In last week’s blog titled “Age & Fertility: A Chinese Medicine Perspective (Jing: Part 1)”, I introduced the concept of “jing”. I explained how it accounts for the relationship between age and the natural decline in fertility. It is advisable you read this blog first as a precursor to better contextualise this blog. In clinical practice, jing directly relates to egg quality and ovarian reserve (AMH). The greater the volume of jing, the better the state of each. These are both key necessities in the path to conception.

There are two approaches in treating jing. The first approach is to simply preplace the jing which has been already consumed. For this approach in treatment, herbal medicine is the preferred method. There are herbs which have varying capacities to replace jing. Time is however needed for them to take affect. Though from my clinical experience, the extent of the improvement will have limitations. If jing has been severely depleted, it is difficult to make significant improvements. Though it is however very probable that jing can be replaced with a mild increase. This method of treatment has enabled me to treat numerous treat where ovarian reserve and/or egg quality improved.

Acupuncture is not effective at replacing jing because it has a regulatory function. This means is only able to reinstate balance. Herbal medicine in contrast has the ability to make adjustments outside of a state of balance. There is no point using acupuncture to make a fertility patent a “balanced” 42 year old. Even is a state of balance she will only have the jing of someone her age. The aim is replenish the jing so that she presents similar to a much younger women.

The second approach to jing is more of a supportive method. This involves balancing the body so as to prevent any further depletion into the reserves of jing. In other words, this involves making the body run efficiently. This role is perfectly suitable for acupuncture. It has the capacity to regulate the physiology of the body as everything runs smoothly and effectively. Treatment of this nature would involve helping each organ function efficiently. It will also involve helping the body fend off external threats, which can cause illness, as well as help the body deal with stress.

Chinese Medicine is an energetic medicine with origins well before the inception of modern medical science. In the absence of technical medical terminology, the theory of Chinese Medicine was often explained using metaphors and symbology. This approach was taken to account for fertility.

The relationship between age and fertility is explained by a concept called “jing”. In English, jing roughly translates to mean essence. In effect, jing serves as the body’s reserve battery. During our lives we eat, drink and breathe to nourish our bodies. If this is not enough to sustain us, it is said we then dip in to the reserves of jing to supplement our needs. Once jing has been lost, it is very difficult to replace. As someone’s jing declines so too does their fertility. Regardless of who well one may look after them self, it is inevitable that jing will naturally decline over time.

For females, jing flows in cycle of seven years. At age seven, the baby teeth give way to adult teeth. Then more pertinent to fertility, at age 14, puberty begins and so too does menstruation (which is poetically called the “dew of heaven”). At the age of 21, jing and fertility is at its peak. Then two cycles latter, at age 35, it is the beginning of the weakening of the reproductive system. Two cycles further, at the age or 49, the “vessel” is empty and the “dew of heaven” has dried up and infertility is experienced.

Nothing is more reassuring than to attend a clinic for fertility treatment and to find nice, easy to read marketing material which reports on the clinic’s rate of success. Before you get all warm and fuzzy, please consider the following pitfalls.

Make sure the statistical information relates to you. Statistics often come with fine print. Do you match the inclusion criteria? Do not get sold on a promise that is not applicable to you. Consider such things as if your age and the cause of your infertility are included in the statistic.

Understand that no matter how high the rate of success may be, there are still patients who do not fall pregnant from the treatment. I have witnessed the following logic many times. Initial thought: the success rate of 70%, 80% etc is very high. Second thought: it is so close to 100%!!!! Which then turns into the false assumption: a positive pregnancy is a certainty. Unfortunately, no, this is not the case. I do not mean to be flippant, but 70% or 80% of a baby is still not a full baby. Please be aware, probability is only a good indicator of success over many attempts. But, on single attempts (such is often the case for fertility treatments) there can be no true promises.

TCM is a very unique modality of health care. Statistics on treating a certain diagnosis are misleading. One cause of infertility according to western medicine can be further broken down into a number of energetic imbalances according to the Chinese medicine model. Each of these imbalances will have varying degrees of difficulty to treat. I often get referrals from satisfied patients. More often than not, they refer others who suffer the same cause of infertility as defined by western medicine. They assume that because I helped them, I will equally be able to help their friend. This is not always the case.

When treating infertility, monitoring a patient’s cervical mucus can be very informative. Cervical mucus is a key ingredient to aid conception. It is needed to assist the sperm to journey deeper into the female reproductive organs to be ready in position for when the egg is released at ovulation.

Cervical mucus goes through changes in viscosity. The different types of cervical mucus are produced by different parts of the cervix. Each type of mucus has its own unique characteristics which help the sperm in a specific manner. Oestrogen peak starts six days before ovulation, and this is the start of the mucus production. Leading up to ovulation, the mucus will change in viscosity and the production will also increase in volume. Both of these factors are why cervical mucus can be used as an indicator of an impending ovulation.

In Chinese Medicine, the monitoring of cervical mucus has a greater implication. It can be used as an indicator of the state of “yin” within the reproductive system. This is of value because a healthy state of yin will also give a general indication of good egg quality. It also is indicative of a fluffy endometrial lining (which will assist implantation). Though, cervical mucus is only one indicator of yin. It should be considered amongst other diagnostic tools, such as tongue and pulse diagnosis, for it to be more conclusive.

Once the bleeding from the period has stopped, cervical mucus should be monitored daily. To check your mucus, insert your finger at the entrance to your vagina and collect any mucus which is present. If you do not find any, carefully insert your finger deeper to the entrance of your cervix. Rate your mucus in terms of watery, sticky or lubricating. Watery is as it sounds, when the mucus is like water. Slippery is when the mucus stretches between your fingers and it has a consistency similar to egg white. Lubricating is less thick and stretchy, and it feels lubricating and more slippery. Also rate the volume of your cervical mucus as either light, medium or heavy. Try your best with this rating, but do not worry if you are unsure. It will become easier to rate as your mucus changes during your cycle or as it changes in response to treatment.

When receiving acupuncture and herbal medicine as a stand-alone treatment at the Fertility & IVF Acupuncture Clinic, most patients are asked to keep tract of their cycle using a BBT chart. This is a Basal Body Temperature Chart and it requires patients to record their temperature taken from the moment they wake up each morning.

A key component to being able to ensure an accurate BBT chart is to have a reliable and accurate thermometer. BBT charts are sensitive to small changes in temperature. The greatest expected change in temperature is 0.4 of a degree, which occurs at the time of ovulation. So it is imperative the thermometer is accurate. Using a mercurial thermometer is ideal. These are however no longer sold because they are more expensive to manufacture than their digital counterpart.

Tips to ensure your digital thermometer gives an accurate reading:

• Buy a BBT specific digital thermometer. These cost about $20 compared to the $10 for a standard thermometer, but they are worth the extra investment.
• Look after the thermometer and don’t knock it around. Damaged thermometers cannot be recalibrated.

If you thermometer is old, buy a new one. It best to have the peace of mind knowing it is in top working order. This also eliminates the chance of a worn battery.

If you would like Dr Wilson to assist with your pregnancy chances, please phone (02) 9231 3377 to make an appointment.