The odds of having children seemed to be stacked against Lower Mainland research scientist Rajwinder Panesar-Walawege.
Over the phone, she told the Georgia Straight that she had twice conceived naturally. “But I had ectopic pregnancies, which means that I ended up losing both my tubes,” Panesar-Walawege said.
She recalled that she then tried in-vitro fertilization (IVF) and it didn’t work. But after hearing someone tell her that she should try acupuncture and traditional Chinese medicine (TCM), she decided to visit Lorne Brown, clinical director of Acubalance Wellness Centre. It’s the first B.C. TCM clinic focused on reproductive health and fertility.
“He recommended starting with a cleanse and then eating whole foods and then doing acupuncture and Chinese herbs,” Panesar-Walawege said.
Along the way, they discovered that she had fibroids in her uterus, which needed to be removed before she could become pregnant. “He helped with doing acupuncture and preparing with Chinese medicine for my body to go through surgery,” she said. “I had the herbs after surgery, too, to help me heal faster.”
Throughout this process, Panesar-Walawege exercised with a personal trainer and engaged the services of a dietitian. These steps, along with Chinese medicine and acupuncture, were taken to prepare her body for the implantation of a blastocyst in her uterus after an in-vitro fertilization treatment. (MedicineNet.com defines a blastocyst as a “thin-walled hollow structure in early embryonic development that contains a cluster of cells called the inner cell mass from which the embryo arises”.)
“Implantation is a process doctors can’t help you with,” she stated. “They can only put the blastocyst inside the uterus, and then that’s it. Then the body has to do what it has to do.”
On December 15, 2014, at the age of 41, Panesar-Walawege gave birth to twin boys. When asked how they’ve affected her life, she replied: “It’s great. It’s amazing.”
A Portland, Oregon–based doctor of acupuncture, Lee Hullender Rubin, pictured right, is one of North America’s leading advocates of using acupuncture and traditional Chinese medicine to complement IVF treatments.
In a phone interview with theStraight from her clinic, Hullender Rubin said that she will publish a cohort study in June on this topic in Reproductive BioMedicine Online. It involved 1,231 women who went through IVF treatments between 2005 and 2010. Of those, 119 received what she called “whole-system traditional Chinese medicine intervention” as part of their prenatal care.
“It could include acupuncture, Chinese herbal medicine, Chinese-medicine-based dietary recommendations, and Chinese-medicine-based lifestyle recommendations like qigong, tai chi—that sort of thing,” she said. “It could have also included dietary supplements.”
In the study, research subjects were divided into three groups: women who chose IVF alone, women who had two treatments of acupuncture on the day blastocysts were placed in their uterus, and a third group who received the whole system well before IVF treatments began.
What Hullender Rubin discovered is that whole-system traditional Chinese medicine was associated with more live births and fewer “biochemical pregnancies”, which she defined as testing positive but with virtually no likelihood of the embryo being viable.
“This is good preliminary evidence that suggests TCM as it’s practised in the real world may positively impact IVF outcomes,” Hullender Rubin said. “And we don’t have a lot of evidence about that.”
She added that the study is significant because there had been concerns that traditional Chinese medicine might have a negative impact on women who receive IVF treatments. “While more research is clearly needed, this paper reports that whole-system TCM did not harm IVF outcomes,” she said.
When asked why traditional Chinese medicine might be effective, she replied that it may calm down the nervous system and enhance blood flow to the uterus and ovaries. In addition, she suggested that it could have an effect on neurotransmitters, which assist the “endocrine balance of the body”.
“The third thing is that we’re helping to release endogenous opioids—your body’s natural painkillers—and that helps mitigate the stress response,” Hullender Rubin said. “Women who report having high stress have a twofold increased risk of infertility.”
One thing Panesar-Walawege said she learned through her experience is that women shouldn't be afraid to seek help from different experts. She also emphasized that infertility is not a woman’s problem but an issue that should be confronted by the family.
“It’s teamwork,” she said. “You need the support of your partner as well. Then, together, you go and get the support of whoever you need externally.”
Lee Hullender Rubin will speak at the Integrative Fertility Symposium, which will be at SFU Harbour Centre from April 30 to May 3. For more information, see the If Symposium website.
Chinese herbs have been used for approximately 2500 years to treat a wide array of health problems.Herbal medicines may enhance fertility by supporting the natural functions of the ovulationand fertility process.
Herbs Are Not Regulated By The FDA, But Are They Safe?
Herbs are generally safe to use. However, because some herbs should not be taken during pregnancy, it is always important to ask your healthcare provider which herbs are safe to take.
For those choosing to use herbs to enhance fertility, it is preferable to consult a healthcare provider who is familiar with herbs and how they affect different aspects of your fertility.
When Should Herbs Not Be Taken?
One of the purposes of prescribing herbal medicines is to increase ovarian function. Therefore, individuals who are taking birth control pills, Antigon/Cetrotide or Lupron should not take herbs. Because these medications are used to impede or lessen ovarian function they have the opposite desired effect of herbs.
How Long Should I Take Herbs?
The effects of herbal medicines are generally cumulative, and the clinical effects of treating the infertile couple are usually seen after 60-120 days. Herbs are also cycle-dependent.
They require the entire menstrual cycle to be effective, and work best with multiple cycles. This means that if, for instance, a woman decides to have an in vitro Fertilization: IVF transfer within a week, she should avoid herbal treatment.
What Types Of Infertility Can Herbal Medicines Treat?
In general, it is appropriate to treat any type ofinfertility condition with herbal medicines. This includes advanced maternal age, luteal-phase-defect, premature ovarian failure, male factor, or unexplained symptoms.
The herbs seem to enhance the effects of the gonadotropins, and they do not pose the risk of OHSS (ovarian hyper stimulation syndrome).
Is Herbal Medicine A Licensed Profession?
Herbal medicine is not a licensed profession. However, some practitioners acquire available Board certification. It is preferable to consult with healthcare providers who are Board certified to prescribe herbal medicines.
Where Can I Purchase Herbal Supplements?
A number of herbal supplements are available that are helpful in supporting fertility for both women and men. For women, vitex (chasteberry), red clover and other herbs traditionally used to help restore hormonal balance are combined with the same vitamins and minerals found in a prenatal vitamin.
A woman’s fertility peaks in her 20s, but the timing of life doesn’t always cooperate with family planning. Today, many couples aren’t ready to bring a child into the picture until after the woman turns 35—when the chances of getting pregnant begin to fall and the likelihood of miscarriage rises.
Just a few decades ago, couples who were unable to conceive had few options outside of adoption.
With the advent of in vitro fertilization (IVF), though, doctors are now able to directly generate fertilization in the lab.
Today, more than 5 million babies have been born through IVF, but the procedure comes at a high price. A single cycle can range from around $12,000 to $15,000 and is not usually covered by insurance. It can also be hard on the body of the hopeful mom-to-be. And it’s not a sure thing.
If couples are willing to take a slightly slower road, they may have a better outcome.
But researchers have discovered that IVF can get a boost from Chinese medicine. In the early 2000s, several studies showed that the addition of acupuncture can substantially increase the success rate of IVF patients. Since then, a growing number of women have included acupuncture and other aspects of Chinese medicine into their IVF protocol.
But Jeanie Lee Bussell, Ph.D., an acupuncturist who has treated many patients going through IVF, saysacupuncture and Chinese medicine should be considered as a first option.
Even while most fertile, women typically ovulate only one egg per month, and it only stays viable for 12 to 24 hours.
Under IVF, a woman’s body is made to ovulate multiple eggs in a single cycle. This increases the odds of fertilization, but requires a strong cocktail of drugs to pull it off: antibiotics, birth control pills, daily injections of gonadotropin and other hormonal injections to get the timing just right, and, if need be, something to treat stress.
“This is very unnatural,” Bussell said. “Women don’t go through the IVF because they want to. It’s because they feel like this is the only option they have available to them.”
One enticing aspect of IVF is that the results can be quick, which can mean a lot for a woman already passed her prime fertility. But Bussell says if couples are willing to take a slightly slower road, they may have a better outcome.
“In Chinese medicine, the way we like to approach it is for couples to be in optimal health even before they try,” Bussell said. “Because it’s not a question of being able to conceive, it’s how to have a healthy child.”
In many cases, doctors can’t identify why a woman can’t get pregnant—these are the best candidates for Chinese medicine.
In many cases, doctors can’t identify why a woman can’t get pregnant—and these cases are the best candidates for Chinese medicine. However, some patients need immediate attention from a fertility specialist. To see what category you belong to, Bussell recommends getting a fertility check-up, a service offered by most fertility clinics for between $100 and $400. This will identify anatomical obstacles to pregnancy that acupuncture alone would not be able to fix.
Quantity Versus Quality
Acupuncture’s anecdotal success stories have prompted researchers to take a closer look at how the treatment works. In 2003, physicians at Weill Cornell medical center published an article in the journal Fertility and Sterility evaluating these researchers’ findings. One showed that acupuncture increased blood flow to the uterus and therefore increased uterine wall thickness, an important marker for fertility.
Other studies found that acupuncture reduced the level of stress hormones responsible for infertility, influenced the level of fertility hormones in plasma, normalized the function of the hypothalamic-pituitary-ovarian axis, and increased the production of endorphins—all conditions wanted for a healthy pregnancy.
IVF is fundamentally a numbers game—more eggs are available so odds go up—whereas Chinese medicine seeks something more holistic.
You can think of the difference between IVF and Chinese medicine as one of quantity versus quality. IVF is fundamentally a numbers game—more eggs are available so the odds go up—whereas Chinese medicine seeks something more holistic. IVF focuses mainly on the uterus and ovaries, while Chinese medicine focuses on the whole body, as well as the mind and spirit. The idea is that if the woman is in balance, she’s more likely to support a healthy pregnancy.
“In Chinese medicine, there is no differentiation between the emotional or spiritual body and the physical body,” Bussell said. “If the patient has a lot of emotional issues, this will cause physical manifestations, as well as physical discomforts will have an impact on the psychological aspect.”
Balancing Yin and Yang
Acupuncture and herbs are tools used to bring about a better balance in the body, but Bussell emphasizes that the basics of health—eating a healthy diet, managing stress, and getting enough sleep—are the foundation that support a couple’s fertile potential.
“Night is the yin time. And in order to have a good balance, you need a good yin to create the good yang and vice versa. We spend a lot of our life sleeping because we need that resting time,” she said.
Men also play a key, yet often overlooked, role in pregnancy. Approximately one third of the time, a couple’s failure to conceive lies with male fertility issues (another third are linked to issues with the woman’s fertility and the final third are issues with the couple together). Chinese medicine can help men too.
“Unless the men have no sperm, Chinese medicine can make improvements,” Bussell said. “He may need acupuncture and herbal remedies, along with diet and lifestyle modification, to help support the recuperation. This will all depend on his individual constitution.”
Acupuncture is even less likely than IVF to be covered by insurance. But for those paying out of pocket, the cost of Chinese medicine is considerably lower than IVF. An individual session can range from $50 to $150. The number of treatments depends on the issues the couple presents and their fertility goals.
Bussell says the internet and social media have helped spread awareness about Chinese medicine as an option for fertility. But her real hope is for medical doctors to recommend it more often to patients who might prefer something more holistic.