A Complementary View of Fertility

What Your Doctor May Not Tell You About Getting Pregnant: Boost Your Fertility with the Best of Traditional and Alternative Therapies
by Raymond Chang, M.D., Elena Oumano, Ph.D.

If you're struggling to conceive, you may be surprised to learn that there are many simple fertility-enhancing strategies that are painless, health-promoting, and inexpensive-and can result in pregnancy.

In this practical guide, internationally renowned fertility expert Dr. Raymond Chang offers individualized strategies for those who want to increase their odds of getting pregnant. Combining research-based Western medicine with holistic Eastern practices, Dr. Chang offers groundbreaking methods you can use alone or in combination with modern conventional procedures. Innovative and easy-to-understand, this book serves as a step-by-step resource for boosting fertility.

Chapter 1

The Turns of Fortune's Wheel

As you're reading, you may be planning ahead for a future pregnancy or you may be in the midst of intense hormonal treatments. You may have tried IVF without success. Or you may not be seeking medical treatment at all, simply growing increasingly frustrated over the number of months you've been trying to achieve a successful pregnancy. You may believe it's your fault, yet statistics indicate the cause of infertility is almost as likely to rest with your partner as with you.

Approximately 35 percent of fertility problems are caused by the man's issues, another 35 percent are caused by tubal and pelvic problems in the woman, 15 percent from ovulation dysfunction, 5 percent by immunological, anatomic, or thyroid problems, and 10 percent are attributed to "unknown" causes.

It is important to keep in mind that while studies indicate that one in ten women between the ages of fifteen and fortyfour years old will experience infertility, more than 95 percent of couples who seek treatment will not need to undergo advanced reproductive techniques such as in vitro fertilization in order to conceive. Of the 10 percent of infertile couples diagnosed with "unexplained fertility," almost half will conceive within three years. As a general rule, of couples trying to conceive:

• 57 percent succeed within three months
• 72 percent succeed within six months
• 80 to 85 percent succeed within one year
• 90 percent succeed within two years

How Conception Occurs

Before we explore what can go wrong, let's go through what happens when everything works. The fertilization process takes approximately twenty-four hours, and it begins with ejaculation. Immediately after being deposited in the vagina, semen coagulates - perhaps as a defense mechanism against the vagina's acidic environment, which allows only about 10 percent of sperm to survive the first ten minutes inside. After about twenty minutes, the sperm become fluid again and swim up to the cervix, where protein strands in cervical mucus that are present only just before or during ovulation carry the sperm into the uterus. Since the released egg is viable for twelve to twenty-four hours and sperm live for fortyeight to seventy-two hours, the window of opportunity opens for only about two to three days. Some experts believe that the chance for conception increases if the woman and man experrience orgasm simultaneously, because the rhythmic contractions of vagina and uterus during orgasm help propel the sperm closer to the cervix. On the other hand, if the woman experiences orgasm before the man ejaculates, that could lessen chances for conception.

Among the hundreds of sperm that reach the uterus and then the fallopian tubes, some become lost or embedded in the lining of the fallopian tubes. By this point, the heads of the sperm have lost their protective coating, so they can penetrate the egg. (During "sperm washing," a procedure used in artificial or assisted conception, this protective membrane is removed artificially.)

Once a sperm reaches and penetrates the egg, the egg undergoes biochemical changes to ensure no other sperm can enter it, and the sperm and egg combine their genetic material. Unlike egg follicles that retire gracefully once a victorious follicle declares itself the "follicle of the month" - the one with the egg that can be fertilized to create new life - sperm rushing out the testes upon ejaculation compete furiously to beat each other to the finish line. They even refuse to accept defeat after one sperm has penetrated the egg and the winner has been declared, by continuing their attempts to enter the egg.

The fertilized egg then takes a four-day journey to the uterus, where it secretes a hormone called human chorionic gonadotropin (HCG) (detectable by home pregnancy kits) and implants itself in the uterine lining. If the egg doesn't make it to the uterus, it can grow in the fallopian tube, forming what is known as an ectopic, or tubal, pregnancy that must be removed surgically. This is more common in women with scarring from endometriosis, sexually transmitted diseases, or previous pelvic surgery.

Structural problems that can cause ectopic pregnancy or infertility also include fibroids and other malformations. All reproductive specialists - conventional, alternative, and TCM - agree on at least a single point: that "mechanical" or structural reproductive obstacles to fertility must be treated before any other problems are addressed and a successful pregnancy can occur.

What Is Infertility?

For a couple, infertility is defined as being unable to become pregnant after one year of steady, unprotected intercourse. Infertility is the reduced ability to have a child. Infertility is not sterility, that is, a lifetime verdict that means you will never have a child. Infertility leaves open the possibility that you can have a child at some point. In the up to 20 percent of all couples who are infertile, only 1 to 2 percent of them are actually sterile.

For most couples, infertility is a temporary crisis, one that can be overcome. Even better news, once you are armed with the information and strategies you'll learn here, your chances of a pregnancy that results in the birth of a healthy child will be even greater.

In general, several possible factors hamper fertility in women:

Lack of ovulation (release of eggs from the ovary) due to hormonal imbalance or cysts in the ovary

Failure of tubes to carry eggs from the ovary to the uterus, often due to scarring (adhesions) of the fallopian tubes caused by endometriosis, or infections such as gonorrhea and chlamydia, or prior surgery

Irregular ovulation accompanied by poor cervical mucus that damages sperm or impedes their progress

Implantation issues in which the embryo cannot implant itself in the uterine lining, caused by fibroid tumors, endometriosis, adhesions, infection, or prior surgery

The subtle, energetic mind-body imbalances that conventional medicine rarely diagnoses or treats (We will deal with this often overlooked important cause of infertility in women.)

Common causes of infertility in men include:

• Sexual dysfunction (erectile dysfunction or impotence)
• Low sperm count (too few sperm in the ejaculate fluid)
• Low sperm motility (the sperm are not good swimmers)
• Malformation of the sperm
• Blocked sperm ducts

No single fertility treatment is ever successful for everyone, but research has shown that a combination of simple treatments and precautionary measures can greatly enhance a couple's odds of conceiving. This is where TCM is so helpful, either by itself or in partnership with modern Western medical techniques.

Copyright © 2007 by Raymond Chang, M.D. and Elena Oumano, Ph.D.

About the Author

Raymond Chang, M.D., is an internist, master herbalist, and licensed acupuncturist who attends at New York Presbyterian and Beth Israel hospitals, and specializes in complementary and alternative treatments for infertility. He has been featured in national magazines and interviewed on the Today show.