The Best Herbs for Fertility Support

There are many reasons to consider using Chinese Medicine for fertility support - it’s natural, it’s safe, and it’s effective. But there’s also a lot more to it than that. In this article, I will introduce how we address reproductive health in Chinese Medicine, the logistics of working with our clinic, fertility preparation, and some simple things that couples can do to support their fertility. 

When you're ready to begin Chinese herbal medicine treatment, visit our Chinese Medicine page to learn more about the process, or get started by filling out our New Patient Herbal Intake. To get started with acupuncture treatment, you can book with our Boise, Idaho clinic here.

CHINESE MEDICINE THEORY AND FERTILITY

Reproduction is one of the most natural processes in the human body. At the same time, reproductive function is not required for our individual health and survival. For this reason, the reproductive system is one of the first systems to decline if the body's health is challenged, stressed, or suffering from illness. Chronic illness, stress, overwork, and nutritional deficiencies are all examples of conditions where the body can be working extra hard just to stay healthy and survive, and may not have the additional resources to reproduce. This makes fertility a complicated matter, because we have to consider not only the function of the reproductive organs - but also the big picture of our body’s health. It should come as no surprise that growing a human being and all its little organs requires a great deal of metabolic energy and resources.

One of Chinese Medicine’s great strengths is the practice of looking at the big picture as well as the zoomed-in view of specific symptoms and conditions. Both aspects are vitally important for successful outcomes. 

COMMON OBSTACLES TO FERTILITY

These are some of the common indicators we look at to determine where a person needs support. 

Menstrual Cycle - the ideal menstrual cycle is regular, approximately 28-30 days in duration, with 3-5 days of bleeding, minimal to no pain, minimal to no PMS symptoms (breast tenderness, mood swings, irritability), with fresh red color and no clotting. 

Common patterns that indicate potential obstacles to fertility are: irregular cycles, short or long cycles, scant bleeding, painful periods, PMS symptoms, dark (purplish or brown) blood with small or large clots. All of these symptoms relate to different aspects of the female reproductive system, and indicate things like problems with microcirculation of blood in the uterus, problems with the egg moving through the fallopian tubes, hormone imbalance, and more. 

Sex Drive - sexual desire in humans is highly complex, involving not just our physical drives but also our mind and emotions. However, physical drive to have sex is an important indicator of fertility in both men and women. Many factors can contribute to low sex drive, and it is important to address them to support fertility. 

Energy - fatigue and low energy can be common obstacles to fertility. If either partner has significant fatigue, there may not be enough available resources to support conception. 

Stress - stress is a significant obstacle for many couples. Our stress response alters our hormones, uses a large amount of metabolic energy, and affects all of our body systems. 

Digestion - good digestive function is essential for our body’s ability to extract nutrients from food. Nutritional deficiencies resulting from poor digestion can interfere with hormone production, building a healthy uterine lining, and being able to sustain a pregnancy. 

CHINESE MEDICINE AS A FIRST-LINE TREATMENT, NOT A LAST RESORT

In our culture, it is far more common for Chinese Medicine practitioners to see people who are at the end of their rope - they’re tried everything, the drugs, the surgery, you name it - and then finally they’re willing to try out Chinese Medicine as a last resort.  The reality is that we often are still able to help in those last resort cases - but it is most definitely not the best way to utilize Chinese Medicine. Chinese Medicine treatment is safe, effective, and will not leave you with any irreversible changes as may be caused by medications or surgical procedures. So it is best utilized as a first-line treatment, and its elegant approach is often able to get the job done with very little risk.

Because fertility is highly complex, and requires a holistic approach for best success, Chinese Medicine treatment is not only safer, less painful, and more affordable, but may also be as effective or more effective than modern treatments like IVF. Research studies on Chinese herbal medicine for fertility cite rates of successful pregnancies ranging from 56% to 70%, with one study reporting 60% success rate with 3-6 months of Chinese Herbal Medicine treatment.* Reported IVF success rates vary widely based on age, with average success rates of 30% to 35% for one IVF cycle.* IVF success rates increase with the number of cycles done. Each cycle, however, is both expensive and potentially physically and emotionally challenging to undergo. 

Chinese herbal medicine is not only safer and more successful, it is also much more affordable. The cost of herbal medicine treatment at my clinic is $2400 to $4800 for 6 to 12 months of treatment. Local IVF clinics in Boise with "affordable" rates charge around $25,000 per cycle and many women go through 2 or 3 cycles.

Chinese Medicine works to support fertility by improving both overall health and specific aspects of reproductive system health so that the conditions for fertility can be met. Many modern drug treatments are capable of forcefully making things happen, regardless of whether our body is wanting to do them or not - which is amazing when we need it, and also creates a lot of problems. IVF is capable of making pregnancy happen even when the body may not be adequately prepared. The inability to conceive is generally an indication that the body is not ready to meet the significant demands of growing a baby. When we force that to happen, we are more likely to see health challenges in the mother both during and after pregnancy. Some studies show higher miscarriage rates in women treated with ovulation stimulating drugs (Clomid/clomiphene etc), in one study 50% pregnancy loss rate in clomiphene induced pregnancy compared to 16% in natural pregnancy.* This is because the drug forcefully stimulates ovulation to result in conception, but other aspects of the woman's health are not ready to carry the pregnancy to term. In many cases, the lack of conception is the woman's body protecting itself from the demands of pregnancy that it is not yet ready to meet.

Like all medicines, there is an appropriate time and place for IVF and there are many beautiful babies brought into the world with the help of IVF. My view, with regard to fertility and across many different areas of medicine, is that it is best to use medical interventions in ascending order of severity and risk. Chinese Medicine is an excellent place to start, and often it's all that's needed.

One way to think about the difference between Chinese herbal medicine and modern pharmaceutical medicine is like this: imagine that a large boulder blocks your path and needs to be moved. Using Chinese herbal medicine is like wedging a 2x4 between a smaller rock and the boulder and using a small amount of force, with leverage in the right place, to roll the boulder out of the way. Using a modern drug medication is like blowing the boulder up with a stick of dynamite - it's fast and effective, but the large amount of force applied via explosion can cause collateral damage. Some boulders require dynamite, many of them do not.

LOGISTICS OF WORKING WITH OUR CLINIC

For couples interested in fertility preparation:  You can get started anytime. I highly recommend fertility preparation as a first step if the timing works out for you to do so. Check out the section below titled “Fertility Preparation” for specific suggestions.

For couples who are actively trying to conceive:  Treatment though my herbal clinic involves evaluation and treatment with herbal medicine approximately every 2 weeks for the first few months, and monthly after that. I will ask you to track your Basal Body Temperature to gather more information about your cycle. We use the best herbs for fertility support and only source herbs from the best companies.

I accept patients for fertility support who are not concurrently using ART (assisted reproductive technologies). This includes IVF, ovulation stimulating drugs like Clomid of Femara, IUI, and hormone treatments like progesterone. The average time for patients to get pregnant working with me has been 6 months, but I ask that you plan to give it a year before moving on to ART. This treatment is not inexpensive, but it is significantly more affordable than ART treatments.

THE MALE FACTOR

Most of the work that we do addresses obstacles to fertility in the significantly more complex female reproductive system. But it takes two to tango, and it’s important to approach this as a team. I recommend that the male partner get semen analysis done before their female partner begins Chinese medicine treatment. It’s easy, affordable, and is a very simple way to determine if the male partner also needs herbal medicine treatment to address low sperm count or motility. If the semen analysis comes back normal, and our primary focus will be on the female partner - I still recommend that the male partner come to the first appointment. I will also recommend that the male partner take Maca or Love pearls, a Chinese herbal capsule formula, to support fertility. When a couple is facing difficulty conceiving, we want to do everything we can to support fertility on all fronts, and we want to encourage better than “normal” sperm - we want sperm that swim like Michael Phelps. 

 A note to the guys - Historically men have been pretty lame about acknowledging their role in fertility. Our culture has created a narrative that our value as men or women lies in our reproductive success. While it can be hard not to feel these culturally pervasive (and perhaps biologically driven) ideas, they are very damaging to the psyche of anyone who struggles to get pregnant, most especially women, who will bear the majority of fertility treatments. So get your semen tested - knowing that the results mean nothing about your value as a person, take some maca, and do your part to normalize the reproductive journey. 

GENERAL RECOMMENDATIONS

These are recommendations that I give to nearly every couple I see in our clinic. 

Love Pearls - Love Pearls is a Chinese herbal formula from Classical Pearls that is a great sexual vitality tonic for men and women. Both partners can take Love Pearls, though most often I will recommend it for men and recommend a custom formula for the female partner. Classical Pearls formulas are available to patients through our online store. Please take a few minutes to fill out our intake form so I can review your health history to make sure they are an appropriate fit for you, and so I can recommend a dosage. The average dosage is 6 capsules/day.

MACA- 1 tablespoon, per day, per partner until conception is achieved. Maca is a food-grade herb that helps provide the building blocks for important sex hormones and supports reproductive health. Research on maca suggests that it increases semen volume, sperm count and sperm motility and sex drive in men, and increases sex drive in women. Use maca from a quality company like GAIA. Dosage is very important - the dosage that I have worked with for years is 1 tablespoon/day. Maca's use in fertility support comes from the traditional Andean practice of eating maca daily until conception occurs. Maca is a root vegetable, closely related to turnips, and the traditional practice of eating it fresh likely topped 100 grams/day. So taking 2 capsules/day is not adequate for the desired therapeutic effect. If you read through the research paper* on maca below, it suggests that the fertility enhancing response is dose-dependent, and they saw a significant reduction in effect below 3 grams/day. One tablespoon of powder is around 9 grams. More is not always better, but in the case of maca - it generally is. Some couples have reported success with using a tincture (like this one from Herb Pharm) and it may be easier to take than powder. The dosage of tinctures is not well understood, so my standard recommendation remains powder, but I invite you to try a maca tincture if you really struggle to take the powder.

Note: Some people find that they need to decrease caffeine consumption when taking maca as it can have an energizing effect. Caffeine tells us we're not tired, but it doesn't change our body's energy output. Herbs like maca actually help our body produce more energy, which is ultimately much better - but must be considered when taking caffeine or similar stimulants.

N-Acetyl Cysteine (NAC) - N-acetyl cysteine is more commonly used to support liver metabolism and to thin mucus for people with allergies and sinusitis. However, it has also been found to support fertility by thinning body fluids overall. This can be useful for women who struggle with fibroids, cysts, or painful menstruation. In men it makes seminal fluid less viscous, which helps sperm to swim more effectively and is especially useful if there is low sperm motility. 600 mg/day is a typical dosage.

Dietary therapy - To put it simply, my dietary recommendations are to eat less sugar,  more cooked leafy green vegetables, and an adequate amount of grassfed red meat (beef, lamb, venison, elk etc). I frequently recommend organ meats (liver, heart, kidney, testicles) as highly nutritious foods, either as part of regular meals or from an organ meat supplement like Heart & Soil. 

Regarding Stress and “Trying” - I don’t think using the term “trying” is going away anytime soon, but it might be good if it did. One of my teachers, an expert in fertility medicine, used to tell patients “You don’t get pregnant up here,” as she pointed to their brain. “Conception is not a mental activity, and you’re wasting too much energy thinking about getting pregnant. Your energy needs to be down here,” as she pointed to their reproductive organs. Some might think my teacher was referring to energy solely in an esoteric sense - but that’s not all she meant. Thinking consumes metabolic energy, sometimes in huge amounts. And that energy is best conserved for our body parts that have baby-making potential. Our stress response also has significant impacts on our hormone function, including on sex hormones. It’s of course easier said than done, but stress and worry about getting pregnant can be very counterproductive - so finding tools to manage stress (like yoga, breath-work, meditation) is very important. Yoga with Adriene on Youtube is a fantastic resource.

FERTILITY PREPARATION

There is a particular phenomenon that happens when couples move from the contemplative stage to when they make the decision to start “trying.” Suddenly, a timeline begins, like a coach has clicked on a stopwatch to time the most important race of your life, what feels like the ultimate evaluation of your value as a human being - will you be able to have a baby? 

The questions start flying. How long will it take? Will we even be able to get pregnant? Your friend got pregnant within a month, your other friend has 3 kids and didn’t get pregnant “on purpose” with any of them. What happens if you can’t get pregnant? What does it mean? What will your life look like if you don’t get pregnant RIGHT NOW!?!....Ok let’s pause.

First, for good measure let me state that your value as a human being is inherent and has nothing to do with your health or fertility. Culturally, we are rather obsessed with thinking that health and disease are somehow moral choices. They are not. Whatever health or disease we experience in life, fertility challenges, or ease in getting pregnant - is exactly what it is, not more and not less. It carries no meaning or measure of your value or goodness.

The stress and anxieties that couples experience around fertility can be extreme. All of these feelings are real, and normal. But the “trying timeline” is a figment, a mental trap of our own making. Here I am not referring to the biological timeline of human fertility, which is real. I am referring to the timeline that we create when we make the decision to start “trying.” 

The couples I see in my clinic are usually people who didn’t get pregnant quickly and easily. They are often 6 months or a year into trying. This is a perfectly good time to start Chinese Medicine treatment, but by this time the trying timeline has often started to stress and wear on people. 

It is very difficult to avoid the feelings that the trying timeline brings on but there is a way to circumvent this mental trap. The secret is to prepare your body for conception well before you start “trying.” In some ways this is just a mental game, but I promise you, it feels much better to most couples to take herbs for 3-6 months of preparation - and then get pregnant within a few months, than to try for a year, then take herbs for 3-6 months before getting pregnant. 

What happens during fertility preparation? In fertility preparation, we prepare the body for possible conception by regulating the menstrual cycle and addressing any underlying imbalances or health challenges that could contribute to difficulty conceiving. We want to see regular menstrual cycles, with minimal to no pain, and minimal to no PMS symptoms. This indicates that the reproductive organs are in good shape and will be more likely to conceive. We encourage this by using herbs that improve circulation of blood to the reproductive organs, improve the motility of the egg moving through the fallopian tubes, and support building a healthy uterine lining and encouraging the removal and metabolism of old blood cells and tissue each month. This phase typically consists of taking herbal medicine for 3-6 months, though it may be longer in cases of more severe irregular cycles.

You can do fertility preparation via individualized treatment by making an appointment at our clinic (in person or via telemedicine). This is the best way to get herbal medicine tailored to your exact needs. With individualized treatment we also identify and address other obstacles to fertility from a holistic approach, for example problems with digestion, sleep or fatigue. 

How do I know if I need to do fertility preparation? That is the great challenge of preventative medicine - if it's working well, it will seem like you didn’t need it at all. If you find out you need it, you’re generally experiencing the challenges that it could have prevented. With regard to fertility support, preparation doesn’t hurt. And according to our experience in Chinese Medicine, fertility preparation is not only likely to lead to shorter time to conceive but also to reduce risk of difficult pregnancies. 

But what if I don’t think I want to encourage fertility until I actually want to be pregnant? This is a common misconception about how fertility and fertility herbs work. When people don’t want to get pregnant, most people are thinking they want to avoid “fertility enhancing herbs” at all costs. That is not the case. Fertility is a measure of your body’s reproductive health, and health in general. It indicates your potential to get pregnant if sperm meets egg. If you want to get pregnant at some point in life - you always want to encourage fertility. You just have to make sure sperm doesn’t meet egg until the point you want to be pregnant. 

A FINAL NOTE

It feels like having a baby should be our birthright as humans, and it can be hard to accept that it is not possible for everyone to do so. We have excellent tools to support fertility using Traditional Chinese Medicine, and there are some amazing modern medical techniques available today as well. But it is still not possible for everyone to get pregnant and give birth.

I believe it's important to remember that there are some things we can control, but there are many that we cannot. We can choose our lifestyle, the food we eat, whether to pursue herbal medicine or IVF. We cannot choose our genetics, or the fact that humans have been engaged in polluting our environment, soil, air, food, and water supply with novel chemicals for nearly 100 years - many of which are linked to fertility decline in humans, in addition to their greater environmental degradation.

We can choose to adopt or foster one of the many children that need homes. We can work to reverse the environmental damage that humans have caused, to reduce the future impact of pollution on human health.

We can do everything in our power to have a baby, and sometimes it still won't happen. And it doesn't mean we will want it any less. But it never means that you did something wrong, or that you didn't try hard enough, or that you weren't good enough. Wherever you are in your journey, do your best to be kind to yourself.

Sincerely, Sean

*Sources:

Chinese herbal medicine for female infertility

https://www.sciencedirect.com/science/article/abs/pii/S0965229914001915

Measuring the Effectiveness of Chinese Herbal Medicine in Improving Female Fertility

https://www.sinocare.ca/wp-content/pdf/Measuring-the-effectiveness-of-TCM-in-improving-female-fertility.pdf

Effect of Chinese Herbal Medicine on Male Infertility

https://www.sciencedirect.com/science/article/abs/pii/S0074774217300235

Final ART success rates: a 10 years survey

https://academic.oup.com/humrep/article/26/8/2239/650853

Subclinical pregnancy loss in clomiphene citrate-treated women. https://www.sciencedirect.com/science/article/pii/S0015028216547700?ref=cra_js_challenge&fr=RR-1

Congenital malformations associated with assisted reproductive technology

https://pubmed.ncbi.nlm.nih.gov/23845610/

Effect of Lepidium meyenii Walp. on Semen Parameters and Serum Hormone Levels in Healthy Adult Men

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4569766/#:~:text=Subjects%20consumed%203%20g%20of,after%2016%20weeks%20of%20treatment.