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Herbal Medicine
The herbal formula prescribed to you will include:

  1. Herbs to correct your particular imbalances.
  2. Herbs to strengthen your entire system and improve your over all health.
  3. Herbs specifically targeted at improving your reproductive system depending on your TCM diagnosis.
  4. Generally the herbs will be taken once in the morning and once in the evening around food.
  5. The herbal formulation will be augmented based weekly based upon where you are in your cycle as well as any symptom changes.
  6. Chinese herbs can be used alone or in conjunction with Acupuncture.

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CHINESE HERBS AND FERTILITY
by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon

THE HERBS USED TO AID FERTILITY
No individual herb is considered especially useful for promoting fertility. Rather, more than 150 different herbs, usually given in complex formulas comprised of 15 or more ingredients, are used in the treatment of infertility with the purpose of correcting a functional or organic problem that caused infertility. The design of the formulas has varied somewhat over the centuries, based on prevailing theories and available resources, and individual practitioners have a preference for particular herbs, thus accounting for some of the variations among formulas that are recommended. However, differences among individuals being treated accounts for the greatest variation in the selection of herbs and formulas to be used. There are some "exotic" materials that are frequently found in fertility formulas, such as deer antler and sea horse, but the prominent materials are derived from roots, barks, leaves, flowers, and fruits. Formulas for men and for women tend to be different, but there is considerable overlap in the ingredients used.

THE SUCCESS RATE FOR CHINESE HERB TREATMENTS
Although the outcome for any given individual cannot be predicted, the clinical studies conducted in China indicate that about 70% of all cases of infertility (male and female) treated by Chinese herbs resulted in pregnancy or restored fertility. Depending on the particular study and the types of infertility treated, success rates ranged from about 50% up to more than 90%. Included in these statistics are cases of infertility involving obstruction of the fallopian tubes, amenorrhea, absent ovulation, endometriosis, uterine fibroids, low sperm count, nonliquification of semen, and other causes. In China, due to the greater experience with using herbs, the ability to directly integrate traditional and modern methods of therapy, and the willingness of individuals to consume relatively large doses of herbs, the success rates are probably somewhat higher than can be achieved in the U.S. at the present time. Nonetheless, U.S. practitioners have had many experiences of success in treating infertility.

DURATION OF TREATMENT TO ATTAIN FERTILITY
In the Chinese clinical studies, daily or periodic use of herbs usually resulted in restored fertility within three to six months. Many Chinese doctors feel that if pregnancy is not achieved within about eight to nine months, then it is unlikely that the treatment will be successful with continued attempts. In Japan, where doctors give lower dosages of herbs and are restricted to using a smaller range of herbs, treatment time is usually longer: from six to fifteen months. In the U.S., nearly the full range of Chinese herb materials are accessible, but the dosage to be used is usually lower than in China; as a result, it is estimated that pregnancy can be achieved within six to twelve months. It must be remembered, however, that approximately one-third of infertility cases may fail to respond to all reasonable attempts. One advantage of the Chinese herbal approach is that even if pregnancy does not occur, benefits to health can be attained because the herbs address imbalances that affect other aspects of health besides infertility.

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MECHANISM OF ACTION
The mechanism of action of the herbs is not known precisely, and undoubtedly varies according to the type of infertility problem being treated and the herb formula that is used. The traditional Chinese views are that infertility tends to arise from one or more of three prominent causes:

  1. A "deficiency" syndrome prevents the hormonal system from properly influencing the sexual and reproductive functions. This is said to be a weakness of the "kidney and liver" which may influence various body functions producing symptoms such as frequent urination, weakness and aching of the back and legs, impotence, irregular menstruation, and difficulties with regulation of body temperature. Deficiency syndromes are treated with tonic herbs that are said to nourish qi (e.g., ginseng, codonopsis, atractylodes, astragalus), blood (e.g., tang-kuei, peony, ho-shou-wu, gelatin), yin (e.g., lycium fruit, ligustrum, eclipta, ophiopogon), or yang (e.g., epimedium, cistanche, cuscuta, eucommia), and are selected according to the overall evaluation of symptoms.
  2. A "stagnancy" syndrome prevents the sexual and reproductive organs from functioning despite normal hormone levels and normal ability to respond to hormones. This is said to involve a stagnancy of "qi and blood," which has the impact of restricting circulation to the tissues involved. Qi stagnation is often noted by tense muscles, restrained anger, and digestive disorders; herbs for resolving the stagnancy include bupleurum, cyperus, lindera, and various citrus products. Other symptoms that might arise include abdominal pain or bloating, chronic inflammation, and formation of lumps (including cysts and tumors). Blood stagnation often occurs following childbirth, surgery, injury, or severe infection and is typically noted when there is severe pain (such as dysmenorrhea), or hard swellings and obstructions; abnormal cell growth, including dysplasia and cancer, are thought to involve blood stagnation. Herbs such as salvia, red peony, persica, and carthamus may be used.
  3. A "heat" syndrome, which causes the affected organs to function abnormally. Heat syndromes may be associated with an infection or inflammatory process. This type of syndrome can produce abnormal semen quality leading to male infertility, while gynecologic infections can maintain female infertility by blocking the passages, altering the mucous membrane conditions, or influencing the local temperature. Herbs that inhibit infections and reduce inflammation are used, including gardenia, phellodendron, patrinia, and lonicera.

In each case, the purpose of the Chinese herbs is to rectify the underlying imbalance to restore normal functions. Western medicine can diagnose tubal blockage (which usually corresponds to blood stagnancy in Chinese medicine) and infection (which corresponds to heat syndromes of Chinese medicine) and in many cases can successfully treat these causes of infertility. However, Western medicine often fails to diagnose deficiency syndromes and most of the stagnancy syndromes. Therefore, the majority of Chinese herb formulas to be applied in the U.S. are those that counteract the deficiency (called tonics) and those that resolve the stagnancy (called regulators). A description of Chinese herb formulas used for infertility is presented in the appendix to Chinese Herbology, a training manual produced by the Institute for Traditional Medicine.
The hormonal effects of Chinese herbs used to treat impotence and infertility and to prevent miscarriage have been demonstrated in laboratory experiments. For example, the laboratory evaluation of Huanjing Decoction (composed of rehmannia, ho-shou-wu, ligustrum, morus fruit, achyranthes, dipsacus, cynomorium, astragalus seed, and cuscuta) was administered to senile mice for four months, two weeks treatment, one week break. Estradiol and dihydrotestosterone receptors in the nucleus of thymic cells were decreased to levels found in young mice; cytosol estradiol receptors increased. Also, the formula influenced the immune system: it increased thymus weight, thymic index, and prevented atrophic changes in the ultrastructures of thymic lymphocytes and epithelial reticular cells.

COMBINING CHINESE HERBS AND WESTERN THERAPIES
In China, the combined use of modern drugs or other Western medical techniques along with Chinese herbs is not uncommon; some doctors are trained in both methods, and Western and traditional doctors often work together in Chinese clinics and hospitals. When the modern methods are applied, the herb therapies do not usually need to be altered compared to cases where the herbs are used alone. Most of the cases of infertility successfully treated in China do not rely on techniques such as in vitro fertilization, which are quite expensive and have only a modest rate of success in the U.S. where the modern fertilization methods are most highly developed.

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