• Frances Tobeck

Unexplained infertility! Where to from here?

Updated: May 19


What is unexplained infertility?

Unexplained infertility is the inability to conceive after 12 months of trying when a full range of investigations (both partners) have been carried out. Basically it is a diagnosis of exclusion. Statistics show up to 20% of couples who struggle to conceive may be diagnosed with unexplained infertility. Having no answers can be both upsetting and frustrating. Couples may wonder, 'where to from here?'


Integrative Chinese Medicine and unexplained infertility.


Chinese medicine may offer other explanations as to why you have been unable to conceive. It is important for us to look outside of blood testing and other investigations and assess all systems from a Chinese medicine perspective.


You may have a few random symptoms that seem unrelated to your fertility however, from a Chinese medicine perspective they will most likely make sense and be an important part in the way we diagnose the underlying cause of disharmony within your body. Chinese medicine views the body as a holistic being - everything is interrelated and affects all other systems, organs and meridians (the channels where Qi or vital energy flow through the body). From our perspective, cases of unexplained infertility are likely to stem from an internal disharmony or an imbalance between cold/heat, yin/yang and excess/deficiency. Chinese herbal medicine and acupuncture aim to balance your internal environment to create harmony within the body.


When assisting couples who have been diagnosed with unexplained infertility we assess the following:


Digestive health

You may be eating healthy food however you may not be absorbing what you are eating. There may also be food intolerances, an imbalance of microflora or an excess of sugar or alcohol in your diet which can lead to excess heat and inflammation.


The microbiome also plays an important role in your overall health and wellbeing. Studies show the gut microbiome is directly linked to the reproductive microbiome which is important in creating a healthy environment for conception and pregnancy outcomes. This may be changed with dietary modification, herbal medicine and supplementation.

Reproductive organ health history

Do you have a history of candida, bacterial vaginosis, recurrent urinary tract infection or pelvic inflammatory disease? Sometimes it takes more than just clearing the initial infection! For those who have a history of pelvic infections we may prescribe Chinese herbal medicine and specific strains of probiotics to target the reproductive microbiome with the aim of creating a healthy environment for conception. Recent research into the reproductive microbiome has found fertile women have an increase in numbers of healthy lactobacilli bacteria and better outcomes for conception and healthy pregnancy.


Stress levels and adrenal health

Are you so used to being stressed that it has become your new normal?

Do you feel wired and tired? Are you sleeping well with 7-8 hours of uninterrupted sleep or or do you suffer from insomnia? How do you feel when you wake? Do you struggle to get through the day?

It is important to support stress levels when trying to conceive. Stress management and good sleep hygiene are important or overall health and desired fertility outcomes.

Recent research has found acupuncture to be effective in reducing stress levels in women undergoing IVF treatments. Significant reductions in stress levels were found when acupuncture was administered prior to embryo transfer. Acupuncture can be used for couples undergoing treatments for both natural fertility or IVF support.


Nutritional status

Do you feel tired often? Do you suffer from frequent colds and flu? How is your skin? Dry and itchy? Do you have cracked lips or suffer from acne?

While some of these symptoms may seem unrelated to reproductive health they very well may be due to deficiencies of certain nutrients which are also important for healthy egg and sperm quality. Zinc, B vitamins, selenium, essential fatty acids and vitamin D are just some of the many nutrients required to assist healthy egg and sperm development and conception.


We provide our fertility patients with a comprehensive dietary plan which emphasises whole foods, fruit and vegetables, healthy fats and proteins. Your Chinese medicine constitution will also be taken into account with dietary recommendations specific to your body type. We may also include supplements such as a good quality prenatal formula with 'folate' (not folic acid) to support healthy methylation and nutrient levels prior to and during pregnancy.

*more on methylation and 'Why not to take folic acid?' soon!


Thyroid Health

Comprehensive testing can give us the full picture of your thyroid function.

Maybe you have been experiencing symptoms of tiredness and fatigue, feeling cold, hair loss, sluggish digestion, weight gain and joint pains but your thyroid blood test comes 'within a healthy range'. Within range is not always optimal!

It is not uncommon for only basic TSH and T4 testing to be carried out. This is not enough!

A comprehensive thyroid test can show us how your thyroid may be impacting your fertility.


Low levels of inflammation that may not show up on testing.

Inflammation is normal however there is a fine balance that needs to be achieved here. Oxidative stress is an imbalance of antioxidants and reactive oxygen species (ROS). ROS stimulate natural inflammatory responses within the body however when there is low levels of antioxidants present they can cause damage to our cells and DNA which can negatively impact our fertility. The inflammation from endometriosis is a good example of this. Even after treatment to excise or ablate endometrial lesions and cysts, the underlying or causative factors have not been addressed. An inflammatory environment is not ideal for conception. We want to find out what may be causing levels of inflammation in your body and guide you to good health before you get pregnant.


Gain insights into your menstrual cycle

While much of your hormone levels will have been tested we like to use other methods to dive deeper into what is happening on an internal level. A basal body temperature chart (BBT) can determine exact ovulation times, the quality of cervical mucus as well as determining your fertile window for timing of intercourse.


Our aim is to work out why you are struggling to conceive!


Chinese medicine and acupuncture have been used for thousands of years assisting women with infertility and decades as an adjunct therapy to IVF. Acupuncture is believed to stimulate the flow of Qi and blood to the reproductive organs and uterus as well as acting on brain neurotransmitters to reduce stress. Continued research is showing acupuncture to be effective when used as an adjunct therapy to IVF.


We suggest a minimum of 4 weeks of twice weekly treatments prior to embryo transfer or trying to conceive. Ideally a 3-6 month preconception care program of one acupuncture session per week is ideal as the effects of acupuncture are accumulative. Seek the help of a qualified and licensed Chinese medicine practitioner with expertise in integrative fertility. They may be able to assist you, even with a diagnosis of unexplained infertility.


References


Franasiak, J. M. (2016) Endometrial microbiome at the time of embryo transfer: next-generation sequencing of the 16S ribosomal subunit

G, Scutiero, G et al. (2017). Oxidative Stress and Endometriosis: A Systematic Review of the Literature.

Hullender Rubin, L. (2015) Impact of whole systems traditional Chinese medicine on in-vitro fertilization outcomes

Jo J, & Lee YJ. (2017 ). Effectiveness of acupuncture in women with polycystic ovarian syndrome undergoing in vitro fertilisation or intra-cytoplasmic sperm injection: a systematic review and meta-analysis.

Manheimer, E et al. (2018). Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis.

Moreno, I & Simon C. (2019). Deciphering the effect of reproductive tract microbiota on human reproduction

Qian, Y. et al. (2016) Therapeutic effect of acupuncture on the outcomes of in vitro fertilization: a systematic review and meta-analysis.

Reba, R. W. (2019). Merck manuals professional. Unexplained Infertility

Smith, C.A. et al. (2018). Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro FertilizationA Randomized Clinical Trial

Wagner, H. (2018) Role of reactive oxygen species in male infertility: An updated review of literature

Van Oostrum, N. et al (2013). Risks associated with bacterial vaginosis in infertility patients: a systematic review and meta-analysis.



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Ballarat-Acupuncture and Herbal Medicine

Dr Frances Tobeck - Chinese Herbal Medicine and Acupuncture - Eleanor Collins - Acupuncture 
Traditional Chinese Acupuncture, Cupping, Moxibustion, Diet and lifestyle counselling

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 ABN #94315709616

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