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The Integrative Approach of Traditional Chinese Medicine (TCM) and Reproductive Technology (i.e. IUI and IVF) | Yi TCM

The Integrative Approach of Traditional Chinese Medicine (TCM) and Reproductive Technology (i.e. IUI and IVF)

22 Jan 2024

By: Kang Ting Tan

Infertility, characterized by the inability to conceive after a year of active attempts, affects both men and women alike.

Assisted Reproductive Technology (ART), such as Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF), becomes a viable option when conventional methods fall short. However, the challenges of these fertility treatments, marked by stress and expenses, create high expectations for success.

IUI is a fertility treatment involving placing sperm inside a woman’s uterus through a catheter by a gynaecologist to facilitate fertilisation. The goal is to improve the chances of fertilization by increasing the number of sperms (by giving them a “shortcut”) that reach the fallopian tubes during ovulation and thus increase the chances of pregnancy.

IVF refers to the fertilisation of an egg outside the body. During IVF, mature eggs are retrieved from ovaries and combined with sperm in the laboratory to achieve fertilisation. Then, the fertilised egg(s)/embryo(s) are transferred to a uterus. 

Both are commonly used to improve the chances of pregnancy.

Contrary to common belief, TCM, particularly acupuncture, proves to be a synergistic partner with modern medicine, enhancing the body’s condition and augmenting the success rates of IUI and IVF.

Let’s understand conception first

“Seed  and Soil” Analogy (种子论)

Seed and Oil Analogy for Chinese Fertility Treatment | Yi TCM

Conception is like gardening and there are 3 basic requirements for fertilization to take place.

      1. Fertile, nutritious Soil  肥沃的土地–having a healthy developed uterus and endometrium lining and no “weeds” like cysts, endometriosis or fibroids that can affect implantation and growth 

      1. Seeds of life 种(zhong3)子 ( *种子必先育卵*) – Healthy egg and the sperm are crucial components for successful fertilization

      1. Time is key 对的时间点– Sperm and egg need to meet at the correct time and location, i.e. during ovulation (usually day 12-16 of the period cycle)

     Age and its Impact on Fertility:

    For decades, the average marriage age has been in the 20s. However, getting married in the 30s may just be the new normal. Getting married later in life is a modern trend and hence affects reproductive and fertility status. 

    The optimal age for childbearing is between 20 and 35. The proportion of women aged 35 years and above who are intentionally delaying pregnancies has been rising in the past few years. Delayed pregnancies lead to an increased chance of infertility.

        • Ovarian Reserve and Ageing:
              • TCM acknowledges the natural reduction in ovarian reserve with age, emphasizing the correlation between age and declining fertility.

              • Women are born with a fixed number of oocytes (eggs) inside their ovaries. 1

        Age No of Eggs
        Puberty 300,000-500,000
        20-30 100,000-300,000
        30-40 10,000-50,000
        40-50 1,000-10,000
        50 (Menopause) 1000+

            • Ageing naturally reduces a woman’s ovarian reserve. The quantity and quality of a woman’s ovarian reserve declines with age. At the start of puberty, there can be 300,000- 500,000 eggs and it reduces to about 25,000 at around the age of 37.

          Male Infertility and Its Causes:

          On the other hand, male infertility is responsible for up to 30% of infertility. It can be caused by low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. 

              • Sperm quality: low sperm count, poor sperm mobility, abnormally shaped sperm or no sperm present. 

              • Varicoceles (enlarged veins in the scrotum) can negatively impacts testicular sperm production

              • Obstruction of the vas deferens or epididymis (the tubes that carry sperm). Blockages can be a result of infection such as traumatic injury or gonorrhoea.

            Enhancing sperm count and quality involves adopting positive lifestyle changes. Consider the following measures:

                1. Stop smoking 

              Tobacco smoke contains more than 4000 kinds of chemicals, including nicotine, tar, carbon monoxide, polycyclic aromatic hydrocarbons and heavy metals. Smoking is associated with dysfunction of spermatogenesis and impaired spermatozoa function2, leading to reduced semen quality including semen volume, sperm mobility, sperm density and normal morphology. 

                  1. Stop habitual heavy alcohol consumption 

                Alcohol can affect sperm mobility and alter sperm count, shape and mobility. In men, heavy drinking can lower testosterone, follicle stimulating hormone, and luteinizing hormone levels  and increase estrogen levels3. These hormone changes can reduce sperm production and development. 

                    1. Have a  healthy diet rich in fruits, vegetables and whole grains.  

                  Do not be a picky eater. You may be lacking zinc, Vitamin B, C or E. Zinc deficiency impedes spermatogenesis and causes sperm abnormalities4. Zinc cannot be stored in the body and hence regular dietary intake is essential. Vitamin C And E are essential antioxidants that protect the cells from damage from oxidative stress and free radicals. 

                      1. Avoid excessive heat

                    The normal physiological temperature of the human testis ranges between 32 and 35 °C. It is cooler than the core body temperature of 36.9°C. This is essential for optimal sperm production, maturity and function5. Hence, it is important to avoid potential heat exposure to the testicles such as prolonged hot baths, laptop, high-temperature work area and prolonged sitting. Avoid wearing tight pants too as it can affect the blood circulation to the testes. 

                    Reasons for Choosing IUI and IVF:

                    We recognize the various reasons (listed below), including cervical mucus conditions, ovulation disorders, and unexplained infertility, leading couples to opt for ART.

                        • Unexplained infertility

                        • Hostile cervical mucus condition

                        • Ovulation disorder

                        • Fallopian tube blockage or damage

                        • Impaired sperm production or function (poor sperm motility, count or quality)

                        • Ejaculation dysfunction

                      Acupuncture’s Role in Enhancing IUI and IVF Success:

                          • Accepted Treatment for IUI and IVF:
                                • Acupuncture’s compatibility with Western medicine makes it a widely accepted form of treatment for ART.

                            • Optimizing the Body with Acupuncture:
                                  • TCM’s acupuncture sessions, especially when initiated three months before IUI/IVF treatments, are highlighted for their role in conditioning the body for optimal success. This is especially so for those who have low ovarian reserve or poor egg quality. 

                              • Improving Sperm Quality:
                                    • Acupuncture’s positive impact on reducing structural defects in sperm and enhancing quality, mobility, and concentration of sperm with normal morphology is emphasized6,7.

                              Acupuncture for IUI and IVF Implantation | Yi TCM

                              As couples navigate the intricate journey of fertility treatments, the harmonious integration of Traditional Chinese Medicine, notably acupuncture, with modern reproductive technology emerges as a holistic and powerful strategy. This comprehensive approach not only enhances physical well-being but also addresses the emotional toll, providing a personalized path to fertility success.

                              Embracing TCM alongside conventional treatments presents a well-rounded and supportive framework for individuals seeking to maximize their chances of conception.

                              References:

                                  1. https://www.healthline.com/health/womens-health/how-many-eggs-does-a-woman-have#eggs-at-puberty

                                  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4814952/

                                  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761906/

                                  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010824/

                                  1. https://www.clevelandclinic.org/reproductiveresearchcenter/docs/publications/93_Durairajanayagam_et_al_Heat_Stress.pdf

                                  1. https://www.webmd.com/infertility-and-reproduction/news/20050803/acupuncture-may-improve-sperm-quality

                                  1. https://www.sciencedirect.com/science/article/pii/S2305050015000226