The ‘egg factor’: Using Chinese

Advanced female age is an important factor in low pregnancy outcomes. As a woman progresses through her reproductive years, her ovarian reserve diminishes, with an approximately 50% decrease in fertility rates in women attempting pregnancy at the age of 40 onwards, and a two to-three-fold increased risk of miscarriage3,4.

Most ART attempts in a woman aged 45+ using her own eggs results in no life births, with spontaneous pregnancies mostly seen in grandmultiparas or greatgrandmultiparas (6-11 previous deliveries).

Common causes for a much reduced conception rate in women aged 40+ with her own eggs are: diminished egg quality and quantity with poor endocrine readings such as high FSH (follicle-stimulating hormone) or low oestrogen levels and less frequent monthly ovulations or reduced cervical mucus secretions; and reduced blood perfusion to the ovaries and uterus.

A common reason for an increased miscarriage rate is high chromosomal abnormalities in the embryos due to poor egg quality.

Female age, IVF procedures and pregnancy outcome

Whilst FSH readings can predict ovarian reserve to a certain extent (with FSH levels often raised in older women), the negative influence of age is relevant even in women with normal FSH readings. In assisted reproduction such as in IVF, women with low FSH levels can still have a poor ovarian response to stimulation. The response of the ovaries when the woman takes injectable FSH for stimulation is often predictive of the egg quantity and egg quality - and therefore also predictive of the relative chances for success with assisted reproductive treatment.

Women aged 40-42 have a very poor outcome if less than five eggs are produced, thus most IVF cycles are cancelled if the stimulation does not result in a minimum of three mature or close to mature (16-20mm) follicles, as in the case discussed below.

As some research shows that the age of the egg rather than the age of the uterine environment determines the pregnancy outcome, older women undergoing assisted reproduction are often advised to consider an IVF cycle using donor eggs. Uterine receptivity is however also important in pregnancy outcomes, and a poor uterine receptivity may lower the success rates of donor egg cycles in women aged 45+.

Chinese medicine and reproduction

Chinese medicine can effectively improve ovarian and uterine function and other fertility markers, and thus optimise the chances of conception and pregnancy. Whilst it cannot turn back time and improve egg quality in an older woman, it may - by improving the growth of the dominant follicle within an ovary that functions more effectively through treatment - improve the environment an egg matures in, and thus indirectly influence its maturity and quality.

Chinese medicine also improves the thickness of the endometrial lining (and thus the endometrial receptivity to an embryo), increasing the chances of a successful conception and pregnancy15.

Research as well as clinical experience has shown that both Chinese herbal medicine and acupuncture can improve ovarian and uterine blood flow, regulate the endocrine hormones FSH & LH (luteinising hormone), increase oestrogen and progesterone and normalise both the follicular and luteal phases of the menstrual cycle.

Full article: http://www.jcm.co.uk/media/cms/File/Inga.pdf

Category: Hormones, Old Eggs, TCM, traditional Chinese medicine