Part 1 of 3: Optimizing Egg Quality and Ovarian Reserve

If you are unable to conceive either due to age, low ovarian reserve or premature ovarian failure, egg quality and the embryo’s ability to implant are the major problems. In many cases scientists have found that eggs seem to fertilize and develop into embryos normally, but fail to implant. Higher rates of aneuploidy (chromosomal abnormalities of the embryo) are one contributing factor, but apart from this scientists have not been able to draw many sound conclusions on why failure to implant happens. When a woman is over age 35, has low ovarian reserve or premature ovarian failure, and IVF has not been successful, egg donation is usually seen as the last available option. However recent research has found that several supplements can help with implantation and pregnancy rates. This will be the first in a three-part series where I examine supplements and techniques used for improving egg quality and pregnancy rates. The supplements I will examine in subsequent posts are DHEA and CoQ-10. I will let you know how these work, who should take them, and who should avoid them. As I am a firm believer that an integrative approach is best, first I will explain how egg quality is viewed from the standpoint of Traditional Chinese Medicine (TCM) and how I as an acupuncturist would address it.

Poor Egg Quality, Low Ovarian Reserve and Premature Ovarian Failure all fall under the umbrella of something we call Kidney Jing deficiency in TCM. The Kidneys are responsible for a person’s essence and reserves of energy, and this corresponds to your genetics, simply put. Any time a condition is present due to genetic predisposition or the condition affects the patient’s most basic genetic materials (eggs or sperm), a kidney Jing deficiency is a contributing factor. Other examples of Kidney Jing deficiency include first menses past age 15, delayed development, or congenital abnormalities. Jing is what you are born with and slowly declines with age. Jing encompasses our ability to reproduce and for women is said to grow or decline in cycles of 7: at age 14 is menarche, at age 21 a woman’s Kidney energy is balanced, at age 28 the body’s energy and reproductive potential peak, and by age 35 it begins to decline. This information is found in ancient texts such as the I Ching and The Huang Di Nei Jing (Yellow Emperor’s Classic of Internal Medicine), and actually seems quite well-supported by modern science.

How is Kidney Jing Decline treated?

1) Acupuncture– there is some debate within the acupuncture community as to whether Jing can be restored through acupuncture alone. My belief is that through balancing the body systems as a whole, we can indirectly and subtly influence the Jing and the Kidney energy as a whole. In addition, certain acupuncture points have been shown to increase blood flow to the ovaries (via blood flow monitoring) which could be helpful in improving the environment in which the eggs mature every month.

2) Adaptogenic Herbs– I recommend adaptogenic herbs because they generally have no adverse effects yet exhibit a normalizing effect on all body systems. Cure-alls? Not quite- but they are helpful with making the body more resistant to the effects of stressors- both emotional and physical. Many types of mushrooms are considered adaptogenic, including reishi, shitake and maitakes. Several varieties of ginseng also are adaptogenic. As you can guess by their name they are able to adapt to the individual, correcting whatever systems tend to be imbalanced. They act on the adrenals, which also correspond to the kidney energy- our reserves of energy.

3) Chinese Herbs– Chinese herbal therapy is a little different from the western idea of taking herbs. In the U.S., we tend to take one single herb at a time for one specific reason. In Traditional Chinese Medicine, formulas, or combinations of 4-15 herbs together are recommended. The herbs work together and their medicinal properties are enhanced by each others’ presence. Many herbs nourish the kidney’s energy, and when taken in an individualized formula for several months, can give the Jing a boost and slow its natural decline. Never take Chinese Herbs that haven’t been specifically prescribed for your condition by a licensed practitioner. Just because your friend took an herbal formula for fertility doesn’t mean it is the right one for you.

4) Supplements backed by modern research– I am not a fan of prescribing someone a laundry list of supplements- I try to keep things as simple as possible. The supplements I will discuss in upcoming blog posts are those that are being recommended by prominent reproductive endocrinologists (RE’s) and that have been examined in clinical research studies.

As with all everything you put into your body, I recommend you do your own research to determine whether the supplement is applicable to your situation. In addition, I NEVER recommend the use of supplements or herbs while you are undergoing an injectable or Clomid/Femara cycle without your doctor’s consent. It isn’t that we have seen adverse reactions, but there isn’t any research on combining the therapies. So, it is better to be cautious and work on building the Jing energy well before your next IVF or IUI.