It's sometimes harder to get pregnant than you think. That may be music to your ears if you're young, single, and nowhere near ready for kids. But for many couples trying to conceive, the reality of infertility is daunting, stressful, and extremely life-interrupting.
"People are always surprised to find out how bad humans are at reproduction," Alan B. Copperman, M.D., director of the division of reproductive endocrinology and infertility at Mount Sinai Hospital tells SELF. "Not all eggs are normal, not all normal eggs implant. There's actually only about a 15 to 20 percent chance in any given month that a couple will conceive," he adds.
In the U.S. alone, 6.7 million women between the ages of 15 and 44 have an impaired ability to get pregnant or carry a baby to term, according to the CDC. About 6 percent of married women 15 to 44 years of age are unable to get pregnant after one year of trying—which is when the "i" word starts to get thrown around, and doctors begin to ask questions and run tests to check the woman's reproductive system and the man's sperm count.
"If we look at all causes of infertility, we would attribute the largest cause to male, 40 percent," explains Meike L. Uhler, M.D., a reproductive endocrinology and infertility specialist at the Fertility Centers of Illinois. Sometimes, it can be the sole cause; other times, it's just one out of a few factors affecting a couple's ability to conceive.
So what else could be going on? For women, these are the most common causes of infertility and how can Traditional Chinese Medicine (TCM) help.
1. Polycystic ovary syndrome (PCOS)
PCOS is the most common cause of infertility in women, according to the CDC. The condition is caused by a hormonal imbalance that results in a series of small cysts on the ovaries. It also throws your whole cycle out of whack, causing irregular periods, or even no period at all for a few months at a time. Shockingly, millions of women are living with it without even knowing—according to the PCOS Foundation, 10 percent of women of childbearing age are affected, but less than half are diagnosed.
2. Other hormonal factors that impact ovulation
Irregular ovulation is the main cause in about 25 percent of infertility cases, according to the Mayo Clinic. While PCOS is the most common of these, causing 70 percent of irregular ovulation-related infertility cases, hormonal imbalances can impact or interrupt ovulation in other ways and lessen your chance of conceiving.
Endometriosis is a condition where the tissue that lines the uterus starts to grow in other places, like the ovaries, behind the uterus, or in the fallopian tubes, causing irritation and the development of scar tissue (adhesions). Besides being extremely painful (though some women may experience no pain), it can make it very difficult to get pregnant by blocking the fallopian tubes, disrupting implantation, causing inflammation in the pelvis, and even altering egg quality, according to the American Society for Reproductive Medicine. Adhesions can also form after pelvic surgeries or trauma to the reproductive organs, such as dilation and curettage (D&C) during pregnancy termination or miscarriage, or a previous C-section.
"A woman who [tries to get pregnant] at 23 and has even severe endometriosis won't be as affected as someone who waits until 37 and then has the diagnosis," he says. That's because generally your eggs are higher quality, increasing the odds you'll conceive despite the endometriosis.
4. Waiting to get pregnant
For many women, simply waiting to get pregnant is a huge contributor to infertility. Now, about 20 percent of women in the U.S. wait to have their first child until after age 35, according to the U.S. Department of Health and Human Services, making age a growing cause of fertility problems. In fact, about one-third of couples trying to conceive when the woman is over 35 have difficulties.
5. Unhealthy body weight
Having a BMI that's too high or low has a proven impact on the ability to get pregnant. "Being overweight or obese, you can have a two- to four-fold higher risk of being unable to conceive, depending on type of obesity, and almost a six-fold risk of having miscarriages," Hernandez-Rey explains. Being extremely over or underweight can impact the pituitary gland, causing it to malfunction and spark problems with ovulation.
If there's no other contributing factor impeding fertility, over 70 percent of women who are infertile for this reason will be able to conceive without intervention once they're at a healthy body weight.
6. Other unknown causes
The Society for Reproductive Medicine says in about 5 to 10 percent of cases of couples having a tough time conceiving, all the fertility tests come back normal. This, or in cases where only minor abnormalities that wouldn't results in infertility are found, is referred to as unexplained infertility. Uhler says that the course of treatment varies depending on the woman's age—if she's younger than 35, doctors will try simpler treatments like fertility drugs and artificial insemination; if she's older and it seems appropriate, they may go straight to IVF.
Traditional Chinese Medicine (TCM) identifies the cause of infertility in terms of energy imbalances in the body. The imbalances may be due to a wide variety of factors, such as an unhealthy lifestyle, poor diet or improper eating habits, lack of exercise, stress, environmental factors, emotional or psychological issues, toxins or hereditary influences.
TCM understands that the location of infertility begins in the uterus, and its development is related to the liver, spleen and especially kidney function. The kidneys control our congenital essence, which is our inherited self; the spleen provides an acquired foundation based on our nutrition, and, the liver stores blood and regulates qi (vital energy) movements. Normal functioning in these organs ensures a proper material basis for conception.
These and other Traditional Chinese practices all form part of TCM, each adding a little to the history and methodology of Acupuncture and Herbs and their ability to help with Infertility.
Eca Brady is a fully licensed physician of Traditional Chinese Medicine BSc(Ac) MBAcC, focusing on Female Infertility with Acupuncture and Chinese Herbs from Harley Street, London.
Make an appointment for an acupuncture or Herbs treatment and we can discuss how we can help you if you suffer from Infertility, to read more about Eca click here or to read more about TCM and increasing your chances fertility click here.