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Day 9 after FET, Amy receives the incredible news of a positive pregnancy test. Amy, who had previously sought IVF assistance at our clinic in 2015, was diagnosed with POI (Premature Ovarian Insufficiency). Due to her low AFC (Antral Follicle Count) and poor response during two previous egg retrievals, she had not been able to produce any viable embryos. However, after undergoing three months of Chinese medicine and acupuncture treatments, Amy’s luck changed. She managed to retrieve three embryos, and upon transferring two cleavage-stage embryos on day three, she conceived fraternal twins. The remaining embryo, a blastocyst (2 BB), was frozen for future use. Recently, Amy returned to our clinic for FET (Frozen Embryo Transfer) treatment.

Amy’s physical condition at the time was thin, weighing 130 Ibs and standing at 5’10”. She had been experiencing hot flashes, a dry vagina, irregular periods (with a 60-day cycle), and a low libido for the past couple of years. Upon examination, we noticed her tongue was purple, indicating weak microcirculation; and had a thick dry coating, indicating an imbalance in gut bacteria.According to Western medicine, Amy was in the premenopausal stage. However, in Chinese medicine, her pattern indicated a deficiency in kidney yin and yang, along with blood stasis and phlegm. Suggesting her immune system was not balanced.

With only 8 days until her transfer date, Amy found herself overwhelmed by the responsibility of caring for her twins. She felt helpless and scared that the FET might fail. Urgently, she made an appointment to see me. “We need to work together to create an optimal environment for embryo implantation,” I reassured Amy. “Balancing the body solely through diet and acupuncture might not be enough. We may also need herbal medicine to address the imbalance.” “I agree,” Amy responded. “I still remember how the herbs you gave me seven years ago helped me conceive fraternal twins. They made a significant difference in the quality of my eggs and the success of embryo implantation.”

Following my recommendations, Amy began taking Chinese herbal supplements daily, attending acupuncture sessions twice a week, before and after the transfer. Amy diligently followed all the recommendations, and within a week, her tongue had changed from purple to pink, with a thin white coating. And then, the incredible happened—she became pregnant! And the HCG double up every other day!

The treatment would not only help balance her immune system and circulation which change the environment of the embryo implanted, but also improve mitochondrial function in the cell of embryo.


Meet Cathy, a 38-year-old Spanish woman, standing at 5’2” and weighing 118 lbs. After a year of trying to conceive (in her second marriage), she sought consultation on July 28th last year. Cathy is a mother of three (aged 19, 15, and 12), while her husband has two children. His semen analysis came back normal. Cathy’s menstrual journey began at 14, with cycles spanning from 5-9/21-23. Her last menstrual period was on 7/7/22, with a flow lasting 5-6 days, occasionally accompanied by blood clots (++). She’s had 4 pregnancies with 3 live births and 1 miscarriage (in 2009). She’s also experienced ovulatory bleeding.

Following an Hysterosalpingogram (HSG) revealing patent fallopian tubes, Cathy often grapples with fatigue, dry mouth, sporadic night sweats, and a slightly swollen, pale red tongue with a white coating. Traditional Chinese Medicine identified a pattern of Kidney Qi Deficiency. Cathy embarked on a journey of Chinese herbal medicine and acupuncture, with a daily dosage of 3.5 grams.

Fast forward to 10/05/22, Cathy found herself pregnant again. The emphasis on nourishing her kidneys for a healthy pregnancy was heightened. However, at 7 weeks of gestation, a miscarriage occurred, revealing trisomy 21 in the embryo tissue pathology report. After a month of rest, the previous treatment plan resumed. On 4/6/23, Cathy found herself pregnant once more, experiencing dry mouth, a pale red tongue, and thin white coating. The regimen now included reinforced kidney tonification and Yin nourishment. Then, at 9 weeks, a sudden, substantial bleeding episode, soaking the bed sheets, accompanied by abdominal pain. Hormone levels were normal, and ultrasound revealed a fetal heart rate of 170 beats per minute and a subchorionic hematoma. Diagnosis: Infertility, recurrent miscarriage; subchorionic hematoma.

Traditional medicine offered no specific intervention. Given the patient’s 4-hour travel distance to the clinic, she was advised to double the original dosage of Chinese herbal medicine. After 5 days, bleeding ceased, and she returned for a follow-up. The herbal medicine dosage was then reduced to the standard amount. The pregnancy was supported until the 12th week. Two months ago, a follow-up with fetal Non-Invasive Prenatal Testing (NIPT) showed normal results. She is currently 28 weeks pregnant.

In summary, both advanced age infertility and supporting a pregnancy are built upon the foundation of nurturing ova and embryos. This constitutes the underlying logic of Chinese medicine for pregnancy support. By enhancing the living environment for ova and embryos, improving the cellular mitochondrial function of ova and embryos, clearing free radicals, reducing DNA damage, preventing mutations and epigenetic variations, regulating immune function, and enhancing circulation, better therapeutic outcomes can be achieved.


Botanical medicine, also known as herbal medicine, is the science and practice of using medicinal plants and extracts to improve overall health, support wellness, and treat acute and chronic disease.

We have practiced botanical medicine based on traditional Chinese medicine for over 35 years. There are a lot of successful cases in our clinic. Herbal supplements can be adapted to treat difficult infertility conditions such as POI, POF, PCOS, endometriosis and repeated pregnancy loss. It is very effective to combine with Chinese herbal medicine in the ÎVF support plan.

  1. Antral Follicles Counts ( AFC)

Antral follicles are the most primitive grade 3 follicles that develop in the ovaries and are important indicators of female ovarian function.

With the help of vaginal ultrasound or color Doppler ultrasound, doctors can count the number of antral follicles to evaluate a woman’s ovarian function and reproductive ability.

The number of antral follicles is closely related to the success rate of IVF.  The greater the number of antral follicles increase the number of mature follicles obtained after ovulation promotion, increasing the likelihood that any available eggs would be accepted during egg retrieval process; the more embryos used for transfer, the better.

Antral follicles are critical to the success of IVF. The data from our clinic show that botanical medicine can significantly increase the number of antral follicles.

There were 43 patients with antral follicle count data before and after treatment. The patients were between 30 and 43 years old, and the median age was 39 years.

We compare the number of antral follicles before and after herbal treatment with the number of antral follicles after 3 months of taking the herbal medicine. The results in Figure show that AFC has a significant upward trend after treatment.

The results in the Figure 1 suggest the herbal supplements may increase the number of antral follicles by blocking the apoptotic pathway of eggs, thereby improving female reproductive capacity and helping to increase the success rate of IVF.

Figure 1: The AFC comparison before and after herbal treatment in 43 cases

  1. Anti-Mullerian Hormone (AMH)

Anti-Müllerian Hormone (AMH) is a glycoprotein. AMH is secreted by granulosa cells in the follicle. The more ovarian follicles, the higher the concentration of AMH in the serum.

The increase in AMH not only reflects the increased function of follicular granulosa cells, but also reflects the increase in the number of antral follicles.

Granulosa cells are not only a source of nutrients for oocyte development, but also a place to aromatize androgens to produce estrogen.  The improvement of AMH suggests an improvement in egg quality and ovarian axis function.

Therefore, reproductive doctors often use it as one of the indicators of ovarian reserve, which can be used to predict female fertility and IVF success rate.

We collected clinical data of 14 patients and compared them before and after. The patients were between 32 and 41 years old, and the median age was 37.5 years.

The results in Figure 2 showed that AMH had a significant upward trend after treatment.

Figure 2: The AMH comparison before and after herbal treatment in 14 cases

  1. Third Day Embryo Counts

After egg retrieval and fertilization using IVF technology, the embryonic development is as follows:

Day 1: Sperm and egg are combined and fertilized, and two pronuclei appear;

Day 2: Embryo develops to 4 cells;

Day 3: Embryo develops to 8 cells;

Day 4: Embryo development to morula stage;

Day 5 and 6: Embryo development to blastocyst stage.

We collected the three-day embryo counts of 16 patients before and after treatment. The patients were between 30 and 43 years old, and the median age was 37 years.

The results showed that the number of three-day embryos obtained by the patients increased significantly after treatment with the herbal supplements.

The results in the Figure 3 suggest that the patients have noticed a significant improvement in  egg quality after taking the herbal supplement —especially the enhancement of the mitochondrial function of the eggs, so as to provide enough energy to promote embryonic development.

Figure 3: The Third Day Embryo Counts comparison before and after herbal treatment in 16 cases

  1. Blastocyst

Compared with the third-day embryo, the fifth-day blastocyst is a more well-developed embryo.  Generally speaking, the implantation rate of embryos on the third day is 20-30%, and the implantation rate of embryos in the blastocyst stage on the fifth day is 40-50%.  Therefore, the increase in the number of blastocysts is a critical factor in the success of IVF.

A total of 17 patients had blastocyst count data before and after treatment. After their  comparison, the patients were between 33 and 46 years old, and the median age was 38 years.

The results showed in Figure 4 that blastocysts had a significant upward trend after herbal treatment.  This result further suggests that the botanical medicine have the effect of blocking egg apoptosis and improving mitochondrial function.

Figure 4:  The  Fifth Day Blastocyst Counts comparison before and after herbal treatment in 17 cases

  1. Euploid Blastocysts (uploid)

Preimplantation genetic screening (PGS) refers to the analysis of 23 pairs of chromosomes of embryos through biopsy of embryonic cells during IVF treatment before the embryos are transferred into the uterus.

If the number of chromosomes of the blastocyst is normal, then  This embryo is called an Uploid blastocyst.

With the increase of age, the quality of women’s eggs gradually decreases, and the aneuploidy rate of embryos increases.

Non-euploidy is the main cause of embryo implantation failure, spontaneous abortion, and congenital malformations.

It is also a key factor leading to IVF failure and the leading cause of early abortion in older women.

To further confirm the effect of botanical medicine on the improvement of egg quality, we collected the changes in the number of euploid blastocysts before and after herbal treatment in 14 patients.

The patients were between 32 and 42 years old, and the median age was 38.5 years.  As shown in Figure 5, most patients cannot obtain euploid blastocysts (uploid) before treatment, which leads to complete failure of IVF.

However, after treatment, 11 patients obtained euploid blastocysts.  One of the patients obtained 12 euploid blastocysts after treatment with the herbal supplement.

This result further suggests that in addition to inhibiting the apoptosis pathway and promoting mitochondrial function, the prescription may also protect the egg DNA from damage and prevent gene mutation.

Figure 5: The Euploid Blastocysts (uploid) counts comparison before and after herbal treatment in 17 cases

 


Elaine, 38 years old woman, 125 lbs, 5’6”, visited my office at February 11, 2021. Patient had tried to conceive for six years. She was diagnosed with stage 4 endometriosis in last August.  The right ovary and the right tube had been removed with surgery. The ovary cyst was measured 7.2×4.3×3.0 cm. She got pregnant one month after the surgery but miscarriaged in the 9th weeks of pregnancy. The cramping had come back since then. The sharp and  paroxysmal pain occurred before and after period on the pain scale of 8 (if the pain scale from 0 to 10 and the greatest pain is 10) with cold sweating. The pain even happened in between the period. She needed a great amount of pain medication to reduce the pain. It is very disturbed to her normal life and her work. The sonogram showed there was 4.8×4.5cm cyst on the right annex area on January this year. Her doctor suggested another surgery, but she would like to find noninvasive treatment to control the disease since the condition recurred in the short period of time after last surgery.

History of GYN: 14 5/28-30, ovulation on day 14th of the cycle. G2 A2 (Patient has had an abortion in 2015). LMP:02/07/21.

Family history: unclear.

Patient came to visit me and ask to decrease the pain to get back to normal life at first. She also would like to control the endometriosis to avoid the repeated surgery if it is possible. Patient had not believed that she will pregnant again since the endometrioma came back so soon. I told her Chinese medicine not only could help her controlling the endometriosis and decrease the pain, but also was able to absorb or decrease the sizes of endometrioma and she could possibly conceive naturally. I encouraged her try to conceive during the treatment. I suggested she changed her diet with anti inflammatory food, took the herbal supplements daily. came for acupuncture once a week.

Chinese medicine is a holistic approach: it go through all the signs and symptoms (Subjective and Objective), family history, life style, the culture of living area and season (weather) etc. to analysis patient’s condition. Then combining all the information together to figure out( call differentiation )a pattern of disease,  then give the treatment according to the pattern. The pattern could reflected the stage of process of disease, or the reaction to the disease from different physique( including the different epigenetic-see explains below).

Elaine was born in Taiwan, she came over to America, when she was 18 years old.  Foods ( for example, eat more meat than she used to), climate and life style (sleeping patterns, stress etc.) are totally different between two areas. For instance, her body was not get used to the high protein diet, especially when her metabolism was getting lower with the age.  Her immune system and hormone balance had changed through the diversity of bacteria in the guts because of high protein intake and age and stress. These changes were reflected in the pelvic area(uterus, tubes, ovaries and guts) as well as on her tongue color and the coating.

 

Endometriosis is a benign disease defined by the presence of ectopic endometrial glands and stroma associated with both pelvic pain and infertility(or miscarriage). The ectopic endometrial lining tends to grow in pelvic area such as ovaries, tubes, large intestine and peritoneum etc. These area will induce the bleeding during period. The bleeding is no where to go which making infection ( adhesion, scar tissue etc.) to create great pain and change the structure of the pelvic, especially reproductive organs. These change will interference the oocyte development and early embryogenesis, inhibit or prevents ovum capture after ovulation, reduced endometrial receptivity. Stage 3 and  4 endometriosis presents severe structure changes.

The causes of disease are still not clear and complicated. According to previous studies, the primary mechanism is possible for retrograde menstruation and implantation of viable endometrial tissue. But why does severe disease develop in some women but not in others? Multiple observations suggest that the endometrium in women who develop endometriosis may be inherently abnormal in ways that predispose to ectopic implantation and propagation.

Genes that may predispose to the development of endometriosis might include any of those that direct the molecular processes that survival of detached endometrial cells, their attachment to an invasion of peritoneal surfaces, proliferation, neovascularization, or the inflammatory responds. For instance, europic endometrial cells from women with endometriosis are resistant to apoptosis; in women with endometriosis, secretory endometrial matrix metalloproteinases expression in unusually resistant to progesterone suppression which can confer an invasive potential in shed endometrial cells to the peritoneal surface and subsequent cell proliferation; aromatase, the enzyme that convert androgen to estrogen is abnormally expressed in the eutopic endometrium of women with endometriosis which improve the disease, etc.

 

Endometriosis also associated with changes in both cell – mediated and humoral immunity, which suggests that an impaired immune response resulting in ineffective removal of reflux Ed menstrual debris may be a causative factor in the development of disease.

 

Based on the causation, endometriosis not only change the structure of the reproductive organs to decrease the possibility of egg releasing and fertilized, but also affect the oocyst’s quality, early embryonic development and embryo implantation etc. which can’t avoid the infertility and miscarriage. Elaine is one of this case.

 

Elaine quickly conceived after the surgery but miscarriaged at the 9th weeks. Now surgery should not be an option anymore from the point of fertility preservation. Elaine is going to be 39 this year, the important thing is to protect her fertility preservation. Usually IVF is the option in this point. But the successful rate would be low in the condition that the disease is progressing if the environment of the pelvic and uterus not changed. In the past practices years, I have used Chinese medicine ( including herbal supplements and acupuncture) to help many of the these similar cases whose failed many IVF, IUI or natural pregnancy. According to the studies in China, I believe Chinese medicine from different angles and levels to work on multiples targets to impact the expression of the genes and repair the immune system in order to create the health environment for pregnancy. I suggested she prepared to conceive for three month.  She could consider the IVF if she was not pregnant in three month.

 

In Chinese medicine, there are serval different patterns for endometriosis. These patterns ( different objective and subjective symptoms) may reflect different expression (different symptoms) of gene in the different body. These expression may be affected by foods, stress, life style, hormones and impaired immune system, etc. call eigenetic. Epigenetics is the study of how your behaviors and environment can cause changes that affect the way your genes work. Unlike genetic changes, epigenetic changes are reversible and do not change your DNA sequence, but they can change how your body reads a DNA sequence.

We suggest the patient change the diet and life style according to the pattern.  Second, the herbal supplements were prescribed for her to get off the symptoms, which I believed it alters the expression of the gene epigenectics. For instance,  the food such as green tea could effect on DNA methylation through to adjust the level of methyltransferase. Most herbal supplements I give to the patient are food grade plants. It indicated the expression has been up or down to reach what they should be if the symptoms were gone. Third, acupuncture helps to decrease stress, anxiety, and balance the munro-immune-endocrine system.

 

According to Elaine’s signs and symptoms, she could be considered as a pattern of Qi and blood stagnation with damp heat, underlining Qi and Yang deficiency in Chinese medicine. I gave her Chinese herbal supplements daily and acupuncture treatment once a week. Her menstrual cramping decreased to 50% after a month of treatment, 90% after second month. The sonogram showed that the ovary cyst decreased to 2.8 cm from 4.8 cm in January 2021 . She conceived naturally in May 2021.


Most of my patients had been going through ÎVF cycles and did not have positive results.

I have conducted a retrospective analysis of some patients successfully treated with pure acupuncture and found that most of these patients were transfer failures.

 

From the perspective of Chinese medicine, the emphasis is on liver-qi incomfort, liver-qi stagnation, and liver fire flame up.

 

It is easy to have anxiety, such as not sleeping well the night before transfer, worrying about failure, cold hands and feet, irritability, worry, etc. before transfer.

 

Infertility is a crisis of the deepest kind. For some families, children are the bond that maintains the integrity of the family. For the family who spend all their money to do lVF, and even in some families, lVF is the last straw to save marriage or partnership. It threatens many aspects of a couple’s life.

 

It is understandable to be nervous.  Anxiety often leads to the secretion of many hormones, such as adrenaline, which can cause uterine contractions.  I have seen patients like this. Just before the transfer, the ET cycle had to be terminated.

 

However, uterine contractions never occurred in the subsequent acupuncture treatment cycle, and they became pregnant smoothly. Such patients are suitable for IVF acupuncture.

 

In other patients, blood heat, (sputum) damp-heat content, such as inflammatory constitution (immune-endocrine: hormone level imbalance, intestinal microbial balance imbalance, inflammation, high blood viscosity, and egg quality are affected, which affects the  In patients with intracavitary anti-implantation, etc., such as endometriosis, PCOS, or drug-induced estrogen levels are too high, not only the egg quality is affected, but the implantation rate is low.

 

For some patients, the use of acupuncture, suction, moxibustion, heat stimulation, as well as dietary modifications, can improve the inflammatory condition by improving metabolism, balancing intestinal flora in order to achieving immune balance, and even endocrine balance. It  makes pregnancy possible. Some young patients can also become pregnant naturally.

 

I used to treat a patient with severe arthritis. She used nearly 10 different drugs for a long while and had failed IUI many times. After half a year of acupuncture and dietary modifications, She stopped taking all drugs except 5mg dexamethasone and got pregnant naturally.  Most of these patients with moderate and severe conditions require long-term adjustments. They are good candidates for the application of Chinese medicine.

 

Fertility acupuncture can be adapted to treat POI or POF patients, which may be related to the  adjustment of neuroendocrine mediators through acupuncture and moxibustion to promote ovulation and achieve natural pregnancy or ÎVF.  There were many successful cases in our clinic. But it is more effective to combine with Chinese herbal medicine in the treatment plan.


Assisted reproductive technology (ART) refers to all technologies that directly obtain oocytes

from ovaries. The most commonly used technique for fertilization is in vitro fertilization-embryo

transfer (IVF-ET). This process refers to taking out eggs from female ovaries, culturing them in a

vessel containing particular nutrients, and adding a certain amount of technically processed

sperm to fertilize them (IVF phase).

 

Then the culture is continued, and the early embryo or blastocyst is formed, which is transferred

to the intrauterine implantation (ET phase) to develop into a fetus until delivery. It includes the

second-generation IVF, which is called intracytoplasmic sperm injection (ICSI), the

third-generation IVF, which is called preimplantation embryo genetic screening (PGS) or

diagnosis (PGD).

 

You may ask how acupuncture connects with IVF and reproductive medicine? As the live birth

rate of assisted reproductive technology is only about 30%-50%, to improve the success rate of

IVF, acupuncture, an ancient therapy, has received attention in the early development of in vitro

fertilization-embryo transfer (IVF) technology.

 

The world’s first test-tube baby was born in the UK in 1978, but the clinical pregnancy rate was

low. Doctors began to seek help from non-mainstream medicine, meditation, psychological

cues, etc. The application of acupuncture in the field of assisted reproduction also began to

receive attention.

 

In 1996, Stunner-Victorin et al. published the first research on the application of acupuncture in

IVF and embryo transfer in the “Journal of Human Reproduction,” which ignited acupuncture

points in assisted reproductive technology.

 

In 2002, Wolfgang E. Paulus applied the evidence-based medicine RCT method for the first

time, using body and ear acupuncture to intervene 25 minutes before and after the IVF embryo

transfer process. As a result, the clinical pregnancy rate can significantly increase, which has

attracted the attention of reproductive endocrinologists.

 

A live birth determines a successful IVF cycle. The following conditions must be met:

  1. Quality eggs and sperm;
  2. Quality diploid embryos;
  3. Uterine body and endometrial receptivity;
  4. Embryo development to full term.

So what is the role of acupuncture in reproductive medicine? I conducted a retrospective

analysis of some patients who were successfully treated with acupuncture.

 

1.Anti-anxiety

 

There are several situations for those who have high-quality embryos but failed transfers.

Anxiety is one of the most common reasons cause failure. ÎVF procedure is costly, and the

successful way of live birth is only 30%-50%, according to the American Society of Reproductive

Medicine. For some families, children are the bond that maintains the integrity of the family. IVF

becomes their Saviour of marriage or partnership. If IVF is the last straw in the relationship,

tension is understandable.

 

Anxiety often leads to abnormal secretion of many hormones, such as adrenaline, which can

cause uterine contractions. I have seen a patient who had to terminate the IVF transfer cycle

just three days before the procedure.

 

However, the uterine contraction never occurred in the subsequent IVF cycle with IVF

acupuncture treatment, and the pregnancy went smoothly. Such patients are good candidates

for IVF acupuncture.

 

  1. Reduce uterine artery impedance

 

If blood flow resistance of the uterine artery increases, the blood supply of the endometrium is

insufficient, affecting the embryo’s implantation and development.

There used to be some reproductive endocrinologists in evidence-based research to observe

patients’ blood flow before and after acupuncture using the uterine artery impedance as an

indicator. I also took part in this observation, and it turned out that the uterine artery impedance

decreased after acupuncture treatment.

 

  1. Improving the inflammatory body

 

Patients with an underlying inflammatory condition, such as immune-endocrine imbalance

levels, unusually elevated estrogen blood levels, imbalance of intestinal microbes, and high

blood viscosity, affect the quality of eggs but also causes intrauterine environment resistance to

implantation.

 

For mild inflammatory conditions, acupuncture, cupping, and dietary modifications can improve

the body state, making clinical pregnancy possible. Some young patients can also become

pregnant naturally. I have treated a 37-year-old white woman with PCOS. She went through two

failed two egg retrievals. After acupuncture and cupping, the eggs were retrieved, and two

normal blastocysts were obtained. I used to treat a 32-year-old patient with severe arthritis. She

used nearly ten drugs to control the joint pain for a long time. She had failed IUI 6 times. After

acupuncture and dietary modifications for six months, she stopped taking all drugs except 5 mg

dexamethasone and became pregnant naturally. Two years later, she came back for fertility

acupuncture treatment and conceived a second child.

 

  1. Adjust the function of the reproductive axis.

 

Long-term overwork or mental stress may cause adrenal hormones to be often at high levels.

Negative feedback inhibits the secretion of adrenal hormone-releasing hormones, promotes

GnRH release, and damages the reproductive axis. Acupuncture and herbal medicine may help

adjust the neuroendocrine system and restore ovulation to achieve the purpose of natural

pregnancies. There are many successful POI and POF case reports.

 

  1. Prevent miscarriage or premature delivery

 

Contractions caused by various reasons cause many miscarriages or preterm births.

A patient had contractions at the 36th week of pregnancy, and the cervix became shorter in

length. The doctor told her that she would give birth prematurely at any time.

 

However, after acupuncture treatment, the contractions stopped, and the cervix became stable

and induced labor at forty weeks.


David, a 35 years man who married a 33 years beautiful women, named Stephanie. His wife has been tried to conceive since the community was locked down in April of this year. Her medical report was good except the right fallopian tube was sluggish and some ovulation issue. She had been treated in our clinic since July and has great improvements. But she still not conceived. In the 5th of August, His seaman analysts was showed his sperm morphology was only 1%. He felt very stress amid Covid-19 pandemic. He was afraid he would lose his job. As her acupuncturist recommended, he came for acupuncture and herbal treatment. After one month of stress treatment, he felt much better and his wife had a positive pregnancy test on 09/25/2020. She is continuing the acupuncture treatment for miscarriage prevention and the baby is growing normal so far.

This couple is not alone. We have seen more infertility cases in the past six months. Covid-19 pandemic has been causing infertility increasingly this year.

Despite the progress of modern medicine, the COVID-19 epidemic has caused more than 1 million deaths world wide in less than a year to date. In addition to the death toll, the epidemic has also caused widespread and serious emotional and health problems. The effects of traumatic stress associated with COVID-19 are reported in recent literature, as well as the effects of less severe stress exposure types. Coronavirus has led to various mental health problems, including anxiety, depression, PTSD and other traumatic and stress-related diseases, such as coronary heart disease, infertility, etc.

During the pandemic, different groups of people meet the trauma exposure standards of DSM-5 post-traumatic stress disorder: individuals who have witnessed the suffering and death of others, such as family members and medical staff; understand that the virus has caused the death or potential of family members or friends Individuals who died; and practitioners who were extremely exposed to details alike, such as journalists, emergency personnel, hospital staff, etc. In addition, social isolation, presidential elections, unemployment and economic losses, working at home and caring for children and other family members, exposure to non-traumatic stress, greatly increase personal emotional burden.

In August, CDC published a large-scale online survey of over 5,000 adults in the United States: 40.9% of them indicated at least one mental or behavioral health disadvantage associated with the epidemic. Traumatic and stress-related diseases were reported to be 26.3% anxiety or depression symptoms were 30.9%, and 13.3% of drug abuse to respond to 13.3%, and 10.7% of the cases of suicide seriously considered.

The online survey from nearly 3,500 people in Spain showed PTSD (15.8%), depression (18.7%) and anxiety symptoms (21.6%). Loneliness is the most symptomatic forecast, and other factors related to these problems are female, previous mental health problems, having physical symptoms similar to the virus, or having a close relative infected.

For fertility issues caused by mental stress, I recommend a gentle approach for stress to effective treatment, which is one of the more effective forms of acupuncture therapy, as we have amply demonstrated in the clinical practice of  nearly six months.

The current pandemic will challenge us and will also give us the opportunity to continue learning and share it with other reproductive medicine peers, hopefully linking us cooperatively.

 

Reference:

  1. Forte G, Favieri F, Tambelli R, Casagrande M. COVID-19 Pandemic in the Italian Population: Validation of a Post-Traumatic Stress Disorder Questionnaire and Prevalence of PTSD Symptomatology. Int J Environ Res Public Health.2020;17(11):4151.
  2. González-Sanguino C, Ausín B, Castellanos MÁ, et al. Mental health consequences during the initial stage of the 2020 Coronavirus pandemic (COVID-19) in Spain. Brain Behav Immun. 2020;87:172-176.
  3. Restauri N, Sheridan AD. Burnout and Posttraumatic Stress Disorder in the Coronavirus Disease 2019 (COVID-19) Pandemic: Intersection, Impact, and Interventions. J Am Coll Radiol.2020;17(7):921-926.

Cindy, a 40-year-old woman, visited us in October 2019. She was referred by her doctor because she had just failed one frozen embryo transfer last month. The implantation failure was unexpected and unexplained because the embryo had been tested and was of good quality. The endometrial lining was thick (8mm) and the texture was perfect. Cindy and her husband were very upset. They only had two embryos left and the new FET cycle started a week ago. They were afraid of failing again.  Her doctor was not going to change the protocol because all indicators before the transfer had been promising. Cindy and her husband did not know what they should do.

Cindy is 5 feet, 140 lbs. When she came to see me, she had a dry mouth and a swollen and dark red tongue with a thick white coating. According to Chinese medicine, analysis of these symptoms indicated some imbalance in her body. The patient had the pattern of accumulation of phlegm and blood.  This kind of condition suggested that her blood flow and metabolism were slow. It indicated that her digestive system was not performing well, which could be caused by a disruption of the bacterial microbiome in the gut. I found out she never drank enough water. She only drank two cups water a day. She liked to eat sausage and cheese, but she had no vegetables with her meals. Her unbalanced diet may have induced the inflammation that caused the implantation failure.

Cindy had been on estrogen for over a week for the second FET cycle by the time she visited me. I recommended that she change the diet including increasing her water intake. She additionally received some acupuncture treatment to create a better uterine environment for the embryo implantation. But her lining measurement this time was thinner than her last cycle, only  7.8mm on day 12 of estrogen. She was worried. I suggested that she take some herbs to enhance the quality of her uterine lining.

Over the past 20 years, I have used Chinese herbs and acupuncture to help many women who have had multiple FET failures. Most of these failures are unexplained. But these women have eventually had babies. My previous experience shows that Chinese medicine can improve endometrial acceptability. Combined with acupuncture, herbal supplements can balance the immune system and create more estrogen and progesterone receptors to further improve the likelihood of embryo acceptance.

Cindy was 40 years old.  I have mentioned that her metabolism and circulation seemed slowed.  But she might also have had immune system imbalance and hormone receptor deficiency.  She also had a history of FET failure and her endometrial lining the second cycle was even thinner that the first FET cycle. With the thinning of her lining, the possibility of failure had increased. Because of this reason, I highly recommended that Cindy combine her acupuncture treatment and increased water intake with Chinese herbs. She agreed.

With the help of acupuncture and Chinese herbal supplements, Cindy is now 12 weeks pregnant!


I have recently met many women who suffered from diminished ovarian reserve (DOR). They all had similar conditions: low antral follicle count (AFC), low AMH or elevated FSH and E2. They have tried to conceive for many years and failed multiple medical treatments, including IVF. Some of them had been persuaded into using donor eggs.

DOR can happen at any age. Although aging is definitely a contributing factor, others risk factors are less well known especially in young women. Contributors to DOR may be related to lifestyle, diet, genetic factors, infections and hospital-related factors. Women who have lower ovarian reserves also indicate they have lower egg qualities. Most of the woman do not know they have diminished ovarian reserves until they have difficulty conceiving. DOR is usually treated by hormones or hormone receptor antagonists. These patients have also either tried timed-intercourse or IUI or IVF, but they do not always have good results.

Chinese herbal medicine and acupuncture have been used to help these types of patients for decades. Clinical studies have shown increased chances of pregnancy after treatment with Chinese medicine.

Kristy is one of these DOR cases.  She was a 38 year old mother and she had tried for two months to conceive a second child. We had helped her conceive her first baby naturally after two failed IVF cycles, multiple IUI, and one miscarriage two years ago. Her son was eight months when she came in. After she stopped breast feeding, she found out her period was getting shorter and shorter: there were only 21 to 23 days per menstrual cycle.  She knew something was wrong. She decided to return and ask for help with preparing for the next pregnancy.

Kristy was a thin lady. She was 5’5” and 110 lbs. Her blood work showed she had positive cardiovascular antibodies (CVA) years ago. She was a business woman, and she was under a lot of stress. Her lifestyle consumed her body essence and it leaded to a condition of essence deficiency.  Here was her test result: FSH 3.8IU/L. LH 2.47IU/L. Estriol 143 pg/ml. AMH 0.39. The antral follicles count (AFC) was 5. According to test results and her CVA condition, we differentiated her health condition as essence deficiency with blood stasis. We introduced her Chinese herbal medicine. She took them everyday and received treatment twice a week. She finally conceived on the third month of treatment and she continued acupuncture until week 18 of pregnancy!


Aging is a sensitive term for most women. No one wants to grow old but no one can stop the process of aging, the onset of wrinkles and gray hairs. But while we can’t stop time, we can moderate the way time affects us. In modern society, our lifestyles can speed up our aging: stress speeds up aging, eating incorrectly can speed up aging…anything from the way we sleep to what we intake can affect how quickly or slowly our bodies decline.

For women, aging has a strong correlatiuuon to the number of eggs in the ovaries. The eggs are present from the time a baby grows in her mother’s womb, never multiplying or replicating as sperm does. As she loses those eggs throughout her life, she also ages: this process usually ends when she is 50, the age at which she goes through menopause. But just as it affects the aging of the rest of her body, her lifestyle—stress, eating habits—will influence the environment of the ovaries, which can quicken egg apoptosis and affect egg quality. Thus, she might reach menopause too early as a result of an unhealthy lifestyle.

For these reasons, women with these qualities and habits have a much lower chance of pregnancy than women of the same age group without this lifestyles. In my career, I have seen many women who suffer from premature ovarian failure due to highly stressful lives. I have also treated many patients with low ovarian reserve because they were vegetarians without nutritional guidance who did not receive all the nutrition they needed. Katie was one of those examples.

Katie, a 44 year old teacher who worked with kids with speech difficulties at school, felt tense and stressed from her job. She was not eating well because she was always running from place to place. When she first visited me, she hadn’t had a period for three months and had an irregular period (skipped periods) for a year before that. She experienced hot flashes, sweating at night, extreme thirst, stress, tiredness, hair loss, dry vaginal sensations and no sex drive. Her period was very light when it came.

She had already had one child through IVF when she was 40 years old. After her first baby was born, she began to try for another. She underwent three cycles of IVF but each of them failed—she either only had one potential egg or the eggs would not grow at all. The level of her FSH—over 50 miu/ml—indicated that she was going through her menopausal stage.

“Do you think I still have hope?” she asked me during that first visit. I knew she did. I told her that Chinese medicine was different from western medicine. Western medicine stimulates the ovaries to make more eggs. It is an external force that pushes the ovaries to work in a way that they wouldn’t naturally function.

Chinese medicine works by balancing the body, changing the environment of the ovaries so that the eggs are encouraged to grow and work efficiently. It changes from the inside out. I explained that she only needed one good quality egg to have a baby. Once she had an egg, she would have a chance. After she listened, she was still doubtful, but she wanted to try. I evaluated her health condition, diagnosed her with kidney deficiency with qi and yin insufficiency. I recommended that she take Chinese herbs every day and receive acupuncture once a week.

After the first week of treatment, her hot flashes and sweating disappeared. Her sleeping was getting better. The second week, she ovulated and her vaginal discharged increased. After four weeks of treatment, she had a full period. After 11 months of treatment, she became pregnant! On the 11th week of pregnancy, her blood work was tested and she had a level 2 sonogram. The result showed that the baby was normal.

Katie was not an anomaly. In the past, I have successfully treated a 45 year old woman with acupuncture, who had a similar condition to Katie. She came became pregnant with twins with an IVF treatment when she was 46 years old. We also had a patient whom acupuncture helped naturally conceive her first healthy baby after a failed IVF cycle—at the age of 45.

These cases indicate that no matter how old you are, your egg quality still has a chance to improve if we are able to create a good environment for the egg to grow. Chinese medicine and acupuncture can help build up this environment, which improves pelvic circulation so that more oxygen and nutrition to the ovaries for egg and antral follicular growth. The improved environment through acupuncture makes egg quality much better. On one hand, eggs will create more receptors to respond to the FSH, so FSH levels will drop quickly. And then the eggs will be able to grow to maturity. On the other hand, the genes inside the eggs would not be varied easily.

This is an advantage of Chinese medicine. Western medicine assumes tight limits to what the body can do: it accepts that bodies need external medicines, outside forces to force it to act in a way that it should. But in truth, the human body is amazing and its own natural abilities should not be discounted. Our bodies were designed to work, not fail—all we must do is treat them the way they were meant to be treated and, in turn, they will treat us well.