When all these tests have been performed and all the results considered normal the next port of call is normally an adulatory stimulating drug called Clomifene (or Clomid). This drug is used to stimulate F.S.H, correct irregular ovulation, help increase egg production or correct luteal-phase deficiency. At this point it is pertinent to point out that this drug will be given even if you do NOT suffer any of these problems- any is given for up to 12 cycles despite the current research from the USA suggesting that this is NOT helpful. Clomid has side effects which actually decrease your chances of conception such as drying up the cervical mucus (which is necessary for the sperm to travel up into the uterus) and also thinning the lining of the uterus which in turn will compromise the ability of the egg to implant.
Following the use of Clomid, the next step is IUI or Intra Uterine Insemination. In this process sperm is collected, washed and then inserted directly into the uterus to coincide with ovulation using a very fine catheter. To enhance the chances of fertilisation the women maybe given clomid to ensure ovulation and cycle monitoring maybe adapted (i.e scans leading up to ovulation to ensure the best possible chances of success). This is not suitable for couples whose sperm is abnormal, a women whose tubes are blocked or is going through premature menopause. This is usually attempted for 3-6 cycles before IVF is suggested.
This procedure involves stimulated eggs being removed from the woman’s body and fertilised using the partners sperm. The fertilised eggs are then re-introduced into the womb for implantation.
This method was originally developed for women with blocked fallopian tubes, however today it is used for most couples who have been through the previously mentioned procedures, and unexplained infertility. Success rated vary but in general they are approx 23% across all the age groups. This figure has been shown to double with the use of acupuncture before and after egg transfer (German protocol – 2002).
It is my personal opinion that these figures could be much higher if the course of the infertility is discovered and dealt with but more about this when I explain the basal body temperatue charts.
This is one of the main causes of infertility because the lining of the womb starts to grow outside the womb which in turn can block the fallopian tubes and this prevents the flow of the egg from the ovary to the uterus.
Symptoms of endometriosis are extremely painful periods, with dark menstrual blood and clotting. Diagnosis can be done via laparoscopy but with Chinese medicine there will be tale tell changes in the Basal body temperature chart and there may also be spotting before the period starts. Chinese medicine sees this problem as stagnate of blood in the uterus and can be treated very successfully with a combination of acupuncture and Chinese herbs.
PCOS (POLYCYSTIC OVARIAN SYNDROME)
One in 5 women who have a scan during gynaecological investigations has polycystic ovaries. About 80% of these women experience a variety of symptoms and are then classed as having PCOS. Symptoms include, irregular or no periods, erratic or no ovulation, sub-fertility, current miscarriages, excess facial and body hair, fatigue, acne, weight gain that is hard to shift, hair loss, mood swings, abdominal pain, aching joints and dizziness. Long term there is a sevenfold increase in the risk of cardiovascular problems and diabetes. Depression, anxiety and low self-esteem are also problems with this condition.
The job of the ovaries is to produce hormones, ripen and release eggs ready for fertilisation and prepare the lining of the womb for pregnancy. If no fertilisation occurs, then the lining of is shed to a period. This whole process is governed by the sex hormones. Follicle stimulating hormone (FSH) and luteinising hormone (LH) are made by the pituitary in the brain, and in response to these hormones the ovaries then produce progesterone, testosterone and oestrogen. PCOS occurs when there is an imbalance in these hormones, namely high oestrogen, testosterone and LH. High levels of the hormone insulin needed to balance blood sugar levels are also produced. The body’s insulin receptors on the surface of cells seem to switch off and stop listening to the signal from insulin and so to compensate, the body overproduces insulin which further disrupts the sex hormones. Research shows that by enhancing the body’s ability to register the insulin, all hormones levels can become normalised.
In one study it was shown that women who use acupuncture without any other fertility treatments were just as likely to conceive in the same period of time as women who took a fertility drug such as Clomid. (Source: Revters Heath: fertility and sterility 2002; 78:1149-1153).
A comprehensive analysis of acupuncture treatment for breech position discovered that 80% of babies turned into normal (cephalic) presentation after treatment using MOXA (No needles).
One of the 1st acupuncture studies in UK (1986) proved its effectiveness in treating vomiting and nausea and is therefore one of the safest methods of treatment for morning sickness.
A recent trial revealed that acupuncture is excellent for the treatment of back pain and is therefore a side-effect free treatment during pregnancy.
PREMATURE OVARIAN FAILURE (POF)
Premature ovarian failure or an early menopause occurs when a woman’s period stops before the age of 40. There is often a warning, just as there is at the time of the natural menopause, with periods becoming irregular and more widely spaced. Sometimes, however, periods can just suddenly stop.
What causes it?
Premature ovulation failure can sometimes run in families; women can have their menopause at a similar age to their mother. Some women have abnormalities of the genes that control ovarian function; others make ‘autoantibodies’. which prevent the ovaries from working, and a few women can be affected to viral infections of their ovaries. The ovaries can occasionally start working again on their own, although this is the exception rather then the rule. Some women have a long period when the ovaries are slowing down rather than stopping and during which ovulation may occur from time to time.
There is a common – if not the most common – cause of female fertility problems and affects about one fifth of patients attending infertility clinics. This is why when you first go to see your doctor, he or she will want ti hear about your menstrual cycle. Simply put, if you are not ovulating, then eggs aren’t being released and natural conception can’t take place.
OLIGOMENORRHOEA AND AMENORRHOEA
Most women will experience irregular or infrequent periods (oligomenorrhea) at some point in their lives, and it needn’t mean you will then go on to have fertility problems. Women with oligomenorrhoea can still get pregnant, it may just take longer than in women with regular periods, but many will not be ovulating.
Stress or poor diet can upset menstrual cycle, as can coming off the contraceptive pill. By following the guidelines on fertility fitness, you can usually rebalance the sex hormones over a matter of months. However it may be that polycystic ovarian syndrome is affecting your menstrual cycle, so it is worth talking it over with your doctor.
Amenorrhea is a lack of periods and like irregular periods, can indicate a hormonal or nutritional imbalance, an under active thyroid or polycystic ovarian syndrome. Emotional upset can lead to an absence of periods and it is now widely known that sudden or extreme weight loss or weight gain can cause a temporary failure of ovaries. One study reported that 12% of ovulatory infertility in the US may be attributable to being underweight and 25% to being underweight. This is why many Gps will recommend a change in diet before going on to consider further medical intervention.
An under active thyroid or the presence of thyroid antibodies in the blood stream will have an impact on fertility and have been associated with recurrent pregnancy loss.
Low levels of thyroid hormone can be checked via the GP but will also be picked up in the BBT charts (it will show as a low level follicular phase)- this will be discussed later.
Uterine fibroids or myomas are the most common neoplasm (abnormal growth) of the female reproductive organs. They are benign tumours found in approximately 20% of women over 35 years of age. They can occur on the inner and outer wall of the uterus or anywhere else in the pelvis cavity. They range in size from small (the size of a pea) to large (the size of a cantaloupe). Some women with fibroids report menstrual pain, heavy menstrual bleeding and fertility problems. Fibroids on the back wall of the uterus can contribute to constipation, urinary tract difficulties and heavy menstrual periods. Larger fibroids can cause pain with intercourse and pelvic pressure. Fibroids may impair conception if they obstruct the uterine cavity or the entrance into the uterus from the fallopian tubes. They also can block an embryo implanting in the uterine wall.
Stress can take its toll on the reproductive system and in turn having problems conceiving can add to existing stress, creating a vicious circle.
When we experience stress, our adrenal glands release the steroid hormone cortisol. If this is happening over a prolonged period of time, the excessive amount of cortisol in the body can upset the balance of other hormones. In women, the hormone prolactin may be overproduced and interfere with normal ovulation, causing your menstruation to become irregular. In men, research has shown that stress can lead to a drop in sperm count and a rise in the number of sperm with abnormalities.