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Chinese Medicine and Assisted Reproductive Technology for the Modern Couple

BACKGROUND

Acupuncture and Herbal Therapy are ancient Chinese methods used for the treatment and prevention of disease. These systems are as ancient and effective as any other medical techniques used in the world today. They have been practiced consistently for the past five thousand years in the Orient. Seventy percent of one quarter of the world's population uses acupuncture and herbs as their main form of health care. Although acupuncture has been used in England, France, and Germany for several hundred years, only in the past two decades have Acupuncture and Traditional Chinese Medicine (TCM) been recognized in the United States. The benefits of Acupuncture and TCM in treatment for the infertile couple can be found in early Chinese medical literature dating back to the 11AD. Not only do these techniques assist in regulating the menstrual cycle and invigorating the sperm, but they also serve to enhance the function of the whole body. This "whole body" health approach, in turn, provides a key to unlock unlimited potential in healing. This is especially appropriate for the over 40 couple as it stimulates overall health to effect reproductive health and a reduction of biological age.

PMS, amenorrhea, endometriosis, blocked fallopian tubes, immune system incongruities, and infertility related hormonal problems yield to many of these old world (traditional) procedures. Furthermore, herbal formulas that tonify the Kidney energy (renal and adrenal function), and Kidney essence (jing) are especially beneficial in raising sperm count and motility. The highly technical and expensive methods used in Western Medicine are supported by the complimentary set of procedures and herbal recommendations. In addition to the use of Acupuncture, TCM and herbal formulas, complete treatment programs also include a series of Qi Kung (pronounced chee gung) healing energy exercises to enhance the flow of specific meridians. These exercises, which were developed by Chinese Taoists (metaphysicians) over 3,000 years ago, stimulate the flow of intrinsic energy in the body which, in turn, enhances health and benefits organ function. The meditative dance-like movements which coordinate with specific visualizations, exercise and oxygenate the blood, while at the same time, enhance one's artistic nature. In the oriental sexological literature there are also specific sexual positions that enhance a man's sperm count and motility as well as regulating a woman's cycle. There are currently a number of studies being conducted in the United States and Europe that are focused on understanding the effects of these techniques. Longevity and regaining a persons youthfulness are key topics.

There are several advantages to using Traditional Chinese Medicine as an approach to heightening a couple's fertility.

SOME ADVANTAGES OF USING TRADITIONAL CHINESE MEDICINE

1. TCM sees the person as an integral Mind/body organism, thereby does not treat just symptoms/diseases. TCM ventures to stimulate the bodies natural healing potential by treating root causes rather than just symptoms.
2. TCM, used in the treatment of infertility, minimizes undesired side effects and accumulated toxicity from invasive procedures and drug therapies, known and unknown.
3. Traditional Chinese medicine may be used to strengthen and balance one's general health so that IVF, GIFT, ZIFT, ICSI, AHT and TET procedures are more effective. The TCM patient derives general health benefits and endocrine system balancing from specific acupuncture and herbal regimes. Pregnancy becomes easier to achieve and postpartum recuperation happens faster. Medical studies have been done in China to verify this type of whole body health enhancement.
4. The widespread use of TCM suggests that it is a complete traditional medical health care system and can be used with or without the integration of Western medical techniques. The integration of Western medicine, as we know it in America, began in the Orient less than a century ago. It is called INTEGRAL CHINESE MEDICINE (ITCM). Ancient medical techniques of acupuncture and herbs utilized with modern procedures, seem to work best.

UNEXPLAINED INFERTILITY / LIVER QI CONGESTION

Irritability, depression, frustration are keywords to the Liver Qi Stagnation. It must be noted that whenever an organ is mentioned in oriental medicine it implies the related conduit or meridian. A meridian is a pathway along which energy / Qi flows. The psychological aspect of the Liver is said to assist us in planning easily and wisely. The person who suffers from Liver Qi congestion may be found in a job that they don't enjoy, working late hours, and with a history of taking birth control pills. There frequently exists an inner psychological frustration about having and raising children. Dysfunctional family factors play a major role in the upset Liver, as the condition may have existed for many years.

Physical symptoms of irregular periods, PMS, dark colored blood with small clots, breast pain with distention, worry and frequent sighing and headaches often accompany the psychological symptoms. Pulse diagnostic palpation at the radial artery usually reveals a wiry and small quality pulse in the person with a Liver imbalance. Pulse diagnosis at the radial artery is an extremely sensitive and skilled art that takes many years to perfect. It is like a laboratory blood test. There are over twelve different pulse positions on each wrist and twenty-eight pulse qualities that can be related to each one of these positions. The readings yield a multitude of relationships when integrated and compared with the patients' signs, symptoms and tongue characteristics. The different pulses can confirm a diagnosis and be used to monitor a patient's progress. Both pregnancy and the sex of a child can be diagnosed from the pulses by a skilled practitioner.

Infertility due to Liver Qi Stagnation manifests mostly in women and is a frequent cause of unexplained infertility. This is because this type of Liver stagnation effects the blood flow in the pelvic cavity. Acupuncture at the right time in the menstrual cycle, in conjunction with an herbal formula and some counseling, very likely can clear the congestion in several months. The resulting pregnancy is more than welcome along with the emotional clarity that arrives when the Liver organ/meridian is less toxic (stagnated).Couples must realize, however, that the prevalence of Liver Qi Stagnation in modern society is not something simple that can be relieved over night. It may take 9 months or more to release the stress, trauma, and toxin in the system, if it is at all possible. There have been cases resolved within a month's time.

MISCARRIAGE; A TRADITIONAL CHINESE MEDICINE VIEWPOINT

Since the Western Han Dynasty (206 BC.- 24 AD.), Chinese people have been using traditional medicine to effectively treat both male and female infertility. Many texts have been published in the medical literature focusing on these problems that have so recently come to the forefront in western society. TCM for threatened miscarriage includes acupuncture, herbs, diet and an a different approach to exercise. It must be remembered that treating infertility and miscarriage using any method is complicated and involved. The medicine that helps the patient attain a healthy vital energy (Tian kuei) can greatly aid the woman who has had miscarriages due to a hormonal imbalance. For the woman over 40 there are herbs that nourish the deeper vitality that is necessary for the body to call forth healthy ovum.

Currently TCM, both in China and America, is used in conjunction with Western medical techniques and testing to design an effective course of treatment for the couple wishing to achieve not only pregnancy, but a healthy baby delivered at full term.

Sixty percent of all spontaneous abortions occur in the first half of the first trimester of pregnancy. Genetics play a key role in habitual miscarriages. To presume that TCM alters genetic structure without triple blind studies etc., would be a stretch of most peoples imagination. However, Traditional Chinese Medicine is very effective in strengthening a persons' constitution.

If a woman has miscarried, it is important to build and conserve her Qi and build her Blood. This usually means building and conserving Kidney Qi, as within the Kidney both Yin (Blood) and Yang (Qi) are generated. We must remember that Kidney does not just mean the ear shaped organs guarded by the ribs just above the lower back. It means the whole psycho physical interrelated matrix and visceral relationship of Kidney function and its meridian pathways.

In oriental medicine we say that all chronic imbalances effect the Kidney organ/meridian network. What this means is that if a person has a weak constitution i.e., is pale, feels cold is undernourished, etc., then this is a result of either prenatal (genetic) influences and or lifetime habits and illnesses. The way to change these conditions, if possible, is to change them through treating the Kidney with tools of acupuncture, herbs, diet, and exercise. Kidney means bone and bone marrow and from the marrow is made blood. Blood nourishes Qi and the cycle regenerates and builds. Essentially, in oriental medicine it is said that the Blood nourishes, the Qi protects, and the Kidney Qi holds the fetus. The Kidney is injured by cold, therefore dietary considerations are generally applicable for this patient. Recent studies have also shown that good dental hygene and quality dental work can increase fertility.

There is a very famous formula, that builds both Qi and Blood, which is used to strengthen the body and prepare a woman for conception. This is especially useful if she has a history of miscarriage. The formula should be given for three to six months before conception is attempted. It is called "The Rock on Tai Mountain Decoction." This somewhat poetic name refers to a great mountain that many Chinese religiously pilgrimage to, hoping to get their prayers answered. It is an extremely demanding climb of a thousand steps, just as pregnancy is demanding of the modern mother. Just giving this herbal decoction does not guarantee that conception will take place and the next baby delivered to full term. Seeing the patient as a whole person and thereby considering their total health picture helps the TCM physician decide how to choose and change a formula to be specific to the patient.

SEX DURING PREGNANCY

In the oriental culture there is a very direct and honest attitude toward one's sexuality. Nothing is considered to be sexually "dirty" as sex is seen as a natural function, as natural as "clouds and rain". Within the training of a TCM practitioner, it is taught that it is not the job of the physician to make judgements about an individuals sexual practices, it is more important to point out the consquences of these practices. Therefore it is easy for the doctor to indicate that sex (intercourse) during the first trimester is contraindicated, especially for the woman that has a history of miscarriage, as the placenta is not yet fully formed. Many men have a problem with this recommendation. Usually, TCM practitioners go one step further and indicate that it is probably best for all couples to abstain for the whole nine months of pregnancy. As mentioned previously, modern couples usually have no problem with this idea especially when they consider the investment they have made. For the couple, where the woman is over 40, intercourse is not recommended for the entire pregnancy even by western physicians.

RAISING YOUR FERTILITY QUOTIENT WITH TCM TREATMENT

1. Timing and consistency of treatment, whether having acupuncture or just taking herbs, is of primary importance. Consistency of treatment is most important for men, as to raise sperm count and motility with herbs starts to take effect at the fourth month of treatment. It takes 70 days to generate new sperm.
   
   Timing and consistency is also important for women as there are specific hormonal adjustments that can be made at each week of the cycle. Missing a week of treatment may lose an important opportunity to heal a particular segment of the four phase menstrual cycle. It takes a minimum of three consecutive cycles (12 treatments) to do the foundation work of regulation regardless of biological age. Most women can benefit from this type of concentrated foundational treatment every two years, even if they aren't trying to conceive. This should be started before a woman reaches 28 years old or earlier if birth control pills have been taken.
2. If a woman is nearing forty years old and has had either numerous fertility drugs (over 3 cycles), birth control pills, PMS, ART procedures, elevated FSH, polycystic ovaries, endometriosis, sperm antibodies, or a history of drug, alcohol, or smoking abuse, then it usually takes longer to balance her reproductive system. Likewise, if a man has a history of STDs, history of drug, alcohol, smoking, or sexual abuse, urinary tract infections, burning urination, chronic lower back pain, prostatitis, difficulty passing urine, or other urological health issues it takes longer to rejuvenate the reproductive function. The extent of rejuvenation is relative to the effort and inherent constitution of the individual. Daily training sessions with the right exercises usually provide tangible results when combined with weekly treatment, meditation and a reasonable diet. The couple must expect to focus six to nine months before really expecting to evaluate results. There is no quick path when it comes to conception, full term pregnancy and recovery after delivery. "Turning back the clock" is indeed possible.
3. If a woman is in a state of high level wellness from a traditional medicine's point of view (warm hands and feet and no PMS are just several indicators), and has a "normal" active and relatively a low stress energy abundant lifestyle, then it is appropriate to evaluate between the sixth and ninth month of consistent treatment.
4. Biological vs. chronological age. According to the 2,000 year old Chinese medical classic (Nei Ching su wen ling shu) there are some precepts of health and aging that are very important in this day and age. Accordingly, the normal life span for humans is over 100 years. There are documented life spans of monks that have lived in good health to well over 150 years old. In the Nei Ching there is a dialogue between the Yellow Emperor and an old Taoist teacher named Chi-po. Why does medicine exist? asks the Yellow Emperor, "...because people have severed themselves from their roots (Tao)". The reconnection between the individual and their "roots" (spirituality) is a very important aspect in the maintaining of youthfulness and is thereby inherent in the basic foundation of traditional medicine. Modern science supports this in the focus on the emerging stem cell technologies and the possible cures for major life threatening diseases. Stem cells are found in abundance in the umbilical cord which suggests this deep root connection to the Jing Qi (essential energy). Understanding the root cause and quality of one's own longevity can slow the aging process and rejuvenate the body as thoughts can create reality. Knowing with certainty that we are an ageless body is the basis for creating high level wellness in the modern world. Longevity however is more than just belief.
5. Correct dietary and exercise habits are just as important for the preconceptive mother as for the father. Eating salads (cold nature food) for a year is not the best diet for a person who has generally a low basal body temperature (BBT). Sometimes eating meat such as lamb (warming food) can help tonify a "cold" barren uterus. For male factor and unexplained infertility there are specific physical and mental exercises to be done by couples to generate the right environment necessary for creativity and conception.
6. Combining conventional reproductive technologies with ancient acupuncture and herbal techniques demands accurate communications between team members which includes the patient as captain. Communication between the patient, the acupuncturist and the reproductive specialist is a delicate process. It is important for the physician to have knowledge of the procedures of the acupuncturist/herbalist and vis a vis. Lacking knowledge of an herbal program that a patient is on can effect the results of an ART procedure. It can even be detrimental as alternative therapies are effective in changing a persons body. Likewise it is important for the patient to inform the acupuncturist of any herbs or vitamins that are being taken while undergoing treatment, other than prenatal vitamins. Over the counter herbal remedies might be effective in some cases but may not be indicated for a particular cycle. It could be like having carpet delivered for the newborns room before the concrete foundation was poured for the house. Traditional Chinese medicines and acupuncture work quite differently than western medicines. They are gentle and deep acting rather than flashy and bright. Expect to feel a growing subtle influence that permeates your life like the smell of star jasmine on a summers night.
7. What if you have already had a course of acupuncture treatment in the past? When selecting an acupuncturist or any healer it is important to know that they are suitably qualified to do fertility work. Communication, experience and skill are important. Having a state acupuncture license means that the acupuncturist has passed a course of study that qualifies them as an entry level practitioner. Usually this is about a 3000 hour training, though there are some physician programs that are only 300. A growing number of practitioners have a greater than entry level experience of treating couples that are integrating oriental medicine with conventional reproductive techniques. These practitioners are to be sought out, as treating an infertile couple demands not just general practice but also specialty skill. General practice skills help remove pre-existing conditions. If these conditions are the cause of infertility then the couples fecundity quotient will be increased. However, if either reproductive function or biological age of the endocrine system is the primary contributory factor then specialty skills and experience is necessary.

BIBLIOGRAPHY

1. The Infertility Book, A Comprehensive Medical and Emotional Guide, Harkness, Carla, 2nd edition 1992, Celestial Arts, P.O. Box 7327 Berkeley, California. (510) 845-8414
2. Infertility: A guide for the Childless Couple, Menning, Barbara Eck, New York, Prentice Hall rev. 1988.
3. You Can Have A Baby, Everything you need to Know about Fertility, Bellina, Joseph H., M.D., Ph.D., Wilson, Josleen New York, Crown Publishers Inc., 1985.
4. Adoption, Is It For You?, Dywarsuk, Collette T. New York: Harper & Row, 1973.
5. Endometriosis & Infertility and Traditional Chinese Medicine, Flaws, Bob, CO, Blue Poppy Press, 1989
6. Endometriosis as Treated by Traditional Chinese Medicine, Cao Ling-xian & Tang Ji-fu,,trans. C,S,. Cheung, M.D., & Carolyn Atkinson, J. Amer. College of TCM. S. F., CA, Vol. 1, No. 1, 1983, p. 54-57.
7. A Woman's guide to Endometriosis, Older, Julia, Charles Scribner's Sons, NY,1984.
8. Handbook of Chinese Herbs and Formulas, Vol. I & II, Him-che Yeung, Los Angeles, 1985
9. Chinese Herbal Patent Formulas, A Practical Guide, Jake Fratkin, Shya Publications, 1986
10. Chinese Tonic Herbs, Ron Teeguarden, Japan Publications, Inc. 1985
11. Wise Woman Herbal For the Childbearing Year, Weed, Susun, New York, Ash Tree Publishing, PO Box 64, Woodstock, NY 12498, 1986.
12. Consumer Protection Issues Involving IVF Clinics (stock number 552-070-06387-1 U.S. Government Printing Office, $31) 202-275-3030.

PREVENTION IS WORTH MORE THAN A POUND OF CURE...
IT SOMETIMES IS THE CURE.

BIOGRAPHY

ROGER C. HIRSH, O.M.D., L.Ac., B.Ac. (UK), Dipl. NCCA, has been working for the last seven years to establish the specialization of reproductive health care within the Oriental medical model and to integrate diverse Eastern and Western medical traditions in his work with fertility. An Honors graduate of the International College of Oriental Medicine (London,1976) he received his Doctorate in Oriental Medicine (1984) with a specialty in Constitutional Medicine. After a 3,000 hour postgraduate internship with Master Sehan Kim, O.M.D. and Mrs. Kyo Ok Kim M.D., Ph.D., he joined the Center for Orthomolecular Medicine in Palo Alto, where he practiced acupuncture and herbal medicine for several years as a member of a six physician team. Dr. Hirsh has served as an adjunct faculty member of the American College of Traditional Chinese Medicine, the California Acupuncture College and Emperor's College of Traditional Chinese Medicine and is one of the founders and is currently chairman of the board of directors of China International Medical University. He is currently in private practice in Beverly Hills, California, specializing in work with couples who have simple to complex fertility concerns or are preparing to have a family.

Roger C. Hirsh, OMD, L.Ac.
Doctor of Oriental Medicine
Acupuncture and herbal science
email: fertility@earthlink.net
310-550-8186  

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