Fertility

With over 20 years of experience as a fertility specialist, Dr. Cindi has helped countless patients in San Jose and the San Francisco Bay Area achieve their dream of parenthood. She offers support, guidance, and hope every step of the way, empowering her patients on their unique journey to parenthood. Her holistic approach addresses not just the medical aspects of fertility but also the emotional and psychological well-being of her patients. Dr. Cindi’s compassionate approach and extensive experience make her a trusted ally for individuals and couples navigating the complex landscape of fertility treatments.

Fertility overview

In the United States, approximately seven-million individuals are currently facing challenges with conception. Roughly one in eight couples experience fertility issues.

Even in the absence of diagnosed fertility conditions, pregnancy may not always occur easily. Among women under 30 with no fertility concerns, the likelihood of pregnancy within one menstrual cycle ranges from 20-30%. For couples in their 30s without fertility complications, it typically takes around 5-6 cycles to conceive. However, for women over 40 with no fertility issues, the chance of pregnancy within one cycle drops to approximately 5%. When fertility issues are factored in, what initially may be months of trying to conceive can evolve into years of frustration.

How can Chinese medicine help with fertility?

Traditional Chinese Medicine (TCM) has been used to treat fertility problems for over 3,000 years. TCM works to enhance fertility by restoring balance to the body and the internal systems responsible for regulating hormones. Researchers from Weill Cornell Medical Center in New York have concluded that acupuncture:

• Increases blood flow to the uterus, thus thickening the uterine lining, which improves the chances of an ovum implanting on the uterine wall.

• Reduces anxiety, stress, and hormones secreted during stressful situations - such as cortisol - which significantly decreases fertility (see section on Stress below).

• Normalizes the systems that regulate ovulation.

• Positively affects the hypothalamic-pituitary-ovarian axis, which plays a major role in fertility.

• Regulates the menstrual cycle.

What fertility issues does Chinese medicine treat?

TCM can help with a wide range of fertility problems, including:

• Advanced maternal age

• Amenorrhea

• Autoimmune conditions

• Cervical mucus issues

• Clotting disorders

• Endocrine imbalances

• Endometriosis

• Elevated FSH

• Fallopian tube blockage (mild to moderate)

• Immunology factors

• Luteal phase defect

• Male factors

• Menstrual irregularities

• Ovarian cysts and Polycystic Ovarian Syndrome (PCOS)

• Ovulation factors (including anovulation)

• Pelvic Inflammatory Disease (PID)

• Premature ovarian failure/poor ovarian reserve

• Poor egg quality

• Recurrent miscarriages

• Stress

• Thin uterine lining

• Thyroid problems

• Unexplained infertility

How does stress affect fertility?

Our body’s biochemical response to stress has a major effect on the reproductive system. Whether due to a major event or just the constant stressors of daily life, stress puts our body into “fight or flight” mode. This reaction to stress increases our levels of adrenaline, which inhibits our ability to use progesterone, one of the key hormones in reproduction. It increases levels of cortisol, which inhibits implantation of the fertilized egg. It also increases levels of prolactin, which inhibits fertility by decreasing or halting ovulation. Additionally, a hyper-stimulated nervous system sends blood away from the uterus and ovaries to the essential organs, thus lessening the overall function of our reproductive system.

TCM is an effective way to reduce stress and rebalance the systems that stress affects. Acupuncture releases endorphins and serotonin, which have a calming effect on the body. These chemicals decrease the physical symptoms of stress by reducing heart rate, lowering blood pressure, and relaxing the muscles. Acupuncture also improves blood circulation throughout the body, which oxygenates tissues and cycles out cortisol and other damaging chemicals. Most importantly, acupuncture has been shown to rebalance the sympathetic nervous system and the endocrine system, thereby regulating the reproductive hormones that stress negatively affects.

How does Chinese medicine work with IUI and IVF?

TCM and acupuncture have been increasingly recognized as a beneficial adjunctive therapy for individuals undergoing assisted reproductive technologies (ART). TCM enhances the overall effectiveness and improves the success rates of ART in several ways:

Stress reduction | Stress negatively impacts reproductive hormones. Acupuncture has been shown to promote relaxation and reduce stress levels, which can create a more favorable environment for successful ART outcomes.

Improved blood flow | Acupuncture enhances blood circulation to the uterus and ovaries, which can improve the delivery of oxygen and nutrients to reproductive tissues. This improved blood flow helps to create a more hospitable environment for implantation and embryo development.

Regulation of hormones | Acupuncture helps regulate hormone levels, including those involved in the menstrual cycle and reproductive processes. Balancing hormone levels can optimize ovarian function and improve egg and embryo quality.

Enhanced endometrial receptivity | Acupuncture promotes optimal thickness and receptivity of the endometrial lining, which is crucial for successful embryo implantation. This can increase the chances of successful embryo transfer and pregnancy.

Reduced side effects | Acupuncture helps to alleviate some of the side effects associated with ART medications, such as bloating, nausea, insomnia, irritability, and fatigue. By mitigating these discomforts, acupuncture improves patients' overall well-being during the ART process.

Support for emotional well-being | Going through fertility treatments can take a toll on emotional health. Acupuncture offers a supportive environment where patients can relax, destress, and focus on their well-being, which can positively impact their ART success.

How does Chinese medicine treat male fertility issues?

Male factors contribute to approximately 40% of all fertility issues. One prominent issue is the noticeable decline in average sperm count observed over recent generations. In addition, there has been a significant reduction in semen volume. These changes in sperm count and semen volume have raised concerns about male fertility and underscore the importance of addressing male reproductive health in regard to fertility.

Several factors contribute to these declines in sperm health. Increased exposure to environmental pollutants, heightened use of recreational drugs and alcohol, and the widespread use of prescription medications like antibiotics are among the leading contributors. These factors collectively influence male reproductive health and contribute to the rising prevalence of fertility challenges attributed to male factors.

Acupuncture offers several potential benefits for male fertility by addressing underlying factors that can affect sperm quality and overall reproductive health:

Sperm quality | Acupuncture has been shown to improve sperm quality by increasing sperm count, motility, and morphology (shape). Studies suggest that acupuncture may help regulate hormone levels, such as testosterone, which can impact sperm production and quality.

Stress reduction | Stress can have a negative impact on male fertility by affecting hormone levels and sperm production. Acupuncture is known to promote relaxation and reduce stress levels, which may in turn improve sperm quality and reproductive function.

Enhanced blood flow | Acupuncture improves blood circulation to the reproductive organs, including the testes, which can promote the delivery of oxygen and nutrients to sperm-producing cells. Improved blood flow may also help remove toxins and metabolic waste products, supporting overall reproductive health.

Regulation of hormones | Acupuncture may help regulate hormonal balance in men, including levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone. Balanced hormone levels are important for sperm production and overall reproductive function.

Treatment of underlying conditions | Acupuncture can be used to address underlying health conditions that may affect male fertility, such as erectile dysfunction, varicocele (enlarged veins in the scrotum), and hormonal imbalances.

Supportive therapy for ART | For couples undergoing assisted reproductive techniques such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), acupuncture may be used as a complementary therapy to enhance the success of these treatments. It can help optimize sperm quality and reproductive function before and during the IVF/ICSI process.

Improvement of semen parameters | Several studies have reported improvements in semen parameters, including sperm concentration, motility, and morphology, following acupuncture treatment in men with infertility issues.

Since new sperm generally take 74 days to form, treatment for male factors is usually recommended for a minimum of three months.

When should I start acupuncture for fertility?

Beginning TCM treatment before attempting conception or undergoing assisted reproductive procedures like IUI or IVF is recommended for several reasons.

First, research indicates that it typically takes around 90 days to observe significant changes in a woman's menstrual cycle. These changes may include enhancements in ovulation, improvement in uterine lining quality, hormone regulation, and resolution of cycle irregularities. Additionally, conditions such as PCOS or endometriosis can be addressed during this time frame.

Second, it's important to recognize that the process of egg development is a lengthy one. It takes approximately 150 days for an egg to mature from a resting follicle to a fully-developed egg ready for release. Moreover, follicles are selected from a pool of resting follicles almost a year before ovulation occurs. Therefore, it takes time to improve egg quality.

However, many women only discover the benefits of TCM for fertility after they've already embarked on their conception journey or initiated Western fertility treatments. In such cases, it's advisable to start TCM treatment as soon as possible. It’s never too late to leverage the potential of TCM to enhance fertility and reproductive health.

How long will I need to get treatments?

Because influencing changes in a woman’s menstrual cycle and egg quality typically takes between 90 to 150 days, and since conception rarely occurs within just one cycle, even in ideal circumstances, a recommended treatment course to achieve pregnancy spans at least three to six months. However, this timeframe is general; some individuals may conceive more quickly, while others may require a longer duration. The length of treatment and its success are individualized and influenced by various factors, including underlying fertility issues.

When trying to conceive, every passing month may feel like a lost opportunity, and the prospect of waiting three to six months or more can seem daunting. Nevertheless, research indicates that a minimum of three months of preparation with TCM is optimal for promoting a healthy pregnancy and baby. In TCM philosophy, no cycle is considered “wasted.” Each treatment session serves to fortify the body and bring it closer to achieving optimal reproductive health, fostering a healthy pregnancy, and ultimately, delivering a healthy baby.

Should I continue treatment if I get pregnant?

Fertility means more than achieving pregnancy - it encompasses the ability to sustain a healthy pregnancy for nine months. Acupuncture has demonstrated efficacy in enhancing ongoing pregnancy rates, particularly among individuals undergoing ART. Moreover, prenatal acupuncture care can address common pregnancy discomforts and contribute to smoother labor and delivery experiences. To learn more about the benefits of acupuncture during pregnancy, please refer to the Pregnancy page. •