Ovarian infertility which refers to any problem pertaining to the ovaries.
Tubular infertility which refers to defective Fallopian tubes and
Uterine infertility referring to any problem in the uterus, usually the wall of the uterus, the endometrium.
There are also diagnoses that dont fit in any of the 3 categories, these are the auto immune issues or less commonly pituitary problems, these will also be discussed below.
Anovulation (no ovulation)
The two most common form of anovulation is polycystic ovarian syndrome and premature ovarian failure, both covered below, other factors include:
- body weight that’s too high or too low
- extreme exercise habits
- eating habits
- high levels of stress
Some of these may have other underlying conditions such as bulimia or anorexia. Excessive exercising will have an impact on the Qi of the kidneys, it is the kidney Qi that provides for the creation of hormones. If you are struggling to ovulate it is important to cut back on exercise if you have a tendency to excess.
Ameorrhea (lack of period)
The largest cause of amenorrhea is pregnancy. Aside from this, it happens because the hormones (oestrogen and progesterone) have not reached a fresh-hold the stimulate menses, Creating fresh Qi for the system of hormones will usually stimulate menses. This is done by working on the liver and kidney qi for oestrogen and progesterone respectively.
Premature ovarian failure (and poor egg health)
Years ago it was believed that female egg production was finite (700 000 eggs at puberty was the magic number), when they run out, that was it. Now we know different, the ovaries contain undifferentiated stem cells. New eggs can be created from stem cells. The ramifications of this are enormous, because the Qi that the body requires to convert these stem cells into eggs comes directly from the meridian system, we also know this Qi can become exhausted, and it can also be rebuilt. The Chong mai (we still use the chinese name) travels upwards through the ovaries, adrenal glands, pancreas, thymus, and thyroid on its way to the pituitary gland and finally onto the pineal gland. This vessel maintains the entire system of hormones and supplies it with Qi. In POF the chong mai is usually weak. Furthermore its susceptible to medication such as antibiotics and steroids, but in particular by synthetic hormones, namely oestrogen and progesterone. The aim of Acupuncture is to rebuild the system of hormones and remove any pathogens, if this is done correctly it is possible to start producing new eggs.
Poly cystic ovarian syndrome
Diagnosis is based on the following 3 findings, no ovulation, high androgen levels (male hormones), and ovarian cysts. There is a strong familial connection with PCOS. One meridian in the body contains all the genetic material, it is called the chong mai, genetic- impure Qi is caught here, removing it from the system will most likely form part of the treatment, all be it nearer the end. The chong mai is also the vessel that regulates the negative feedback loop of all the hormones (with the pituitary), which tells us it is also involved with the excessive production of androgens, normally produced in low levels in the ovaries and adrenal glands. Synthetic hormones are usually given at some point, these hormones further imbalance the chong mai, removing these from the system (which takes many years if not done with acupuncture), is important for restoring normal periods and ovulation.
The cysts themselves are caused by the presence of heat. Just as the heat from an injury will cause the body to bring water (inflammation), so the heat in and on the ovary will cause the body to form a cyst to ‘contain’ it and minimise the damage. If we solve the heat the cyst itself is reabsorbed. In Chinese medicine all the glands are connected to the Qi of the spleen. The heat from the cyst will be found in the part of the pulse where we find the spleen Qi, even the side they present can be ascertained. The heat itself can be released out of the meridian system in a number of ways.
Blocked Fallopian tubes
The main causes of blocked fallopian tubes:
A condition in which the tissue that normally lines the uterus grows outside the uterus. In Classical Chinese medicine we find stagnation in the Qi of the liver. The stagnation is caused by either heat or wind (wind is a CM term that describes movement). The 5 phases of Chinese medicine are wood fire earth metal and water, fire and wood both have expansive qualities, they also consume healthy Qi. The heat (or wind) has penetrated the Qi of the uterus which is controlled by liver energy, this consumes normal ‘upright’ Qi and the ensuing deficiency stagnates the flow of Qi leading to endometriosis. Acupuncture is then applied, to first of all get the Liver Qi moving, this starts to cool down the heat. The underlined heat or wind must be dealt with also, usually it is dispersed from the body. The cause from a western sense is not entirely clear. Risk factors include having a family history of the condition, but also infection, emotions, or even medication might trigger it.
Pelvic inflammatory disease
PID is an infection of the upper genital tract that can include ovaries, fallopian tubes or the uterus. For a bacteria or virus to penetrate there has to be an underlined deficiency in the immune system, 70% of the immune system is in the gut (gut associated lymphoid tissue), from the gut, immune strength is created, modern life absolutely bombards gut bacteria, wrong diet, sugar, antibiotics in animal feed as well as taken orally and intra venously, hormones, medications, inoculations, pesticides, herbicides, chlorine in the drinking water, it goes on, is it any wonder immune systems are weakened! Acupuncture is most helpful here to remove any little critters that have invaded the body, they are usually found in the Qi of the liver, and felt on the pulse as a hardness (because their nature is coldness), afterwards it can also be used to strengthen the immunity. The difficulty with PID is the scar tissue left behind, in my experience though, if the system of energies can be rebalanced the body will find a way for successful pregnancy.
Ectopic pregnancy is when a fertilized egg is lodged in the fallopian tubes instead of the uterus, it is possible to move the egg into the uterus with acupuncture, but it doesn’t always work, sometimes the tubes are too blocked, never the less acupuncture is indicated, if it fails an operation is required.
Hormones: It is essential for the uterus to be in good condition for pregnancy, is it after all a nest. The quality of the nest is built by fertility hormones, mainly oestrogen and progesterone. A common cause of infertility is caused by the contraceptive pill, which slowly but surely leads to a hormone imbalance. The pill produces changes in the endometrium, the nesting environment has deteriorated. The amount of contraceptive hormone a woman has had in her life is actually a good indicator of the length of time required for acupuncture treatment. The synthetic hormone trapped in the body needs to be removed before the endometrium can improve (unless fertility hormones are used to improve endometrial quality as in IVF procedure, this is of course for one cycle only).
Antibiotics are also known to deteriorate the quality of the endometrium by disrupting hormones. Little is known about the half life of antibiotics, in fact they can stay in the body for many years, incubating, leading to all kinds of issues, infertility being just one. Again, they need to be removed, sometimes the presence of antibiotics is the only problem blocking successful pregnancy, if this is the case the results can be quite spectacular.
Uterine fibroids are benign smooth muscle tumors of the uterus, they are usually symptomless but can cause painful periods, and if they get large enough can put pressure on nearby structures such as the bladder resulting in urgency and frequency. Fibroids are oestrogen sensitive and higher oestrogen levels cause their formation. In classical Chinese medicine the entire system of connective tissue is maintained by the Qi of the spleen. The fibroid tissue itself is quite soft, and this softness can be felt in the pulse of the spleen, the expression is a build up of dampness, or sometimes it’s even called phlegm. Dampness occurs when there is a stagnation in the flow of Qi. To solve them the Qi has to be moved, this is done by increasing the flow, applying acupuncture to meridians preceding where it is blocked. Think of the fibroid as a dam in a river, and the acupuncture as able to increase the amount of water flowing down the river, the increased pressure will force the dam to break, understand this occurs purely on an energetic level, once the energy is less stagnated the body will reabsorb the excess fibroid tissue. Treating Fibroids is not a difficult thing to do with acupuncture, it normally takes in the region of 4 or 5 sessions. After the fibroid has shrunk, it is prudent to do some work on the hormones to prevent it reoccurring.
Others causes of infertility
Auto immune infertility
Before starting this section I thought I’d have a little scoot around google to find the prevailing wisdom about autoimmunity and infertility, what I found was a complicated quagmire of esoteric terms half written in Greek that made me feel for the layman trying to find out what their problem is! For every 1 identified disease, there could easily be 2 or 3 unidentified, with a new diagnosis just around the corner. In general the treatment is woeful, either steroids or immunosuppressants, both causing many side effects. Drugs might be necessary for life threatening conditions like diabetes, encephalitis, or sarcoidosis, but commonly patients taking these drugs are worse off a few years later. Steroids are known to cause autoimmunity, this is not common knowledge to GPs. The situation with steroids is similar to antibiotics 5 years ago, the medical establishment was incredibly slow to catch up the the fact that antibiotics are harmful, every body knew but them! In fact now that doctors don’t prescribe antibiotics so readily they are falling back on steroids, for now however, they are still kicking the proverbial can down the road.
From the Chinese medicine perceptive all autoimmunity has the same aetiology, for information please follow this link to my page on autoimmunity
High killer cells
This is a controversial one, some doctors believe that uterine immune cells (white blood cells) are mistakenly destroying the sperm before fertilisation. The Qi producing the killer cells has become stagnant, stagnation of Qi means there is more heat, the heat produced speeds up the production of killer cells, the extra activity limits the success of fertility, this Qi can be controlled with Acupuncture.