Though traditional Chinese medicine is an ancient science it can be adapted to support patients undergoing IVF. As a result we have seen some clinical trials overseas used to show the effectiveness of IVF being supported by acupuncture.

It is said in Traditional Chinese medicine (TCM), “Look at a women’s cycle and you will know everything about her”. Bearing this saying in mind, PMT is like a barometer for how stressed, tired and unhealthy a woman is feeling that month. In this way it is a useful feedback mechanism to assist women in knowing that life is a bit too hectic and health and lifestyle issues need to be addressed. The more severe the PMT symptoms, the sooner health and lifestyle issues need to be tackled.

A TCM consultation is designed to diagnose exactly what is going on with each woman’s individual constitution. PMT will manifest in a variety of symptoms depending on a woman’s inherited constitutional strengths and weaknesses. An understanding of this allows for a tailored treatment and better results. Traditional Chinese medicine addresses PMT very well.

Quote from the Yellow Emperor’s Classic of Internal Medicine,
“Ch'i Po answered:” When a girl is seven years of age, the emanations of the kidneys become abundant, she begins to change her teeth and her hair grows longer. When she reaches her 14th year she begins to menstruate and is able to become pregnant and the movement in the great thoroughfare pulse is strong. Menstruation comes at regular times, thus the girl is able to give birth to a child.

When the girl reaches the age of 21 years the emanations of the kidneys are regular, the last tooth has come out, and she is fully grown. When the woman reaches the age of 28, her muscles and bones are strong, her hair has reached its full and her body is flourishing and fertile.

When the woman reaches the age of 35, the pulse indicating the ‘sunlight’ deteriorates, her face begins to wrinkle and her hair begins to fall. When she reaches the age of 42, the pulse of the three regions of the Yang deteriorates in the upper part of the body, her entire face is wrinkled and her hair begins to turn white.

When she reaches the age of 49 she can no longer become pregnant and the circulation of the great thoroughfare pulse is decreased. Her menstruation is exhausted, and the gates of menstruation are no longer open; her body deteriorates and she is no longer able to have children.” (Translated by I Veith, University of California Press, Berkeley, 1949, pp. 98-99.)

IVF studies show that there is a decline in fertility after the age of 35. In this classic text (thought to be over 2000 years old) 35 is also a turning point in a woman's fertile cycle. The text suggests that women finish being able to conceive at 49 years of age. Interestingly for me the oldest women I have seen conceive naturally was 48 years of age.

There are two interesting discussions on this topic in the IVF circles.

The first, by Professor Jansen (Jansen et al, 1999), cites studies that suggest that women between 40 and 45 years of age have a 10% chance of conceiving naturally and a 6% chance of conceiving using IVF. The next point that he makes is that women in this age group who have embryos that develop to the blastocyst stage have the same chance of conceiving as a woman of a younger age group.

The second discussion of note was initiated by a study done in London. (Lass et al, 1998.) This study showed that pregnancy rates were significantly lower in women over 40 years of age compared to women less than 40 years of age and pregnancy rates decreased sharply in women over 42 years of age. No women over 45 years of age conceived. The pregnancy rate when only one embryo was available for transfer was 3.3%.

Both these studies highlight the need for women to prepare their bodies to improve their chances of conceiving whether it is naturally or whether it is through IVF. General health dictates the outcomes. General health is the difference between one woman conceiving and delivering a healthy baby and another woman not.

1. Transmission of the Mitochondrial Genome”, in R. Jansen & D. Mortimer (Eds.) (1999) Towards Reproductive Certainty, Parthenon Publishing Group, New York.
   
2. Lass, A., Croucher, C. (1998). “One thousand initiated cycles of in vitro fertilisation in women ≥40 years of age”, Fertility and Sterility, 70:1030-4.

Background

One in six couples experience infertility. (6.12.) Of this group, 40 percent is caused by a male factor, 40 percent is related to a female factor and 20 percent is a combination of both male and female causes. (12.13.14.)

Studies show that male sperm counts are declining and abnormal sperm morphology is increasing. (1.6.) Other studies suggest that there is a correlating associated increase in testicular cancer, cryptorchidism and hypospadias. (6.11.16.) Male fertility declines with age and sperm are more likely to be abnormal. (6.)

Medical diagnosis suggests that the major causes of infertility are ovulation disorders; (9.35.) male infertility, which includes sperm count < 20 million per ml, abnormal sperm numbers > 70 percent, sperm motility < 30 percent, sperm antibodies, disorders of ejaculation, spermatogenesis and obstruction of the vas deferens; female tubal blockage; endometriosis; and fibroids. ( 3.5.16) Between 10 percent and 30 percent of couples are diagnosed with unexplained or unknown causes of infertility. (5.6.) The author of the proposed study has a clinical experience closer to 45 percent.

The percentage of each type of infertility documented varies between studies and populations. (6.) “Lack of standardization in analytic methods for assigning infertility data is attributed to inadequate classification of fertility problems and a lack of consistent methodology in evaluating outcome of infertility therapy.” (2.)

Within the medical diagnostic framework, the pathologies that cause male and female infertility are not well understood. These pathologies include ovulation disorders, endometriosis, fibroids or low sperm count. As a result, infertility and miscarriage are often undiagnosed and there are few treatment options.

In contrast, Traditional Chinese Medicine (TCM) has long had an appreciation of the causes of infertility and the treatment of infertile men and women through acupuncture, Chinese herbal medicine, diet, lifestyle and prevention. “The time period for diagnosing infertility was first recorded in the 11th century BC in the book Yijing in which it says, infertility is when a ‘married woman did not have a pregnancy after three years.’ (7.)

The effectiveness of TCM treatments and Chinese medicine’s deep understanding of male infertility is reflected in numerous studies and case histories recorded and published in TCM journals. The studies claim fair to excellent results in improving semen count, morphology, motility and pregnancy rates (8.9.10.16.17.18.19.20.21.22.23.24.25.).

Chemical poisons and male infertility

• Trichloroethylene (TCE), the chemical widely used in industrial settings and present in groundwater supplies, has been found in the semen of infertile male mechanics. TCE is extensively used in the motor and metal industries as the degreasing agent, and is also found in PCs, lubricants, paints, paint strippers, pesticides, spot removers and cleaning fluids. New US national toxicology program has estimated that 3.5 million workers are exposed to the chemical, which has also been linked to liver, kidney and lung damage. (Reference: Drug Metab Dispos 2003 31:360 311)

• Bisphenol A (BPA), of which 2 billion pounds is produced in the US every year, goes into the making of the polycarbonate plastic-used in plastic baby bottles, food and drink containers and the lining of most food and drink cans. It has been found that very low levels of Bisphenol A show highly significant increases in two types of chromosomal aberrations in the developing mouse, which goes through almost identical processes of maturation as human eggs. In human eggs, such abnormalities are the leading cause of miscarriage, mental retardation, and congenital defects such as Down's syndrome. (Thanks to the Chemical and engineering News, http://pubs.acs.org/cen/today/april29.html)

References

1. Sinclair, S. (2002). Male infertility: nutritional and environmental considerations. Alternative medicine review: Journal of clinical therapeutic, 5(1), 28-38.
2. Cramer, D. W., Walker, A. M., Schiff, I. (1979). Statistical methods in evaluating the outcome of infertility therapy. Infertility and sterility, 32(1), 80-86.
3. Khalaf, Y. (2003). ABC of sub fertility. Tubal Sub Fertility. British medical Journal 7415, 610
4. Hamilton-Fairley, D., Taylor, A. (2003).ABC of sub fertility. Anovulation. British medical Journal 7414, 546
5. Hart. R. (2003). ABC of sub fertility. Unexplained infertility, endometriosis and fibroids. British medical Journal 7417, 721-724
6. Taylor, A. (2003). ABC of sub fertility. Extent of the problem. British medical Journal 7412, 434-436.
7. Qiang G. Z. (1995). Infertility.European Journal of Oriental medicine, 1(5), 22-33
8. Liang, H., May, B. Male Infertility: 16 cases of severe azoospermia treated with Bu Shen Yi Jing Fang. Pacific Journal of Oriental medicine, 7, 40-41.
9. Siterman, S., Eltes, F., Wolfson, V., Zabludovsky, N., Bartoov, B. (1997). Effect of acupuncture on sperm parameters of males suffering from sub fertility related to sperm quality. Archives ofAndrology, 39, 155-161.
10. Yang, W. P. (2001). A review of traditional Chinese medical treatment of male infertility and erectile dysfunction. Journal of Andrology, 22(2), 173-182.
11. De Jager, T., Bornman, M.S. (1999). Reproductive toxins affecting the male [Abstract]. In R. Jansen & D. Mortimer (Eds.), Towards reproductive certainty: The plenary proceedings of the 11 th world congress on In Vitro Fertilisation & human reproductive genetics (p.265-267). New York: Parthenon publishing group.
12. Cox, S. (Presenter). (2003, August 21). Infertility: Dealing with the inconceivable [Radio broadcast transcript]. Health online special series. Sydney: Australian Broadcasting Corporation, Radio national. Retrieved August 28, 2003 from http://www.abc.net.au/health/features/infertility/.
13. Salleh, A. (Presenter). (2001, February 5). Male infertility is not just a sperm problem. [Radio broadcast transcript]. Science online. Sydney: Australian Broadcasting Corporation, Radio national. Retrieved February 13, 2001 from http://www.abc.net.au/science/news/stories/s241290.htm.
14. McLachlan, R. I., de Krester, D. M. (2001). Male infertility: the case for continued research. Medical Journal of Australia, 174 (3), 116-117
15. Chen, G. (2003). Research Review from China. Vitaforce News, 1.
16. Jansen, R. (1999). Transmission of the mitochondrial genome [Abstract]. R. Jansen & D. Mortimer (Eds.), Towards Reproductive Certainty: The plenary proceedings of the 11 th world congress on In Vitro Fertilisation & human reproductive genetics (p.333). New York: Parthenon publishing group.
17. Zhiyuan, Q. (1996). Clinical observation of 54 cases of Male infertility treated by acupuncture and moxabustion. The Journal of Chinese medicine, 52, 12.
18. Zhiyuan, Q. (1997). Male infertility three cases treated by acupuncture. The Journal of Chinese medicine, 53, 26.
19. Jiasheng, Z. (1987). The acupuncture treatment of 248 cases of Male infertility. The Journal of Chinese medicine, 25, 28.
20. Becker, S. (2000). Treatment by Chinese medicine semen anomalies. The Journal of Chinese medicine, 62, 46.
21. Xiangyi, S. (1997). Xu Runsan’s experience in treating sperm abnormalities. The Journal of Chinese medicine 54, 9.
22. Zongchong, Z. (1997). Analysis of the therapeutic effect of combined use of acupuncture and medication in 297 cases of Male sterility. The Journal of Chinese medicine, 56, 44.
23. Yachun, Z. (1990). TCM treatment of Male infertility due to seminal abnormality. Journal of traditional Chinese medicine, 34, 33.
24. Baocun, Y. (2001). The therapeutic effect of Sheng Jing Zhing Zu Tang in treating Male infertility [Abstract]. In The Journal of Traditional Chinese medicine, 67, 46. [Abstract]. In Deadman, P. (Ed.), The Journal of Chinese Medicine, 63.
25. Clavey, S. (2003). Notes on the treatment of Male infertility. The Journal of Chinese medicine, 73, 45-52.

Detecting ovulation

A German study in 2003 (1) showed that the Basal temperature graph and fertile mucus detection was a more accurate way of predicting ovulation than test kits based on taking urine and saliva.

Since June 2000 Jann Mehmet has documented over 9000 treatments on a computer database that she established at The Rozelle Acupuncture and Chinese Medicine Centre. From this data she has observed that the basal temperature graph is an excellent tool in predicting ovulation, miscarriage and infertility.

Acupuncture and Chinese herbal medicine may assist in the diagnosis and treatment of miscarriage and infertility and promote normal ovulation. For women who have experienced miscarriage and infertility, monitoring of the basal temperature graph during corrective treatments may indicate when they are no longer at risk.

At The Rozelle Acupuncture and Chinese Medicine Centre women are educated on preconception care and the use of the basal temperature graph.

1. German researchers call for clinical trials of menstrual cycle monitors used for natural family planning” (2003). Human Reproduction.18 (12), 2628-33.