National fertility awareness week
Today marks the start of National Fertility Awareness Week. 1 in 6 couples have difficulty conceiving. Sometimes some simple changes to diet and lifestyle or even a clearer understanding of our reproductive systems can help. However, for others, some form of assistance might be needed.
Acupuncture has grown a solid reputation for supporting fertility for both men and women. So much so that many mainstream fertility clinics recommend and offer acupuncture to support fertility. This article considers what optimal fertile health looks like through the Chinese medicine lens and how divergences from this can give helpful clues to an acupuncturist to help formulate a diagnosis and prepare a treatment plan and inform dietary tips or lifestyle modifications that can help to improve fertility.
Traditional Acupuncture is a branch of Chinese medicine, which is an excellent model to use to understand fertility. Chinese medicine is based on very simple principles that can be combined and interwoven to understand the very complex reality of an individual’s fertility and broader health.
The Yin and Yang of the Menstrual cycle
One of these sets of principles is the ebb and flow of Yin and Yang. This elegantly mirrors the different stages of the menstrual cycle. Yin is still and quiet, nurturing and moistening – it is the preparation phase. Yang is more dynamic and warming, it is the active growing phase.
Daoist Yin and Yang symbol
The Yin phase equates to the oestrogen dominated half of the cycle prior to ovulation. It is the first half of the cycle, and is preparing for ovulation by first shedding the endometrial layer from the previous cycle (the period), building the new layer for an embryo to implant into and ripening the follicles. It is responsible for governing the cervical secretions which need to be rich in potassium to fuel the sperm and loose and slippery for the sperm to swim through easily. The middle of the cycle is dedicated to ovulation when the follicle ruptures and the egg is released. The next phase is the Yang phase, the progesterone dominated half of the cycle. It dries up mucosal secretions to allow smooth passage the fertilized zygote and aid implantation. It facilitates the release of nutrients from the endometrial layer to nourish the embryo. If there is no conception and implantation, Yang is the motive force that builds to get the next period started to begin the new cycle.
Observing the Menstrual Cycle
A very useful fertility to tool to view the health of the menstrual cycle is charting. It can help a couple to know when the most fertile time is, and provide useful information for the acupuncture practitioner to track not only the length of the menstrual cycle, but also the length of the Yin/oestrogen phase and the Yang/progesterone phase. Charting is done based on your Basal Body Temperature (taking on waking at the same time each morning) and recorded on a chart. Below is a typical temperature chart.
It shows that in the first half of a typical cycle the temperature is lower than the second half. It shows that there is a dip in body temperature, a result of an oestrogen surge just in advance of ovulation. Around this time you should also see an increase in cervical mucous. Shortly after ovulation at the start of the Yang phase, there should be a spike in temperature, which should stay relatively constant for the remaining half of the cycle.
Charting is not for everyone, it does take dedication to taking the temperature every morning and paying very close attention to the cycle. However, there are other signs and symptoms that can be very informative – details that may not be considered as particularly relevant by a Western medical doctor – but can provide insightful clues into why a couple may be having difficulty conceiving.
Examples of signs and symptoms of particular relevance are: when and how your period starts and finishes; colour of blood; pain at any time during your cycle; headaches; cervical secretions; sleeplessness; mood. These signs and symptoms and temperature fluctuations help to understand the how the balance of Yin and Yang is in the individual and therefore where the focus of treatment should be.
For example, the first half of the cycle is very susceptible to emotional strain and can cause early ovulation (i.e. before day 14). Emotional strain can cause imbalances resulting in a slightly raised temperature, irritability and a degree of insomnia. Early ovulation can mean that eggs are being released before they are fully ripe and therefore either might not be fertilized or may not implant well if they are fertilized. Acupuncture treatment in this instance would focus on regulating your temperature, calming the mind and reducing stress.
Another example can be where the temperature is too low in the second half of the cycle and this can cause poor implantation or early miscarriage. In this instance treatment would focus on raising temperatures and nourishing the endometrial layer.
Each individual woman’s cycle is different and as such each treatment is personalized for whatever your particular set of circumstances might be. Advice around observing the fluctuations in the menstrual will help to maximize chances of conception and can be provided around diet and lifestyle for each individual’s health.
Acupuncture is not just used to support female fertility but male as well. There are a variety of signs and symptoms that can help to identify areas of treatment to focus on for men too. For example, men who experience feelings of coldness, fatigue and reduced sexual desire may well have sperm with low motility. In this case, treatment would focus on supporting the Yang aspect of a man’s health and advice around eating habits may be appropriate.
There has been research into how acupuncture can help support fertility naturally. Showing that it can:
be effective in regulating the hormones involved in fertility (Jin 2009, Huang 2009).
It can reduce the stress response, also known as “the fight or flight response” which can have a significant impact on the function of the reproductive organs and can inhibit ovulation (Magarelli 2008, Anderson 2007 ).
Increase blood flow to reproductive organs – improving the supplying of oxygen and nutrients to developing eggs in the ovaries and improve the blood supply to the uterus, thus making a healthier, thicker endometrial layer – which improves chances of successful implantation. (Stener-Victorin 2006, Lim 2010, Liu 2008)
It can work to counteract the effects of PCOS – balancing hormone levels, increasing ovulation and warming the uterus to improve blastocyst implantation (Stener-Victorin 2000, 2008, 2009, Zhang 2009.
Research into acupuncture for male fertility has shown that acupuncture can help to improve sperm maturation (Crimmel 2001), lower scrotal temperature (Siterman 2009), improving blood supply to the reproductive organs (Komori 2009).
More details on this research and full references can be found on the British Acupuncture Council website at the following links:
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