Approximately 1 in 4 pregnancies end in miscarriage. If you include pregnancies the lost before a pregnancy can be taken, then it is possible that miscarriage rate is 40%. 75% of miscarriages occur in the first trimester. 80% of the time this will be a onetime occurrence, and women will later go on to have a healthy pregnancy. However, if she does not, this may be called is recurrent miscarriage. If a miscarriage occurs 3 or more times it may be considered habitual miscarriage.
Warning symptoms include cramps, low back ache, spotting, an abrupt decrease in pregnancy symptoms, and a declining basal body temperature.
Close to half of the causes of female infertility are issues relating to ovulation. If you haven’t yet, we recommend using an ovulation predictor kit (OPK) for several months to get a “feel” for when you’re ovulating. If you never or rarely get a “positive” on your OPK, this may indicate a problem. Anovulation (not ovulating) can often be treated with acupuncture and herbal medicine, without resorting to the use of clomid. Ovulating several days earlier, or later of the norm of 14 days into your cycle can be an obstacle to getting pregnant. The goal of the treatment will be to promote a normal, healthy ovulation during the correct window. This can often be achieved with acupuncture. During the treatment, I will also coach you on correct timing, to pinpoint your fertile window, while we are trying to correct your ovulation. A valuable tool for tracking ovulation is keeping a basal body temperature chart (please cross link to PDF of chart). Ovulation issues are often linked to Luteal Phase defect, and Lack of Cervical Mucus.
Scanty Cervical Mucus
Scanty or missing cervical mucus is often linked to lower hormonal activity, and ovulatory issues. It also tends to become less plentiful in the later 30’s and early 40’s. Cervical mucus is stretchy and egg white-like, and should appear just prior to ovulation. It is a critical component, and indicator of fertility. This healthy mucus creates a medium that allow the sperm to survive the others hostile environment of the vaginal tract.
If you don’t notice cervical mucus at all mid-cycle, it is likely playing a role in fertility problems. Fortunately, acupuncture, herbs and certain supplements can improve the quantity and quality of cervical mucus fairly quickly, and can be used in conjunction with fertility medicines like clomid, that can cause a drying of the cervical mucus.
Uterine Lining issues/ Implantation
Problems with the uterine lining can affect implantation of the newly fertilized egg after it makes is way down the fallopian tube. The lining may too thin, and lack the nourishment and blood supply to support implantation, and pregnancy. Poor blood flow may also be the result of surgical procedures, miscarriage, fibroids, tampon use, and fertility unfriendly living habits. Many of these issues can be greatly aided by acupuncture and Chinese medicine treatments before, and during the menstrual cycle. If you have a scantly menstrual flow, that’s lighter and shorter than usual, or have flow that’s dark in color and painful with many clots, you likely have issue with your uterine lining. These issues should be treated and corrected at least 3 months prior to trying to conceive.
Luteal Phase Defect
The Luteal phase is the time between ovulation and menstruation. Normally, it should be around 14 days. When the Luteal phase ends significantly earlier than 14 days, this is deemed Luteal phase defect. In addition, basal body temperatures may be fluctuating, or dropping, rather than keeping steady, resulting in a shorter than normal overall cycle.
This occurs because the Corpus Luteum, which forms on the ovary after ovulation, is not putting out enough progesterone for a healthy luteal phase. We want stable, high temperatures during the second half of the cycle.
The reason this creates a problem for fertility is that if the luteal phase is too short, or progesterone secretion too low, it will be difficult for implantation to complete. The menses will come too early, and the uterus will shed its lining before the embryo can sustain itself.
Acupuncture and Chinese herbs can treat luteal phase defect by improving egg quality, and the strength of the corpus luteum. This promotes a healthier ovulation, and stronger output of progesterone which creates a longer cycle with higher basal body temperatures.
Egg Quality Issues
Poor egg quality is often blamed in unsuccessful IUI, and IVF cycles, and when advanced maternal age is considered a main factor. Often times a lower then expected number of eggs respond to the fertility medicine, or a lower then hoped for number of eggs fertilize, or survive to the transfer. Tests used to determine expected egg quality are blood tests that show a high FSH and a low AMH, as well as ultrasounds to check the number of antral follicles.
Poor egg quality is often attributed to damage to the egg cell’s DNA and mitochondria to by free radicals though the life of the woman. Although western medicine doesn’t believe egg quality can be changed, practitioners of Traditional Chinese medicine believe that improvements can happen with the correct herbs, and supplementing with nutrients and antioxidants over time. Since eggs take a full year to develop from primordial follicles to follicles that can be recruited for ovulation (antral follicles), the minimum amount of time to improve egg quality is generally 3 months. Acupuncture helps egg quality by enhancing blood flow to the ovaries, and Chinese herbs help nourish the ovaries, as well as the other organs they depend on. Egg qualities issues are also related to, diminished ovarian reserve and premature ovarian failure.
PCOS stands for ”Polycystic Ovarian Syndrome.” This is a disease is closely linked with blood sugar and hyper insulin levels, which may lead to infrequent, or no menses, and often no ovulation. Follicles are unable to fully mature and erupt from the ovaries, and instead become numerous cysts in the ovaries. These cysts will produce their own hormones further throwing off the reproductive cycle.
Some of the common signs of the disease are obesity, excessive hair growth, often on the face stomach and thighs, and acne. However, some individuals are thin, and don’t show the major signs.
PCOS makes pregnancy hard to achieve because of infrequent, and unpredictable ovulation, and the general hormonal imbalance of the body. Because the lack of menstruation put women at risk for endometrial cancers, birth control pills are often used to regulate the cycle; however this is not feasible when trying to conceive.
How can acupuncture help? Acupuncture is often successful at bringing back a more regular cycle, and helping ovulation. It should be noted that establishing a natural rhythm with acupuncture and herbs can take time, and for some women it may take several months. In addition to this, it is generally necessary to adhere to a low carbohydrate diet, and regular exercise in conjunction with the fertility treatments. A weight loss program may also be recommended. These lifestyle changes should be adhered to throughout one’s life to reduce the risk of diabetes.
Endometriosis is a disease commonly associated with infertility. It is difficult to diagnoses without laparoscopic surgery. Endometriosis may be suspected in cases of infertility with strong menstrual cramps, heavy bleeding and pain with intercourse.
With endometriosis, fragments of uterine lining are thought to enter the fallopian tubes and settle in the pelvic cavity creating “implants” of endometrial tissue that grow on the ovaries, uterus, fallopian tubes and other organs. These implants will cause inflammation, excess immune response, and adhesions of scar tissue, that can disrupt fertility and potentially harm ovarian function.
How can acupuncture and herbal medicine help? Surgery is often elected as a quick, although temporary method of eliminating the endometriosis growth, but is not a long term solution. If pregnancy is not achieved within 6 months, endometriosis often grows back. Acupuncture and herbal medicine can provide a longer term strategy to prevent endometrial implants from growing back, or significantly slow their return, and can also help the body break down the implants itself.
Achieving pregnancy and breast feeding itself will halt the grown of endometriosis.
Stress and Your Fertility
Stress can have a detrimental effect on Male and Female fertility. It can also be detriment to having a successful IVF cycle. Stress can reduce blood flow to certain parts of the body. The body will shift blood away from “non-essential organs” during times of stress. Since the ovaries are not essential for “fight or flight,” reduce blood flow can mean the ovaries are not nourished with enough blood and nutrients, reducing egg quality.
The sympathetic nervous system readies the body for fight or flight, and is often hyper-mobilized when we under stress. When under long term stress, certain hormones such as cortisol, can become over- secreted, and create an unhealthy environment in the body. Furthermore, long term stress can lead to adrenal fatigue, which can exhaust the kidneys and result in diminished fertility in both men and women.
Acupuncture stimulates the parasympathetic nervous system, which calms and balances the sympathetic system.
Stress can also lower the libido of couples trying to conceive, and the added pressure of having to perform during a specific fertile window can have a big impact on the male libido. Acupuncture and Chinese herbs can both work wonders on improving libido, for both partners.
Stress can have a specific impact on a successful IVF cycle, and it’s recommended to take steps to reduce stress as much as possible for this. You can read about stress and IVF here.
In Chinese medical though, stress has a stagnating and delaying effect on the body. Because stress creates stagnation, it can lead to delayed ovulation and delayed menstruation. This can greatly impact your fertile window, as well as lead to a much more uncomfortable period. In fact, stagnation plays a huge role in a very large number of health issues that go far beyond fertility.
When to start treating? Please read this helpful post on when to start acupuncture treatment.
In summery stress can play an important role in:
- Delaying ovulation
- Delaying the menses
- Increase in PMS and menstrual pain
- Decreased libido
- Poor blood circulation
- Decreased response in IVF cycles
- Poor dietary choices, and unhealthy eating