Traditional Chinese Medicine after failed IVF – A Different Perspective

Laura Bicker
Acupuncturist & Chinese Medicine Practitioner, Laura Bicker – Traditional Chinese Medicine Practitioner

Emotions and Support, Failed IVF Cycles

Failed IVF attempts and Chinese Medicine
From this video you will find out:
  • How to understand Chinese medicine?
  • What does treatment consist of?
  • What is the philosophy behind Qi, Yin, Yang and Jing?
  • How our diet influences our wellbeing?
  • What is Zang Fu organs and meridians?
  • What are the real patient cases after using Chinese medicine?

How can Chinese medicine help me after IVF failure?

In this session, Laura Bicker, Acupuncturist & Chinese Medicine Practitioner has been discussing what kind of Traditional Chinese Medicine can help you if you had failed IVF attempts.

The exact origin of Chinese medicine is not known because it predated the written language. What is known is that the descriptions and the writings about Chinese medicine that were written about 1766 BC, the things that were written or talked about, things that had gone back as far as 2000 years and acupuncture and Chinese medicine weren’t exclusive to China, but because China was real experts’ observation they became more highly developed in these skills, so it was more dominant in the east.

Most patients who are seeking out support for fertility or IVF think firstly about acupuncture, but Chinese medicine is a full medical system. There’s much more than acupuncture, which is the insertion of very fine needles at specific points across the body, there is also electro-acupuncture, which is used quite a lot in fertility treatment, particularly when trying to stimulate the ovaries, and this is where electrodes are attached to the needles.

There is also cupping, called an adjuvant treatment, which helps enhance acupuncture by increasing blood circulation and lymph. Moxibustion, on the other hand, comes in very different forms, such as rolls, you can use the loose punk and form it into cones or pole moxa, which is like a cigar shape. Moxibustion is made of a particular herb called Aicai, its English name is Mugwort or Wormwood, which is burnt. The properties of those herbs in Chinese medicine increase circulation and break up blood, and it’s used in miscarriage treatments.

Chinese herbal medicine comes in different forms, you’ll find it in dried herbs that you boil, or more often, now, you’ll see lots of granulated herbs because it’s more practical and easier to use. Diet and lifestyle are other things worth checking, Laura explained that they look at the energetics of foods and how they suit a person’s constitution.

Qi & blood

Two of the main things that a practitioner is going to look at when you come to see them are first, the state of your QI (also known as chi) – usually translated as ‘vital life force’, and blood. For example, Gu Qi is the energy you get from food. Gu Qi combines with the air in the lungs, and it then becomes something called Zong Qi, which is involved in different roles in the body in Chinese medicine. It works mainly with the lung and the heart, and it helps with involuntary processes like breathing or your heart beating. If you have strong Zong Qi, you will have a strong voice and good circulation. Some of that Gu Qi that you get from your food passes through the lungs and then goes to the heart, where it combines with other types of Qi. There’s Yuan Qi, which is the foundation of yin and yang in the body, and it also combines with the kidney Qi and those together all form blood. In western medicine, the kidneys are said to control the production of red blood cells in the body, and they signal hormone production, which then activates blood production in the bone marrow.

Deficiency & excess

Deficiency and excess are other concepts that your practitioner will look for. The yin and yang energies can describe so many things, yin is dark, yang is light, yin is woman, yang is man, and in the body, the yin is the blood, the fluids. If your body is not nourished or you’re overworked, the yin can become deficient, and similarly, the yang can become deficient. From a fertility point of view, the yin is your estrogen, your yang is your progesterone, and the jing is your life force. Some are determined by genetics, and some by lifestyle. A practitioner will look at your jing and see if they need to tonify that and try and support that to improve the quality of eggs, etc.

There can also be excess heat in the body, for example, somebody who has been having a lot of alcohol, and lots of spicy foods then generated heat in the body, and that would be an excess condition. As an example, there could be stasis, which can accumulate, and in excess levels, it’s going to produce symptoms like endometriosis, fibroids, and patients tend to have very fixed focal stabbing pains with stasis.

When the energy doesn’t move the Qi in the body, you will develop stagnation, which can be easy to treat, particularly with acupuncture and herbs. By getting that Qi moving, and releasing that stagnation, it’s possible to quickly resolve a lot of symptoms.

Failed IVF cycle & Chinese medicine

The most common reasons for failed IVF cycles are a poor ovarian response to medication, and so your Chinese medicine practitioner is going to look and say, what is the Qi and blood like, is there good circulation to the ovaries? Acupuncture has a fantastic effect, and it improves blood circulation to the ovaries in the uterus. A practitioner will look at all factors that are affecting your body, he will give you some advice on how to change some of the things that you’re doing, what foods you can eat better to improve those things and how to strengthen your body and just prepare it for your next cycle. The next thing to focus on will be to calm your mind and help you relax, to get that Qi moving smoothly.

Another reason that IVF cycles commonly fail is poor embryo quality. For embryo quality, a practitioner will look at both sides because the male factor is equally important. Therefore, a practitioner will also look at the male to see if there are signs of infection or heat and things that can be improved. Stress, and a bad diet, all affect sperm quality and therefore embryo quality.

Another common reason for IVF failure is a thin endometrium or a kind of poor-quality endometrium. A practitioner again will look at that Qi and blood circulation, if the circulation is good, then the endometrium is good, if it’s poor, then it’s going to have an impact on how implantation occurs and how is placental development, which can then increase chances of miscarriage. A Chinese medicine practitioner is going to look for signs of blood stasis, signs of blood deficiency, if this patient has yin deficiency, do the drugs have an impact on their body. This is how a Chinese medicine practitioner can give you a different perspective and build a treatment plan to prepare your body before an IVF cycle.

Case example

This patient was a 36 female lady with unexplained infertility, and she’d been trying for 3 and a half years, with 2 IVF treatments and 2 miscarriages.

Her cycles were irregular, sometimes as long as 6 weeks, so as a practitioner, I started to think, why are her cycles long, is she ovulating really late, why is it taking so long for it to ovulate, has a body got a sufficient yin and blood to nourish her follicle to grow.

She had a Hysterosalpingography (HSG), and everything was clear, so it was all still unexplained. She did her first round of IVF, she had 13 eggs, 9 of those fertilized at day 3, there were 2 top grade and 5 good embryos, but by day 5, only 1 good blastocyst. That IVF cycle did result in a pregnancy, she did miscarry, so she had a 6-month break, and she did her second round of IVF. She got 12 eggs that time, all fertilized, then at day 3, she had 4 top and 6 good at day 5 embryos. This time 2 embryos were transferred, and it resulted in a low HCG level and a period shortly after, at which point her clinic suggested that she think about egg donation. She had a stressful job, and she wasn’t sleeping enough, therefore, Laura asked the patient to focus on those things and to just try and address that work-life balance. She and her husband got some recommendations on diet, and so they also decided to take a long holiday, after that she and Laura started to do some treatments to focus on this blood stasis and nourishing the spleen and the heart, in these deficiencies seen in her body.

One of the things that go hand in hand with heart yin deficiency are signs of anxiety, so it’s important to reduce the stress and balance her body back.

She started IVF, and everything was going well, and we worked throughout her cycle on all of these factors, and her cycle, she had 16 eggs 8 fertilized, and she had 1 blastocyst on day 5, and still at this point, she was fairly negative because the pattern had followed very similar cycles before with not many blastocysts to transfer. I saw her after a two-week wait, and what I could see was that she had very good kidney energy, her pulse was really strong, and that’s the thing that we look for in Chinese medicine. Because of her history of miscarriage, I used herbs to support her pregnancy, and she got past that 6-week stage that she’d never passed before, she got past the 8-week stage which for me is crucial because once you get past 8 weeks that chance of miscarriage reduces to less than 1% and she had a 12-week scan and baby was healthy. She’s now progressing along beautifully. I think that’s a nice example of how we can look at a failed IVF cycle and find the things that just need tweaking a little bit to give us that successful pregnancy.

- Questions and Answers

Would Chinese Medicine be an alternative for cases where both eggs and sperms are fragile and of poor quality? And in situations where no embryo reached blastocyst?

I don’t have enough information on the case to say that it would be a possibility. We need to know why you’re doing IVF in the first place, what’re the AMH levels like. There’s always a potential that we can improve things to a level where natural conception can occur, but we have to be smart about things and think well how old is a patient and what’s going to get them there first. If you can do some work before an IVF cycle potentially to build and support the body, then the results of the following IVF cycle could be better, but I would suggest speaking to a Chinese Medicine practitioner and maybe having a consultation so you can go through everything. They will be realistic and pragmatic about it as well, we can’t do everything, and time is a big issue for a lot of people and some of the work we do, particularly if there are deep-rooted deficiencies like with the yin. If the yin is very deficient, then sometimes the work would take a lot longer than most patients are willing to give it, but I’d say it’s an avenue worth exploring.

What herbs can be taken to improve egg quality?

There’s no magic herb that cures all people. With Chinese medicine, we’re very bespoke about what we do, and this is where the syndrome differentiation comes in, and there’s kind of a saying in Chinese medicine that you can have the same symptoms, and you’ll get a different treatment. Then you could have completely different symptoms and get the same treatment, so for example, you could have poor egg quality because your yin is deficient and because you have kidney indeficiency and so what would happen is your practitioner would look at all the symptoms and signs, your full health history, your menstrual history, they’ll even look at blood test results and see what your hormones are up to and then they will formulate, well a Chinese herbal formula is how we would describe it for you, and they’ll put different ingredients in, depending on what’s specific to you. They would produce a completely different formula for somebody with different symptoms and signs.

What herbs help to decrease fibroids?

It’s the same answer again. With the syndrome differentiation for most conditions, there’s going to be maybe three or four different potential syndrome differentiation that we see commonly in the clinic, and so a practitioner is going to ask the questions, see which kind of category you fall into, and then there’s no very hard or fast rule. If one of them is qi deficiency, one of them is blood deficiency, one of them is heat, that’s not to say that you can’t have a combination of different ones within your syndrome differentiation, they’re going to tailor it specifically to what’s going on in your body.

How did you help the spleen qi deficiency and heart yin deficiency of the case study?

For the case that I saw recently with the spleen qi deficiency, we did a lot of work with the lifestyle stuff. Just looking at foods that are not nutritionally energetically good for the spleen, for example, having things like porridge for breakfast. The change in the way she cooked her foods and trying to eat just really warm, simple, easy to digest foods will help support the digestive system. In the heart yin deficiency in the spleen, I also use specific acupuncture points that fitted the diagnosis, and what I tend to do is just change it depending on how someone’s feeling on the day that I treat them and what I know from their case history. Then with herbs, we used herbs to support the spleen, to nourish the yin during the pregnancy, to help support the progesterone levels. So it’s just tailored, and that’s one of the beauties of Chinese medicine, everything is tailored to the individual, and what we see each time it’s not just one size fits all.

How can Chinese medicine help prepare for a frozen embryo transfer? With a frozen embryo transfer, it’s no different really to any other cycle, other than we’re not worried about what follicles you’re going to produce and how your eggs are going to be. 

We would again look at how good is the lining, how good are your bleeds, do we need to give your endometrium a bit of a kick and give it a good clear out for a few cycles. Energetically what do you like, and that way a practitioner would plan how long maybe you’d need to have a bit of prep work. It may be that there’s a male factor involved more so, and a little bit of prep work is enough, and some treatment throughout your stimulation on the build-up to your transfer and then working with you through your transfer and beyond would be enough.

I have scar tissue in my uterus. Are there any options for that?

This would depend on the severity of the scar tissue, the position of it, and what your consultants are saying the options are with it. For some things the herbs again, there’s potential that they can help with scar tissue but in practice, if it is pronounced, have we got enough time to really work on that? There are possibilities there, but it also depends on what the actual situation is in your case.

My clinic is quite anti-Chinese herbs. Can I take herbs with Progynova and Cyclogest (estrogen and progesterone)? I’m doing FET from a double donor. I’m 44, no fertility issues except for age

What I would say is Chinese herbs can be safely used through IVF. I understand that doctors are often very concerned about their use because again, there’s not a lot of knowledge out there about the interactions. What a lot of practitioners tend to do is they try and do that preparation work first, so you don’t have to combine the herbs with your medication. What I find is sometimes patients will come to me at a point when it’s almost the last case, last chance, and using a small number of herbs is really the only hope we’ve got, and I’ve seen very good results doing that. I think in an ideal situation, we try and minimize the use of herbs just to really help keep the clinic happy and also just know that your body’s reactions are down to the medication, so it’s usually ideal that you’ve had some IVF cycles before and we know, how your body reacts to the medication when the medication is the same. That’s not to say that they can’t be used concurrently. If you wanted to do that and your clinic was very anti, I would suggest finding a practitioner who is confident in using the herbs through an IVF cycle and then seeing if your clinic is open to discussing with them.

I get on well with my acupuncturist & he often prescribes me herbs to deal with GI(Gastrointestinal) symptoms, I’m suffering from. I’m just often worried it would affect things when doing an ICSI cycle. I know he would not prescribe it if it did, but I always worry & maybe that’s why I’m not too good & finishing the herbs, which I know doesn’t help me either. Anything you can advise?

If you’re using them to help control symptoms. Is your practitioner may be stopping them just before you start your medication? If you are concerned about using them during your IVF cycle and you are, I think you need to weigh up the benefits of how they’re supporting your digestive system as well. Because good digestive health is really important for fertility and we know a lot now about the Gut biome and the different biomes within the body and how they impact fertility. I think just to have a real deep, discussion and it’s really easy to find information on Chinese herbs now. There are huge amounts of data online. I would say, if you trust your practitioner, then you’ve put your trust in him, go with it. I really wouldn’t be worried, but you can read about all of your herbs online. You should have all the ingredients of your prescription on your herb bottle or whatever they’ve been prescribed in, and it’s very, very easy to just put them online and read a little bit of information about those herbs and how they work. You can try and find some information out about how they interact with hormones, but just have a really good conversation with your practitioner, and if it is creating high levels of anxiety, then maybe it’s a little bit counterproductive as well.

Would herbs help improve sperm quality in combination with vitamins?

Yes, they can but there has to be a little bit of caution here because there can be issues that arise from doing too much work, and so if patients are on high levels of antioxidants and then the herbs are having a similar antioxidant effect, it can have a negative effect. Again, your practitioner should have the knowledge and experience to know what you need to take with herbs and not.

Should we only drink warm drinks? Are cold drinks bad for fertility? When to drink which one?

That depends on you. If you are a cold person and you feel cold a lot, it goes back to this idea of the energetics of food, and you don’t want to be putting cold into a cold body because that’s just going to affect circulation more, and we have this idea in Chinese medicine that we want the body to be warm for conception. That old kind of wives description of a bun in the oven, your body is the oven, and we want those like yang levels to be high, yang is like the fire in the body, the progesterone. If you’re a cold person and you’re drinking icy cold drinks particularly, now when it’s getting really cold then, I would try and stick to warm drinks. Environment plays a role in this, so if you live in a very warm country then you can probably get away with a little bit cooler drinks and things but try and drink them more at room temperature rather than icy cold.

I’ve been to two acupuncturists. I used moxibustion and used cupping. Is one better than the other? I also got told I have low energy. Any tips?

They have completely different effects on the body. We generally use cupping to increase circulation, it’s fantastic for releasing tension in the muscles and drawing toxins out of the body. Moxibustion is about nourishing the body and putting heat into the body, so because you’ve got low energy, your practitioner was probably using some moxibustion on points that are going to help support and nourish the spleen. One of the things the spleen likes is warmth. What we often see is patients have what we would describe as spleen Yang deficiency, so the fiery part of the spleen is deficient, and we need to give it a bit of a boost, and using the moxibustion can really help that. With that low energy treatments, like moxibustion will help boost the energy when they’re used on those points that nourish and build the qi in the body. To boost your energy going back to things like eating foods that are going to support the spleen, warm, simple, easy to digest foods. If you think about convalescence foods, chicken soup, the Chinese make congee and it’s like a rice soup where they keep adding water to the rice, and then, they’ll crack an egg in it, or they’ll put bits of chicken in it, so it’s nourishing, but it’s really easy to digest, so your body isn’t having to expand lots of energy digesting your food to extrapolate that energy, as well. Make sure you get plenty of rest as well and think about everything in moderation the things that wear us down and deplete our bodies are things in excess, staying up too late, overwork, overthinking, overheating, try and find balance.

I live in one of the Asian countries where Chinese herbs are widely available, but none are specialized in fertility. I’m afraid they don’t understand much about helping infertility situation. How do I explain them to create herbs for me?

I would say, have faith. I don’t know what part of Asia you’re talking about, but there’s lots of research that goes on that. Even western practitioners like me, I don’t have access to because they’re not produced in a language that I can read, and all practitioners who train, at least in the way I did, are taught the whole of internal and external medicine. Similar to the way a GP would be taught to learn a little bit about everything and so they should have some fertility grounding, it may be that they don’t necessarily know the lingo in terms of IVF cycles, but they will have some basis there and if their training is good and they’ve got a good level of experience. If they’ve been practicing for a long time and they’ve seen a good number of fertility patients, then they should have sufficient experience in that area and if they’re trained in Chinese medicine, then they will know how to put a formula together. That’s the beauty of Chinese medicine, to some degree, you don’t always need to be a specialist because if you have a good diagnosis and if they’ve diagnosed you correctly, then they know what herbs to put together to treat you. Where the kind of more specialization stuff comes in is what I really see around the kind of the immunology side and the really complex cases, so patients who’ve had things like recurrent miscarriage, recurrent implantation failure, or they’ve just been trying for a very long time with no obvious reasons as to why they are not conceiving, patients like myself who’ve done things like the fertility support training and the advanced diploma, we’ve spent time training with reproductive immunologists and embryologists, so we have a deeper level of knowledge, and we can translate that into our treatment, but not every patient needs that level.
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Laura Bicker

Laura Bicker

Laura Bicker is an Acupuncturist and Chinese Medicine practitioner specialized in women’s health and fertility support. Laura has been helping couples with fertility issues through her expertise in acupuncture and traditional Chinese medicine for over 15 years. Laura studied a five-year degree in traditional Chinese medicine before spending six months in Beijing training in two of the city’s teaching hospitals, where she received a Bachelor of Medicine. Laura's training began when she was just nineteen years old and started a 5 year BSc Hons degree in traditional Chinese medicine. This took her to Beijing where she spent 6 months training in two of the city’s teaching hospitals and received a Bachelor of Medicine. In 2005 Laura opened her first clinic in Jesmond. In 2006 due to demand, Laura completed training to specialize in acupuncture and Chinese medicine for fertility. Laura's passion fuels her to continuously build on her knowledge and skills. In 2019 Laura completed an Advanced Fertility Diploma, which brings together Western diagnostic techniques with Traditional Chinese Medicine acupuncture and herbal treatments.
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Caroline Kulczycka

Caroline Kulczycka

Caroline Kulczycka is managing MyIVFAnswers.com and has been hosting IVFWEBINARS dedicated to patients struggling with infertility since 2020. She's highly motivated and believes that educating patients so that they can make informed decisions is essential in their IVF journey. In the past, she has been working as an International Patient Coordinator, where she was helping and directing patients on their right path. She also worked in the tourism industry, and dealt with international customers on a daily basis, including working abroad. In her free time, you’ll find her travelling, biking, learning new things, or spending time outdoors.
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