Infertility and Nutrition Traditional Chinese Medicine (TCM) Acupuncture
Nutrition plays a key role in our reproductive health. Along with acupuncture treatments and herbal medicine, changes to your diet and lifestyle are necessary in order to optimize your chances of conceiving and bringing your pregnancy to term. This resource, an overview of nutrition, diet and lifestyle, was prepared for our patients as an educational tool. It contains tips, recommendations, and general advice that you can use to achieve maximum health. For a more detailed resource, we encourage our patients to read The Fertility Cure, by Randine Lewis.
The goal of our dietary advice is to bring the body back into balance. Here are some general dietary recommendations for our patients:
- Eat alkaline foods rather than acidic ones – such as non citrus fruits, vegetables, sprouts, cereal grasses (wheatgrass, barley grass), and herbs like black cohosh and valerian root to help provide the entire reproductive system with the right pH for conception and implantation.
- Get plenty of essential fatty acids – linoleic acid and alpha-linoleic acid are key in ovulation. Good sources are fish, fish oil, flax seed and pumpkin seed oils, eggs, soy products, raw nuts and seeds, dark green and winter vegetables (steamed) like broccoli, cauliflower, beets, carrots, kale, collards, cabbage, turnips, and Brussels sprouts. Omega 3 fatty acids, found in deep sea fish oil, increases blood flow to the uterus.
- Eat organic foods and hormone free meats whenever possible – simply put, food loses its essence and qi as it moves away from its source.
- Add more cruciferous vegetables like cabbage, broccoli, Brussels sprouts, and cauliflower to your diet. They contain DIM – di-indolylmethane, a compound that stimulates more efficient use of estrogen by increasing the metabolism of estradiol.
- Supplement your diet with a natural, high potency multivitamin and mineral complex with iron, folic acid and B vitamins. The vitamins and minerals important for reproductive health (vitamins A, C, E, B complex, zinc and selenium) enhance fertility yet are lacking in the usual Western, highly processed diet.
- Other supplements you may wish to include are Bee Pollen and/or Royal Jelly, Blue Green Algae, Chlorella, Wheatgrass, Vitamin B6, Coenzyme Q10, Reishi & Shiitake mushroom, Kombucha Tea, and Folic Acid. PABA has also been found to correct certain aspects of infertility especially in disorders of Folic Acid production.
- Eliminate caffeine, nicotine, and alcohol.
- If at all possible, avoid unnecessary medications and drugs, especially glucocorticoid medications. Over the counter preparations included.
- Avoid junk food, excessive stress, too little sleep, too much exercise, or anything taxing to the immune system.
DIET & LIFESTYLE ACCORDING TO CHINESE MEDICINE
JING, YIN and YANG EXPLAINED
JING or ESSENCE is considered to be very precious – it is the Life Spring sourced in our deepest origins, a substance or energy inherited from our parents. It is a finite bundle which must be conserved because it is not so easy to replenish it once spent. Healthy Kidney Jing is vitally important to Fertility!
It is the balanced path through life which helps to conserve Jing. Stress, traumatic accidents, serious illness, excessive sexual activity (men), childbirth & ovulation drain Jing in women. There are some ways Jing can be nourished, although clearly even the most careful and nourishing life and diet cannot replace the Jing that must be spent in living. It is recommended to avoid caffeine, alcohol, and nicotine. Take the time each day for rest and relaxation. Avoid too much external stimulation (parties, drugs, loud music, and too much sex).
JING AND FOOD
Food substances which are designed by nature to nourish offspring can enhance many different levels of energy, including the Jing. Substances like Royal Jelly which is produced by bees to nourish larvae, offer this type of nourishment.
Eggs of birds are one of nature’s most complete protein food packages and represent a type of Jing themselves, containing as they do the gametes of the female of the species. Fish eggs, roe and caviar are also excellent Jing tonics.
Seeds and nuts, such as black sesame seeds, walnuts & chestnuts, contain not only fertilized germ cells but also supplies for the immediate nutritional requirements of the potential new plant; hence they are useful sources of Jing nourishment.
Some animal organs and tissue nourish the Jing, bone marrow, brains and kidneys of animals provide Jing nourishment. Oysters also bolster Jing by delivering essential minerals like zinc to the sperm manufacturing cells. Clams, lobsters, and crayfish as well.
Other plant products which nourish Jing are seaweeds, spirulina, chlorella and blue green algae. These plants provide trace elements which are necessary for many processes in the body, including the production of the gametes and the hormones which control their development.
Additional foods reported to have a special effect on the Jing are artichoke leaf, nettles, oats, and raw milk. In addition, the following foods may also increase JING: Black beans and legumes, kelp, parsley, wheat germ, wheatgrass, string beans, mulberry, millet, tofu, raspberries, wild rice, pork, venison, Lyceum fruit, adzuki beans, yams, & corn.
YIN cannot exist or be described except with reference to Yang, its opposite force. The Yin energy of the body is the internal, quiescent, restorative and moistening force to balance Yang’s more outward, active, stimulating and warming force. An overly stimulating and rushed lifestyle damages it by not allowing time for rest and regeneration.
Yin Deficient women, especially older ones find getting and staying pregnant a challenge. Their juices are dried up – they have little fertile mucous to carry the sperm safely into the uterus, and the lining of the uterus can be thin. The development of the egg too is compromised if the Yin is inadequate.
Men are not immune from the damaging effects of the Yin depleting lifestyle; internal Heat which develops as a result of Yin deficiency can have very dire repercussions for the development and maturation of sperm.
HOW CAN YIN BE NOURISHED AND REBUILT?
Pay attention to your inner calm. Meditation, Tai Chi, Qi Gong exercises, and walks in serene natural environments such as rainforests, riverbanks, oceans, parks, etc. recharge Yin. Decrease excess mental stimulation or any activities that heat or dry the body. Do not miss any meals. Avoid long hours in front of computer screens, cell phones, TV screens, or around electronic machinery such as photocopiers. Avoid toxic fumes and other environmental pollutants. Supplement with L-Carnitine.
YIN AND FOOD
Attention to lifestyle habits and avoiding stimulating drinks and foods has more impact on conserving or recovering the Yin than does making specific additions to the diet. In general, diets composed of foods which are rich in nutrients and not overly stimulating are those which nourish the Yin. Fruits and vegetables and adequate protein such as tofu, fish, and milk fortify the Yin. On the other hand drinking too much coffee and eating very spicy food can consume yin.
Some recommended foods are: barley, rice, wheat germ and millet, string beans, asparagus, all dark coloured beans, fruits like blackberry, mulberry, pineapple, mango, bananas, apples and blueberry; seaweeds, spirulina, chlorella and blue green algae, aloe vera juice, and animal products including fish eggs, dairy produce, and pork.
Ensuring that the body is well hydrated is also important. Yin deficient people are often thirsty and dry. Drinking a lot, however, will not necessarily hydrate the tissues if the fluid passes straight through the body and is excreted. Yin can also be damaged by chronic dieting and by the use of recreational drugs. It is also advised not to over exercise, take saunas, or do Bikram yoga.
YANG deficiency often develops out of a Yin deficiency, but can also be provoked by certain environments, behavior and dieting. Living and working in cold icy climates or even damp cold ones can damage the YANG. External cold enters the body and can weaken the Yang. In the first few days of a woman’s period her body is slightly Yang deficient (because she is losing body heat with the blood loss) and is more vulnerable to a direct attack of Cold to the Uterus because the CHONG Channel is open. In Asia, women are advised not to swim in cold water during their periods. If the Cold restricts or inhibits the rapid and easy flow of the blood it can stagnate, setting the stage for many gynecological problems later, including infertility.
When Kidney Yang is damaged, so is fertility in both men and women. Libido will be low. In women the function of the corpus luteum and the processes of implantation of a newly fertilized embryo into the uterine lining will be compromised. Kidney Yang deficiency in men can lead to impotence and/or low sperm counts and motility.
A Yang deficient body is one without enough driving or warming energy, so that metabolism and mental processes become sluggish. The body and limbs easily feel cold and lethargic, and motivation and assertiveness are low.
YANG AND FOOD
Yang benefits from a diet that is warming. Eat foods nutrient or calorie rich – cooked foods, proteins, carbs, but avoid ice cold drinks, ice cream and such. Long slow baking and simmering increase the Yang Qi in foods. Cooking foods like fruits can reduce their cooling nature and addition of some spices like ginger, shallots or cinnamon can increase Yang Qi in foods. Very hot foods like cayenne and chili add heat to food and in moderation can be helpful in raising a sluggish metabolism. When very pungent spices are eaten a lot (as they are for example in some very hot and tropical climates) they can have the opposite effect, i.e., become cooling, because they provoke sweating.
Stimulants like coffee are favorites by Yang deficient people because the adrenaline (epinephrine) they provoke creates the impression of internal heat and activity. However, it is false Yang, and eventually consumes reserves rather than stimulating them.
The organs most affected by Yang deficiency are the Spleen and Kidney. A diet of raw and cold foods can quickly douse the inner Fire, creating problems of Spleen and Kidney Yang deficiency.
Adhere to the dietary suggestions of Kidney Jing Deficiency. Supplement with L-Arginine (increases blood flow to the ovaries). Also, the following foods are recommended to boost Yang: garlic, onion, chicken, lamb, trout, salmon, lobster, shrimp, mussel, black beans, walnuts, chestnut, pistachio, raspberry, sweet brown rice, quinoa, citrus peel, dates, and cherries.
QI AND BLOOD
Plentiful Blood and Qi make us more substantial and resilient in both physical and emotional ways. When the Blood and Qi are adequate and move well, all the tissues are well nourished and the complexion appears to be a good colour. A pale tongue is a sure sign that the Blood reserves are low.
Healthy Qi requires adequate rest, movement and flexibility. A sensible exercise program will help the Qi build and move. Meditative techniques also relieve the mind of stress and undue worry. Spleen Qi is important for the absorption and metabolism of food and the production of Blood.
QI AND FOOD
A diet of various fresh foods eaten in an unhurried and regular routine will benefit the Spleen Qi and enable it to transform the nutrients in food into the myriad molecules which are required for all the thousands of biochemical processes which occur every moment in every organ and tissue.
To support the Spleen Qi, foods should be lightly cooked, never raw or cold, and balanced in flavor and nature. The diet should include some with sweet, some with bitter, and some with pungent flavors. The sweet flavor is found in root vegetables and grains and these usually form the base of a meal. If eaten in excess, they can cause stagnation. Bitter leaves like arugula or watercress help digestion and pungent foods like onions, garlic, coriander or chives also help digestion and Qi movement. Chinese people sip green teas during meals to facilitate digestion (especially of fats).
Do not consume ice cold beverages, or put ice in your drinks. Avoid ice cream and popsicles and don’t eat any food straight out of the refrigerator. Avoid damp creating foods such as milk and milk products such as cheese or ice cream. Also, avoid “energetically” cold fruits like mango, watermelon, and pear and “energetically” cold vegetables like cucumber, lettuce, celery, and spinach. Do not drink any fruit juice. Good fruits and vegetables to eat are cherries, coconuts, dates, figs, grapes, potatoes, and shiitake mushrooms.
Eat beef, chicken, ham, herring, mackerel and sturgeon.
Do not eat refined carbs like white bread or pasta. Avoid any food made with white flour. Instead eat grains like rice and oats. Avoid sugar and sugar substitutes and any concentrated sweets like honey and maple syrup
BLOOD AND FOOD
Diet is very important if we are trying to build blood. A severely blood deficient person may be called anaemic, and iron would be prescribed so that more hemoglobin can be manufactured. Whole foods can be a source of iron, and if the Qi of the Spleen is strong, blood can be built up.
Foods which build blood best are meats and poultry, and especially stocks and soups made from bones. Such stocks provide Blood-fortifying bone marrow and also calcium from the bones (if a little vinegar is added to leach it out). Egg yolk and legumes also help to nourish the Blood, as do grains, green leafy vegetables, beetroots, red wine and stout.
It is important to build Blood after menstruation. A good post-menstrual soup is made by boiling a whole chicken with a selection of herbs and vegetables including carrots, mushrooms, shallots, and sweet potato. The herbs added to the soup are Chinese yam (shan yao), Lyceum berries (gou qi zi), longan fruit, (long yan rou) and ginger (sheng jiang). The resulting stock makes a great postmenstrual soup.
To build and nourish blood, include the following foods in your diet: Apricots, blackberries, raspberries, grapes, mulberry, eggs, organic meats, spirulina, turnips, watercress, spinach, dark leafy greens.
Heat is not conducive to the development of good quality sperm or eggs or a thick endometrium. Foods that Heat the blood too much (alcohol, chili, pepper, coffee) should be avoided, especially if one runs on the hot side all ready (heavy periods, skin rashes).
To allow the Blood to flow freely during the period, sour, astringent foods (vinegar, pickles, grapefruit, sour yogurt) should be avoided. If consumed in excess, such foods can inhibit or temporarily stop the flow. Also, very fatty foods are not advisable because they slow the blood and make it thicker and easier to stagnate.
QI AND BLOOD STASIS
In the case of Stasis, as opposed to Deficiency, we want to move the Qi and/or Blood.
To move BLOOD… buy only organic fruits and vegetables. Avoid refined hydrogenated oils. Eat raw nuts and seeds, and dark green vegetables. Use cold pressed flax seed or pumpkin seed oil as well as oils from fish and evening primrose oil. Include dietary spirulina. Avoid animal products except fish. Eat walnuts, chestnuts, chives, crabs, hawthorn berries, peaches, mustard leaf, onions, scallions, dark greens, broccoli, beets, cauliflower and carrots. Foods especially good for resolving blood stasis include lemons, limes, onions, kelp, Irish moss, and bladder wrack (seaweeds)
To move QI…do not overeat. Try to avoid heavy, hard to digest foods like nuts, peanut butter, butter, animal fat, too much meat, and too much bread. Avoid foods with preservatives and chemicals. Eat small frequent meals. Use spices that move the Qi like peppermint, rosemary, spearmint, turmeric, and thyme. Do not drink alcohol or caffeine or smoke cigarettes. Get adequate physical exercise. Breathe deeply and relax.
PHLEGM DAMP
Phlegm Damp creates an internal environment of congested and stagnant fluids. Excess mucous forms in the gastrointestinal tract and bowel movements become sluggish and unformed. The lungs and other parts of the respiratory tract can also become congested with fluid or mucous. The urine becomes cloudy if the bladder is affected. Obesity, diabetes, and heart disease can develop. In terms of fertility these congested or stagnant fluids can block the cervix (pathological vaginal discharges or inflammation) or the tubes (mucous and inflammation), or affect the ovaries (cysts), or the uterine lining (excess secretions). Damp in men can contribute to impotence, prostatitis, discharges from the penis or thick congealed semen – all of which have an effect on sperm.
PHLEGM DAMP AND FOOD
Where there is evidence of internal Phlegm-Damp, reducing intake of fatty meats, dairy products, sweets, (especially chocolate and ice cream), bread and fried foods is important. There is a correlation in clinical studies between overconsumption of dairy (especially milk) with loss of fertility, especially impaired ovarian function.
In cases where infertility is related to Phlegm-Damp, a diet based on aromatic rice (and some millet and barley) with the addition of broad beans, chick peas, and adzuki beans will support the Spleen and dry damp.
FLUID INTAKE
Water is used in the digestion and absorption of food and nutrients and the elimination of digestive wastes. Keeping moisture levels up are important to nourish the egg in the follicle, the fallopian tubes, and the endometrium. The quality and quantity of semen is also dependent on healthy Yin and moisture levels. Adequate water is also needed to keep the blood circulate properly and to avoid blood stagnation. A daily fluid intake of 8 or more glasses (minimum) of liquid which does not contain sugar, salt or caffeine is advised.
NUTRITIONAL SUPPLEMENTS
Healthy, well nourished parents have healthy pregnancies and make healthy babies. A sound, well balanced diet (and no junk food or added chemicals) and the optimum intake of many vitamins and minerals: namely zinc, selenium, manganese, iron, iodine, calcium, chromium, boron, vitamins A, B Complex, C, D, E, Folic acid (very important in early development of fetus) and essential fatty acids.
ORGANIC FOOD & AVOIDING TOXINS AND ARTIFICIAL CHEMICALS
Organic means food which has been grown or raised without exposure to artificial fertilizers, pesticides, antibiotics or hormones. It is important that embryos are not exposed to toxic chemicals of any sort at any level. IVF clinics are now purifying water used to make the culture medium and air in the clinics.
Commonly encountered fumes such as dry cleaning liquid, petrol, ammonia, and nail polish remover can interfere with conception in susceptible people. Exposure to heavy metals has been implicated in reproductive disorders and fetal maldevelopment. Mercury, lead and cadmium have been linked to infertility.
Advice given to couples trying to get pregnant and those newly pregnant is to avoid pesticides and other chemicals and fumes in order to safeguard the well being of the embryo.
WEIGHT
Restriction of caloric intake can affect the pituitary hormones acting on the ovary and a loss of even 10% of body weight below the standard can cause ovulation problems and reduced fertility. More extreme weight loss can inhibit ovulation altogether.
Overweight women can also have difficulty conceiving. This difficulty is sometimes related to polycystic ovary syndrome – (PCOS). Exercise programs and nutritional diets (that clear Damp-Phlegm) will improve metabolism, burn calories, and improve circulation.
STRESS
Stress has been implicated, along with depression, in ovulation irregularities, and in men abnormal sperm development. A study of women undergoing IVF showed that it appeared to be those who exhibited lower levels of measureable physiological stress who had a higher chance of success. Stress in TCM terminology usually means Liver or Heart Qi Stagnation. Exercise is a useful strategy for moving the Qi and disengaging the mind. Massage can do the same. A regular rhythm of life is important in mitigating the effects of stress and stagnation of Qi. One of the most effective means to prevent Qi stagnation is meditation, completely emptying the mind of all its chatter and allowing the body and mind to be completely untrammeled. If this can be achieved, then Qi and Blood have no place to become stagnant.
SLEEP
The benefit of good quality sleep is a most ignored and underrated aspect of lifestyle. It is of paramount importance, however, in building and nurturing Kidney Yin and Kidney Yang. Placing the body and mind at complete rest is crucial for restoring and recuperating stores of essential energy. Many fertility clinics in China warn their patients that without ADEQUATE rest treatment will not be effective.
The average adult needs 8 or 9 hours of sleep every night. Just 1 week of shortened sleep (5 or 6 hours a night) will affect the body’s ability to metabolize food, manage stress, maintain a proper balance of hormones and fight off infections. Sleep deprivation causes alterations in metabolic and endocrine function – all the hallmarks of ageing. The Kidney energy is damaged and the Yin and Jing are consumed quickly when rest is inadequate.
TCM/Acupuncture and herbal remedies are usually quite effective at programming healthy sleep patterns.
COFFEE, ALCOHOL, ET AL.
Coffee, alcohol, cigarettes and marijuana are not a good idea for someone who is trying to get pregnant. Sure we all know people who imbibe regularly and have broods of children, but the point is that if fertility is compromised for some good reason, then all factors which reduce it further must be addressed.
CAFFEINE
A large study carried out by the Yale School of Medicine found that the risk of infertility (which they defined as not being able to conceive after 12 months) was 55% higher for women drinking just 1 cup of coffee per day, 100% higher for women drinking 1.5 – 3 cups per day and 176% higher for more than 3 cups per day and this was backed up 5 years later by a study in Europe which found that caffeine intake in women slowed rates of conception.
Additionally, there is evidence that coffee drinking in men and women increases miscarriage rates and that caffeine intake during pregnancy has a negative influence on fetal growth. Most studies indicate that that it is the consumption of 300 mg or more of caffeine daily that can lead to fertility problems.
ALCOHOL
Excessive alcohol consumption is associated with altered estrogen and progesterone levels as well as menstrual irregularities and increased incidence of endometriosis, abnormalities in the ovaries and the early onset of menopause. Some studies have found evidence that moderate drinking by women (5-10 drinks per week) is linked to lower fertility and increased miscarriage. And others have found a definite relationship between even modest alcohol consumption in women (less than 5 drinks per week) and delay in conception.
Most professionals working in the field of fertility will advise against too much alcohol consumption on the part f either partner for both general health reasons and consideration of health of the gametes.
Once pregnancy is confirmed, then all alcohol consumption by the mother should be avoided for the duration of the pregnancy and breast feeding. Even small amounts of alcohol have been shown to have effects on the child both before and after birth.
NICOTINE
Women who smoke have markedly lower levels of all three major estrogens during their cycle and smoking delays conception. Female smokers also experience menopause earlier than usual. Additionally, smoking has been strongly associated with tubal factor infertility, and it has been linked to increased rates of miscarriage. Smoking also has been shown to have a deleterious effect on sperm counts. On average, smoker’s sperm counts are nearly 20% lower than non-smokers.
MARIJUANA
THC is toxic to the developing egg and at certain levels could delay ovulation markedly. THC can also have a negative effect on sperm count. Sperm production and motility have been shown to be drastically reduced in heavy marijuana smokers and new research indicates that the THC might also interfere with the binding of the sperm to an egg and its ability to fertilize it.
OTHER DRUGS
There is some evidence that taking non-steroidal anti-inflammatory drugs for arthritic or painful conditions may interfere with the chemical signals which allow release of the egg at ovulation time, producing a well-characterized syndrome known as LUFS or luteinized unruptured follicle syndrome.
The body of knowledge about the impact that our environment and lifestyle has on our health is growing rapidly. By applying the health management principles of Traditional Chinese Medicine in combination with such knowledge we can optimize fertility.
