ARTICLES
Opening the Blockage to Reproduction: Infertility
Wei Liu, TCMD, MPH, L.Ac.
Infertility is a big problem for many couples these days - up to 15% of American couples are considered to be infertile. Once a couple decides to embark on fertility therapy with conventional Western medicine, they often face years of expensive, time-consuming and frustrating treatments. The introduction and popularization of traditional Chinese medicine in this country, however, provides new options for infertile couples. Chinese medicine has a long tradition of treating infertility in both men and women, and anecdotal success stories are a significant part of Chinese gynecology/obstetrics textbooks. Recent success stories in the United States include celebrity Vanna White, who happily attributed her healthy baby to acupuncture treatments; and actress Annie Potts, who had a nightmare 15-year ordeal with conventional medicine until she discovered acupuncture, Chinese herbal medicine and Tai Chi, and safely delivered a 9-pound baby.
A standard definition of infertility is "failure to achieve conception after a year or more of regular sexual activity with no contraceptive use." Infertility is also the inability to carry a pregnancy to full term. As stated above, up to fifteen percent of American couples have fertility problems, and twenty percent of married American women seek medical help for infertility in their childbearing years.
In Chinese medical theory, the Kidney is the internal organ which is responsible for reproduction, growth, and aging. When Kidney energy is insufficient to support normal growth and development, or becomes depleted by lifestyle factors such as poor diet, overwork, or excessive sexual activity, many health problems can result, including infertility. Kidney Deficiency is the most common cause of infertility. Other patterns that can result in infertility are Liver Qi Stagnation, Blood Stasis or Deficiency, and Dampness with Phlegm or Heat. In Western terms, Chinese medicine has a high success rate with functional infertility, which results from factors such as hormone imbalances, endocrine gland disorders, and emotional problems. Chinese medicine can also significantly improve some structural infertility problems, such as pelvic inflammatory disease, endometriosis, vaginitis, ovary dysfunction, and immune-system-related infertility.
Seven patterns of female infertility are differentiated in traditional Chinese medicine. The causes and clinical manifestations of each pattern are noted below, as well as the leading herbal formulas used to treat the pattern.
Kidney Yang Deficiency: Chronic illness or long-standing weakness is the origin of this pattern. Clinical manifestations include delayed menstruation; irregular periods; scanty, light-colored menses; fatigue; dizziness; ringing in the ears; dull-pale complexion; back soreness; lack of sexual desire; cold limbs; loose stools; long-drawn-out urination with a thin stream or dribbling; a thick or puffy tongue body with a white coating; and a thin-soft pulse. Time-tested herbal formulas for this pattern include Yu Lin Zhu, Wu Zi Yan Zong Wan, You Gui Wan, and Jin Gui Shen Qi Wan.
Jin Gui Shen Qi Wan:
Rehmannia (Shu Di Huang)
Dioscorea (Shan Yao)
Peony Root (Mu Dan Pi)
Poria (Fu Ling)
Cornus (Shan Zhu Yu)
Alisma (Ze Xie)
Cinnamon (Rou Gui)
Aconite (Fu Zi)
Kidney Yin Deficiency: Constitutional (genetically inherited) weakness is the underlying cause of this pattern. Clinical manifestations include early menstruation; irregular periods; scanty menses with red color and no clots; palpitations of the heart; fatigue; dizziness; ringing in the ears; back soreness; dry mouth, dry bowl movements; a feeling of heat in the palms, soles of the feet, and the upper chest; low-grade fever in the afternoon; a red tongue body with a thin tongue coating; and a thin and rapid pulse. Top formulas for this pattern include Liu Wei Di Huang Wan, Zuo Gui Wan plus, Wu Zi Yan Zong Wan, and Yang Jing Zhong Yu Tang plus.
Zuo Gui Wan plus:
Rehmannia (Shu Di Huang)
Dioscorea (Shan Yao)
Cornus (Shan Zhu Yu)
Cyathula (Niu Xi)
Atler's Horn (Lu Jiao Jiao)
Tortoise Shell (Gui Ban Jiao)
Cuscuta (Tu Si Zi)
Raspberry (Fu Pen Zi)
Schizandra (Wu Wei Zi)
Lycii (Gou Qi Zi)
Plaintain (Che Qian Zi)
Blood Stasis: Surgery, emotional trauma, or excessive menstrual bleeding are the origins of this pattern. Clinical manifestations include infertility; scanty periods; delayed periods with dark purple menstrual blood and blood clots; painful menstruation; frequent abdominal pain; a pale tongue body with purple dots; and a thin-wiry pulse. Widely-used Chinese herbal formulas include Xue Fu Zhu Yu Tang and Shao Fu Zhu Yu Tang.
Xue Fu Zhu Yu Tang:
Persica Seed (Tao Ren)
Safflower (Hong Hua)
Angelica (Dang Gui)
Rehmannia (Sheng Di Huang)
Cnidium (Chuan Qiong)
Red Peony Root (Chi Shao)
Cyathula (Niu Xi)
Platycodon (Jie Geng)
Buplerum (Chai Hu)
Aurantium (Zhi Ke)
Licorice (Gan Cao)
Liver Qi Stagnation: Emotional stress is the origin of this pattern. Clinical manifestations include inability to conceive for many years; irregular periods; abdominal pain with periods; scanty, pale-colored menses; dark-colored menses with clots; painful distention of breasts; depression; irritability before periods; a pale-red tongue body with a white-thin tongue coating; and a wiry pulse. Popular herbal formulas include Kai Yu Zhong Yu Tang and Hei Xiao Yao San.
Hei Xiao Yao San:
Bupleurum (Chai Hu)
Angelica (Dang Gui)
White Peony (Bai Shao)
Atractylodes (Bai Zhu)
Poria (Fu Ling)
Licorice (Gan Cao)
Mint (Bo He)
Ginger (Gan Jiang)
Rehmannia (Di Huang)
Damp-Phlegm Obstruction: Chronic overweight or the habitual consumption of greasy, oily foods are the origins of this pattern. Clinical manifestations include infertility; irregular periods; delayed period or absence of period; menses with blood clots; weight gain; white, sticky vaginal discharge; irritability; dizziness; palpitations; chest congestion; nausea; gray tongue body with a white-sticky tongue coating; and a slippery pulse. Herbal formulas for this pattern include Qi Gong Wan and Cang Fu Dao Tan Wan.
Cang Fu Dao Tan Wan:
Poria (Fu Ling)
Pinellia (Ban Xia)
Tangerine Peel (Chen Pi)
Licorice (Gan Cao)
Lanceagrey Atractylodes (Cang Zhu)
Cyperus (Xiang Fu)
Arisematis (Nan Xing)
Aurantium (Zhi Ke)
Ginger (Sheng Jiang)
Leaven (Shen Qu)
Damp Heat: This Dampness pattern can also be caused by the habitual consumption of fatty foods and alcohol, and by weak Spleen energy. Clinical manifestations include failure to conceive after the last delivery; irregular periods; delayed periods; constant spotting; white vaginal discharge; pains in the loins; abdominal pain which is worse with menstruation and fatigue; low-grade fever; pre-menstrual breast distention; a red tongue body with a white-sticky or yellow-sticky tongue coating; and a wiry-rapid pulse. Jie Du Si Wu Tang is widely used to eliminate Damp Heat.
Jie Du Si Wu Tang:
Coptis (Huang Lian)
Scutellaria (Huang Qin)
Phellodendron (Huang Bai)
Gardenia (Zhi Zi)
Rehmannia (Di Huang)
Angelica (Dang Gui)
White Peony (Bai Shao)
Cnidium (Chuan Qiong)
Blood Deficiency: This pattern can result from loss of blood due to trauma, surgery, or childbirth; and from insufficient blood production due to Deficient Qi or Congealed Blood. Clinical manifestations include failure to conceive; delayed periods with scanty, light-colored menses, or copious, watery menses; absence of menstruation; pale complexion; a thin, weak body; dizziness; palpitations; breathlessness; insomnia; poor memory; tiredness; a pale tongue body with a thin-white tongue coating; and a thin-soft pulse. Wen Tu Yu Ling Tang, Gui Pi Tang, and Wen Shen Bu Xue Tang are effective formulas for this pattern.
Wen Shen Bu Xue Tang:
Codonopsis (Dang Shen)
Angelica (Dang Gui)
Millettia (Ji Xue Teng)
Rehmannia (Di Huang)
Psoralea (Bu Gu Zhi)
Epimedium (Xian Ling Pi)
Morinda (Ba Ji Tian)
Curculiginis (Xian Mao)
Placenta (Zi He Che)
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