Infertility is defined as inability to achieve pregnancy after 12 months of unprotected and frequent intercourse. Two thirds of cases are due to a female problem, one-third to a male problem.
In women, the incidence of infertility increases significantly over 35 years old. Evaluation and treatment is normally recommended after six months of trying to conceive.
There are numerous causal factors that could result in infertility. Both systems, Western medicine and traditional Chinese medicine (TCM), have their insights and understanding on the causes and pathophysiological mechanisms of human infertility, and thus the corresponded approaches to the disease management.
In Western medicine, the common causes of infertility include the following.
• Oligozoospermia (low sperm count, <20millions/ml) – the most common male factor of infertility, and azoospermia (lack of viable sperm).
• Sperm abnormally: morphology <50% normal, motility<50%.
• Semen factors: semen volume < 1 ml/ejection; abnormal pH (normal 7.2~7.8); prolonged liquefaction time.
• Some sexual functional disorders, such as retro ejaculation.
• Systemic diseases such as cystic fibrosis (an autosomal recessive genetic defect).
In many occasions, the exact underline causes and mechanisms of the resultant abnormalities in semen and sperm listed above can be very complex and difficult to address.
• Irregular menstruation cycles.
• Anovulation (no egg released from the ovary at midcycle): seen in polycystic ovary syndrome (PCOS), hypothyroidism or hyperprolactinemia, etc.
• Fallopian tube diseases: the egg will unable to be conveyed through the tube due to the obstruction.
• Pelvic inflammatory diseases (PID). PID is the most common cause of preventable infertility in the U.S., and is a most likely cause of infertility in a normal menstruating woman under the age of 30. PID can cause a tubal problem.
• Uterine/endometrial diseases, such as uterine fibroids and endometriosis. Endometriosis is a condition in which small pieces of the endometrium (the lining of the uterus) migrate to other places in the pelvic area, such as the fallopian tubes, ovaries, or other pelvic structures. It often results in painful menstruation, painful intercourse, and infertility.
• Other causes, such as cervical mucus abnormally that prevents sperm from entering the uterus cavity, anti-sperm antibody formation and, etc.
• Unknown causes.
Traditional Chinese Medicine (TCM)
In the view of traditional Chinese medicine, human fertility relies on the normal functioning of the Kidney, Liver, blood and Spleen. The infertility occurs when one or more organs (i.e., Kidney, Liver, blood and Spleen) are impaired. As one should understand, the terms of the organs here are used primarily to classify a certain group of physiological functions, although they may or may not be physically consistent with the anatomic organs.
The management of infertility cases typically include making a causal diagnosis and give the proper treatments based on the diagnosis.
The following are the most commonly used steps that assist a clinician to reach a causal diagnosis in the infertility management.
After the necessary diagnostic assessments have been done, you may want to discuss the results of examination and the treatment options with you physician. There are a number of treatment measures available in both Western medicine and TCM and you are responsible to make your decision based on your need and preference.
Western medical approaches
Patients are encouraged to have a necessary medical evaluation done in order to assess any immediately correctable medical disorders (as mentioned above), or exclude any underlined malignant diseases before they start the TCM treatments.
It can be very helpful if the patients bring their medical exam data/results (including a basal body temperature chart, if any) when visit our clinic. A defined Western medical diagnosis, if available, will also be valuable for us in evaluating and treating the case even in TCM system.
In addition to infertility as a chief complain, a patient usually presents with a certain clinical profile composed with various particular symptoms and signs, including a life style and personality (see Causes – traditional Chinese medicine section). Each clinical profile will usually fit into one or more categories described as follows and this is how a TCM categorical diagnosis ( or called Zheng identification) is reached.
A regimen of TCM treatments (i.e., acupuncture and Chinese herbal medicine), including the selection of acupuncture channels and points, needle manipulation and herbal composition, is made based on a refined categorical diagnosis or Zheng identification.
Acupuncture and Chinese herbal treatments are least invasive and generally safe, and are recommended for the infertility patients with the following conditions.
The infertility treatment by TCM has been a long history in China and other Asian countries and areas, and is getting popular in Europe and the U. S. in the recent decades because it is natural, effective and less costly. In our clinic, the overall success rate in infertility treatment is 78.2%, and the treatment course normally ranges from 2 to 8 menstrual cycles depending on the individual case; some difficult cases may need a longer period of treatment to achieve pregnancy.
As you may have found, the two systems, Western medicine and TCM, seem quite different and sometimes even “irrelevant” to each other in diagnosis and treatment of infertility and other diseases. They both, however, try to approach a same objective target, the human body, simply via the different directions and paths. This is not an issue of which one is the superior, but the fact that by integrating the two systems, we are able to “see” more about the entire picture of human body with a wider-angled view and in a various-depth focusing, and thus we have more treatment approaches to choose for each unique disease scenario, which, we believe, is a blessing for human from God.
By Henry D Wu, MD, L.Ac and Sharon Y Weng, OMD, MS, L.Ac
This article gives some highlighted information on infertility based on our best knowledge, understanding and daily practice. It is by no means a substitute for the medical advice from your physician. © All Rights Reserved.