Age and Female Infertility

One of the most common causes of female infertility today is delayed childbearing years, i.e. age. It is a simple fact of life that female fertility decreases significantly after mid thirties. Due to large numbers of my patients are in this category, I wrote the following content specifically for female infertility patients beyond age of 40 or prior to age of 40 but displayed premature sign of aging in their reproductive system.

As we are all keenly aware, even with recent advance in assisted reproductive technology, it is still a great challenge to help this group of women to get pregnant. Acupuncture could be used as an effective complementary and/or alternative therapy to improve their reproductive function and achieve viable pregnancies for this group of women. In our clinical practice, long term acupuncture treatment has been observed to potentially:

  • Improve follicle reserve
  • Reduce FSH readings
  • Improve ovarian response during IVF stimulation
  • Increase success rate of embryo transfer during IVF
  • Raise possibility of natural pregnancy

In other words, high FSH and Premature Ovarian Failure, low follicle reserve or low response to ovarian stimulation medication does not automatically means to an end of a woman’s reproductive function. Over the years, I have helped numerous women in this category to get pregnant, though it is not an easy task, but definitely not impossible.

Best of East & West

In a very general sense, Chinese medicine can be more effective in the treatment of infertility caused by functional anomalies. Advanced assisted reproductive technologies are very good tools for the treatment of structurally related infertility.

Overall, an integrated approach provides the best of both worlds for our age-related female infertility patients.

Case study

Over the years, I have successfully treated numerous age-related female infertility patients with remarkable success. Some patient case information is provided to demonstrate the therapeutic potential of long-term acupuncture and Chinese herbal medicine treatment for age-related female infertility patients. (Real names are not used to protect the identity of these patients):

Age Name/Occupation History, Diagnosis & Previous Treatments TCM Diagnosis
45 Laura
Unexplained infertility. No previous treatments Spleen & Kidney Yang deficient
43 Louise
3 miscarriages, unexplained infertility/unsuccessful hormonal treatment Kidney & Liver Yin deficient
37 Cathy
Premature menopause, FSH 30.9 with 2 miscarriages Liver Qi stagnant, Spleen deficient, Heat & Dampness accumulation
35 Mirela
Software Engineer
2 IVF failed, 1 IVF cancelled, FSH 50, irregular menstruation Kidney Qi and Essence deficient
40 Chantal
Hypothyroidism blocked fallopian tubes, 5 IUI & 2 IVF all failed (1 ectopic pregnancy). Kidney and Spleen Qi deficient
41 Paula
Travel Agent
1 miscarriage, 7 failed IUI, FSH 15.3, 1 Failed IVF, Kidney and Spleen Qi deficient
42 Paula
Travel Agent
1 failed IUI, 1 cancelled IVF due to poor response to IVF stimulation Kidney and Spleen Qi deficient
39 Sylvia
4 Failed IVF with frozen embryos. Kidney and Spleen Qi deficient

Chinese Medicine Treatment

One of the most important principles in TCM is called Bian Zhen Shi Zhi (辨证施治), which means “to identify and treat the root cause for each patient”. The following section contains more information concerning the common pathologies and treatment orientations of female infertility:

TCM Pathology Typical Symptoms Potential Causes
Kidney Yang Deficiency Inability to conceive, prolonged menstrual cycles, small volume of pale menstrual discharge (in some cases amenorrhea), accompanied by dull complexion, lassitude, cold extremities, lower backache, and weakness of the legs, poor libido, copious clear urine, and formless stools. Overexposure to cold weather, overeating of cold food, constitutional deficiency, stressful and sedentary lifestyle.
Kidney & Spleen Deficiency In addition to all symptoms for Kidney Yang Deficiency, low appetite, bloating, frequent loose stool, cold sensation in mid and lower abdomen. In addition to all symptoms for Kidney Yang Deficiency, low appetite, bloating, frequent loose stool, cold sensation in mid and lower abdomen. Same as the above.
Kidney Yin Deficiency Inability to conceive, shortened menstrual cycles, a scanty menstrual discharge that is red in color and contains no blood clots, emaciation, weak aching lower back and legs, dizziness and vertigo, blurred vision, palpitations, insomnia, dry mouth, and afternoon fever. Constitutional deficiency, chronic disease, abortions and miscarriages, multiple childbirths, overly taxing lifestyle, drug abuse, aging, and chronic malnutrition.
Liver Qi Stagnation Inability to conceive, irregular menstrual cramps, difficult menstrual flow, scanty dark menstrual discharge containing blood clots, premenstrual breast or abdominal distention, depression and irritability. Mental stress, sedentary lifestyle, substance abuse (cigarette, alcohol, medication, drugs…), large consumption of medication, stressful life and sedentary style.
Phlegm-Damp Obstruction Inability to conceive, overweight, prolonged menstrual cycles, amenorrhea in severe cases, copious thick vaginal discharge, pale complexion, dizziness and vertigo, palpitations, and nausea. Overweight, overexposure to cold weather, overconsumption of cold food (in temperature and energetically).
Blood Stasis Inability to conceive, prolonged menstrual cycles, scanty blackish purple menstrual discharge with blood clots, menstrual cramps, lower abdominal pain, aggravated by palpation. Overexposure to cold weather, overconsumption of cold food, sedentary lifestyle, and chronic malnutrition.

Chinese Medicine Pathology

As you can imagine, the pathology of female infertility in Traditional Chinese Medicine (TCM) can be very complex. The terms used in TCM, such as Kidney, Liver and Blood, have different meanings from those of Western medicine, and are capitalized here to show that the meaning isn’t the same. They are widely used for lack of better translations. If you’d like to learn more about TCM and infertility, refer to the books recommended in Resource – Book – Infertility section of our website.

According to a study published in the Journal of Traditional Chinese Medicine, liver Qi (vital energy) Stagnation and Kidney Deficiencies account for 51.7% and 22.4% of female infertility patients. This conclusion is hardly surprising when you consider current lifestyles and the demography of many female infertility patients. Liver Qi Stagnation is often associated with stress, a sedentary lifestyle, and a greasy diet. Kidney (whether Yin, Yang or Essence) Deficiency on the other hand is often the result of a very demanding lifestyle and the natural process of aging.

These percentages confirm my own clinical observation which is that younger infertility patients tend to have Liver Qi Stagnation and older (over 40) patients tend to have Kidney Deficiency. However, it’s important to understand that this finding is just one piece of the puzzle as almost all fertility patients show more than one pattern.

Kidney – One of the major functions of the Kidney is to store the Kidney Jing (the Essence of life), which includes Prenatal Jing (inherited from parents, and not replaceable) and Postnatal Jing (acquired from food and replaceable). The Kidney Jing can be transformed into Blood and Kidney Qi, which becomes the source of human growth, development and reproduction.

According to Chinese medicine, the variation of Kidney Jing supply produces significant physiological changes in a woman’s life every seven years. At 7, a girl starts to mature into a young woman; at 14, she has her first menstruation and is able to conceive; at 21 and 28, she reaches her most fertile years; at 35, her fertility starts to diminish; at 42, her fertility is mostly lost and at 49, a woman’s Kidney Jing is depleted, and therefore, she has her menopause.

Liver – two of the major functions of the Liver are to regulate Qi and Blood and to store Blood.

Spleen – The main functions of the spleen are to transform food nutrients to Qi, Blood and Postnatal Jing, to maintain proper humidity in the body and to keep the Blood circulating within the Vessels.

According to TCM theory, the Liver plays a vital role in the reproductive system. Liver Qi moves the Blood and stagnation of Liver Qi is likely to cause Blood Stasis. In time, Blood Stasis may cause endometriosis, uterine fibroids and ovarian cysts, dysmenorrhoea, irregular menstruation and scanty menstruation, which are all known contributors to female infertility.

The Kidney is the most important organ in the reproductive system, and any aspect of Kidney deficiency, whether Yin, Yang or Essence Deficiency often leads to amenorrhea, anovulation, a small uterus, thin endometrium, low ova quality and premature ovarian failure.

The Spleen is also a very important organ in the reproductive system. Unfortunately, over eating of cold, uncooked food, cold climate, unrestrained consumption of sweet food, overactive mind and not active body life style all negatively affected Spleen health. It is very common in clinical setting to see patients with various level of Spleen deficiency. A deficient Spleen is likely to cause scanty or abundant menstruation, spotting, prolonged menstruation, repeated miscarriages etc.