5 Conditions You Didn’t Know Could Affect Fertility

Link copied! Fertility issues are often shrouded in misconceptions, with many people attributing difficulties in conceiving solely to age or reproductive health. While it’s true that age and the health of the reproductive system play significant roles in fertility, these factors only scratch the surface of what can influence one’s ability to conceive. Fertility is a complex interplay of various bodily systems, environmental factors and lifestyle choices. Surprisingly, several conditions that might seem unrelated at first glance can significantly impact fertility. Understanding these lesser-known factors is crucial for those trying to conceive, as it can help identify and address potential obstacles more effectively. Here, we explore five conditions you might not know could affect fertility. 1. Thyroid Disorders The thyroid gland is a small but mighty organ crucial in regulating metabolism and hormone production, both essential for reproductive health. Thyroid disorders, such as hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid), can significantly impact fertility. In women, an underactive thyroid can lead to prolonged menstrual cycles, heavy periods, or even the absence of menstruation. This occurs because insufficient thyroid hormones interfere with the production of sex hormones like estrogen and progesterone. The resulting hormonal imbalance can prevent the maturation and release of eggs, hampering ovulation and making it difficult to conceive [1]. In men, though less common, low thyroid hormone levels can result in decreased testosterone levels, which are associated with erectile dysfunctions, delayed ejaculation and deteriorated semen quality [2]. Conversely, an overactive thyroid can cause irregular menstrual cycles and lighter, shorter periods in women. Excess thyroid hormones can accelerate metabolism and disrupt the normal balance of reproductive hormones such as follicle-stimulating hormone and luteinising hormone, leading to irregular ovulation or even the complete absence of ovulation [3]. In men, elevated thyroid hormone levels affect testosterone levels, thereby affecting testicular functions, semen volume and quality [4]. In TCM, thyroid disorders are often linked to imbalances in Yin and Yang. Hypothyroidism is often associated with Yang deficiency, which leads to a dip in overall Qi and energy levels. This imbalance can manifest as fatigue, sensitivity to cold and constipation. On the other hand, hyperthyroidism is attributed to Yin deficiency, resulting in a dehydrated body constitution with symptoms such as dry skin and eyes, heart palpitations and weight loss. TCM offers a holistic approach to regulating thyroid function and improving overall fertility through personalised herbal medication and acupuncture. Herbal formulas are tailored to each individual’s needs, nourishing Yin or Yang as required, while acupuncture helps harmonise the body’s energy flow, promoting optimal thyroid health and enhancing fertility. Tech-enhanced therapies like Electro-Lymphatic Therapy (ELT) help stimulate lymphatic flow to improve circulation and regulate the flow of hormones while Cell Pro Therapy introduces reducing electrons into the body, helping to improve cellular metabolism and oxygenation, further supporting thyroid health. With this comprehensive approach, individuals can achieve a better hormonal balance, paving the way for improved reproductive health and increased chances of conception. 2. Polycystic Ovary Syndrome (PCOS) Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that is becoming increasingly more common, affecting an estimated 8–13% of women of reproductive age, with up to 70% of cases remaining undiagnosed [5]. PCOS is characterised by irregular menstrual cycles, excess androgen levels and polycystic ovaries. Women with PCOS may have elevated levels of hormones such as estrogen, luteinising hormone and anti-müllerian hormone. These hormones regulate menstruation and ovulation by controlling the growth of the uterine lining and triggering ovulation. Disruptions in these hormone levels interfere with ovulation, making it difficult to conceive [6]. In TCM, PCOS is associated with Phlegm-Dampness accumulation and Blood stagnation. A modern sedentary lifestyle, combined with a diet high in processed and fatty foods, can impact our Spleen, or digestive system in TCM. This causes an uneven distribution of nutrients and fluids in our body, an accumulation Phlegm-Dampness, resulting in symptoms such as weight gain, oily skin and a lowered metabolism. Additionally, this accumulation can disrupt the flow of Blood, causing it to stagnate and accumulate in the womb, which affects reproductive organ function and creates a less-than-ideal environment for conception. Despite being one of the leading causes of infertility in women, PCOS can be managed with herbal medication, acupuncture and lifestyle modifications. Herbal medications are prescribed to address root issues, such as removing Phlegm-Dampness from the body, while acupuncture helps to regulate organ energy and hormone levels. Tech-enhanced therapies such as Electro-Lymphatic Therapy help promote smooth lymphatic flow, which boosts circulation and alleviates symptoms caused by Phlegm-Dampness. Improved lymphatic flow also helps regulate hormone levels and create a uterine environment that is more conducive for pregnancy. Together, TCM and tech-enhanced therapies work to regulate menstruation, balance hormone levels and increase the chances of getting pregnant. 3. Endometriosis Endometriosis is characterised by severe pain in the abdomen or lower back during menstruation. This condition occurs when tissue similar to the lining of the uterus grows outside the uterine cavity. Each month, when the uterine lining sheds during menstruation, this tissue outside the uterus also sheds into the abdomen, leading to severe pain, chronic inflammation and scar tissue formation. These scars can create adhesions between reproductive organs, distorting pelvic anatomy, including the fallopian tubes and ovaries. This distortion can interfere with the release and transport of eggs, hindering their journey to meet sperm for fertilisation. Additionally, the inflammatory environment created by endometriosis is hostile to sperm, eggs, and embryos, making fertilisation and implantation more challenging [7]. Endometriosis is often underdiagnosed because its symptoms can be mistaken for regular menstrual pain. Early diagnosis and treatment can significantly improve fertility outcomes for those trying to conceive. In TCM, endometriosis is associated with Blood stagnation in the womb. Blood stagnation can result from Qi stagnation, Cold accumulation or Dampness. These factors disrupt the normal flow of Qi and Blood, leading to pain and poor womb conditions for fertility TCM offers effective treatments for endometriosis through acupuncture and moxibustion, which help relieve pain, expel Cold, and balance uterine conditions. With a proper diagnosis, herbal medication can address underlying

How does TCM help men during IVF?

Link copied! So much of fertility and related support is focused on the female and very few males seek out TCM support. On top of that, a trip to the fertility specialist might leave male patients feeling flustered and confused – What do the abbreviations like PR, NP, IM in a semen examination report mean? Terms like low motility, low volume and low concentration might be uttered by the doctor. Does this experience seem familiar to you? We have previously discussed ways to improve fertility, and in this article, we will zoom in specifically into providing support to men going through IVF and outline how TCM can help the male patient in your IVF journey. Note: All words in Italics refer to the TCM organ-system or TCM terminology and not the anatomical organ referenced in western medicine. What is IVF? IVF (In-vitro fertilization) is a kind of ART (Assisted-reproduction therapy) commonly used today to help couples conceive when natural methods fail. There are 4 generations of IVF in the world today: IVF-ET (In-vitro fertilization-embryo transfer) ICSI (Intracytoplasmic sperm injection) PGD/PGS (Preimplantation Genetic Diagnosis/Preimplantation genetic screening) GVT (Germinal vesicle transfer) In Singapore, the first 2 procedures are often done. Between PGS and PGD, only PGD is done in Singapore if either parent has a family member with a genetic condition to prevent said hereditary disease from being passed down to the future child. Due to issues concerning medical ethics, GVT is currently not being done in Singapore. Who requires IVF? Men undergoing IVF usually have one or several issues associated with: Semen quality Poor sperm motility (asthenozoospermia) means that the sperm do not swim properly. Sperm morphology refers to the size and shape of the sperm in a given semen sample. You want at least 4% of sperm to be a normal shape. Otherwise, you could have fertility problems because of abnormal sperm morphology Semen quantity Sexual function Typical semen analysis results for to-be IVF candidates: Poor motility in their sperm sample – Grade A sperm lower than 25% or Grade A+B lower than 32% Sperms lower than 4% normal morphology Diminished sperm concentration – between 10 x 106 to 15 x 106 sperm/ml In couples who have had recurrent miscarriages, failure to conceive despite having near to normal sperm parameters or if both parties have normal parameters [1], the male would be recommended to undergo testing for sperm DNA fragmentation or DFI (DNA fragmentation index). There are many ways and methods by which DFI is measured but it is usually presented as a percentage. A person with DFI value above 30% is thought to be a viable candidate for ICSI. [2] A major cause of high DFI values are excessive oxidative stress caused by ageing, improper lifestyle choices, or exposure to chemicals and radiation. [3] DFI testing is not done routinely in a semen analysis yet. However, from our observations over the years, high DFI values can result in recurrent miscarriages and be the missing piece to explain increasing infertility whereby a cause cannot be found in either party. Typical DFI readings Source: www.researchgate.net After proper diagnosis, men with moderate to severe reduction in sperm concentration also known as Oligozoospermia, ICSI will be the better choice to increase the chance of fertilization. ICSI involves the insemination of an ovum from the female using just one sperm chosen from the semen sample from the male. This is done using a special needle which can penetrate the zona pellucida and insert a sperm directly without the sperm having to push its way through the Zona pellucida – a thick transparent membrane surrounding the ovum. ICSI involves the insemination of an ovum from the female using just one sperm chosen from the semen sample from the male. Source: www.researchgate.net How can men prepare for IVF Having to watch one’s female partner endure IVF can be a stressful period for the male. The procedure is costly and puts a physiological, emotional, psychological and financial toll on the couple. In addition, the female has to undergo painful self-injections during the ovarian stimulation period which can result in her experiencing severe mood swings. As a result, there is a change in family dynamics and the male might feel guilty for putting their wife through such a gruelling ordeal especially if the fertility issue was not hers to begin with. It is important for the male to prepare mentally to manage these stresses to prepare adequately for IVF. If the male is overweight, it is also necessary for him to control his diet so as to reduce the amount of visceral fat which can disrupt the balance of endocrine hormones in the body. [4] Additionally, TCM views lifestyle habits like smoking, drinking, improper diet or eating habits, and sleeping late as detrimental to proper sperm development. To get more tips on improving fertility in general, you can read more on Improving Male Fertility Using Traditional Chinese Medicine (TCM). How can Oriental Remedies Group help men undergoing IVF? Timing is essential during IVF and therefore there is also a recommended treatment schedule for acupuncture on IVF patients. The schedule is as below: Herbal Medication & Dietary Changes TCM believes that issues of infertility are generally related to the Kidney. That being said, the Kidney can only produce good quality sperm if the Five Organs are also well-nourished and have surplus to provide for the Kidney. Hence, tonifying and nourishing the Five Organs is the basis of infertility treatment with emphasis placed in the provision of surplus Qi for the Kidney. Herbs like Wolfberries 枸杞子 and Chinese dodder seed菟丝子 have been used over many centuries to help increase quality of sperm by tonifying the Kidney and Liver. Codonopsis root党参 and Astragalus 黄芪 are also commonly used herbs which tonify both Spleen and Lung Qi.

Improve your IVF success rate with Acupuncture

Improve your IVF success rate with Acupuncture Link copied! Infertility is more common than we think. Statistics have shown that 40% of married Singaporean couples who are actively trying for a baby are “not happy” with their progress. Many factors such as stress in our lives, our sedentary lifestyle, chemicals and toxins from our environment or the food we eat, may cause infertility. To help more couples fulfil their baby dreams, Oriental Remedies Group will be sharing a series of articles on fertility issues, for both male and female fertility. Whether you are: Trying to conceive naturally Going through assisted reproductive technology such as IUI Preparing or going through IVF, fresh or FET cycle We will share how TCM can be used to help condition the body for conception naturally and via assisted reproductive technology such as IUI and IVF. The path towards conception can be long and daunting and we hope to help educate and bring practical solutions for couples. For this specific article, we will look at how TCM can help the female during the IVF process. Fertility Series: Acupuncture for females during IVF What is IVF? In vitro fertilization (IVF) is a complex series of procedures used to help with fertility or prevent genetic problems and assist with the conception of a child. During IVF, mature eggs are collected from ovaries and fertilized by sperm in a laboratory. Then the fertilized egg (embryo) or eggs (embryos) are transferred to a uterus. One full cycle of IVF takes about three weeks. Sometimes these steps are split into different parts and the process can take longer. How can acupuncture help? Research has proven that TCM can help condition your body and therefore increase the success rates with IVF.  This can be done through various ways such as through taking herbal medication and acupuncture. In this article, we will discuss how acupuncture complements IVF. 1) Effect on Ovarian Follicles Acupuncture has positive effects on ovarian follicles and assists in ovulation. Modern medicine believes that acupuncture helps to regulate the function of the hypothalamic-pituitary-ovarian axis system, which improves the secretion of various hormones such as the follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone etc.[1]. This enhances ovulation in the individuals[2]. Farnoosh Bidouee’s study[3] on acupuncture in 120 infertile patients who received artificial insemination discovered that ovulation is improved after acupuncture.  2) Effect on Ovaries During IVF, follicular growth after ovulation induction is dependent on the blood supply of the ovaries. Studies [4][5] have shown that acupuncture in IVF patients increases the blood flow to the ovaries as compared to the placebo acupuncture group and control group. Therefore, acupuncture can improve the blood circulation in the ovaries and uterus, which helps to promote the growth and development of follicles. 3) Effect on Endometrial Receptivity Endometrial receptivity is a temporally unique sequence of factors that make the endometrium receptive to embryonic implantation. It is closely related to the success of implantation and pregnancy. Various conditions such as endometriosis, polycystic ovary syndrome and luteal insufficiency can affect endometrial receptivity. Zhong et al[6] has concluded that acupuncture is effective and safe to use in women with low endometrial receptivity, thereby increasing the chances of pregnancy. 4) Effect on Emotions IVF is a process that can be emotionally intense and stressful for the couple, especially so for the female who has to go through hormonal changes, side effects of drugs and potential complications of the medical treatment. The most common psychological challenges of infertile patients are depression and anxiety. These adverse emotions may be due to various factors such as high treatment cost, frequent blood draws, intramuscular injections, side effects of various complications etc. A number of studies [7][8] have shown that consecutive sessions of acupuncture from the day of injection of gonadotropin till HCG day, can reduce the excitability of the sympathetic nervous system, relieving negative emotions which aids in increasing the pregnancy rate. All couples who are preparing to start a family naturally or for those who are undergoing assisted reproductive technology, such as IUI and IVF can benefit from doing acupuncture to condition their bodies. What is the treatment schedule for acupuncture in IVF patients? Timing is essential during IVF and therefore there is also a recommended treatment schedule for acupuncture on IVF patients. The schedule is as below: Click to enlarge Your journey is the most important! In Oriental Remedies Group, we have more than 10 certified bi-lingual TCM Physicians. Each of them has been trained in both Nanyang Technological University (Singapore) and China for a minimum of 5-8 years, in both Biomedical Science and TCM before being certified to practice in Singapore. Specifically, we have Physician Poh who specializes in female fertility, gynaecological conditions and beauty. IVF is a procedure that takes time, effort and great determination. The chances of success if higher when the female further prepares her body for the procedure. With current research on how acupuncture complements IVF, we hope to be able to help more females trying for IVF. Do contact us at +65 8087 0486 for a personalized consultation to help you with your worries. Also, when it comes to fertility, it really does takes two hands to clap. The male partner who does his part to ensure that the sperm quality is optimal for use during IVF increases the couple’s chances. Do refer to our earlier article by male fertility expert, Physician Lim, to find out more about improving male fertility in order to improve quality of sperm – Improving Male Fertility Using Traditional Chinese Medicine (TCM). For those who wants to start a family naturally and wants to find out how you can prepare yourself and your partner, do also look out for our other articles on fertility. This article is written by Senior Physician Leong Weizhen, with contributions from Senior Therapist Hannie Hong. Leong Weizhen Chief Medical Officer, Lead Physician VIEW QUALIFICATIONS Upon graduation from NTU/BUCM with double degree in both Biomedical Science and TCM, Singaporean Physician Leong Weizhen was awarded the prestigious Chinese Government Scholarship (out of only seven places offered) for a 3-year Master’s course in BUCM and under the prestigious