconds to breathe deeply when stress beckons, and take the time each day to meditate, walk, do yoga, or some type of activity that involves quieting your mind and engaging your breath.

May this journey to parenthood lead you to your greatest moments of self discovery, and the beautiful family of which you dream.

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