Unexplained Infertility—How Acupuncture and Herbal Solutions Can Help*
Unexplained infertility can be one of the most frustrating diagnoses a couple can be given and can affect between 10% – 30% of couples going through a medical fertility evaluation. The majority of my practice is focused on treating fertility and about 30% of my patients present with a diagnosis of unexplained infertility.* Located just 20 minutes from Boston, I am one of only four acupuncturists in Massachusetts certified as an infertility specialist by the American Board of Reproductive Oriental Medicine. I offer support with acupuncture, Chinese herbal medicine and lifestyle recommendations, depending on what is most appropriate. An initial study on acupuncture and herbs for unexplained infertility concluded that Chinese medicine can be successful, particularly for those who receive a full course of treatment. * To read about just a few of our success stories, click here.*
Chinese Medicine May Offer Explanations for Unexplained Infertility that Western Medicine Cannot
Typically, couples given this diagnosis appear, on the surface, to be in good health. Hormones will be within normal range. The ovaries, fallopian tubes and uterus will look fine on ultrasounds and hysterosalpingograms. Ovulation comes at regular intervals. There will be no sign of endometriosis or uterine fibroids, and semen analysis is typically normal. For these couples, Western medical treatments will usually start with IUI or clomid and progress to IVF when unsuccessful. If these interventions are unsuccessful, couples will usually look to alternative solutions, such as acupuncture.
The approach of Traditional Chinese Medicine (TCM) is to look at the whole picture. When I go through my evaluation, I am looking for areas of health that appear out of balance. For instance, even though their lab tests are normal, I may be able to find other health concerns seemingly unrelated to infertility—such as issues with stress, headaches, poor digestion, insomnia, anxiety, depression, painful periods, and severe PMS—that can be improved upon and that may be hindering their progress. If I do find areas of imbalance, I focus my treatments on addressing those issues and optimizing a person’s health so that they can have the best chance at succeeding.*
Optimizing Success by Supporting the Four Phases of a Woman’s Cycle*
If I don’t find anything out of balance, then my next approach is to regulate and optimize the four phases of a women’s cycle:
- Menstrual phase*
- Follicular phase*
- Ovulatory phase*
- Luteal phase*
These four phases are governed by different physiological mechanisms and can be supported through acupuncture and herbal medicine.*
Phase 1: The Menstrual Phase
The menstrual phase starts when estrogen and progesterone hormone levels drop, causing the uterine lining to break down and be shed from the uterus (i.e., the onset of a period). The period should be moderate, not too heavy or too light. It should not be too dark or very clotted, and there shouldn’t be too much discomfort. If the menses does not fit this profile, our treatment approach is to assist menstruation through the use of acupuncture and Chinese herbs that help to expel the uterine lining and reduce pain.* We use Chinese herbs such as tao ren (peach kernel), hong hua (carthamus flower), chuanxiong (chuan xiong rhizome), yan hu suo (cordalis), yi mu cao (leonurus), and ze lan (lycopus).
Phase 2: The Follicular Phase
The follicular phase begins with the onset of the period. It represents the pituitary glands’ release of FSH to stimulate new generation of a dominant ovarian follicle and the re-growth of the uterine lining. During this phase, estrogen is the dominant hormone, which is released by the growing follicle. The follicular phase should generally be around 14 days; anything that is much shorter or much longer will make it more difficult to conceive.
In Chinese medicine, our goal is to stimulate blood flow to the ovaries and uterus and use herbs to replenish blood stores and estrogen development (we say nourish blood and yin).* This may assist in supporting follicle growth and proliferation of the uterine lining.* We use Chinese herbs such as Shu di huang (Rehmannia), Dang gui (Chinese angelica root), Gou qi zi (lycium berry), and Bai shao (white peony root), and shan zhu yu (cornus fruit) to name a few. Additionally, we often use lower back and abdominal acupuncture points to facilitate blood flow to the ovaries and uterus.*
Phase 3: The Ovulation Phase
The ovulatory phase marks the end of follicular development. At this stage, a dominant follicle has been selected for ovulation. Estrogen, at its peak, signals the pituitary gland to release significant levels of Luteinizing Hormone (i.e., the LH surge) which promotes ovulation and final maturation of the egg.
We use acupuncture and herbs to promote the smooth flow of circulation and the transition from estrogen dominance to progesterone, and assist the ovaries in pushing out the egg.* Ideally, a woman should ovulate close to day 14, but this may fluctuate. Irregular ovulation may degrade one’s chances of success. We use herbs like ze lan, tao ren, hong hua and xiang fu to facilitate ovulation, and herbs like shu di huang (rehmannia root), dang gui (Chinese angelica root), tu su zi (cuscuta seed), xian mao (curculigo rhizome), and yin yang hou (epimedium) to encourage the transition from estrogen to progesterone.*
Phase 4: The Luteal Phase
The luteal phase is the post-ovulation phase that is dominated by progesterone and is generally marked by a rise in basal body temperature. During this stage, the uterine lining should be 8-10 mm thick and should be trilaminar (three layers) in appearance with appropriate glandular and protein expression, making it receptive to embryo implantation. The luteal phase should be around 14 days long—anything less then 12 days will make it more difficult to conceive and may indicate a luteal phase defect.
We use acupuncture and herbs to support the uterus and embyro-implantation by improving uterine blood supply, reducing uterine contractions, and supporting progesterone.* By doing this, our goals are to provide a plush uterine lining with all the components necessary for a healthy nurturing environment where a developing embryo can grow.* Some of the Chinese herbs we use at this stage may include Tu su zi, Ba ji tian, xu duan, yin yang hou, bu gu zhi, huang qi, and dang shen. Interestingly, studies with these herbs have reported increases in ATP production by as much at 222% within the mitochondria–meaning that they are extremely good at supporting cellular energy-similar to CO-Q10, which may be helpful during early embryo development.*
If you are struggling with unexplained infertility and would like to explore a different approach, I offer a free 30-minute evaluation. Give us a call today!
*Disclaimer: Specific results are not guaranteed. Results may vary from person to person.