Infertility, Subfertility, and Fertility Enhancement

Paul L. Reller L.Ac. / Last Updated: August 03, 2017


A Realistic Approach to Fertility Issues Involves Understanding the Problems and Making Intelligent Decisions with Restoration of Reproductive Health Before Resorting to Expensive and Problematic Artificial Reproductive Technologies

Infertility is an increasingly common problem in modern industrial societies, but most couples seeking infertility treatment are subfertile, with a decreased monthly possibility of pregnancy, not a true infertility. Overtreatment with harsh drug regimens and expensive fertilization techniques are becoming an increasing concern as fertility clinics are heavily promoted. In 2000, 1/6 of all marriages suffered infertility or subfertility, with approximately 60% due to female health dysfunction, and 40% due to male health dysfunction. About 1/3 of these couples had problems related to infertility or subfertility in both the man and the woman. The numbers continue to rise, prompting a great increase in fertility therapy in the United States. In 2002, the Centers for Disease Control (CDC) reported that at least 8% of women of reproductive age had sought treatment from a medical doctor for infertility or subfertility in their life. By 2007, a study in the Oxford Journals found that in more developed nations, this rate had risen to 16%. This statistic does not represent couples that sought medical care from Complementary Medicine, which is a rapidly expanding and popular form of therapy in fertility issues, nor does it represent couples who sought care from a medical doctor or clinical nursing specialist and wished to preserve confidentiality. Due to this rising estimate of subfertility and infertility in developed countries the use of Assisted Reproductive Technology (ART) has increased dramatically. There is growing concern about the long-term adverse health effects with this therapy, though, for both the mother and the child. A large cohort study published in 2014, conducted by the Harvard School of Public Health and the Brigham and Women's Hospital, of Harvard Medical School, in Boston, Massachusetts, found that 94 percent of women utilizing ART used clomiphene (Clomid) to induce ovulation, and 74 percent reported that they chose to use clompiphen as their only form of treatment, while 13 percent used recombinant gonadotropin injections alone, 11 percent utilized IVF (in vitro fertilization), and 11 percent utilized intrauterine insemination (IUI) (PMID: 24746739). Both the high cost of ART and the health risks were considerations in choosing the simplest form of the fertility therapy.

Problems with fertility function do not imply poor health or inadequacy, but are common health problems that need to be addressed with the most sensible health restoration of both the woman and the man. The basic choice when the possibility of fertility issues arises is whether to restore health and healthy reproductive function, or to use artificial methods to induce pregnancy. Hopefully, attention to your health will not be ignored even if you resort to the latter.

Today, the most successful fertility clinics advise that the most sensible route to take is to patiently resolve health problems in the reproductive system first, even when ART, AI or IVF is chosen (assisted reproductive technology, artificial insemination or in vitro fertilization). Reproductive health may have an impact on the health of your baby as well as related health problems that may arise in the future for both the mother and the child. Restoring health to the reproductive system may also result in pregnancy without IVF, or may decrease the necessary cycles of attempted fertilization, saving a large amount of money and preventing the adverse health problems that come with the array of drugs, and the stress of the fertility process.

When a couple is trying to get pregnant, Complementary and Integrative Medicine (CIM), especially acupuncture and herbal/nutrient medicine, can help with general improvement of physiological and hormonal health, stress reduction, and pertinent advice on fertility related issues such as clearing environmental chemicals from the body that may affect fertility, as well as low grade microbial infection that may impair ovarian health or cause problems with the fallopian tubes or uterus. Acupuncture and herbal medicine may also help address related health problems that are sometimes not apparent, or subclinical, such as polycystic ovarian syndrome, subclinical hypothyroid and hyperparathyroid disorder, metabolic syndrome, and endometriosis. These treatments, unlike the pharmaceutical protocols, come with no side effects and adverse health effects. This healthy and beneficial medical approach is relatively inexpensive and helps to insure the most healthy pregnancy and birth. Since statistics in the United States show that a 38-40 year old woman using her own unfrozen eggs in assisted reproductive technology (ART) has only an average of 21.6 percent of having a baby with this expensive fertility treatment, which now averages $12,400 per cycle, and may take up to 5 menstrual cycles and implantations to succeed, utilizing the inexpensive therapies in Traditional Chinese Medicine before starting standard fertilization therapy is a sound investment in not only higher chances of success, but a healthier outcome.

Despite the research and science devoted to this health problem, success rates with the various standard therapies to treat infertility are still poor. The IVF (In vitro fertilization) Registry in 1997 gave a 27.9% delivery rate per retrieval for IVF, with each subsequent implantation of ova having approximately 10% less chance than the previous implantation. They gave a 30% delivery rate for gamete intrafallopian transfer (GIFT), and a 28% rate for zygote intrafallopian transfer (ZIFT). The CDC was required to report success rates for all Assisted Reproductive Technology (ART) by law in 1992, because of the impression that women were being given that the technology had a high success rate. In 2007, data from 430 fertility clinics showed a 30.47% success rate for all ART, only slightly improved from 1997 (approximately one in five of these pregnancies resulted in multiple births, often triplets, which poses significant health risks for the children later in life). We now know from extensive data that the success rate with increased age drops dramatically. This data is available at The CDC reports that women under the age of 35 have only a 30-35% success rate with the first cycle, and women between the age of 35-40 have only a 20-25% success rate. The rates of success with each subsequent attempted cycle decrease. The average cost of the IVF is $12,000 per cycle now, as the clinics utilize more intensive and frequent testing and monitoring. With advancing age, a series of 5 cycles of implantation may cost an average of $60,000, and still have a relatively low rate of success. Multiple cycles of ART come with increased risks of long-term health risks for both the mother and the child.

Most highly rated fertility clinics no longer perform IVF on women over 40 years of age due to the very low success rates. The CDC reports that women over the age of 40 have only a 6-10 percent chance of success with the first cycle of IVF. Drug induced pregnancy has a slightly higher success rate for targeted patients, but the harsh side effects cause a great number of women to stop the therapy. The number of women that do complete therapies with harsh drugs such as clomid have nearly a 50 percent success rate in some clinics largely because of the high number of women that have become alarmed by negative health effects and stopped the therapy (often a 25 percent drop-out rate). This drop-out rate tilts the rate of success. Widespread acknowledgement of risks and adverse health effects in ART has resulted in the utilization of minimal ovarian stimulation within a natural menstrual cycle combined with IVF and single embryo transfer, especially utilizing frozen embryos studied to determine the greatest chance of success. A large cohort study completed in 2014 by the Center for Reproductive Medicine in Brussels, Belgium confirmed that success rates for this safer and more minimal ART was about 60 percent for women under 38 years of age (PMID: 24631167). To fully analyze the actual rates of success with this therapy, though, we must consider that if 100 women started therapy and 25 dropped out due to side effects, that 60 percent of the remaining 75 equals 45 successful pregnancies out of the original 100 women. Complementary and Integrative Medicine, especially in the form of acupuncture combined with professional herbal and nutrient medicine, is proven to increase the rates of success if performed properly, and may reduce the need for allopathic overtreatment and help resolve some of the harmful effects of drug therapies. Even if these ART therapies have been tried and have failed, restoration of healthy reproductive function with Complementary Medicine may still produce a healthy pregnancy with persistence. Because assisted reproductive technology has failed, this does not mean that underlying health problems cannot by resolved and a normal healthy pregnancy finally achieved, and Complementary Medicine may help with this task as well. Integrating Complementary Medicine at various stages of the process in fertility therapy offers an array of potential benefits, and is relatively inexpensive.

A relatively short course of therapy with a knowledgeable Licensed Acupuncturist and herbalist is inexpensive and may save a lot of money and prevent a lot of stress when choosing to utilize assisted reproductive technology (ART) when trying to get pregnant. Acupuncture and herbal/nutrient medicine also offers an array of health benefits that may insure a healthier outcome, and decrease the side effects of the harsh drugs utilized in standard fertility protocols, as well as address the potential for future adverse health effects. The only side effect of fertility-related therapies in Traditional Chinese Medicine is better overall health.

Acupuncture combined with herbal/nutrient medicine is now highly studied and shows a variety of ways that contribute to a healthy pregnancy, even when ART, such as IVF, is utilized. A large 2015 randomized controlled human clinical study in China found many measurable benefits when adding acupuncture and herbal medicine to standard ART with minimal use of Clomiphene, showing improved pregnancy rates, and reduced rate of miscarriage (PMID: 25854013). To take full advantage of the Complementary protocol, first go through a thorough testing process, then bring these test results to the Licensed Acupuncturist. Patiently resolving the standard problems, such as poor ovarian health or viability, hormonal imbalances in the menstrual cycle, and low grade microbial infections, may be very important. Acupuncture and herbal/nutrient medicine may also integrate to help clear polycystic ovary syndrome or thyroid problems. Pregnancy may occur as these problems resolve. Preparing the health of the ovaries, fallopian tubes and uterus before IVF or AI may be the key to success as well. Most of the failures with ART are not due to the technology itself, but to the problems with optimal health of the woman, which is very important in ART. Clearing of mild enodometriosis, restoring a healthy uterine lining, clearing inflammatory tissue problems in the fallopian tubes, and restoring ovaries to the best state of health may insure that the ART works and that less time and money is spent. Complementary Medicine provides a thorough restoration of reproductive homeostasis, not a targeted allopathic induction of pregnancy. Also, the side effects of ART are common, and may be addressed with Complementary Medicine as well.

With the success of acupuncture and Traditional Chinese Medicine in the field of assisted reproductive technology, large randomized and controlled human clinical trials are finally underway. In 2013, at Heilongjiang University of Chinese Medicine, in Harbin, China, more than 326 women were enrolled in a study of inducing ovulation in women with polycystic ovarian syndrome (PCOS) and anovulation seeking pregnancy (PMID: 24023577). To insure the quality and integrity of the study, the University worked with researchers at University Medical Schools of a number of other countries. The anecdotal clinical success of inducing ovulation and clearing PCOS with acupuncture stimulation is now well known in China. The group of women will be divided into not only true acupuncture and control acupuncture, but into groups utilizing Clomiphene citrate to induce ovulation, and a placebo Clomiphene citrate, combined with both the true and control acupuncture points. The expected parameters of success of even the control acupuncture will be included in the study design and reporting of this trial, as new guidelines for acupuncture clinical study require. Such study will show whether specific real acupuncture therapy is successful in inducing ovulation in fertility treatment even when the patient is expecting pharmaceutical induction of ovulation but receives a placebo. Such studies as this show that there is a high expectation among medical doctors and researchers in the field for a degree of success in utilization of true acupuncture treatment to achieve ovulation and pregnancy. Utilization of this relatively inexpensive therapy that has no adverse effects could allow many women to either try to avoid the high expense and adverse health effects and risks to the fetus with Clomiphene and Human Chorionic Gonadotropin, often combined with IVF, or to increase the chance of success with this standard fertility protocol. Since the average cost of pharmaceuticals and IVF now averages over $20,000 in the United States, and sometimes exceeds this amount greatly with repeated cycles, first trying a relatively short course of acupuncture combined with a holistic approach and herbal/nutrient medicine could achieve a healthier pregnancy without the economic burden.