DR. BERGER’S CORNER: HEALTH TOPICS FROM THE MEDICAL DIRECTOR OF CHA FERTILITY CENTER, LOS ANGELES
Eastern Medicine and Fertility
Using acupuncture and Chinese herbs for fertility
Many couples that come to my facility have been using fertility treatments recommended by their Traditional Chinese Medicine (TCM) providers. Sometimes people are embarrassed or unsure about talking to me about their non-Western treatments. There is always some level of fear or discomfort when discussing this topic with a Western doctor.
Sticking needles in your body and brewing up tea from twigs seems a long way from the highly advanced scientific techniques of the 21st century. If one looks outside of the literature in the United States, however, there are some studies suggesting that acupuncture and traditional Chinese medicine may work. However, rigorous scientific studies are lacking; thus, the majority of Western providers stay away from recommending or co-treating patients.
For instance, there are currently no double-blind placebo controlled studies that have produced or even reproduced findings showing that TCM, such as acupuncture or using Chinese herbs, around the time of natural or assisted conception increases the likelihood of pregnancy.
What is Traditional Chinese Medicine (TCM) for fertility?
Acupuncture is an ancient treatment – a part of Eastern TCM that’s been around for thousands of years. It’s used to treat everything from diabetes to rheumatoid arthritis. In fertility terms it can be used as a stand-alone treatment or used together with herbal remedies. It involves fine needles being inserted into various parts of the body. It is said to help rebalance your Qi (chee), or energy. The needles stimulate key energy points around your body. For Western providers, such as myself, it can be given in a coordinated team approach to personalizing treatment options for each patient.
The Chinese medicine understanding of the menstrual cycle is sophisticated, and involves paying close attention to any changes in the length of the cycle and menstrual bleeding. This is the same for a Western specialist in Reproductive Endocrinology and Infertility. For example, Chinese medicine views a disorder known as polycystic ovary syndrome (PCOS) as a complex combination of different patterns. Ovarian cysts are seen and treated as an accumulation of ‘phlegm damp’ in the uterus, enlarging the ovaries. This pattern is often accompanied by blood stagnation that is responsible for painful menstruation (stabbing pain) and dark, scanty, thick blood. According to TCM, the roots of the disease are both kidney and spleen in origins. Very often a liver qi stagnation, worsened by years of stress or frustration, is added to the mix. In order to treat PCOS, Chinese medicine uses herbs and acupuncture to regulate menstrual cycles, improve digestion, dissolve cysts, promote ovulation, improve egg quality, support conception and prevent a miscarriage when a pregnancy is achieved.
In terms of specific fertility treatments, there is some anecdotal but not mainstream evidence showing that within a 4-month period couples with fertility issues were twice as likely to conceive using TCM than they were when using Western fertility drugs or IVF. The results of the few scientific trials do validate the combination of Eastern and Western approaches. Research in Germany suggested that acupuncture 25 minutes before and 25 minutes after embryo transfer helped the implantation success rate compared to women who didn’t have acupuncture. A different review of studies in 2008 also found that acupuncture around the time of IVF embryo transfer increased the likelihood of pregnancy by 65%.
In Los Angeles, I often work hand-in-hand with an expert TCM provider in order to optimize results for those willing to try this approach. I often speak with patients and discuss the theoretical benefits versus the negative to different treatment approaches. In the end, it is a team approach that best serves each individual. I do stress that either way, the patient is receiving a “treatment”, and that after a certain amount of time there needs to be an assessment of the treatment approach. In the end, if someone has tried TCM for 4 years and is now 40 years old and wants to try Western medicine, I discuss the realities of their situation. By working in conjunction with other providers as part of a team, we can provide each person with the best possible approach to treat their fertility issues.