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Traditional Chinese Medicine (TCM) in Assisting In-Vitro Fertilization (IVF)

05 Jan 2024

By: Sheryl Tay

In recent years, the integration of Traditional Chinese Medicine (TCM) with Western medical practices has gained significant attention, one notable application is the complementary role TCM plays in enhancing the outcomes of In-Vitro Fertilization (IVF). As more couples seek fertility treatments, the holistic approach of TCM is increasingly gaining popularity and getting recognized for its ability to support and optimize the IVF process.

IVF is a type of fertility treatment where sperm and an egg are fertilized outside of the human body. Several days after fertilization, the fertilized egg (embryo) is placed inside the uterus. Pregnancy occurs when the embryo implants into the uterine wall. It’s a procedure used to aid in achieving pregnancy conception in individuals who are having difficulty doing so spontaneously. IVF involves many complex steps and is an effective form of assisted reproductive technology (ART).

A competent embryo and receptive uterus are two critical components for a successful implantation and therefore successful conception. TCM is shown to be a useful complementary tool to support IVF procedures and increase success rates.

How does TCM support IVF?

  1. Optimising womb environment
  • TCM practitioners focus on promoting a balanced flow of Qi and enhancing blood circulation throughout the body, especially to the reproductive organs. Improved blood flow helps nourish the ovaries and uterus, creating a more conducive environment for successful embryo implantation[1]. TCM herbs and acupuncture can also help improve uterine lining thickness, as well as to increase endometrium receptivity (the ability of the endometrium to accept embryos) [2].

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  1. Enhancing Egg Quality and Sperm Health
    Improving the quality of egg and sperm is crucial for successful fertilisation and the development of a good quality embryo. This can therefore increase the chances of conception [3].  
    • Kidneys in TCM govern the reproductive system. Hence, by invigorating the kidneys is one of the ways to improve egg quality as well as sperm quality

    • Increasing blood circulation throughout the body also enhances the blood circulation to the ovaries and testes, thereby nourishing the eggs and sperm with good oxygen and blood flow, hence enhancing the quality of eggs and sperm.

    • Reducing inflammation and stress also plays a part in improving the quality of egg and sperm, hence increasing the chances of a successful pregnancy.

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  1. Reducing Stress:
  • The process of IVF can be emotionally and physically taxing, involving hormonal treatments, invasive procedures, and the emotional rollercoaster of hope and disappointment. This stress may further exacerbate the challenges of infertility. Some researchers suggest that a patient’s mental and physical health can influence the success rate of IVF. TCM, through acupuncture and herbal medication, helps reduce stress levels, promoting a more favorable environment for successful IVF. Stress management can also positively impact the hormonal balance and improve the chances of conception.

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  1. Minimising Side Effects of IVF Medications:
  • The medications used in IVF procedures can sometimes cause side effects such as bloating, hot flushes, irritability, headaches etc. TCM interventions can help alleviate these side effects, promoting the overall well-being of the individual undergoing IVF [4].

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  1. Supporting Implantation and Pregnancy:
  • TCM treatment before and after embryo transfer can help prepare the uterus for implantation and support the embryo’s attachment and reduce the risk of miscarriage. It can also reduce stress and anxiety, which can positively impact the success of the transfer. 

 

It is recommend to start receiving TCM treatments three months before going through IVF. This gives the TCM physician a chance to assess and adjust the underlying body constitution to improve fertility and increase chances of conceiving. However, if you have already started on drug stimulations, your TCM practitioner will schedule your treatments in line with your IVF procedure schedule. The image below is a rough timeline of the acupuncture sessions in preparation for and during IVF treatment.

TCM Treatment modalities in supporting IVF

1. Acupuncture

Acupuncture is the insertion of fine needles into the body at specific points called “acupoints”. Acupuncture points are believed to stimulate the central nervous system. This, in turn, releases chemicals into the brain. These biochemical changes may stimulate the body’s natural healing abilities and promote physical and emotional well-being. 

 

Therapeutic effects of acupuncture:

  • Remote therapeutic effect of acupuncture: Infertility is due to imbalances in the organ systems in the body e.g. the kidney, liver and spleen. Therefore, via Remote Therapeutic Effect of acupuncture, by stimulating the acupoints located along the meridian channels governed by the respective organ system, it helps to rebalance the organ system, facilitating natural healing mechanisms, thereby improving fertility.  

  • Systemic Therapeutic Effect of acupuncture: It is known that TCM can help to improve blood circulation, be it to the womb, ovaries or testes. Therefore, via Systemic Therapeutic Effect of acupuncture, some acupoints are known to have “unique” functions such as to improve “blood” (血海 SP10 acupoint), regulate menstruation(三阴交 SP6 acupoint), improve “qi” (足三里 ST 36acupoint),  etc, thereby contributing to increasing chances of conceiving.

2. Herbal medication

  • Herbal medication will be prescribed according to the individual’s body constitution, restoring the body’s imbalances thereby improving fertility. A licensed TCM Physician would first consult the patient to understand and diagnose their body constitution, before prescribing herbal medication which can help to improve the quality of eggs or sperms, to increase the thickness and quality of endometrium lining, to improve uterine environment etc.
  • Secondly, some may experience stress and anxiety. Herbal medication could help manage stress, anxiety, and mood swings. Furthermore some may experience side effects of going through IVF. Herbal prescription could also be prescribed to aid the patient in having a better experience going through IVF.
  • Do note to consult a licensed physician and always check with the physician before taking any herbal supplements or medicine.

3. Moxibustion

Involves the burning of the herb mugwort (艾草), the effects of mugwort would penetrate through the skin and into the body. Mugwort is used due to its warming properties. Secondly, due to its abilities to dispel dampness, eliminate stagnation, dissolve stasis, thereby improving blood circulation in the body. Moxibustion for fertility would usually be done on the lower abdomen or on the lower back.

References:

[1] Chen Q., Hau C. Impacts on pregnancy outcome treated with acupuncture and moxibustion in IVF-ET patients. Zhongguo Zhen Jiu . 2015;35(4):313–317.

[2] Jin F, Ruan X, Qin S, Xu X, Yang Y, Gu M, Li Y, Cheng J, Du J, Yin X, Mueck AO. Traditional Chinese medicine Dingkun pill to increase fertility in women with a thin endometrium-a prospective randomized study. Front Endocrinol (Lausanne). 2023 Sep 28;14:1168175.

[3] Zhou L., Xia Y., Ma X., et al. Effects of menstrual cycle-based acupuncture therapy on IVF-ET in patients with decline in ovarian reserve. Zhongguo Zhen Jiu . 2016;36(1):25–28

[4] Altutunji A. Z., Liu L., Cai J., Wang Z., Gao Y. The effect of acupuncture on anti-mullerian hormone and assisted reproduction outcome in Polycystic Ovary Syndrome patients undergoing in vitro fertilization. JPMA. The Journal of the Pakistan Medical Association . 2019;69(Suppl 3)(8):S4–S8