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Unexplained infertility! Where to from here?

Unexplained-infertility-

What is unexplained infertility? Unexplained infertility is the inability to conceive after 12 months of trying when a full range of investigations (both partners) have been carried out. Basically, it is a diagnosis of exclusion. Statistics show up to 20% of couples who struggle to conceive may be diagnosed with unexplained infertility. Having no answers can be both upsetting and frustrating. Couples may wonder, ‘where to from here?’

Integrative Chinese Medicine

Chinese medicine may offer other explanations as to why you have been unable to conceive. It is important for us to look outside of blood testing and other investigations and assess all systems from a Chinese medicine perspective.

 

You may have a few symptoms that seem unrelated to your fertility however, from a Chinese medicine perspective they will most likely make sense and be an important part in the way we diagnose the underlying cause of disharmony within your body.

 

Chinese medicine views the body as a holistic being – everything is interrelated and affects all other systems, organs and meridians (the channels where Qi or vital energy flow through the body). From our perspective, cases of unexplained infertility are likely to stem from an internal disharmony or an imbalance between cold/heat, yin/yang and excess/deficiency. Chinese herbal medicine and acupuncture aim to balance your internal environment to create harmony within the body.

How we assist couples with unexplained infertility

Digestive Health

Your digestive health is the foundation of all of your health from a Chinese medicine perspective therefore this is one area we put a strong focus on.  You may be eating well, however you may not be absorbing what you are eating due to impaired digestive function. Food intolerances, an imbalance of beneficial microflora (gut bacteria), or an excess of inflammatory foods in your diet can lead to excess heat and inflammation and poor fertility outcomes. 

 

The microbiome also plays an important role in your overall health and wellbeing. Studies show the gut microbiome is directly linked to the reproductive microbiome which is important in creating a healthy environment for conception and pregnancy outcomes. Our microbiome is easily optimised with dietary modification, herbal medicine and supplementation.  

Reproductive Organ Health History

Do you have a history of candida, bacterial vaginosis, recurrent urinary tract infection or pelvic inflammatory disease?

 

Sometimes it takes more than just clearing the initial infection! For those who have a history of pelvic infections, we may prescribe Chinese herbal medicine and specific strains of probiotics to target the reproductive microbiome with the aim of creating a healthy environment for conception. Recent research into the reproductive microbiome has found fertile women have an increase in numbers of healthy lactobacilli bacteria and better outcomes for conception and healthy pregnancy.

Stress Levels and Adrenal Health

Are you so used to being stressed that it has become your new normal?

 

Do you feel wired and tired? Are you sleeping well with 7-8 hours of uninterrupted sleep, or do you suffer from insomnia? How do you feel when you wake? Do you struggle to get through the day?

 

 

It is important to support stress levels when trying to conceive. Stress management and good sleep hygiene are important or overall health and desired fertility outcomes.

 

Recent research has found acupuncture to be effective in reducing stress levels in women undergoing IVF treatments. Significant reductions in stress levels were found when acupuncture was administered prior to embryo transfer. Acupuncture can be used for couples undergoing treatments for both natural fertility or IVF support.

Nutritional Status

Do you feel tired often? Do you suffer from frequent colds and flu? How is your skin? Dry and itchy? Do you have cracked lips or suffer from acne?

 

While some of these symptoms may seem unrelated to reproductive health, they very well may be due to deficiencies of certain nutrients which are also important for healthy egg and sperm quality. Zinc, B vitamins, selenium, essential fatty acids and vitamin D are just some of the many nutrients required to assist healthy egg and sperm development and conception.

 

 

We provide our fertility patients with a comprehensive dietary plan which emphasises whole foods, fruit and vegetables, healthy fats and proteins. Your Chinese medicine constitution will also be taken into account with dietary recommendations specific to your body type.

 

 

We may also include supplements such as a good quality prenatal formula with bioavailable ‘folate’ (not folic acid) to support your body and nutrient levels prior to and during pregnancy.

Thyroid Health

Comprehensive testing can give us the full picture of your thyroid function.

 

Maybe you have been experiencing symptoms of tiredness and fatigue, feeling cold, hair loss, sluggish digestion, weight gain and joint pains, but your thyroid blood test comes ‘within a healthy range’. Within the ‘adequate’ range is not always optimal!

 

It is also not uncommon for only basic TSH and T4 testing to be carried out. This is not enough! A comprehensive thyroid panel test involves more than these two tests and can show us how your thyroid may be impacting your fertility.

Low Levels of Inflammation that MAY NOT show up on Testing

Inflammation is normal however, there is a fine balance that needs to be achieved here. 

 

Oxidative stress is an imbalance of antioxidants and reactive oxygen species (ROS). ROS stimulate natural inflammatory responses within the body. However, when there is low levels of antioxidants present, this inflammation can cause damage to our cells and DNA which can negatively impact our fertility. 

 

The inflammation from endometriosis is a good example of this. Even after treatment to excise or ablate endometrial lesions and cysts, the underlying or causative factors have not been addressed. An inflammatory environment is not ideal for conception and with conditions such as endometriosis we need to work with the immune system to target inflammation.  We also need to find out what may be causing levels of inflammation in your body (the root cause) and guide you to good health before you get pregnant to achieve a healthy pregnancy.

Gain Insights into Your Menstrual Cycle

While much of your hormone levels will have been tested we like to use other methods to dive deeper into what is happening on an internal level. 

 

A basal body temperature chart (BBT) can determine exact ovulation times, the quality of cervical mucus as well as determining your fertile window for timing of intercourse. This is a great tool for a Chinese medicine fertility practitioner as it helps us confirm your unique constitutional pattern and direct our diagnosis and prescriptions. Other more comprehensive forms of testing may also used such as the ‘DUTCH test’ (urine test for comprehensive hormones). This enables us to assess hormone levels and how they are being metabolised within the body. It’s a gold standard test that can give us a lot of information about your hormonal health

 

 

Our aim is to work out the ‘why’ you are struggling to conceive!

 

Chinese medicine and acupuncture have been used for thousands of years assisting women with infertility and decades as an adjunct therapy to IVF. Acupuncture is believed to stimulate the flow of Qi and blood to the reproductive organs and uterus as well as acting on brain neurotransmitters to reduce stress. Continued research is showing acupuncture to be effective when used as an adjunct therapy to IVF.

If you would like assistance with your fertility, Ballarat Acupuncture & Herbal Medicine offers both telehealth and in clinic consultations to assist you on your fertility journey. We offer courses of acupuncture treatments prior to embryo transfer or trying to conceive.  Seek the help of a qualified and licensed Chinese medicine practitioner with expertise in integrative fertility. They are likely to be able to assist you, even with a diagnosis of unexplained infertility.

References
  • Franasiak, J. M. (2016) Endometrial microbiome at the time of embryo transfer: next-generation sequencing of the 16S ribosomal subunit
  • G, Scutiero, G et al. (2017). Oxidative Stress and Endometriosis: A Systematic Review of the Literature.
  • Hullender Rubin, L. (2015) Impact of whole systems traditional Chinese medicine on in-vitro fertilization outcomes
  • Jo J, & Lee YJ. (2017 ). Effectiveness of acupuncture in women with polycystic ovarian syndrome undergoing in vitro fertilisation or intra-cytoplasmic sperm injection: a systematic review and meta-analysis.
  • Manheimer, E et al. (2018). Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis.
  • Moreno, I & Simon C. (2019). Deciphering the effect of reproductive tract microbiota on human reproduction
  • Qian, Y. et al. (2016) Therapeutic effect of acupuncture on the outcomes of in vitro fertilization: a systematic review and meta-analysis.
  • Reba, R. W. (2019). Merck manuals professional. Unexplained Infertility
  • Smith, C.A. et al. (2018). Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro FertilizationA Randomized Clinical Trial
  • Wagner, H. (2018) Role of reactive oxygen species in male infertility: An updated review of literature
  • Van Oostrum, N. et al (2013). Risks associated with bacterial vaginosis in infertility patients: a systematic review and meta-analysis.

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