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The Role of Chinese Medicine & Acupuncture for IVF & Fertility

What is the role of Chinese medicine and acupuncture for IVF and fertility? This article will shed light on some of the history of Chinese medicine in addressing women’s health and hormones. Research articles will be cited which demonstrate the potential for acupuncture and Chinese herbal medicine for fertility and IVF support. We will also cover some Chinese medicine dietary lifestyle tips to help improve your fertility journey.

Background on IVF

In-vitro fertilisation (IVF) refers to a series of medical interventions which assist an individual or couple in successfully conceiving a child. IVF is often needed as a result of prolonged difficulties with conception or failure to reach full term in pregnancy. This could be due to age, genetics, underlying health conditions, hormonal or cycle issues, and diagnosed conditions such as endometriosis, polycystic ovarian syndrome (PCOS) or cancer. IVF is also a treatment option for men who face reproductive issues such as low sperm count and motility, abnormal morphology, or high levels of sperm antibodies which prevent the sperm from successfully fertilising an egg. Lastly, IVF is a viable treatment option for individual’s who are single or in a same-sex relationship.

Although IVF is widely accepted as the standard practice for infertility, many women who have experienced more than one round of IVF cycle will attest that the process can often feel stressful and taxing both emotionally and financially. As a result, it is common to look towards adjunctive treatment options which can support conventional IVF treatments.

What does Chinese medicine say about fertility?

Chinese Medicine has a long history of treating underlying women’s health concerns which is backed by empirical evidence and growing clinical research. There are dedicated Chinese medical texts that address women’s menstrual cycle and pregnancy related conditions, which today encompasses fertility. One of the oldest texts, called the Essential Prescriptions from the Golden Cabinet (Han Dynasty 25-220AD), contains various Chinese herbal formulas that address irregularities with the menstrual cycle, PMS, threatened miscarriages and other pregnancy related conditions such as nausea, reflux, and spontaneous bleeding. According to modern day Chinese medicine principles, the causes of these medical conditions is due to an imbalances of the five elements, internal organs and Yin-Yang balance in the body.

Acupuncture IVF

In terms of Chinese medicine diagnosis, there are many diagnostic patterns for women’s hormone and fertility concerns. Patterns such as Liver Qi stagnation, internal Cold-Dampness, internal Damp-Heat, chronic Blood stasis, Kidney Yin and Yang deficiency and Blood deficiency are amongst the most common patterns diagnosed in clinic. These patterns are often a result of constitutional tendencies, dietary and lifestyle factors, chronic stress, trauma and prolonged emotional disturbances.

It is essential to seek out a qualified practitioner of Traditional Chinese Medicine who can carefully assess your symptoms, pulse, and tongue diagnosis, and discern the Chinese medicine pattern which is leading to fertility difficulties. After careful consideration, your practitioner will give you an individualised acupuncture treatment or prescribe a Chinese herbal formula. Specific Chinese medicine dietary lifestyle suggestions are also important aspects in treatment.

Acupuncture and IVF research

There is now emerging clinical evidence which demonstrates acupuncture is an effective adjunct therapy for IVF. Much of the clinical research has been used to study the effects of standardised non-individual acupuncture treatments for patients either undergoing IVF or those who are not under any current medical intervention. A research paper in the Acupuncture in Medicine Journal was conducted to review current research in acupuncture for in-vitro fertilisation outcomes. They reported,

“evidence suggests several acupuncture sessions improve endometrial thickness, reduce stress, and improve patient satisfaction. Observational studies suggest more sessions are associated with increases in clinical pregnancy and live birth rates”.

Hullender Rubin LE, Anderson BJ, Craig LB. Acupuncture and in vitro fertilisation research: current and future directions. Acupunct Med. 2018;36(2):117-122

A systematic review and meta-analysis in the Archives of Gynaecology and Obstetrics was conducted to explore the therapeutic effect of acupuncture on the outcomes of IVF. They assessed women undergoing IVF in randomised controlled trials (RCTs) and specifically evaluated the effects of acupuncture on IVF outcomes. Their systematic review concluded that,

 “Based on an analysis of the studies, acupuncture improves the clinical pregnancy rate among women undergoing IVF.”

Qian Y, Xia XR, Ochin H, et al. Therapeutic effect of acupuncture on the outcomes of in vitro fertilization: a systematic review and meta-analysis. Arch Gynecol Obstet. 2017;295(3):543-558

A cohort study in Reproductive Biomedical Online looked at the impact of whole systems Traditional Chinese Medicine on IVF outcomes. That is to say, whole Chinese medicine therapies were used, instead of isolating treatment to only acupuncture or only herbs for IVF. The authors concluded that,

“Overall, IVF with adjuvant Whole Systems-Traditional Chinese Medicine was associated with greater odds of live birth in donor and non-donor cycles. These results should be taken cautiously as more rigorous research is needed.”

Hullender Rubin LE, Opsahl MS, Wiemer KE, Mist SD, Caughey AB. Impact of whole systems traditional Chinese medicine on in-vitro fertilization outcomes. Reprod Biomed Online. 2015;30(6):602-612.

Chinese herbs for fertility and IVF support

Similar to the studies on acupuncture for IVF support, there is also promising research in the realm of Chinese herbal medicine for successful IVF outcomes. A systematic review in the journal of Complementary Therapies in Medicine was conducted to investigate efficacy of Traditional Chinese Herbal Medicine in the management of female infertility. This is what the authors had to say after conducting their review.

“Our review suggests that management of female infertility with Chinese Herbal Medicine can improve pregnancy rates 2-fold within a 4 month period compared with Western Medical fertility drug therapy or IVF. Assessment of the quality of the menstrual cycle, integral to TCM diagnosis, appears to be fundamental to successful treatment of female infertility”.

Ried K, Stuart K. Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: a systematic review. Complement Ther Med. 2011;19(6):319-331.

Chinese herbs for fertility

Furthermore, a 2015 meta analysis of more than 4200 women taking Chinese herbal medicine, found a two-fold improvement of pregnancy rates over four months compared to Western medicine. Trials included women with endometriosis, PCOS, fallopian tube blockage, anovulation or unexplained infertility. Their conclusion was,

“Chinese herbal medicine can improve pregnancy rates 2-fold within a 3-6 month period compared with Western medical fertility drug therapy. In addition, fertility indicators such as ovulation rates, cervical mucus score, biphasic basal body temperature, and appropriate thickness of the endometrial lining were positively influenced by Chinese herbal medicine therapy, indicating an ameliorating physiological effect conducive for a viable pregnancy”​.

Ried K. Chinese herbal medicine for female infertility: an updated meta-analysis. Complement Ther Med. 2015 Feb;23(1):116-28.​

Lastly, an analysis in the journal Medical Acupuncture was used to investigate acupuncture and Chinese herbal medicine on assisted reproductive treatments, and assessed six cases and their clinical significance. The authors stated,

“These 6 cases demonstrated the positive effect of a combined approach, using acupuncture and herbs to reduce diminished ovarian reserve and regulate hormonal disorders, creating sustainable environments for conceiving and maintaining pregnancy, thus, translating into clinical success. Clinical observation of these cases sheds new light on designing future clinical trials and practice of TCM for practitioners who provide infertility treatments.”

Jiang D, Li L, Wan S, Meng F. Acupuncture and Chinese Herbal Medicine Effects on Assisted Reproductive Technology: Six Cases and Their Clinical Significance. Med Acupunct. 2019;31(6):395-406.

It must be noted that these are only a handful of clinical studies which have been used to assess Chinese herbal medicine and acupuncture for IVF support and fertility. Some trials have shown inconsistencies in the past, which could be due to numerous factors. Therefore it is essential that more rigorous clinical trials and systematic reviews are performed. However, based on our current level of research, it is likely that Traditional Chinese medicine is an effective adjunctive tool for fertility and IVF, and empirical evidence supports this in clinic.

Common acupuncture points

In the clinic, there are many points which we can use to target fertility. Common points chosen include Liver 3, Spleen 4, Conception Vessel 4 and Heart 5. These points can be easily located on yourself and stimulated using gentle acupressure for 5mins each day.

Liver 3:

This point is located between the 1st and 2nd toe and close to where both the bones meet. It clears Liver Qi Stagnation and is great for individuals who are chronically stressed, irritable, have menstrual irregularities or pre-menstrual symptoms, and are prone to digestive concerns when stressed. Please note that this point should not be stimulated during pregnancy.

Spleen 6:

Regarded as one of the quintessential points for all gynaecological disorders, Spleen 6 (SP6) is known as the “Three Yin Channel Crossing” point. It is a very commonly used in clinic for patients with menstrual irregularities, fluid retention, digestive concerns, chronic urinary disorders or UTI’s, and painful or interrupted periods. This point is located approximately 3-4cm above the inner ankle bone on most people, and for many women can feel a little tender to touch. Similar to Liver 3, this point should not be stimulated after successfully falling pregnant.

Spleen 6 acupuncture point for fertility

Conception Vessel 4:

This point is located approximately 2 centimetres above the pubic bone and is often used in fertility support due to its function to benefit the uterus, regulate menstruation, tonify the Kidney energy and assist conception.

Heart 5:

This is one of the points almost everyone requires in modern times! Heart 5 is located on the inner wrist approximately 1.5cm from the wrist crease. It is mainly used for emotional or stress related concerns. When assisting a woman through IVF, Heart 5 is often used post-embryo transfer to settle emotions. As the wait time for the hCG blood test is approximately 10-14 days, most patients will schedule 1-2 acupuncture treatments during this period to ease stress, anxiety and regulate sleep.

Heart 5 acupuncture point

What else can you do?

Aside from working with an IVF specialist and allied health professional, it is also important to optimise one’s diet and lifestyle. Many of the suggestions listed can be also applied to most conditions and people as these are considered fundamental aspects to improving health and wellbeing from a Chinese medicine perspective.

Exercise

It is recommended to exercise for at least 20-40mins a day to move the Qi and Blood and prevent emotional stagnation.

  • This could be a gentle walk, weightlifting, swimming, yoga or Pilates, Tai chi or Qi Gong. But most importantly, find something that you enjoy and stick with this. If you haven’t regularly exercised, then start slow and build yourself up, and always consult your general practitioner if you have any health concerns which may affect your ability to perform certain exercises.

Sleep

Regarded as one of the cornerstones to good health, it is essential to regulate one’s sleep cycle. If you suffer from insomnia or disturbed sleep patterns, you can try some of these suggestions:

  • Avoid screen use at least 45mins before bed and instead listen to some gentle music, read or listen to an audio book, meditate or do some self-care routine in low level lighting.
  • To optimise sleep, try to make your room as dark as possible with no external light coming into your bedroom.
  • Avoid consumption of alcohol for at least 3 hours before bed – although some individuals may use alcohol to help get to sleep, it often leads to decreased sleep quality, as well as having numerous other harmful effects on the body, including fertility.
  • Try to sleep at regular times every night and wake at the same time each morning.
  • Sleeping with your feet uncovered can be useful in regulating your core body temperature and allow for a deeper sleep.
  • Clinical research indicates that magnesium may be an effective supplement to help reduce stress, anxiety, and insomnia. Always consult your GP or trusted allied health professional before taking a new supplement.

Diet:

Listed below are some general considerations regarding diet which are very useful in regulating digestion and sustaining balance of the internal organs to assist with fertility, according to Chinese medicine principles.

  • Eat seasonally – that is predominately consume vegetables and fruit which are grown in season.
  • Consume your meals at regular times of the day and in a relaxed state.
  • Avoid excessive intake of raw, cold foods such as cold smoothies and juices, raw salads, and dairy.
  • Focus more on eating a rich variety of steamed or cooked vegetables, soups and healing broths.
  • Try and aim for a balance of the Five Flavours according to Chinese Medicine, which are Sour, Bitter, Sweet (and Bland), Pungent and Salty. Avoid eating any one flavour to excess, which in most cases are the sweets foods!
  • For Blood deficiency individuals who are prone to anaemia, cold hands and feet, aversion to cold, fatigue, pale complexion and low mood, it is best to consume more lamb, beef, pate’ and red coloured foods such as beetroots, cherries and tomatoes.
  • Consume water on a regular basis to stay hydrated but avoid consuming fluids to an excess, unless otherwise specified by your general practitioner.
  • If not suffering from histamine overload, daily bone broth consumption can be wonderful to tonify the Blood, Yin and Kidney energy which are critical for optimising fertility according to Chinese Medicine. You can read more about the benefits of bone broth + a basic recipe here.

Stress

Last, but certainly not least, is stress reduction. Stress is so often involved with fertility concerns in the clinic, especially as chronic stress and emotional disturbances can lead to Liver Qi Stagnation and disrupt the cycle. To help reduce stress, you can try some of these things.

  • Exercise regularly
  • Practice meditation or mindfulness
  • Reach out to friends and family and talk about any worries or life stressors
  • Speak with a counsellor or other professional if experiencing pronounced stress, anxiety or depression
  • Practice an art form and find something that you connect with e.g. painting, drawing or pottery
  • Use aromatherapy and music to help you relax
  • Practice gratitude by listing three things every day that you feel grateful for
  • Practice breath work
  • Seek out an allied health professional who can help with stress reduction. This could be massage, acupuncture or energetic based work.
  • Find things and people in life which inspire you or make you happy – slowly incorporate more of these aspects into your life

This article is certainly not an exhaustive look at the role of Chinese Medicine and Acupuncture for IVF and fertility, but hopefully it sheds light on how Chinese herbs, dietary & lifestyle factors, and acupuncture can be used as a adjunctive tool for current fertility medical interventions. If you feel you need assistance on your own health journey, it might be time to book in for a Chinese medicine assessment and see if this ancient form of medicine is right for you.

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