Traditional Acupuncture and Male Fertility

This short article originally appeared in the summer 2014 edition of Nurture magazine.

needlingAs a traditional acupuncturist I treat infertility based on traditional Chinese medicine (TCM) theories, treatments are either standalone or tailored to complement assisted reproduction techniques such as IVF. Statistics suggest that between 35-50% of infertility is due to male pathologies and the NHS suggests that in 25% of all cases the exact cause is unknown.

From a Western biomedical viewpoint it is thought that acupuncture stimulates the nervous system, influencing the production of hormones and neurotransmitters, thus activating the body’s self-regulating homeostatic systems encouraging your natural healing abilities. An increasing weight of evidence from Western scientific research is demonstrating the effectiveness of acupuncture for treating a wide variety of conditions.

Traditional acupuncture takes a holistic approach and regards illness or dysfunction as a sign that the body is out of balance. This holistic understanding that we are all individuals and that the exact pattern and degree of our imbalances are ultimately unique to us is one of the key strengths of TCM. My skill as an acupuncturist lies in identifying the precise nature of the underlying imbalances and selecting the most effective treatment plan.

Male fertility is influenced by many factors including genetics, environment, age, injury and physical or emotional stresses. I usually see men in the clinic after they have been tested and found to have a low sperm count, reduced motility or sperm with abnormal shape and size.

From a TCM perspective fertility problems typically fall under the influence of the Kidney. The Kidney is an approximate translation of the Chinese 腎 shèn and describes a conceptual framework affecting particular functions within the human body; the Kidney is often referred to as the ‘Root of Life’.

Kidney deficiency is commonly seen in male infertility and may include or lead to other pathologies such as Blood and Qi stagnation (Qi in this context means the flow of bodily functions or energies). I typically aim treatment at balancing and strengthening the Kidney and smoothing or invigoration the flow of Blood and Qi.

The Kidney thrives under moderation and a healthy lifestyle, difficult for many of us in these modern times. Stress relieving activities such as qigong, yoga and meditation are helpful as are refraining from long term excessive exercise, excessive physical work and excessive sexual activity. Long term consumption of cold and raw foods, living with chronic illness and just getting older all deplete the Kidney.

A diet high in fruit and vegetables, warm cooked foods and if possible organic foods is preferable. Reducing alcohol and caffeine, stopping smoking and reducing exposure to toxins and pollutants can all be helpful. Men should also ensure their testes are kept relatively cool by not using a laptop on the lap and avoiding tight underwear.

In my experience male and female fertility can often be directly improved through the use of traditional acupuncture and indirectly improved by relieving stress and anxiety and improving ones general sense of wellness.

Sources and further reading:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/male-infertility.html

http://acupuncture.rhizome.net.nz/infertility-men.aspx

Liang, L. (2004) Acupuncture & IVF Increase IVF Success By 40—60%, Boulder: Blue Poppy Press.

Lyttleton, J. (2004) Treatment of infertility with Chinese Medicine, Philadelphia, Churchill Livingstone.

http://www.nhs.uk/conditions/Infertility/pages/causes.aspx

Ni, D., and Herko, D. (2008) The Tao of Fertility: A Healing Chinese Medicine Program to Prepare Body, Mind, and Spirit for New Life, New York:  HarperCollins.

http://www.resolve.org/diagnosis-management/infertility-diagnosis/male-factor.html

http://www.webmd.com/infertility-and-reproduction/news/20050803/acupuncture-may-improve-sperm-quality

Menstrual Cycle Diary & Most Fertile Times

As your Traditional Chinese Medicine practitioner I may ask you to complete a menstrual cycle diary sheet as part of your treatment at Austin Acupuncture. The information gleamed from the diary will greatly assist in understanding your personal cycle and in treating disharmonies such as infertility, painful periods, irregular periods and pre-menstrual syndrome.

It is important that you understand your treatment and are as comfortable and stress free as you can be with the process, so if you have any queries or concerns please discuss them with me. If you feel that completing a menstrual cycle diary is too stressful don’t worry we can use your anecdotal information and rely on other diagnostic data.

Menstrual Cycle Diary

The menstrual cycle diary can record a large amount of information and is reasonably self-explanatory. During your consultation I will explain what sections should be completed for your particular needs.

Measuring Basal Body Temperature (BBT) requires a thermometer, I recommend a digital one specifically designed for BBT readings as this will bleep when the reading is complete and store the readings in memory, a useful feature to have first thing in the morning when you are half asleep.

You should take your temperature at the same time every morning after at least 3 hours of uninterrupted sleep. If you sleep past your normal waking time then some accuracy can be maintained by adjusting the temperature DOWN by 0.1oC (one square on the chart) for every hour of oversleeping, conversely if you wake earlier then adjust the temperature UP by one square for every hour earlier that you woke; this adjustment method should only be used occasionally as it will never be as accurate as a reading taken at a regular fixed time.

Most Fertile Times

It is generally accepted that the most fertile times for sexual intercourse are no more than 6 days before ovulation and Lyttleton (2004: 57) suggested some studies indicated the highest conception rate is 2 days before ovulation.

You can predict your ovulation date by understanding your cycle through your menstrual cycle diary and observing changes in your vaginal mucus and cervix. Some modern test devices predict ovulation and for many women these are a good and easy indicator of their most fertile times, however when there are disharmonies and abnormalities the additional data provided by a BBT record and associated data can prove invaluable in personalising treatments for maximum benefits.

Vaginal Mucus

Changes in vaginal mucus may be monitored as a personal feeling of moisture at the vulva, such as a dry feeling or a moist, slippery or lubricating feeling. More objective observation can be seen by collecting mucus (if plentiful) from the vaginal entrance or on underclothes, toilet tissue or your fingers. If mucus is less plentiful it can be collected with clean fingers gently from the cervix.

The mucus is usually clear, white or cloudy in colour with a non-offensive odour. If yours is excessive, sparse, yellow, green, bloody or smells more than you might think normal (often a strong fishy or leathery smell) then tell me as these are signs of disharmony that can be addressed in treatment.

The least fertile time is often associated with a dry feeling at the vulva (G-type mucus, see list below). The production of fertile (S-type) mucus usually starts as oestrogen peaks, about 6 days before ovulation.

Vaginal_mucusG_andS_type

To check for S-type mucus and your probable fertile days collect a little on the fingers and draw the fingers apart to observe the spinn. The last day of fertile mucus is often seen as P-type mucus and felt as a moist sensation and is referred to as the ‘Peak Day’, a highly fertile time. Sperm can live for up to 5 days in the reproductive tract but are most successful within the first 48 hours. Your egg is viable for 6-12 hours and some studies have suggested the highest conception rate through normal sexual intercourse is 2 days before ovulation (Lyttleton, 2004: 57).

Pharmaceutical Medications

Some common pharmaceutical medications can effect cervical mucus, however this is not necessarily a detrimental effect and stopping or modifying medication should be discussed with your doctor.

Medications

Cervical Changes It can be useful to observe changes in the shape, position and texture of the cervix as the uterine ligaments tighten in response to the peak of oestrogen that occurs just before ovulation; this pulls the uterus up positioning the cervix higher in the vagina.

check the cervical surfaceTo check the cervical surface some women may need to adopt a squatting position, see image.

The surface of the cervix is softer at ovulation (feeling more like your lips than the tip of your nose). As the cervical glands release fluid the uterine os [opening] opens. This may be checked at the same time as checking for fertile mucus, perhaps during an evening shower. Immediately after ovulation or from several hours to several days after ovulation (depending on the individual) the cervix returns to being low and firm (feeling again more like the tip of your nose and less like your lips) and the os becomes tightly closed – due to the stretching during labour women who have previously given birth vaginally may notice the os feels open at all times.

Conclusion

Information from the menstrual cycle diary and observations of the cervix and its secretions provide key information, for example only fertile mucus can indicate that ovulation is about to happen, and only the temperature shift observed in the BBT can show that ovulation has occurred. This information combined with length of the period, spotting, appearance of clots, mood swings, etc. can provide invaluable information allowing me to make an accurate pattern diagnosis, implement a suitable treatment plan and effectively monitor treatment progress.

References and further reading:

Liang, L. (2004) Acupuncture & IVF Increase IVF Success By 4-60%, Boulder: Blue Poppy Press.

Lyttleton, J. (2004) Treatment of infertility with Chinese Medicine, Philadelphia, Churchill Livingstone.

Maciocia, G. (1998) Obstetrics & Gynecology in Chinese Medicine, Philadelphia: Elsevier Churchill Livingstone.

Ni, D., and Herko, D. (2008) The Tao of Fertility: A Healing Chinese Medicine Program to Prepare Body, Mind, and Spirit for New Life, New York:  Harper Collins.

Routine Pre-Birth Treatments

One of the leading experts in the use of acupuncture in pregnancy and childbirth is Debra Betts and I often look to her teachings, including the recommending of acupuncture as a pre-birth treatment.

The following is the introduction to ‘THE USE OF ACUPUNCTURE AS A ROUTINE PRE-BIRTH TREATMENT’ written by Debra Betts and published in the Journal of Chinese Medicine (October 2004:76).

“Pre-birth acupuncture refers to a series of treatments in the final weeks of pregnancy to prepare women for childbirth. Research1 has demonstrated that the mean duration of labour in a group of women giving birth for the first time was reduced from 8 hours and 2 minutes in the control group (70 women) to 6 hours and 36 minutes in the group of 70 women who had received pre-birth acupuncture. In clinical practice acupuncture is an ideal method to help women prepare themselves to have the most efficient labour possible. Feedback suggests that pre-birth acupuncture offers a range of positive effects in labour that goes beyond reducing the time spent in labour, with midwives reporting a reduced rate of medical intervention. This article outlines the use of pre-birth treatments in clinical practice in the hope that this will encourage practitioners to promote this practical treatment.”

The full article is aimed at acupuncture practitioners but I thought it my be of interest to some of my existing clients and others interested in acupuncture for pre-birth treatments, a full copy of the article can be found here.

For more information regarding women’s problems, fertility, obstetrics or paediatrics please contact me.

By Austin ©2014 Austin Austin www.austinaustin.co.uk