Fertility Acupuncturist - Emiko Kanematsu R.Ac. & R.TCMP

Have you been trying to conceive? If so, you may want to try acupuncture and/or Chinese herbal medicine to increase your fertility and chances of getting pregnant. Does one or more of the following apply to your condition?

I have been trying to conceive for over 12 months (or 6 months if you are over 35 years old)

I was diagnosed with unexplained infertility

I want to conceive naturally

I have irregular menstruation (including too short and too long)

I have a history of miscarriages in the past (especially two or more)

I am in an advanced maternal age (age 35 and older)

I was diagnosed with endometriosis, polycystic ovarian syndrome (PCOS), uterine fibroid(s) or any other gynecological condition

I have been diagnosed with low ovarian reserve (low AFC/AMH, high FSH etc.)

I am going to have an intrauterine insemination (IUI) for the first time

I had a failed IUI(s), and am going for another

I am going to have in-vitro fertilization (IVF) for the first time

I had a failed IVF(s) and I am going for another or want to try to conceive naturally

I had a failed IVF cycle due to poor egg quality

I have a thin uterine lining

I have a short luteal phase (Luteal Phase Defect)

My husband has a sperm/semen problem (please refer "Male Fertility")

My husband has a low libido (please refer to "Male Fertility")

How can acupuncture help your fertility?

It regulates the hormone balance naturally by stimulating the nervous system and acting on the Hypothalamus-Pituitary-Ovarian axis, and hence it regulates menstruation.

It promote the blood flow to the reproductive organs, including the ovaries and uterus, which also helps improve the thickness of the endometrium and implantation. Remember that your own hormones, nutrients from food and supplements you take, oxygen and IVF drugs are all conveyed to the ovaries/eggs by the bloodsteam.

It improves the ovarian function (more production of follicles and better quality eggs) by balancing the hormones and promoting the blood flow to the ovaries. This may help your ovarian function such that less stimulating drugs will be needed.

It reduces stress and makes you feel relaxed by harmonizing and calming the sympathetic nervous system. This is one of the important roles in acupuncture because it is reported that high stress reduces fertility. It also reduces uterine contractions and spasms of the fallopian tubes, which may help increase the success of IVF/IUI and prevent miscarriages.

It reduces miscarriages by balancing hormones, promoting the blood flow (more nutrition for the embryo/fetus), and reducing uterine contractions.

It improves the immune system. Women with immunological factors hostile to pregnancy may be effectively treated with acupuncture and herbal medicine.

It reduces pain after surgical procedures such as egg retrieval and endometrial biopsy by releasing the endorphins (natural pain killer) from the brain.

When should I start treatment? How often do I need treatment?

If you are planning to conceive as soon as possible or have your IVF/IUI soon, you should start receiving treatment right away. Acupuncture and Chinese medicine regulate your body naturally to restore the normal function of your body and therefore it takes longer to see results.

If you are trying to conceive naturally, acupuncture once or twice-a-week with Chinese herbal medicine is recommended. Since the effects of acupuncture generally last only a few days at the beginning of treatment, frequent treatment brings faster results. Chinese herbal medicine is recommended for everyone, but strongly for cases with advanced maternal age, poor ovarian reserve, a history of miscarriages, thin uterine lining, or certain Chinese medicine diagnoses (called differentiation).

Why do you recommend Chinese herbs for fertility?

While acupuncture works on your body by stimulating the nervous system, Chinese herbs work more internally (like food, supplements and drugs). I would say that acupuncture and Chinese herbs work together, but in very different ways. Acupuncture is good at "regulating" and "harmonizing" the body to restore the normal functions of your body through your brain and nervous system; however, when it comes to "replenishing" substances you are lacking such as the qi/vital energy, blood, yin and yang in Chinese medicine, Chinese herbs work better and faster. In the theory of Chinese medicine, your eggs (both quantity and quality), uterine lining (endometrium) and fertile mucus all come from the blood, yin and essence. Chinese herbs work way better at nourishing the blood, yin and essence than acupuncture. If you have a factor of advanced maternal age, poor ovarian reserve or thin uterine lining, you likely have blood yin/essence deficiency (diagnosis in Chinese medicine), which need to be corrected with blood/yin/essence tonics. If you have a short luteal phase and are diagnosed with luteal phase defect (LPD), you may have yang deficiency (diagnosis in Chinese medicine), which can be corrected with yang tonics.

For those who are going for an IVF, Chinese herbs are not recommended with fertility drugs (injectables) because your fertility doctor will likely be opposed to the idea of using Chinese herbs with fertility drugs although it is safe for both medicines to be used together. I strongly recommend starting treatment with acupuncture and Chinese herbs three months BEFORE your IVF cycle so that you have three months to take Chinese herbs. If you are going to have an IUI or a frozen embryo transfer in a natural cycle, Chinese herbs are still recommended, depending on your condition.

If you have regular cycles, a formula of Chinese herbs is often (not always) given depending on the phase of your cycle to enhance your fertility. Here is explanation on what the four phases of your menstrual cycle are and how Chinese medicine (and acupuncture as well) helps your fertility.

Menstrual Phase

This phase starts on the first day of your menstrual cycle and lasts for 3-5 days.

It is important to regulate the menstruation and ensure proper shedding of the uterine lining.

Post-menstrual Phase (Follicular Phase)

This phase starts when your menstruation finishes or is finishing (typically around Cycle Day 4) and lasts until there starts to be evidence that the yin is well established (e.g. vaginal discharge starts to become a little more marked).

The treatment in this phase is focused on supporting the yin, essence and blood for your eggs and endometrium (a bed for a fertilized egg to grow).

The fertile cervical mucus usually starts on average 6 days before ovulation. Some studies have found that the fertile period starts 5 days before ovulation and ends on the day of ovulation, with the greatest chance of pregnancy being 2 days prior to ovulation.

The fertile cervical mucus plays a very important role here for natural conception since it is necessary for allowing the sperm to swim freely through the cervix, protecting them from the acidic environment and nourishing them for a long journey.

Mid-cycle Phase (Ovulation Phase)

It starts when the yin is established (usually Cycle Day 12 if your cycle is 28 days) and lasts for 5 days (2 days before ovulation, on ovulation and 2 days after ovulation).

This phase needs to be focused on supporting an efficient and complete ovulation, including the proper movement of the egg in the tube.

Post-ovulation phase (Luteal Phase)

It starts a couple of days after the temperature has risen on the BBT chart (usually Cycle Day 17 if your cycle is 28 days) and lasts until your menstruation starts.

This phase needs to be focused on supporting implantation, which generally happens between 6 and 9 days (average) after ovulation, and keeping the uterus warm (supporting the yang energy) - your BBT should be elevated for 12-14 days.

If pregnancy does not occur, your temperature will drop and your period will come.

FYI - here is a study on efficacy of herbal treatment for fertility.

Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: a systematic review. Ried and Stuart. Complement Ther Med. 2011 Dec;19(6):319-31 [PMID: 22036524]: "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."

Should I stop acupuncture treatment as soon as I find that I am pregnant?

Acupuncture is safe when it is performed by a qualified acupuncturist and brings a lot of benefits to pregnancy. It can support pregnancy by preventing uterine contractions and helping with the blood circulation in the uterus (this is especially important before a placenta is formed).

For further information, please click here.

Are Chinese herbs safe to take during pregnancy?

Chinese herbal medicine has a long history of use during pregnancy. Chinese herbs are safe to take during pregnancy when they are prescribed by knowledgeable an experienced herbalists.

Chinese herbs may be recommended for severe morning sickness, threatened miscarriage, habitual miscarriages and complicated cases in conjunction with acupuncture.