Dr. Lifang Liang

Contemporary Gynecology




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Acupuncture & IVF

What are the factors that cause infertility?

Any imbalance or physical impairment can affect a person's ability to become pregnant. There are many different factors that can affect a person's fertility. For women, the factors are ovarian factors, uterine factors, and fallopian tube factors. Also, immune system irregularities can play a role in infertility. Determining the correct factor that is causing infertility is similar to finding the right key to unlock a door. If you do not have the right key, the door will not open. Thus, it is very important to determine the factors that are causing one's infertility so that the correct treatment can be administered.

  1. Ovarian Factors

    1. Ovarian Cysts due to Endometriosis

      Cysts are considered a product of qi and blood stagnation and dampness or phlegm in Chinese medicine. TCM can help dispel the fluid within the cyst to reduce the size or even make it disappear. Endometriosis is the overgrowth of endometrial cells outside the uterus. The method involved in treating endometriosis in TCM is to circulate the qi and blood to help the body dissolve the excess endometrial cells.

      Case #1505 - Endometriosis and IVF
      A 32 year old client presented with a history of endometriosis. Also, in the past she had a 3 cm diameter ovarian cyst surgically removed. Her FSH was reported at 8.1. She had three prior attempts with IVF before treatment with acupuncture and herbs, none of which had resulted in pregnancy. After being treated with Chinese Medicine, the patient's fourth IVF resulted in a successful pregnancy. Fifteen embryos were produced, all of which were of much better quality than in the prior three IVF cycles. Seven of the embryos were frozen, and three were transferred. The transfer resulted in triplets!

    2. No ovulation, also known as Amenorrhea, due to polycystic ovaries

      Ovulation is unable to occur in polycystic ovaries due to the stagnation of qi and blood, along with fluid, in the ovaries. The kidneys play a significant role in the reproduction systems of both males and females, in Chinese medicine. The goal of TCM is to restore ovulation and the menses and reduce or dissolve the cysts in the ovaries. By tonifying or strengthening the kidneys and moving the qi and blood, TCM can help facilitate the normal cycles of menstruation.

      Case #1368 - Amenorrhea
      Amenorrhea is one factor of infertility that acupuncture and herbs can successfully treat. For example, I treated a 35 year old patient who had been struggling with the absence of menstrual cycles for most of her life. In her entire life, she had had only five menstrual cycles without the use of hormone supplementation to force her cycle. For ten years she was on birth control pills in order to achieve menstruation. After one month of treatment with acupuncture and herbs, the patient's menses returned with regularity, and within nine months she was pregnant without the use of Western intervention for conception. The patient shared with me how amazed her Western practitioners were that she had been able to become pregnant without IVF.

    3. Decline of ovarian function

      This occurs naturally with age and as FSH (follicle stimulating hormones) increase, ovarian function declines. Traditional Chinese medicine can decrease FSH levels and help improve and support ovarian function. In this case, it is important to tonify the kidneys, spleen, qi, and blood in order to nourish the ovaries.

      Case #1661 - High FSH

      A 40 year old woman was scheduled for her third IVF when she came to my clinic. The first IVF resulted in ectopic pregnancy requiring surgery. The second resulted in miscarriage during her seventh to eighth week. Her FSH level was between 17- 20 (10 is high and 30 is considered menopausal). She began acupuncture and herbs. Her third IVF also resulted in pregnancy which has continued into her 19th week.

      Case #735 - Decreased Ovarian Function

      A couple came in for treatment after three failed IVF procedures. The client who was 40 years old had poor ovarian function and was producing only one to five eggs per IVF cycle. Her husband, aged 42 had weak sperm. Acupuncture and herbs combined with IVF produced ten eggs. In their fourth IVF attempt, after treatment with Chinese Medicine, the client had produced ten eggs, became pregnant and gave birth to a baby girl.

  2. Uterine Factors

    1. Thin endometrial lining of uterus

      The goal here is to increase the thickness of the lining. By tonifying the kidneys and blood, there is an increase in blood flow to the uterus, which results in an increase in the thickness of the uterus lining.

      Case #853 - Thin Endometrial Lining

      A 45 year old woman came to the clinic for infertility. She had a 17 year old son from a previous marriage and was attempting another pregnancy in her second marriage. Three years previously she underwent IVF, but miscarried. Her husband was also treated, as his semen analysis reported poor semen quality. By increasing sperm quality and thickening the uterine lining, the chances of a successful implantation were greatly improved. IVF treatment involved a donor egg and the husband's sperm. For six months the patient prepared for IVF. The patient's bleeding was normal in quantity and quality again, whereas previously it was too light in flow. An ultrasound also showed that the uterine lining was greatly improved, thickening to 10 mm, whereas previously it was only 4-5 mm. Implantation and pregnancy proved to be successful. The patient continued this treatment for six and a half months during her pregnancy, as a prevention against miscarriage. The woman gave birth to a healthy boy.

    2. Uterine Fibroids

      Fibroids are slightly different than cysts in Chinese medicine. As stated before, cysts are fluid (water) filled sacks while fibroids are considered to be products of blood stasis in TCM. The treatment method, in this case, is to dispel the blood stasis by circulating the qi and blood, and opening the blood vessels to remove the blockage.

      Case #397 - Endometriosis and Fibroids, no IVF

      A 43 year old patient, diagnosed with infertility due to fibroids and endometriosis, became pregnant without IVF, using only acupuncture and Chinese herbs. She had fibroids in the muscular wall of her uterus, as well as in the uterine cavity. The fibroids were 4x5 cm in size. She had an ovarian cyst that was 6.5cm that was surgically removed some years prior to treatment with Chinese medicine. After six months of treatment with acupuncture and herbs, her menstrual bleeding became normal and the severe cramping almost completely alleviated. The patient soon became pregnant but in her fifth month of pregnancy experienced strong uterine contractions. Her cervix opened an inch in diameter and she began spotting and passing clots. With acupuncture and herbs, she was able to maintain her pregnancy, carry to full term, and give birth to a healthy baby boy.

  3. Fallopian Tube Factors

    Infertility caused by fallopian tube factors is very difficult to treat. In China, some cases have been treated successfully but in severe cases, surgery is a risky and difficult option. IVF is the most common method used to treat infertility caused by fallopian tube factors.

    Case #237 - Fallopian Blockage and IVF

    A 42 year old woman presented with a history of pelvic infection leading to obstruction of her fallopian tubes and infertility. While acupuncture and herbs alone did not clear the blockages and enable this patient to become pregnant without the use of IVF, the treatments did, however, significantly improve ovarian function and contributed to the patient's successful IVF procedure. After six months of treatment, the patient produced an unusually large number of follicles with IVF. On average, a woman of her age would produce less than ten follicles in a given IVF cycle. This patient produced thirty five follicles, twenty eight eggs and twenty one embryos. These were excellent results. The patient had four transfers before she became pregnant. In December of 2002, she gave birth to healthy twin boys.

  4. Immune System Irregularities

    When the immune system is in overdrive, it is difficult for a woman to become pregnant. If she has a high number of NK killer cells or antibodies, her body will not accept an embryo. In Chinese medicine, we can help regulate the immune system by tonifying the spleen qi, which will help the body rid itself of the bad antibodies or excess NK cells. It is also important to circulate the qi and blood to help the body regulate itself.

    Case #1248 - Immune Vacuity and IVF

    A 38 year old woman came for treatment with a history of infertility related to immunological incompatibility. She had two miscarriages in the year and a half prior to treatment with acupuncture and herbs. Immunological examination revealed an antagonism between the husband's sperm and the wife's egg. Western treatment for antibody antagonism of this kind is limited and experimental. This patient was prescribed the drug "Metformin", a medicine which has been shown to improve immune function for patients with diabetes. Metformin has not been proven for use in treating antibody antagonism such as in this case. The patient simultaneously took herbal prescriptions with the Metformin. After three months of treatment, the patient was retested for antibody levels, and her tests came back normal. The patient prepared for IVF. There were 17 follicles, 15 eggs and 12 embryos eventually produced from the IVF cycle. Five of the embryos were transferred, all of which had eight cells, and seven embryos were frozen for future use. Unfortunately, the attempt failed and the patient did not become pregnant. The next month, the remaining embryos were transferred, and the patient did become pregnant!

    Case #1032 - Immune Vacuity and IVF

    A 37 year old woman who had been coming to my clinic underwent IVF. Prior to starting the process, lab results showed an immunity deficiency. Initially her percentage of CD19 and CD5 cells was above the normal limits. The normal limits are between 5 and 10 wile hers were at 24.2. Her Fertilization Specialist wanted her to undergo a blood transfusion as a result. After just two months of treatment with acupuncture and herbs, her percentage decreased to 10.7. Her doctors were very surprised and decided that the patient did not have to undergo the blood transfusion. Pregnancy resulted and the patient is currently 10 weeks pregnant.

  5. Cervical factors

    1. Short or narrow cervix

      Surgical removal of abnormal cells in the cervix may result in the growth of scar tissue thereby causing a narrowing or shortening of the cervical os. This makes it difficult for the sperm to travel up the cervix into the uterus. It is also easy for miscarriage to occur in cases of narrow or short cervix, because the cervix cannot support the fetus once it becomes large and the cervix may become loose and open.

      Case #1278 and #1323 - Abnormal Cervix, low progesterone, and IVF

      A diagnosis of infertility due to scarring in the cervix and low progesterone brought a client in for treatment. She was 42 years old and presented with a history of abnormal pap smears. Surgical removal of the abnormal cells resulted in a narrowing of the cervical os due the formation of scar tissue. The patient was unable to become pregnant for more than two years prior to treatment with Chinese Medicine. Complicating the patient's difficulties in becoming pregnant were her husband's poor sperm motility (22%) and morphology (4%). She and her husband tried two IUI with Clomid before coming in for treatment with acupuncture and herbs. Unfortunately, both IUI procedures were painful and difficult due to scar tissue blocking her cervical os, and neither resulted in pregnancy. The patient decided to try IVF but one month prior to her appointment she became pregnant. She now has a healthy three month old.

  6. Hormone Dysfunction

    Hormones play a vital role in the ability of a woman to become pregnant. The imbalance of hormones can occur at any age and is easily influenced by factors such as age, stress, diet, exercise.

    Case #171 - Irregular Menstruation/Pre-menopause and IVF

    A 48 year old client began treatment after a western diagnosis of infertility due to pre-menopausal syndrome, which included irregular menstruation. Her cycle was fifty days to three months apart, with heavy bleeding and painful cramping. After three months of treatment, the patient's cycle had again been established with regularity with normal amount of bleeding and only mild cramping. To prepare for IVF, the patient continued to receive acupuncture and herbs. Eighteen eggs were produced with the IVF procedure, a very good count considering the patient's age. Unfortunately, during the transfer, the uterine lining was thin at only 0.3 cm, and the embryos failed to implant. After using acupuncture and herbs for another three months, the transfer of her frozen embryos was successful, as the endometrial lining had thickened from 0.3 cm to 0.9 cm and implantation was able to occur. She now has a healthy six year old child!

  7. Male Infertility

    There are many factors that influence a male's fertility. It is important to test sperm quality and quantity including count, volume, motility, morphology, and liquefaction. Other factors that can affect fertility include low testosterone levels, seminal duct blockages or varicoceles, and prostatitis.

    Case # 1655 - High Follicle Count, Low Sperm Motility, IVF

    After two years of Infertility a 37 year old woman came to my clinic. I treated her and her husband with acupuncture and herbs. I prepared her for IVF and focused on her husband's low sperm motility count which was only 3%. After a few months of treatment, the female patient produced 42 eggs and the husband's sperm motility count increased from 3% to 40%. The woman is now carrying a 15 week pregnancy. Case #1102 and #1103 - Irregular Menstruation and Low Sperm, IVF I treated one married couple in which the wife had irregular menstruation, and the husband had a low sperm count, and weak motility. The female was 39 years old and the male was 42 years of age. The couple had two unsuccessful IVFs prior to treatment with acupuncture and herbs. Their third IVF was successful, and today they have a two year old baby girl.

    Case # 857 - Low Sperm Count and Motility, Natural Pregnancy

    A man aged 32 and his wife were diagnosed with Infertility. They were trying for a natural pregnancy. I treated the wife with acupuncture and herbs without any success so focused on the husband. Lab results showed a low sperm concentration of 51 and an overall motility of only 18%. He began acupuncture and herbs. His wife became pregnant a few months later. They had their first child a year later.

    Case #686 and #1235 - Infertility, Male and Female

    A 37 year old woman and her husband had been trying to conceive for four years prior to coming to my clinic. There were 2 failed IVF and 3 failed IUI attempts before treatment with acupuncture and herbs. In her previous IVF cycles, only two to seven follicles were produced, which was demonstrative of poor ovarian function. Her husband's sperm was of poor quality, with a motility of 14% (normal is >50%), and a total count of 0.6 M/ml (normal is >25 M/ml). Both husband and wife were treated in my clinic with acupuncture and herbs. The third IVF, which took place two months into receiving acupuncture and herbs in my clinic, also produced only three follicles. Because of this, the third attempt at IVF was abandoned, so the patient used IUI instead. While she did not become pregnant in the procedure, the patient did conceive one month later on a natural cycle, without the use of IVF or IUI. The hormones used in IVF linger for over a month, and continue to influence a woman's ovarian function. I would encourage women to keep this in mind, and to not give up after the disappointment of a failed IVF. The patient now has a healthy three year old daughter!