This article is intended for couples who have been trying to conceive for around six to twelve months or more, without success. In it, I shall outline some of the issues which are important from a Chinese medical perspective, so that you can consider whether acupuncture is something you might like to try with the aim of improving your chances of a natural conception.
We can simplify this complex subject a little for ourselves to start with. There are three main causes of infertility to bear in mind. Firstly, a woman may not be releasing an egg every month ie. not ovulating. Secondly, fertilisation may not be taking place, perhaps due to problems with sperm quality or blocked Fallopian tubes. Thirdly, the embryo is failing to implant in the womb lining, perhaps because it is not thick enough.
Couples I see are at one of two stages:
1) The first group have been trying to conceive for long enough (often around two years) for their GP to have arranged some tests, usually a semen analysis for men and blood hormone tests for women, depending on any accompanying signs and symptoms. The results of these tests are of interest to me, and they may or may not point towards anything of significance. If one partner’s tests are revealing an abnormality, then it is that partner who should come to see me. If neither partner’s tests indicate any significant abnormalities, then in the first instance, I recommend you both attend for individual consultations. The tendency in the NHS is for this group to move swiftly to the IVF waiting list, but there are other steps that can be worth taking and which may avoid the need for IVF. Remember also that IVF circumvents the first two causes of infertility mentioned above, but still only around 30% of transferred embryos will successfully implant.
2)The second group are those who have been trying for a shorter time, perhaps six to twelve months as a guide, but who would like to take the step of arranging an acupuncture consultation. If you fall within this group, then in the absence of any orthodox medical investigations to this point, we can see whether a Chinese medical analysis of your health, reveals patterns which could be impeding conception. Hence it again makes sense for you both to come for individual initial assessments.
At the first interview, I shall be interested in your general health, and details such as your age, whether one or both of you is already a parent (indicating past fertility), your occupation, energy levels, your diet, smoking, alcohol consumption etc. For women, the precise characteristics of your cycle offer invaluable information from a Chinese perspective: your cycle length, period length, and flow for example. Have there been any changes in the last few years? Do you experience any PMS, and if so, how? Have you used the contraceptive pill and when? Your levels of stress and anxiety, particularly around trying to conceive, are particularly important: over the years, I have noticed what an effective contraceptive stress can be; acupuncture can be very helpful here. See the research reported below.
As regards men, if you have had a sperm sample analysed, and have had a result indicating low fertility, then that is obviously significant. Besides that though, Chinese medicine looks at a much wider picture of your health and lifestyle, so I will have many other questions to put to you. At this point, it’s worth digressing a little and saying some more about male sub-fertility. Western medicine has usually put its focus on female infertility: a female reproductive system which is as healthy as possible, can assist the sperm in several useful ways; further, western medicine has few treatment options for male sub-fertility and often cannot even find a cause. The latter is however, a growing problem worldwide. Reports began appearing in medical journals in the early 1990s, and explanations include lifestyle factors and/or chemicals in our environment: oestrogens excreted into the water supply by women using the contraceptive pill or hormone replacement therapy, may be one small factor; a larger contribution might come from oestrogen-like chemicals released from common products as diverse as plastic bottles, sunscreen lotions and clingfilm; more significant still might be anti-androgens used in a similar range of products for decades.
Lifestyle factors are fortunately more in our control. There is growing evidence that a high intake of soya eg milk, yoghurts, tofu, is associated with reduced sperm counts. Male fertility also declines with age. There is a correlation between body weight and male fertility: in one study of 1500 men, those with a body mass index (BMI) below 20, had a 28% lower sperm count, and those with a BMI above 25, had a 22% lower sperm count, so maintenance of a health body weight appears important. Sperm production is most efficient at 34 degC, which is 3 degrees below normal overall body temperature; men might therefore be well-advised to avoid hot baths, saunas, and using a laptop computer literally on the lap, and a change from tight underwear to loose boxer shorts would seem sensible. Smoking can also reduce fertility, as can excessive alcohol and cannabis use.
Returning to our main topic then, I will gather together all of the information gained from interview, and will put together a treatment plan for either or both of you, and offer some lifestyle advice. The latter may involve diet, exercise, more rest etc. I will usually suggest a fixed number of treatments followed by a review.
If you are a woman of 38 or over, or if either of you have in the past had any medical conditions which could have affected reproductive health, then it is my preference that you see your GP if you have not already done so. It does not prevent you embarking on a course of acupuncture treatment, but it might save us valuable time.
I hope the above has given you an outline of my approach, but you are always welcome to call me if you would like to discuss acupuncture further.