Traditional Chinese Medicine after failed IVF – A Different Perspective

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.