Traditional Chinese medicine (TCM) has thousands years history. It has unique basic theories and diagnostic methods. It is a very effective therapy in treating many chronic diseases and some acute diseases. If you are interested in TCM, welcome to pop in to this TCM forum, let's discuss on any topic about Chinese herbal medicine and acupuncture. If you have any health problem, you are welcome to visit my clinic Knowhow Acupuncture at No.1 Harley street, London. If you are far away from London, you can pop in my online clinic to get some help. If you like this blog please share it to your friends.

Friday, 3 June 2011

Infertility and its TCM treatment

Tiejun Tang
First of all, I need to identify the concepts of the three key words in this topic.

Infertility: The infertility diagnosis standard of World Health Organization (WHO) is that couples who failed to conceive after 12 months of contraceptive-free intercourse if the female is under the age of 34, or 6 months of intercourse if the female is over the age of 35. Couples who have never been able to conceive are classified as primary infertility, whilst others are called secondary infertility.
TCM: traditional Chinese medicine, which includes Chinese herbal medicine, acupuncture, moxibustion, and electric acupuncture in some conditions.

Treatment: I am very cautious in using the word “treatment” here. A new advertising code had been announced by The Advertising Standards Authority (ASA) in March 2011. The code lays down strict restrictions to advertisements of complementary medicine practices. Wordings such as “cure”, “treatment” are prohibited from the advertisement of our leaflet or clinic website. Some practitioners use wordings like “management” or “help” instead. I never use the word “cure” in my leaflet, because in medicine, it can never be 100% sure that any disease could be cured. I think “treatment” just means the process of a therapy. It doesn’t indicate whether the result will be positive or negative. Why are we not allowed to use the word “treatment” in advertisement? What is the difference amongst “treatment”, “management” and “help”? What a strange code! The code also declared that objective claims must be backed by evidence. Substantiation will be assessed on the basis of the available scientific knowledge. I have two reasons why I used “treatment” here and also in my other blog articles. Firstly, this blog is not a clinic website, hence it is not an advertisement. Secondly, I always show some scientific evidence to support my opinion

The causes of infertility can be due to either the female or male or both parties. In some cases, the cause can be unexplained. In UK the statistic data of 2009 is shown below.

In female infertility the common reasons are shown below.

In a clinical study from Germany (Paulus, 2002), 160 patients who were undergoing assisted reproduction therapy were divided into two groups randomly: embryo transfer with acupuncture (n=80) and embryo transfer without acupuncture (n=80). Acupuncture was performed at 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy. The results showed clinical pregnancies were documented in 34 out of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group.

Another report is from Denmark (Lars G. 2006). Patients treated with IVF/ICSI (intracytoplasmic sperm injection) were divided into three groups. Group 1 received acupuncture on the day of embryo transfer (ET), group 2 on ET day and again 2 days later, and both groups were compared with a control group that did not receive acupuncture. Results showed clinical pregnancy rates were significantly higher in group 1 as compared with controls (37 of 95 [39%] vs. 21 of 87 [26%]) and ongoing pregnancy rates were also higher in group 1 as compared with controls (34 of 95 [36%] vs. 19 of 87 [22%]). The clinical and ongoing pregnancy rates in the group 2 (36% and 26%) were higher than in controls, but the difference did not reach statistical difference. Conclusion can be drawn that acupuncture on the day of ET significantly improves the reproductive outcome of IVF/ICSI, as compared with no acupuncture.

Acupuncture also has good effect in treating male infertility. In a prospective controlled study, statistical evaluation of the transmission electron microscopy data showed a significant increase after acupuncture in the percentage and number of sperms without ultrastructural defects in the semen. A statistically significant improvement was also detected in acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibers of sperm organelles. (J. Pie. 2005)

In addition to acupuncture, Chinese herbs can also greatly increase the chances of pregnancy. There is an experimental study which showed that Erzhi Tiangui Decoction could significant raise the quality of oocyte in mice (F. Lian 2004). A clinical track study showed Wenshen Antai Decoction can also increase the pregnancy rate after re-transplant of IVF (D. Li. 2009).

Fertility problems affect one in seven couples in the UK. Many couples choose IVF or IUI, but they have to be prepared for the low success rate and the high cost. Much evidence showed that acupuncture and Chinese herbs can treat infertility for both male and female. Only a few reports amongst many were mentioned above. TCM treatment can help get natural pregnancy, prevent miscarriage and increase the success rate of IVF, although the success rate would vary with different treatment plans and different causes of infertility.

Reference:Lian Fang, Sun Zhen-gao, Zhang Jian-wei, et al.(2004). Experimental Study on Effect of Erzhi Tiangui Recipe on Quality of Oocyte in Mice. Chinese Journal of Integrated Traditional and Western Medicine. 24(7):625-7.

Li Dong (2009). Increase of pregnancy rate by Wenshen'antai Decoction combined with assisted reproductive technology in patients with embryo transplant failure. Journal of Beijing University of Traditional Chinese Medicine. 32(2):

Pei J, Strehler E, Noss U. et al. (2005). Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertility and sterility, 84 (1): 141-147

Paulus WE, Zhang M, Strehler E, et al. (2002). Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertil and Steril. 77 (4): 721–4.

Westergaard LG, Q Mao, M Krogslund. et al (2006) Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Fertility and sterility, 85(5): 1341-1346.