The Older Patient
Any woman who is thirty-six years old or older is considered to be an ‘older’ patient when it comes to reproductive status.
What makes the ‘older patient’ in fact ‘older’? It is the diminishment of egg quantity as well as a reduction in egg quality which typically starts to occur after the age of thirty-five.
What does everyone want to know? “I’m forty-years-old, can I get pregnant with my own eggs?” The answer is complicated and multifactorial. It depends on 1). The overall health of the individual; 2). The antral follicle count; 3). The health of the uterine lining; 4) The quality of the partners sperm; 5). The absence of disease which can affect fecundity. These diseases include but are not limited to PCOS and endometriosis. And finally; 6). The quantity and quality of the eggs.
We must presuppose that the quantity and quality of the eggs and lining are diminished in the ‘older’ patient. So, the question remains: As acupuncturists what can we do to support and facilitate a pregnancy which concludes in a live birth? Maybe something and maybe nothing. It’s similar to IVF. Maybe it will work, and maybe it won’t. We know, at this point, that IVF works; it just doesn’t always work. The very same scenario exists when utilizing acupuncture and herbal medicine; sometimes there is success and sometimes not. Acupuncture has been repeatedly shown (in many cases, not all!), to improve egg quality. Acupuncture cannot increase egg quantity. Acupuncture is natural and cannot diminish conception odds or hurt in any way; it either helps or it doesn’t.
What is the difference between Western reproductive medicine and Chinese reproductive medicine?
In Western reproductive medicine, the goal is to hyper stimulate follicular development and, in the case of an IUI, deposit sperm, and keep your fingers crossed. In IVF, the same is true: stimulate folliculogenesis, retrieve eggs, fertilize with sperm, create an embryo and transfer said embryo into the uterine cavity; and again, keep our fingers crossed. Even with PGS, there is no guarantee of conception or, if conception manifests, there is no guarantee of having a live birth. Its’ all hit or miss. By combining Western and Chinese medicine, the outcomes are better. Why? Because Western reproductive techniques allow for the mechanical deposition of either sperm or embryo into the uterus (and tubes) – all the moving parts are taken care of; Chinese medicine improves the things necessary to achieve pregnancy. IUI and IVF are very effective means of assisted reproduction. The problem with this effective approach is that the reproductive endocrinologist must use the equipment that is available; that is, egg, sperm, and lining. If there is a diminishment of quality and functionality in any of these areas the cycle will fail. In other words, the reproductive doctor has no real means to improve the quality of the components necessary to improve outcomes.
In the context of Chinese medicine things are a little different.
Most acupuncturists, including myself, often make the mistake of telling our patients that our mission is to help them conceive. But it’s not done by mechanistic approaches. It’s done by treating the underlying pathomechanism(s) that may be precluding conception.
The job of the acupuncturist is not really to ‘get’ the patient pregnant, but rather to help her or him to improve the things that are denying fertility. It is our job to improve egg quality, sperm quality, lining quality, and to reduce stress during this most challenging time in a patient’s life. Think about it like this: you can hire the best architect, and the best contractor and you can have a ten-million-dollar budget for your new home. But if the home is built with balsa wood, it will collapse at the first good wind.
The key is not just spending money on procedure after procedure but rather to get all the necessary items (sperm, egg, lining) for conception maximized. Acupuncture and herbal medicine do this.
I also want to state that acupuncture and herbs are not the be all and end all of conception. I have had many unsuccessful cases. However, what is interesting, and rewarding is that I’ve also had many successful cases where good outcomes were thought to be impossible.
In my opinion, after being involved in reproductive medicine for 22 years, the new gold standard for reproductive medicine should be the combining of Western and Chinese medicine. As you can see, there is only an upside potential with this scenario.
The Berkley Center for Reproductive Wellness is the oldest center for acupuncture and herbal medicine in New York City to specialize in treating those with reproductive challenges.
We’ve been treating fertility cases for 22 years. We are members of and certified by the aborm.org. and the NCCAOM. We are licensed and board certified in acupuncture and board certified in Chinese herbal medicine.
Combining these two methods of care may mean the difference between patient and parent.