FERTILITY & TCM. On line course provided by. Taught by Clara Cohen

Transcription

1 FERTILITY & TCM On line course provided by Taught by Clara Cohen

2 FERTILITY & TCM FERTILITY AND TCM THE PRACTITIONER S ROLE CAUSES OF INFERTILITY RISK FACTORS OBJECTIVES UNDERSTANDING TESTS

3 Conception in TCM Future Mother: conception depends on good Blood & Essence, strong KD & LV & healthy Ren & Chong meridians. Future Father: conception depends on good Essence. Future parents: Conception occurs between mother, father & the warm fire of Ming Men.

4 Fertility in TCM The practitioner role Regulate the menses Always address the patient TCM patterns Regulate hormones: ask for test Support for IUI, IVF, egg donor... Nourish & move blood after the patient ceases the BCP Talk about lifestyle changes

5 Fertility in TCM The practitioner role Educate the patients The woman should keep track of her period dates and also her Basal Body Temperature which should drop a day before ovulation and be at its highest during the 2 ovulation days.

6 Fertility in TCM The practitioner role Educate the male patients Intercourse every second day is best. Sperm regenerate every 48 hours. Sperm lasts up to 5 days in the uterus.

7 Cause: Infertility The Western World Causes of female infertility Ovulation disorders, which hinder or prevent the ovaries from releasing eggs, such as polycystic ovary syndrome, excessive exercise, eating disorders, injury or tumors. Uterine or cervical abnormalities, including problems with the opening of the cervix or cervical mucus, or abnormalities in the shape or cavity of the uterus. Benign tumors in the wall of the uterus that are common in women (uterine fibroids) may interfere with implantation of the fertilized egg. Fallopian tube damage or blockage, which usually results from inflammation of the fallopian tube. This can result from pelvic inflammatory disease, usually caused by sexually transmitted infection, endometriosis or adhesions. Endometriosis, which occurs when endometrial tissue implants and grows outside of the uterus.

8 Cause: Infertility The Western World Causes of female infertility Primary ovarian insufficiency, also called early menopause, when the ovaries stop working and menstruation ends before age 40. Pelvic adhesions, bands of scar tissue that bind organs after pelvic infection, appendicitis, or abdominal or pelvic surgery. Thyroid problems. Cancer and its treatment. Certain cancers particularly female reproductive cancers often severely impair female fertility. Both radiation and chemotherapy may affect a woman's ability to reproduce. Other conditions, amenorrhea, celiac disease, Cushing's disease, sickle cell disease, kidney disease or diabetes, can affect a woman's fertility. Also genetic abnormalities can make conception and pregnancy less likely. Some medications.

9 Cause: Infertility The Western World Causes of male infertility Abnormal sperm production or function due to various problems, such as undescended testicles, genetic defects, health problems including diabetes, prior infections such as mumps, trauma or prior surgeries on the testicles or inguinal region. Enlarged veins in the testes can increase blood flow and heat, affecting the number and shape of sperm. Problems with the delivery of sperm due to sexual issues, such as premature ejaculation, semen entering the bladder instead of emerging through the penis during orgasm (retrograde ejaculation), certain genetic diseases, such as cystic fibrosis, structural problems, such as blockage of the part of the testicle that contains sperm (epididymis), or damage or injury to the reproductive organs. Overexposure to certain chemicals and toxins, such as pesticides, radiation, tobacco smoke, alcohol, marijuana, and steroids (including testosterone), heat, such as in saunas or hot tubs, can elevate the testicular temperature, impairing sperm production. Damage related to cancer and its treatment, including radiation or chemotherapy. Cancer treatment can impair sperm production, sometimes severely.

10 Cause: Infertility The TCM World Cold: affect Chong & Ren causing infertility, menses & post delivery problems. Heat: affect LV causing heavy menses, irregular uterine bleeding and miscarriage.

11 Cause: Infertility The TCM World Overwork & excessive exercise (especially during puberty, pregnancy & menses): weakens SP, LV & KD Diet: weaken SP & ST Traumatic injury: creates blood stasis Emotions: if not balance cause infertility, irregular menses, miscarriage TMCTCT Too many children too close together M

12 Fertility Risk Factors

13 Fertility Risk Factors Age. Infertility in older women may be due to the number and quality of eggs as they age, or to health problems that may interfere with fertility. Men over age 40 may be less fertile than younger men are.

14 Fertility Risk Factors Tobacco use. A couple's chance of achieving a pregnancy is reduced if either partner uses tobacco. Smoking also reduces the possible benefit of fertility treatment. Miscarriages are more frequent in women who smoke. Smoking can increase the risk of erectile dysfunction and low sperm count in men.

15 Fertility Risk Factors Alcohol use. For women, there's no safe level of alcohol use during conception or pregnancy. Alcohol use increases the risk of birth defects, and it may also make it more difficult to become pregnant. For men, heavy alcohol use can decrease sperm count and motility.

16 Fertility Risk Factors Being overweight. Among American women, an inactive lifestyle and being overweight may increase the risk of infertility. In addition, a man's sperm count and testosterone levels may be affected if he is overweight.

17 Fertility Risk Factors Being underweight. Women at risk of fertility problems include those with eating disorders, such as anorexia or bulimia, and women who follow a very low calorie or restrictive diet.

18 Fertility Risk Factors Exercise issues. Lack of or not enough exercise contributes to obesity, which increases the risk of infertility. Ovulation problems may be associated with frequent strenuous, intense exercise in women.

19 Fertility in TCM First Step Educate the patient on how long treatments need to be. It can, on an average take 3 months or more to get the results we want. Consistency is key! Determine what the objective is: natural conception, support for IUI, IVF, egg donor, or prevention of miscarriage. Then establish a treatment plan.

20 Fertility Second Step If the patient has been trying to conceive for 1year without success, testing is required. 6 month if the patient is over 35 yrs old.

21 Fertility in Women Understanding Tests Woman Day 3 and 21 FSH Progesterone Estradiol Prolactin

22 Fertility in Women Understanding Tests Day 3 - FSH Day 3 - Estradiol Follicle stimulating hormone (FSH) is the main hormone involved in producing mature eggs in the ovaries. Elevated estrogen level can "mask" the potential for detecting low ovarian reserve by suppressing FSH into the normal range. Anything above 11 is high and will require help! Anything above 200 on day 3 is considered an issue

23 Fertility in Women Understanding Tests Day 3 - Prolactin High level of Prolactin inhibits FSH secretion and can lead to irregular period or anovulation Strenuous exercise, lack of sleep, PCOS, Hypothyroidism, and some foods and medications (especially some anti-depressants and painkillers) can raise prolactin levels. Prolactin above 25 is considered high

24 Fertility in Women Understanding Tests Day 21- Progesterone Progesterone level will determine if ovulation has occurred 7 to 14 days prior Less than 3 - no ovulation Anything above 30 means ovulation has occurred and the corpus luteum is producing sufficient progesterone to induce adequate secretory changes in the endometrium to assist implantation. Between 3-30 means ovulation has occurred but the level is probably not adequate to sustain endometrial growth for satisfactory implantation.

25 Fertility in Men Understanding Tests Man Sperm Count Morphology Motility

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