In Singapore, we are pretty familiar with Traditional Chinese Medicine (TCM) as a form of alternative healthcare. In fact, there are numerous physicians and clinics all over the city that are frequented often, and are especially helpful during instances where we experience ailments that Western medicine cannot adequately address. TCM has been around for thousands of years and was first introduced to the masses in Singapore by early migrants from mainland China. Today, it has become more recognised and has won the general public for its holistic approach and effective cures. Given the number of successful results TCM garners, it should not be ignored or discounted. What we should understand is that traditional Chinese medicine and Western medicine are not entirely opposing In this article, experienced TCM practitioner,Physician Tay, walks us through everything we In the context of traditional Chinese medicine, infertility is often distinguished as an individual who is sexually active for two years or more and is still unable to conceive. This can happen to bothmen and ladies,and could be due to a variety of lifestyle habitsorinjuries. Read more:What are the causes of infertility from a TCM perspective? According to World Health Organization (WHO) data, general sem*n quality has been deteriorating globally over the years. In a study reported in 2017, scientists at the Hebrew University of Jerusalem found that sperm counts among men in the West have more than halved in the past 40 years. While there is a lack of nationwide data regarding male reproductive health, doctors say rising male infertility rates here mirror the global phenomenon of declining sperm quality in the last 40 years [5]. A drop in sperm count due to bad lifestyle habits can cause infertility in men.Researchers have found that the testicular function is temperature-dependent and requires a temperature of around 2 - 4°C below body temperature. Elevated scrotal temperature was found in men with occupations and lifestyles associated with high temperature exposure, hot bath and sauna users, men wearing tight jockey shorts and suspensories, and car driving. Multiple human studies have confirmed the harmful effects of scrotal hyperthermia (having a higher scrotal temperature that is greatly above normal) on the production and development of mature spermatozoa. Hence, men are advised to wear loose clothing for their male genitalia to function optimally [6]. This is just one of the few factors that contribute to infertility in males.Many other factors often point towards bad diet and lifestyle habitssuch as smoking and excessive alcohol consumption. Being overweight, inactive, consistently using a laptop on one’s lap and even stress or depression can also contribute to a lower sperm count in males. The common contributing factors are: Also read:Urologist Reveals 7 Reasons For Male Infertility and the Treatments Available From a TCM perspective, male infertility is usually associated with various forms of “kidney” deficiency and this occurs naturally as one ages. As far back as about 2000 years ago, the earliest TCM text 黄帝内经 (Huangdi Neijing, Inner Canon of the Yellow Emperor) detailed how one’s age will affect his fertility. This corresponds amazingly well with modern medical science as research has found that the sperm concentration, motility, morphology and seminal volume decline as age increases [7]. The issue of infertility ismore complex when it comes toladies. Having a more biologically complex reproductive system,ladiescan suffer from infertility for a plethora of reasons. The first point of note for theTCM physicianis to examine the menstrual cycle of the patient. Traditional Chinese medicine believes that the “kidney”, “liver”, and “spleen”affect the likelihood of conception as imbalance in these organs will disrupt the menstrual cycle of a lady. This is especially true for the “kidney” as TCM believes that “kidney” stores our “reproductive essence”.
Introduction
forces but in fact, two sides of the same coin — providing a holistic approach to health care. This is particularly
true forTCM fertility treatments,which can be used as a stand-alone treatment or used in tandem
with Western fertility treatments, such as
IVF, to increase the success rate for aspiring mommies and daddies.
need to know about TCM fertility treatments in Singapore for both men and
ladies, the various costs of treatment and what to expect during your visit.What is Infertility from a TCM perspective?
Infertility in Men
Infertility in Ladies
TCM theory had long held that irregular menstrual cycles are one of the most important causes of infertility. This ties in well with modern medical science as irregular menstrual cycles are usually associated with ovulatory dysfunction (meaningovulation fails to occur, or occurs on an infrequent or irregular basis).
Also read:The Ultimate Guide to TCM for Irregular Periods in Singapore (2021)
TCM herbal medicine andacupuncturewould then be used to help regulate the lady’s menstrual cycle to improve her chances of conceiving.
Questions concerning one’s work and lifestyle would also be asked as TCM believes that“the way the human body functions is interlinked and closely related to the natural world” (天人相应). Different environments that people live and work in, coupled with the differences in the individual’s ability to adapt to the environment, have an effect on the constitution of the person.
Therefore, whenTCM physiciansare diagnosing and treating the same disease, they will pay more attention to theseason, place, and individual conditions, instead of viewing everyone as being the same.
This is especially relevant to Singapore. This is because as our society advances, many ladies are working long hours or are holding jobs that are stressful in nature. TCM theory had long stated that Liver Qi stagnation (a potential cause of infertility) is closely associated with stress andvariousnegative emotions.
Also read:How stress affects your fertility
This correspondswellwith a researchconductedby US National Institutes of Health, Ohio State University and the University of Oxford on how stressalonemight reduce a lady’s chance of conceiving by 12% [8].
Here is a list ofcauses (non-exhaustive) that TCM believes can hinder a lady’s ability to conceive:
- Kidney-Yin deficiency （肾阴虚）
- Kidney-Yang deficiency （肾阳虚）
- Blood and Qi deficiency （气血两虚）
- Blood and Qi stagnation （气血瘀滞）
- Liver Qi stagnation （肝气郁结）
- Phlegm and dampness （痰湿中阻）
It is important to note that in Traditional Chinese Medicine, the concept of yin and yang serves as a foundation for understanding health, as well as diagnosing and treating illnesses. This concept applies todiagnosing infertilityas well.
What are the Traditional Chinese Medicine treatments for infertility?
Traditional Chinese Medicine takes on a different approach when it comes to the treatment of diseases and body constitutions. Centered around the idea of yin and yang, it believes in balancing the internal elements of the body to help all of its organs function properly. Hence, when something is out of order, it will usually be compensated for with its polar opposite to help restore balance in the system.
To do so,acupunctureand herbal medicineare usually used.
Acupunctureis the treatment involving the insertion of very long and thin needles through a person’s skin at specific points of the body.
TCM physiciansare experts trained in anatomy and can pinpoint specific areas of the body that require acupuncture to treat different diseases. In doing so, they help regulate the flow of energy or life force (Qi) along the various meridians, and in the long run, are helping to maintain balance in the body.
The practice of TCM also believes in usingherbsto help preserve the balance in the body. As such, herbal products are also often used together with acupuncture to help give the body the boost it needs to compensate for a shift in balance [9]. The physician will also recommend a change in diet to suit your needs.
For example, patients that often feel cold in their extremities are encouraged to consume more lamb meat and beef to warm one’s body. Ginger-red date tea is also another substitute if meat is not an option in the diet.
In the case of fertility treatments,In-Vitro Fertilisation (IVF)and Intrauterine Insemination (IUI) can be complemented by TCM treatments. IVF acupuncture is a treatment that helps to improve the rate of pregnancy for ladies who are trying to conceive through IVF [10].
Also read:What do I need to know when choosing between IVF and IUI?
Chinese herbal medicine can also be prescribed by the TCM physician to prepare the body for conception and 1 treatment cycle will typically last 3 menstrual cycles.TCM fertility treatment will require the physician to follow up with the patients regularly during the course of the treatment.
This is because the herbal medication prescribed will be adjusted according to the symptoms manifested during each menstrual cycle, hence we can say thatevery treatment is tailored to each individual’s needs.
Related:A TCM Physician Tells You What You Need to Know Before Trying Acupuncture
How is TCM a natural fertility treatment?
Couples trying to conceive should consider trying out TCM as a form of natural fertility treatment and this is especially so if the lady is below the age of 38 and her ovarian reserve is still relatively high. This is because women with the above attributes tend to have a good chance of conceiving naturally through TCM treatments [11].
Some TCM clinics do refer their patients to laboratories for diagnostic testing so that patients are able to check their sperm count, sperm motility, sperm morphology, ovarian reserve, and hormonal profile through sem*n analysis and blood tests before deciding on a treatment plan.
Also read:What can I expect from a fertility assessment?
It is worth noting that IVF treatment requires the lady receiving the treatment to receive daily hormonal injections and do multiple transvagin*l ultrasound scans over the course of the treatment.These procedures tend to create a lot of stress and anxiety for thepatientinvolved, not to mention the fact that undergoing IVF treatment can be quite costly [12].
TCM physicians can complement IVF treatments by prescribing TCM herbal medicine and acupuncture to help prepare the body before the IVF treatment to help increase the chances of success.This process usually takes 3 to 6 months and there are a number of patients who got pregnant naturally during this process.
TCM can also help withunexplained infertilityby measuring the internal balance of the individual. Oftentimes, patients will enter the clinic feeling “wrong” without knowing exactly what is wrong with them. In such cases, TCM physicians may help schedule a laboratory test as a primary diagnosis.
However, in certain cases,some couplesare still unable to conceive,even though the diagnostic tests may indicate that everything is fine.In such occasions, TCM believes that the body may have an imbalance of elements, resulting in the person’sconstitutionbeing either “too cold” or “too warm”.
Through asking a series of diagnostic questions, a TCM physician will be able to determine one’s type of constitution, and will then go on to prescribe individualised treatment plans for the couple.
How effective are TCM fertility treatments?
The effectiveness of TCM fertility treatments not only depend on thecouple’s medicalcondition,but also on howcommittedthey are in adhering to their treatment plan.It is important to note thatTCM treatment is not a one-time solutionto your infertility issues and willrequire continuous treatment over a period of time.
TCM treatments take time to restore the body back to its balance. As such, fertility treatment plans in TCM normally range from about3 - 6 months and can go on for as long as a year or two for serious cases(1 TCM treatment cycle is 3 menstrual cycles).
It is worth mentioning that there were a number of cases where the couples managed toconceive naturally within 3 menstrual cyclesafter following my instructionsclosely.Unfortunately, many patients tend to stop treatment within 1 - 2 monthswhenthey are not able to see instant results.
Efficacy for Ladies
For ladies,patients of the younger demographic (under 35)will most likely see faster results, with many patients within this demographic conceiving naturally afteradhering to the treatment plan for 3 - 6 months.
The length of time and efficacy of TCM fertility treatment is largely dependent on ageand if the treatment does not yield resultsafter 6 months, patients would begiven thesuggestion to try IVF treatment, this is especially so forladiesabove the age of 38 whose ovarian reserves are depleting fast [13].
Efficacy for Men
For men, herbal medicine and acupuncture is normally provided. Due to the physiology of the male testicl*s, male infertility is easier to treat as the main goal is mainly tostimulate the testicl*s to produce more sperms and improve their motility.TCM fertility treatment is usually able to improve sem*n quality as long as one’s testicl*sretainthe ability to produce sperms [14].
One cycle of TCM fertility treatment for men typically takes 3 months ason the average, sperm production takes 74 days from start to finish [15]. Clinical research done by Tainan Municipal Hospital in Taiwan between 2013 to 2016 found thatTCM treatment significantly improved sem*n quality.
In this study, it was found that TCM users account for 92.5% of the total sem*n improvement subjects, the other 7.5% is up to TCM nonusers. The TCM users had 10.7-fold better sem*n improvement than TCM nonusers after adjustment for age, duration of infertility, BMI, history of smoking and alcohol use, and infertility type [16].
It is important to note that this only applies to men who are infertile due a low sperm count and/or low sperm motility. Men suffer fromobstructive azoospermia or testicular azoospermia(azoospermia is the medical condition of a man whose sem*n contains no sperm)might require intervention in the form of surgery and/or testicular biopsies,which aretypically performed in a hospital [17].
That being said, researchers have found that acupuncture may be a useful, non-traumatic treatment for men with azoospermia, especially for those who have had a history of genital tract inflammation [18].
Related:Does acupuncture for fertility really work?
Erectile dysfunctioncan also be treated with TCM through medication and acupuncture as it would allow for improved blood flow to the penis and help stimulate energy flow in the meridian.
Therefore, it is paramount that you trust your TCM physician and work together with them in crafting a treatment plan that would best suit your needs.
What can I expect when I visit a TCM physician?
When going to a TCM physician for a fertility consultation, patients should bear in mind that althoughits treatment methods are different from Western medicine, the diagnosis and process remains the similar:
- A TCM physician would typically ask for your medical history and relevantdiagnostic lab reports.
- Questions regarding menstrual cycle, erectile dysfunction, nature of work, lifestyle, stress level/ emotional wellbeing would also be asked.
- The physician will do preliminary diagnostic tests such as pulse taking and checking your tongue to see if you are healthy and if the elements in your body are balanced.
- Patients could be referred for furtherdiagnostic testing(typically ultrasound scan, blood or sem*nanalysis) if there are information gaps to be filled.
- The physician will then decide on the necessary steps and construct a personalised treatment plan that would best suit you.
Couples are encouraged to consult a TCM physician together when seeking fertility treatments. This is because the husband would be able to provide emotional support for his wife and help her feel a sense of ease duringthe course oftreatment. Furthermore,men have just as much chance of being infertileas the ladies and in certain cases, the husband only discovered that he had poor sem*n quality after being advised by the TCM physician to go for sem*n analysis [19].
Also read:The Complete Guide to Seeing a Traditional Chinese Medicine (TCM) Physician in Singapore (2021)
What is the cost of TCM fertility treatment in Singapore?
The cost of TCM fertility treatments in Singapore depends on the types of treatment recommended by the physician.
Different medicinal herbs may vary in prices, with most of them costing between$15 - $30 a day, depending onifthemedicationprescribed are traditional herbal decoction (boiling herbs) or scientific TCM medicine (powders, syrups and pills).It is important to understand thattraditionalherbal decoctions are typically morecostly.
It is also worth knowing that TCMmedication for fertilitytreatmenttend to be more costlybecausetonics such as ginseng and deer velvet antler (鹿茸), could be prescribed depending on the nature of the patient’s condition [20].
As TCM restores the imbalances in the body over a period of time, the effects of the medicinal herbs are to be observed over a span of 3 to 6 months (with 3 menstrual cycles being 1 treatment cycle).
Other procedures such as acupuncture andmassagesvary in cost with some TCM clinics charging higher prices.Unfortunately, TCM fertility treatments are not Medisave claimable as of yet.
Read more:How much is the cost of TCM fertility treatment in Singapore?
Summary
You should definitely consider TCM fertility treatments if you desire to conceive naturally.
Acupuncture and herbal medicines date back at least 2,200 years with the earliest recorded use of it being in the 3rd century BCE. TCM has been healing the Chinese people since then and is now being practiced worldwide today.Its effectiveness is now observed by various clinical studies that are being conducted around the world.
As such, patients looking for alternative fertility treatmentsshouldconsider Traditional Chinese medicine as an option, or as a complementary treatment to IVF and IUI. Perhaps natural healing and strengthening your body may be just what you need to conceive.
