Acupuncture and Chinese herbal medicine for helping female fertility
Infertility is an important reproductive health issue that affects people worldwide.[1] Western medicine offers several approaches to infertility management including surgery, drugs, in vitro-fertilisation (IVF) and other assisted reproductive technologies (ART).[5] However, the success of these treatments are not always guaranteed and may fail to result in a viable pregnancy and live birth.[6]
Furthermore IVF treatments can be costly and emotionally draining. In these instances, holistic approaches to infertility management such as traditional Chinese medicine (TCM) may be able to assist women experiencing infertility.[7] This alternative therapy is often cheaper and less invasive than the conventional western medical treatment.[8]
Traditional Chinese medicine aims to detect and treat the individual’s underlying imbalances causing the infertility.[11] This can be achieved by observing the pulse, tongue, complexion, general physical and emotional wellbeing as well as menstrual history.[12] In particular, observation of the period cycle including basal body temperature, colour and flow of the menstrual blood, clot formation, mucus changes and any related pain or distension can provide useful information as to the women’s fertility status.[13] A balanced, regular menstrual cycle provides a healthy environment for conception, implantation and maintenance of a viable pregnancy.[14]
Therefore, it is essential that any irregularities in the menstrual cycle and the general health are attended to before conception is attempted.[15] Furthermore, the following symptoms are commonly manifested in women with infertility which include kidney jing (heat) deficiency, spleen qi deficiency, liver qi stagnation, phlegm-dampness or blood deficiency.[16]
Chinese herbal medicine aims to correct these imbalances thereby enhancing the egg quality and other environmental factors such as the quality of the endometrium.[17] Upon completion of the necessary observations, herbal mixtures will be formulated based on the patient’s characteristics and symptoms.
Also, the practitioner may advise on diet and lifestyle, recommending healthy weight management, exercise and a fertility conducive diet.[18] Patients with kidney jing deficiency may be recommended to consume foods such as chicken, fish, eggs, seeds, nuts, ghee, oats, seaweed and full-cream milk.[19] It is also beneficial to warm foods and spices and to engage in food preparation methods such as roasting, grilling, baking and braising.[20]
Resorting to traditional Chinese medicine for diagnosis and treatment of underlying symptoms may reduce time and financial burden of patients experiencing infertility.[21]
Research findings
In 2013, 40 randomized controlled trials (RCTs) involving 4247 women with infertility were conducted to assess the effect of traditional Chinese herbal medicine on pregnancy rates compared with western medicine treatment.[22] From the research, the following conclusion was drawn: “Our review suggests that management of female infertility with 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 CHM therapy, indicating an ameliorating physiological effect conducive for a viable pregnancy.”[23]
Likewise in 2010, a systemic review was taken to assess the effect of traditional Chinese herbal medicine on female infertility and pregnancy rates compared with western medical treatment. The review involved 1851 women with infertility from 8 RCTs, 13 cohort studies, 3 case series and 5 case studies.[24] The participating women were between 18 and 45 years of age, with a mean of 30 years.[25] They experienced infertility on average for 4.5 years.[26] The following conclusion was drawn: “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.”[27][1] S5.
[2] Zegers-Hochschild, F.; Adamson, G.D.; de Mouzon, J.; Ishihara, O.; Mansour, R.; Nygren, K.; Sullivan, E.;
van der Poel, S. The International Committee for Monitoring Assisted Reproductive Technology (ICMART)
and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009. Hum. Reprod. 2009,
24, 2683–2687
[3] Mascarenhas, M.N.; Flaxman, S.R.; Boerma, T.; Vanderpoel, S.; Stevens, G.A. National, regional, and global
trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med. 2012, 9,
e1001356.
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[7] Alfred A, Ried K. Traditional Chinese Medicine – women’s experiences in the treatment of infertility. Aust Fam Physician 2011; 40:718 – 22; Ried K, Afred A. Quality of life, coping strategies and support needs of women seeking Traditional Chinese Medicine for infertility and viable pregnancy in Australia: a mixed methods approach. BMC Women’s Health 2013; 13:17.
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[10] S1.
[11] S2.
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[13] S1.
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[17] S1.
[18] S1.
[19] Kastner J. Chinese Nutrition Therapy. Dietetics in Traditional Chinese Medicine (TCM). 2nd ed. Stuttgart, New York: Thieme; 2009.
[20] Kastner J. Chinese Nutrition Therapy. Dietetics in Traditional Chinese Medicine (TCM). 2nd ed. Stuttgart, New York: Thieme; 2009.
[21] S1.
[22] S1.
[23] Ried K1, Chinese herbal medicine for female infertility: an updated meta-analysis. Complement Ther Med. 2015 Feb;23(1):116-28. https://www.ncbi.nlm.nih.gov/pubmed/25637159, [Accessed , 15 May. 2018].
[24] S2.
[25] S2.
[26] S2.
[27] 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): 319-31. https://www.ncbi.nlm.nih.gov/pubmed/22036524, [Accessed , 15 May. 2018].
