Infertility

Female Infertility

In recent years, increasing numbers of infertility patients are using acupuncture during their IVF to increase the rate of pregnancy. The tremendous growth began with the publication of Dr. Paulaus Wolfgang’s ground breaking clinical study in 2002.

Groundbreaking Study

The study found that clinical pregnancy rate was 41.5% higher in treatment group when patients received pre and post ET (embryo transfer) acupuncture. Two subsequent clinical studies, conducted by Lars Westergaard et al and Stefan Dieterle et al also demonstrated that acupuncture around ET increased the clinical pregnancy rate by 33.3% and 55.5%, respectively. That is an impressive 43.43% average improvement for a 2% of incremental cost of the IVF, assuming $200 for pre and post IVF acupuncture, and $10,000 for an IVF.

Increased Awareness & Acceptance

The proliferation of Internet technologies, such as Google and chart-room, provided easy access to aforementioned clinical studies and a platform for infertility patients to share their positive experience with acupuncture among IVF patients.

In 2010, acupuncture, as a viable alternative and complementary therapy to western ART (Assisted Reproductive Technology), received a major boost when celebrities, such as Julie Snyder, and international super star Celine Dion, publicly endorsed acupuncture in their successful pursuit of parenthood.

The year 2012 marks another turning point – half of the Montreal’s infertility clinics are either offering on-site, pre and post embryo transfer acupuncture or planning to do so in the near future, due to an ever increase amount of support from recent clinical studies and patients’ demand.

Finding an experienced acupuncturist and faithfully following the requirements – whether it’s drinking bitter herbal teas, changing your lifestyle or receiving regular acupuncture treatments – are the keys to successful fertility treatment.

Chinese Medicine treatment

Like western medicine, the first step to successful treatment with TCM is proper diagnosis. Once the syndromes (the nature of illness) are diagnosed, the TCM practitioner has already formed an opinion on the pathogenic factors, pathogenesis, location, and prognosis.

In my practice, I pay more attention to the syndromes than the disease itself. This means that if I find the same disease in a number of patients and determine that they have different syndromes, I treat each case differently. For example, two female patients each have polycystic ovarian syndromes (PCOS), but one patient’s PCOS is caused by Spleen and Kidney Deficiency, and the other by Liver Qi Stagnation. In treating each of these patients, I would use very different acupuncture points and herbs.

When the diseases presented in different patients are different, but the syndromes are the same, I treat the patients similarly. For example, if I have three infertility patients, one with PCOS, another with endometriosis and a third with premature ovarian failure (POF), and I find that they are all caused by Kidney Deficiency, then I would use very similar acupuncture points and herbs to treat these three patients.

Depending on the diagnosed syndromes, the patient’s personal constitution and diagnosis from the fertility clinic, I then outline a treatment objective. To achieve the treatment objective, I often use a combination of acupuncture and Chinese herbal medicine. Sometimes, nutritional supplements and dietary regulation are also used

Infertility

In recent years, increasing numbers of infertility patients are using acupuncture during their IVF to increase the rate of pregnancy. The tremendous growth began with the publication of Dr. Paulaus Wolfgang’s ground breaking clinical study in 2002.

Groundbreaking Study

The study found that clinical pregnancy rate was 41.5% higher in treatment group when patients received pre and post ET (embryo transfer) acupuncture. Two subsequent clinical studies, conducted by Lars Westergaard et al and Stefan Dieterle et al also demonstrated that acupuncture around ET increased the clinical pregnancy rate by 33.3% and 55.5%, respectively. That is an impressive 43.43% average improvement for a 2% of incremental cost of the IVF, assuming $200 for pre and post IVF acupuncture, and $10,000 for an IVF.

Increased awareness and acceptance

The proliferation of Internet technologies, such as Google and chart-room, provided easy access to aforementioned clinical studies and a platform for infertility patients to share their positive experience with acupuncture among IVF patients.

Complementary therapy is embraced

Most recently, acupuncture, as a viable alternative and complementary therapy to western ART (Assisted Reproductive Technology), received a major boost when celebrities, such as Julie Snyder, and international super star Celine Dion, publicly endorsed acupuncture in their successful pursuit of parenthood.

Finding an experienced acupuncturist and faithfully following the requirements – whether it’s drinking bitter herbal teas, changing your lifestyle or receiving regular acupuncture treatments – are the keys to successful fertility treatment.

Male Infertility

Acupuncture has been increasingly used as an alternative and complementary treatment for female infertility, in recent years. However, the significant therapeutic potential of acupuncture, in the treatment of male infertility, is still largely unknown. Male factors are contributory in at least 50% of infertile couples (Collins, 1989), and yet it is notoriously difficult to treat. There are several non-surgical therapies, but the current trends is toward using micro-surgical techniques, such as ICSI, MESA and TESE, which exclusively use the best few sperms of however poor quality1.

Presently, there are a few dozens of published clinical studies published to support this ancient therapy in the treatment of male infertility. The results of these clinical studies are encouraging and have shown significant potentials to increase both the quantity and quality of sperm.

In my clinical observation, male infertility patients generally respond slower but better than their female counterparts. Since the sperm may take two and half months to form, the effectiveness of the treatment for certain conditions could only be assessed after three to six months.

On the other hand, I have observed that male patients are, unfortunately, much less likely to follow the full course of treatment. It is unclear if this phenomenon is due to lack of information, education or willingness to try an unfamiliar alternative treatment.

Unexplained Infertility

For up to 40% of Infertility patients, their infertility has no apparent cause after a full series of Western medicine tests and assessments are completed.

Don’t despair, an experienced acupuncturist can provide a complete assessment from Chinese medicine’s perspective. In most cases, reasons could be found. Please contact Sinocare for additional information.

Case Study

To illustrate the healing potential of acupuncture and Chinese herbal medicine, I list three recent case histories for your reference.

Male Patient History Western Medicine Diagnosis & Treatment Chinese Medicine Diagnosis & Treatment
Age 33,
Secondary Infertility: 24 months		 Lower sperm count and low motility; sperm antibody Kidney Essence and Qi deficient; acupuncture weekly and herbs daily for 4 months
Age 36
Primary Infertility: 24 months		 Poor morphology 10%; poor motility (7% moving rapidly) Kidney Qi deficient; herbal medicine daily for 7 months
Age 33
Primary Infertility: 18 months		 Low sperm count (13.2 million/ml); poor motility (3% moving rapidly) Damp-heat accumulation in liver/gall bladder meridian; acupuncture weekly and herbal medicine daily for 5 months

Observed Benefits

There are many additional benefits that I have observed during my twenty years of practice:

  • It is an effective treatment for unexplained infertility.
  • It offers new hope for patients who are unwilling or unable to conceive with the help of Assisted Reproductive Technology (ART) alone.
  • It relieves physical and emotional stresses associated with infertility and its treatment.
  • It has virtually no short-term or long-term side effects.
  • It is relatively inexpensive and may be covered by private insurance.

Reported Benefits

According to recently published clinical studies (please go to Research section for a comprehensive list of relevant studies and articles), acupuncture and Chinese herbal medicine could significantly:

  • Increase the percentage of normal-form sperm for idiopathic infertility patient.
  • Increase sperm motility and intactness of the axonema.
  • Increase the sperm quality (morphology) .
  • Reduce the existence of sperm antibody.
  • Reduce varicocele.
  • Improve overall quality of sperms (counts, motility and morphology) , and moderately improve azoospermia.
  • Remedy retrograde ejaculation and erectile dysfunction.
  • Reduce sperm disomy (an extra chromosome).

Age and Female Infertility

One of the most common causes of female infertility today is delayed childbearing years, i.e. age. It is a simple fact of life that female fertility decreases significantly after mid thirties. Due to large numbers of my patients are in this category, I wrote the following content specifically for female infertility patients beyond age of 40 or prior to age of 40 but displayed premature sign of aging in their reproductive system.

As we are all keenly aware, even with recent advance in assisted reproductive technology, it is still a great challenge to help this group of women to get pregnant. Acupuncture could be used as an effective complementary and/or alternative therapy to improve their reproductive function and achieve viable pregnancies for this group of women. In our clinical practice, long term acupuncture treatment has been observed to potentially:

  • Improve follicle reserve
  • Reduce FSH readings
  • Improve ovarian response during IVF stimulation
  • Increase success rate of embryo transfer during IVF
  • Raise possibility of natural pregnancy

In other words, high FSH and Premature Ovarian Failure, low follicle reserve or low response to ovarian stimulation medication does not automatically means to an end of a woman’s reproductive function. Over the years, I have helped numerous women in this category to get pregnant, though it is not an easy task, but definitely not impossible.

Chinese Medicine Pathology

As you can imagine, the pathology of female infertility in Traditional Chinese Medicine (TCM) can be very complex. The terms used in TCM, such as Kidney, Liver and Blood, have different meanings from those of Western medicine, and are capitalized here to show that the meaning isn’t the same. They are widely used for lack of better translations. If you’d like to learn more about TCM and infertility, refer to the books recommended in Resource – Book – Infertility section of our website.

According to a study published in the Journal of Traditional Chinese Medicine, liver Qi (vital energy) Stagnation and Kidney Deficiencies account for 51.7% and 22.4% of female infertility patients. This conclusion is hardly surprising when you consider current lifestyles and the demography of many female infertility patients. Liver Qi Stagnation is often associated with stress, a sedentary lifestyle, and a greasy diet. Kidney (whether Yin, Yang or Essence) Deficiency on the other hand is often the result of a very demanding lifestyle and the natural process of aging.

These percentages confirm my own clinical observation which is that younger infertility patients tend to have Liver Qi Stagnation and older (over 40) patients tend to have Kidney Deficiency. However, it’s important to understand that this finding is just one piece of the puzzle as almost all fertility patients show more than one pattern.

Kidney – One of the major functions of the Kidney is to store the Kidney Jing (the Essence of life), which includes Prenatal Jing (inherited from parents, and not replaceable) and Postnatal Jing (acquired from food and replaceable). The Kidney Jing can be transformed into Blood and Kidney Qi, which becomes the source of human growth, development and reproduction.

According to Chinese medicine, the variation of Kidney Jing supply produces significant physiological changes in a woman’s life every seven years. At 7, a girl starts to mature into a young woman; at 14, she has her first menstruation and is able to conceive; at 21 and 28, she reaches her most fertile years; at 35, her fertility starts to diminish; at 42, her fertility is mostly lost and at 49, a woman’s Kidney Jing is depleted, and therefore, she has her menopause.

Liver – two of the major functions of the Liver are to regulate Qi and Blood and to store Blood

Spleen – The main functions of the spleen are to transform food nutrients to Qi, Blood and Postnatal Jing, to maintain proper humidity in the body and to keep the Blood circulating within the Vessels.

According to TCM theory, the Liver plays a vital role in the reproductive system. Liver Qi moves the Blood and stagnation of Liver Qi is likely to cause Blood Stasis. In time, Blood Stasis may cause endometriosis, uterine fibroids and ovarian cysts, dysmenorrhoea, irregular menstruation and scanty menstruation, which are all known contributors to female infertility.

The Kidney is the most important organ in the reproductive system, and any aspect of Kidney deficiency, whether Yin, Yang or Essence Deficiency often leads to amenorrhea, anovulation, a small uterus, thin endometrium, low ova quality and premature ovarian failure.

The Spleen is also a very important organ in the reproductive system. Unfortunately, over eating of cold, uncooked food, cold climate, unrestrained consumption of sweet food, overactive mind and not active body life style all negatively affected Spleen health. It is very common in clinical setting to see patients with various level of Spleen deficiency. A deficient Spleen is likely to cause scanty or abundant menstruation, spotting, prolonged menstruation, repeated miscarriages etc.

Best of East & West

In a very general sense, Chinese medicine can be more effective in the treatment of infertility caused by functional anomalies. Advanced assisted reproductive technologies are very good tools for the treatment of structurally related infertility.

Overall, an integrated approach provides the best of both worlds for our age-related female infertility patients.

Case study

Over the years, I have successfully treated numerous age-related female infertility patients with remarkable success. Some patient case information is provided to demonstrate the therapeutic potential of long-term acupuncture and Chinese herbal medicine treatment for age-related female infertility patients. (Real names are not used to protect the identity of these patients):

Age Name/Occupation History, Diagnosis & Previous Treatments TCM Diagnosis
45 Laura
Massotherapist		 Unexplained infertility. No previous treatments Spleen & Kidney Yang deficient
43 Louise
Financial
Analyst 		3 miscarriages, unexplained infertility/unsuccessful hormonal treatment Kidney & Liver Yin deficient
37 Cathy
Lawyer 		Premature menopause, FSH 30.9 with 2 miscarriages Liver Qi stagnant, Spleen deficient, Heat & Dampness accumulation
35 Mirela
Software Engineer 		2 IVF failed, 1 IVF cancelled, FSH 50, irregular menstruation Kidney Qi and Essence deficient
40 Chantal
Teacher 		Hypothyroidism blocked fallopian tubes, 5 IUI & 2 IVF all failed (1 ectopic pregnancy). Kidney and Spleen Qi deficient
41 Paula
Travel Agent		 1 miscarriage, 7 failed IUI, FSH 15.3, 1 Failed IVF, Kidney and Spleen Qi deficient
42 Paula
Travel Agent 		1 failed IUI, 1 cancelled IVF due to poor response to IVF stimulation Kidney and Spleen Qi deficient
39 Sylvia
Singer 		4 Failed IVF with frozen embryos. Kidney and Spleen Qi deficient

Chinese Medicine Treatment

One of the most important principles in TCM is called Bian Zhen Shi Zhi (辨证施治), which means “to identify and treat the root cause for each patient”. The following section contains more information concerning the common pathologies and treatment orientations of female infertility:

TCM Pathology Typical Symptoms Potential Causes
Kidney Yang Deficiency Inability to conceive, prolonged menstrual cycles, small volume of pale menstrual discharge (in some cases amenorrhea), accompanied by dull complexion, lassitude, cold extremities, lower backache, and weakness of the legs, poor libido, copious clear urine, and formless stools. Overexposure to cold weather, overeating of cold food, constitutional deficiency, stressful and sedentary lifestyle.
Kidney & Spleen Deficiency In addition to all symptoms for Kidney Yang Deficiency, low appetite, bloating, frequent loose stool, cold sensation in mid and lower abdomen. In addition to all symptoms for Kidney Yang Deficiency, low appetite, bloating, frequent loose stool, cold sensation in mid and lower abdomen. Same as the above.
Kidney Yin Deficiency Inability to conceive, shortened menstrual cycles, a scanty menstrual discharge that is red in color and contains no blood clots, emaciation, weak aching lower back and legs, dizziness and vertigo, blurred vision, palpitations, insomnia, dry mouth, and afternoon fever. Constitutional deficiency, chronic disease, abortions and miscarriages, multiple childbirths, overly taxing lifestyle, drug abuse, aging, and chronic malnutrition.
Liver Qi Stagnation Inability to conceive, irregular menstrual cramps, difficult menstrual flow, scanty dark menstrual discharge containing blood clots, premenstrual breast or abdominal distention, depression and irritability. Mental stress, sedentary lifestyle, substance abuse (cigarette, alcohol, medication, drugs…), large consumption of medication, stressful life and sedentary style.
Phlegm-Damp Obstruction Inability to conceive, overweight, prolonged menstrual cycles, amenorrhea in severe cases, copious thick vaginal discharge, pale complexion, dizziness and vertigo, palpitations, and nausea. Overweight, overexposure to cold weather, overconsumption of cold food (in temperature and energetically).
Blood Stasis Inability to conceive, prolonged menstrual cycles, scanty blackish purple menstrual discharge with blood clots, menstrual cramps, lower abdominal pain, aggravated by palpation. Overexposure to cold weather, overconsumption of cold food, sedentary lifestyle, and chronic malnutrition.

Chinese & West Medicine Pathology

As you can imagine, the pathology of male infertility in TCM can be very difficult to understand. The terms used in TCM, such as Kidney, Liver, and Blood, have different meanings from those of Western medicine, and are capitalized to differentiate. These terms are widely used due to lack of better translations. If you’d like to learn more about TCM and its infertility treatment, please refer to the four books recommended at the end of this article.

According to TCM theory, the Kidney is the most important organ in the male reproductive system, and any aspect of Kidney Deficiency, whether Yin, Yang, or Essence Deficiency, often leads to male infertility or contributes to unexplained infertility.

To facilitate the understanding of this complex subject, I have correlated the pathologies of male infertility per Western medicine and TCM :

  • Infection of reproductive system – Damp-Heat accumulation in Lower Burner or Liver/Gall Bladder meridian.
  • Varicocele- Blood & Qi stasis blocking collaterals.
  • Blocked ejaculatory ducts – Blood & Qi stasis blocking collaterals.
  • Autoimmune factor – Liver & Kidney both deficient, Damp-Heat downward attack, Blood stasis blocking collaterals,
    Kidney Yang deficient.
  • Poor motility – Kidney Yang deficient.
  • Poor morphology – Damp-Heat complicating Kidney Essence
  • Low count – Kidney Essence deficient
  • Azoospermia (no sperm) – Kidney Yang deficient, Kidney Essence deficient, Kidney & Spleen both deficient, Damp-Heat downward attack and Blood stasis blocking collaterals.
  • Low semen volume – Kidney Essence deficient, Kidney Yin deficient
  • Poor liquefaction – Hyperactive Yang due to Ying deficiency, Damp-heat downward attack.
  • Impotent – Liver Qi stagnation, Kidney Qi deficient, Damp-heat downward attack.
  • Premature ejaculation – Kidney Qi deficient.
  • No ejaculation – Blood & Qi stasis blocking collaterals, Kidney Qi deficient.
  • Retrograde ejaculation – Liver Qi stagnation, Kidney & Spleen both deficient.

It may still seem to be an daunting task to understand the pathologies of male infertility, but it is actually pretty simple: there are only deficient, replete, and deficient and/or replete – three types of pathologies. Accordingly, there are only three governing treatment principles – replenish the deficiency, deplete the repletion, and prioritize the treatment if deficiency and repletion are both present. In my experience, Kidney Yin, Yang, and Essence deficiency, Damp-Heat accumulation, and Blood & Qi stagnation are the four most common pathologies of male infertility

Safety and Controversy

The safe practice of acupuncture and herbal medicine has been meticulously recorded over two millennia in China. Today, well-developed acupuncture treatment protocols used to complement modern ART have been tested in clinical studies to ensure their efficacy and safety.

Chinese herbal medicine is also safe and even more versatile and potent than acupuncture. It is much less known and therefore much less used, even by many acupuncturists in Quebec.

Some patients and fertility doctors have unfounded fears of these herbs interfering with fertility procedures and drugs. If used expertly in conjunction with acupuncture, they are truly a powerful tool in the treatment of female infertility. Personally, I have been using herbal powders in my clinic since 1995 and have never found any adverse reactions.

Success Rate

I have been asked countless times about the success rate of acupuncture to treat female infertility. Unfortunately, I can’t offer a straight and definitive answer to this question. Presently, there aren’t any sizable, randomized and controlled clinical studies available to prove the efficacy of acupuncture in the treatment of female infertility. The absence of such studies is probably due to a lack of funding.

Currently, many infertility patients come for acupuncture treatment after they have exhausted all other options, and these are often the most difficult cases to treat. Until there are randomized, controlled studies to make a fair comparison between the efficacy of acupuncture and various ART techniques, no meaningful comparison can be made. In my clinical observation, although the numbers below are not statistically significant, they do show that acupuncture treatment certainly does not lack for success in the treatment of female infertility. For an example, from May to June 2006, I am pleased to report that there were eighteen pregnancies in my clinic. Eleven of these patients used acupuncture and herbal medicine exclusively and were treated from a few weeks to over a year. The other seven patients received ART treatment, mostly IVF, in addition to acupuncture and herbal medicine.

In addition, successful treatments also largely depend on the knowledge and experience of the individual practitioner. In Quebec, the minimum requirement for an acupuncturist is a three-year CEGEP degree, which is only offered at Rosemont College, but Chinese herbal medicine is not part of the curriculum. Personally, I think that it takes minimum five years of full time clinical practice in TCM gynecology, for a TCM university graduate to be reasonably proficient in infertility treatment. To increase the level of expertise of acupuncturists in this field, L’ordre des acupuncteurs du Quebec has mandated me to conduct an educational seminars, named “Treating female infertility with acupuncture”, in April of 2011.

Due to increase awareness among potential patients and infertility specialists, there is a growing number of patients seeking acupuncture treatment early in the fertility treatment process rather than making it a solution of last resort, in the last a few years. This change should have a very positive impact on the results offered by acupuncture and Chinese herbs.

Alternative to IVF

For infertility patients, who chose not to use ART for financial, religional, moral, personal reference or health reasons, acupuncture and Chinese herbal medicine is an effective alternative. In my clinic, roughly half of patients got pregnant without using ART.

It seems that younger, better educated infertility patients and whose who had benefited from TCM in their first pregnancy are more likely to use acupuncture and Chinese herbal medicine exclusively.

Complementary to IVF

Doing acupuncture pre and post ET is currently one of the most studied, publicised and well-known form of acupuncture application in infertility treatment. However, by far, it is not the only one.

The protocols for using acupuncture and herbal medicine to support fertility treatment are clearly explained in a book titled Acupuncture & IVF by Lifang Liang (see Resource – Book – Infertility). Treatments complementary to IVF involve three phases: Pre-IVF, During IVF and Post-IVF.

In the Pre-IVF phase, weekly acupuncture is recommended for at least three months to alleviate the side effects of medical treatments, increase the response to hormonal stimulation and improve the patient’s reproductive organs and overall health.
In the 2nd phase, for the duration of the IVF treatment, weekly acupuncture plus pre & post transfer acupuncture is recommended. This will increase blood flow to the uterus and ovaries, reduce the stress response caused by IVF and calm the uterus to facilitate implantation.

In the Post-IVF phase, weekly acupuncture for up to three months is recommended for pregnant patients to reduce their risk of miscarriage and ectopic pregnancy. It is essential for patients with a history of miscarriage and ectopic pregnancy to receive treatment during this phase.

In my clinical practice, the above protocol can easily be modified to accommodate just about any Assisted Reproductive Technologies, such as IVF and IUI procedure.

Clinical Practice

Unlike scenarios presented in these clinical studies, TCM doctors usually want to have a minimum of three month of weekly treatment before IVF.

There are many additional benefits that I have observed during my twenty five years of practice:

  • It is an effective treatment for unexplained infertility.
  • It has many desirable effects, such as a regulated menstrual cycle, reduced premenstrual syndromes (PMS), relieved physical and emotional stresses associated with infertility and subsequent treatment, and improved overall health.
  • It has no short-term or long-term side effects.
  • It offers new hope for patients who are:
    1. unable to conceive with the help of ART alone;
    2. can’t afford ART treatment
    3. unwilling to use ART technique due to religional, moral or health conditions.
  • It is relatively inexpensive and is often covered by private insurance, or even public insurance in British Columbia.

Clinical Studies

As an acupuncturist, who had 8 years of education and over 30 years of clinical experience in both Chinese and Western medicine, I watched these clinical studies with a mixed feeling.

On one hand, they popularized the application of acupuncture in the mainstream medical establishment and raised its credibility and awareness among medical professionals and patients.

On the other hand, most of these clinical studies completely ignored many fundamentals of TCM and only used a very limited sets of acupoints rigidly in the search of some “miracle combination of acupoints” to boost the IVF pregnancy rate. It should not come as a surprise that sometimes these clinical studies produced less-than-optimal results. Consequently, many fertility specialists are still hesitate to recommend acupuncture as a complementary therapy to patients. However, most fertility doctors could agree with the findings of a meta-analysis published in British Medical Journal: Acupuncture around ET is safe, makes patients feel better and may increase the success rate of IVF.

As of 2012, the trend is pretty clear, infertility clinics that encourage patients to do Pre and Post ET acupuncture are increasing. I and my colleagues in Sinocare have performed acupuncture in all six infertility clinics in Montreal and sometimes several times a week.

Ten years ago, I probably saw a handful of infertility patients a year and none of them were referred by fertility clinics. Today, I see the same amount of infertility patients in less than an hour. To me, this is nothing short of monumental change.

If two acupuncture sessions, one before and one after embryo transfer during IVF, are proven to increase pregnancy rate by 43.43%, imaging what long term acupuncture and Chinese herbal medicine treatment could do for you in treating infertility.

Chinese Medicine Pathology

As you can imagine, the pathology of female infertility in Traditional Chinese Medicine (TCM) can be very complex. The terms used in TCM, such as Kidney, Liver and Blood, have different meanings from those of Western medicine, and are capitalized here to show that the meaning isn’t the same. They are widely used for lack of better translations. If you’d like to learn more about TCM and infertility, refer to the books recommended in Resource – Book – Infertility section of our website.

According to a study published in the Journal of Traditional Chinese Medicine, liver Qi (vital energy) Stagnation and Kidney Deficiencies account for 51.7% and 22.4% of female infertility patients. This conclusion is hardly surprising when you consider current lifestyles and the demography of many female infertility patients. Liver Qi Stagnation is often associated with stress, a sedentary lifestyle, and a greasy diet. Kidney (whether Yin, Yang or Essence) Deficiency on the other hand is often the result of a very demanding lifestyle and the natural process of aging.

These percentages confirm my own clinical observation which is that younger infertility patients tend to have Liver Qi Stagnation and older (over 40) patients tend to have Kidney Deficiency. However, it’s important to understand that this finding is just one piece of the puzzle as almost all fertility patients show more than one pattern.

Kidney – One of the major functions of the Kidney is to store the Kidney Jing (the Essence of life), which includes Prenatal Jing (inherited from parents, and not replaceable) and Postnatal Jing (acquired from food and replaceable). The Kidney Jing can be transformed into Blood and Kidney Qi, which becomes the source of human growth, development and reproduction.

According to Chinese medicine, the variation of Kidney Jing supply produces significant physiological changes in a woman’s life every seven years. At 7, a girl starts to mature into a young woman; at 14, she has her first menstruation and is able to conceive; at 21 and 28, she reaches her most fertile years; at 35, her fertility starts to diminish; at 42, her fertility is mostly lost and at 49, a woman’s Kidney Jing is depleted, and therefore, she has her menopause.

Liver – two of the major functions of the Liver are to regulate Qi and Blood and to store Blood.

Spleen – The main functions of the spleen are to transform food nutrients to Qi, Blood and Postnatal Jing, to maintain proper humidity in the body and to keep the Blood circulating within the Vessels.

According to TCM theory, the Liver plays a vital role in the reproductive system. Liver Qi moves the Blood and stagnation of Liver Qi is likely to cause Blood Stasis. In time, Blood Stasis may cause endometriosis, uterine fibroids and ovarian cysts, dysmenorrhoea, irregular menstruation and scanty menstruation, which are all known contributors to female infertility.

The Kidney is the most important organ in the reproductive system, and any aspect of Kidney deficiency, whether Yin, Yang or Essence Deficiency often leads to amenorrhea, anovulation, a small uterus, thin endometrium, low ova quality and premature ovarian failure.

The Spleen is also a very important organ in the reproductive system. Unfortunately, over eating of cold, uncooked food, cold climate, unrestrained consumption of sweet food, overactive mind and not active body life style all negatively affected Spleen health. It is very common in clinical setting to see patients with various level of Spleen deficiency. A deficient Spleen is likely to cause scanty or abundant menstruation, spotting, prolonged menstruation, repeated miscarriages etc.

Conclusion: Male Infertility

There is no doubt that acupuncture has been gaining support from patients and even some fertility specialists. More infertility patients are coming much earlier in the process, and many fertility clinics have started routinely recommending acupuncture to their patients.

Finding an experienced acupuncturist and faithfully following the requirements— whether it’s changing your lifestyle, drinking bitter herbal teas or receiving regular acupuncture treatments for many months at a time – are the keys to successful male infertility treatment.