Diagnosis

Fallopian tube obstruction can be diagnosed in a number of ways.  Laparsocopy is a surgical procedure which uses a small lighted tube that is inserted through a tiny incision (cut) on the abdomen.  With this procedure, a surgeon is able to see directly into the abdominal cavity and check the state of the fallopian tubes on the outside and the inside by injecting colored dye through the cervix and watching for its appearance at the end of the tube.

Hysterosalpingogram is a procedure in which a dye is injected into the uterus and the uterus is examined via X ray to see if the dye spills into the tubes and pelvic cavity.  These diagnostic techniques are quite invasive so they are not done routinely unless a woman has been trying to conceive for a long period of time without  success (and male factor infertility has been ruled out).

Causes

The common reason for the fallopian tube blockage is a pelvic infection which may produce minor symptoms or no symptoms at all.  However, if the infection was left untreated it can cause scarring, adhesions and complete obstruction of one or both tubes.  In cases of PID (pelvic inflammatory disease), opportunistic bacteria coming from the uterus can spread to the fallopian tubes since they are the structures closest to the uterus.  If a woman is experiencing acute infection, antibiotic therapy is indicated in order to prevent damage to the fallopian tubes.  However, if a woman already has obstruction and damage of the fallopian tubes, a surgery that can repair the damage may be indicated.

Endometriosis can be another possible cause for fallopian tube obstruction.

It’s also possible that fallopian tubes are blocked only some of the time.  This type of blockage is referred to as a “functional blockage”.  This scenario is typical in women who experience a lot of stress.  Stress tends to constrict pelvic musculature and decrease blood flow and this can be a factor in inability to conceive.  This type of functional blockage responds very well to acupuncture as well as Chinese herbal medicine.   Also, excessive mucous buildup within the tube can create a plug and cause blockage.  In Chinese medicine, this would be refered to as “damp accumulation” and would be treated through dietary therapy, herbs and acupuncture.

Infertility Treatment for Blocked Fallopian Tubes

If there is an extensive damage and scarring in both fallopian tubes  it is very difficult (or nearly impossible) for a woman to conceive and IVF is probably the best route to take.  IVF was actually developed for women with extensive fallopian tube obstruction and damage since it can bypass the problem.

Using acupuncture prior to an IVF treatment is a wise decision since  it can help decrease side effects of drugs, decrease stress levels and remove any stagnant blood and energy in order to ensure successful implantation.

Microsurgery is another treatment option for women whose tubes are not damaged along too much of their length.  Surgery seems to be more effective if the damage is in the area closer to the uterus.

The good news is that modern technology does help women with tubal blockage have a healthy pregnancy and birth. If you decide to use assisted reproductive technology, you should make an effort to take good care of yourself in order to create optimal conditions for a new life to flourish. Nutritious diet, proper rest, moderate exercise and stress reduction are the most important things that you can do to improve your health as well as increase your chances of conception.

“Let food be thy medicine and medicine be thy food”

You have probably come across this famous quote written by Hippocrates (460 BC-377 BC), an ancient Greek doctor who is considered the father of Western medicine.  Sounds nice, right?  But how many of us really take this quote to heart?  How many of us really believe that we can cure ourselves with food?  Ancient Chinese doctors were strong believers in that food can be used as medicine.  During their time, when patients got sick, the first thing that the doctor would do is to change their diet.  Back then, these doctors didn’t have to deal with removing processed, denatured, chemically treated, high fructose corn syrup infused “food” that most of today’s population consumes.  They were concerned with making sure that the food was perfectly balanced energetically.  For example, if patient experienced symptoms of “dryness” e.g. dry skin, dry mouth, constipation with hard stools, doctor would prescribe foods that “moisten dryness” such as: pears, apples, soybean products, honey, eggs. clams etc.  If food therapy was not sufficient to completely cure particular symptoms, herbal medicine was prescribed as well as certain physical exercises that patient can do at home.  Each patient received different dietary recommendations because there is not such thing as one diet that fits all, a concept that we are struggling to prove wrong today.
Amazingly enough, ancient Chinese doctors were also aware that most of our immunity comes from our gut or Stomach and Spleen energies.  What we eat, how we eat it and most importantly how we digest it will have a direct impact on our energy, emotional state and immune system functioning.  After all, eating is something that we do multiple times every single day so it would be foolish to think that the quality of the food that we have consume will not have an impact on our health.  In order to increase the functioning of our immune system, it is important to increase the functioning of our gut.  How do you do that?

GENERAL GUIDELINES

1.  Regularly consume fermented foods rich in beneficial bacteria which help with digestive process.  Examples of fermented foods include: sauerkraut, kimchi, plain yogurt, kefir, miso, tempeh.  Small amount is all that you need but it has to be consumed regularly.  If you truly can’t stand any of these foods then it would be important to supplement with beneficial bacteria supplements.  I believe that no supplement can match the innate wisdom of food that nature has provided for us but something is better than nothing.  Acidophilus capsules can be found in most health food stores.  Feel free to contact me if you have questions about the brands that I recommend.

For more info on fermented food please visit: http://www.westonaprice.org/foodfeatures/lacto.html

2.  Remove highly processed foods from your diet.  Avoid products made with artificial ingredients, colors, preservatives, partially hydrogenated or hydrogenated trans fats (e.g. margarine and other fake butter spreads, non dairy creamers,), artificial sweeteners, highly processed and bleached wheat flour. Bottom line is: if a product that you are buying has a ton of ingredients that you can’t even pronounce, it is fair to say that it contains artificial ingredients that are bad for you.  Ideally, you want to switch to real food that has no ingredients other than what it is e.g. apple, potato, celery, carrot, kale (you see where I am going with this one).  Artificial ingredients and chemicals tax our immune system.  Toxic chemicals are unfortunately a daily part of our lives so if we can give our body a little break by not consuming toxic foods, it will thank us by providing us with more energy, better digestion and a healthier immune system.

3.  Drink only small amounts of room temperature or warm liquids during your meal.  Large amounts of ice water can dilute digestive enzymes present in your saliva as well as slow down your digestive process.  Certain amount of heat has to be present in order for stomach to function efficiently and digest food. It is better to take small sips of hot tea, clear soup or room temperature water during meals or drink liquids 15-30 minutes after a meal.

4.  Eat at regular times.  Eating at regular times and starting your day with nutritious breakfast which contains protein helps keep your blood sugar stable and makes your crave less unhealthy foods.  Eating at regular times also helps with having regular bowel movements.

5.  Don’t eat late at night.  According to Chinese medicine, our digestive system receives the most energy between 7-9am.  Make the most out of your breakfast and lunch time and try to eat less in the evening.  Digestive system should be resting at night while you sleep as opposed to working hard to digest the food that was eaten shortly before bed time.  Laying down right after a meal can cause heart burn and can interfere with your sleep.

5.  Don’t eat while emotionally stressed.  When we are under stress, our sympathetic nervous system diverts blood flow from out gut to other places e.g. muscles (in order to prepare us for the “fight or flight” response).  Stress is also known to alter our appetite and while some people have no appetite at all while stressed, others tend to overeat.  It is also important not to eat in places that you associated with stress (e.g. place where you pay your monthly bills) but to reserve a calm, comfortable area where you can relax and enjoy your food.

6.  Take your time, chew properly and enjoy every bite.  Eating while driving, working on computer, talking on a phone or doing crossword puzzles interferes with proper digestive process.  It is not incidental that in most cultures people used to (or still do) say a short prayer right before they start their meal.  Having a small ritual, saying a prayer, or simply being grateful for the food that you have can trigger the release of digestive enzymes and prepare your body to accept the nourishment.

SPECIFIC FOODS THAT INCREASE IMMUNITY

Foods which increase energy of the Stomach and Spleen have traditionally been used in Chinese dietary therapy to improve energy and immunity.  The dietary treatment for Spleen qi deficiency involves foods that are either warming or at least neutral in their thermal nature.  Foods with cooling properties weaken digestion as well as “digestive fire” necessary for healthy extraction and absorption of nutrients.  In order to strengthen your immune system you should eat:

Vegetables. Mushrooms are especially helpful for immunity so are: onions and garlic, carrots, squash, sweet potatoes, yams, peas, pumpkin, cabbage, kale, leeks, chives, parsnips, green leafy vegetables as well as sea vegetables like kelp and other seaweeds.  Avoid eating raw, uncooked vegetables since they take more energy to digest and can cause loose stools.  Small amounts of salad in addition to your meal is fine especially in the summer time when vegetables are fresh and abundant.

Whole grains.  Rice, barley, oats and quinoa are recommended.  If you experience excessive mucous and chronic nasal congestion you might want to experiment with completely avoiding wheat and wheat products for two weeks.  If you notice that your condition is getting better it means that you could have an intolerance to gluten.  Gluten intolerance is also known to cause infertility and recurrent miscarriage.

Fruits. In Chinese medicine, most fruit has cooling energetic nature.  That is why fruit is abundant during summer time or tropical climates.  It is used to refresh us and cool us down.   Fruits that has neutral temperature includes: cherries, apricots , peaches, berries and are more appropriate for people who tend to run cold.  Fruits should be eaten in larger amounts during summer time.  In winter time, cooking or baking fruit is more advisable.

Beans and legumes. Garbanzo beans are especially good for tonifying the Spleen energy.  Other beans like black bans, kidney beans and all forms of lentils are also helpful.  You can start your day by eating rice and beans for breakfast.  Beans digest slowly and keep your blood sugar levels even so you will feel full of energy and satisfied until lunch time.  You will also be less likely to reach out for sugary treats during the day.

Meats and fish. Small amounts of of chicken, beef and lamb are used to tonify the energy.  It is important that meat is of highest quality and organically raised.  Smaller fish like sardines, trout, mackerel should be eaten in larger quantity as opposed to large fish like tuna and salmon because larger fish contains higher mercury content.

Warming spices like onions, garlic, ginger, cayenne pepper, black pepper, cinnamon, cloves, nutmeg, fennel, basil, dill, cumin and rosemary should be added to food.

Milk and dairy products.  Milk has a cooling energy and tends to exacerbate mucous conditions.  Small amounts of high quality raw milk can be consumed if you don’t suffer from too much mucous (or asthma).  Yogurt is best when consumed plain and it is easier to digest than plain milk.  For more information on milk and dairy please refer to my article “Got Real Milk?”.

So, you have decided you want to try acupuncture for your fertility concerns.  If you don’t know anybody who is seeing an acupuncturist or if your doctor does not have any referral sources, what do you do?  Do you start searching the Internet first or do you get your phone book out and call the first person that you randomly selected by sticking a pencil into the page with your eyes closed?  How do you find an acupuncturist that you can trust who can address your needs?

Searching for the right practitioner is not an easy task.  Some practitioners might have great personalities and charisma but have mediocre medical skills.  On the other hand, some might have strong personalities and terrible bed side manners but excel in their medical knowledge.  Just like in any profession, there are practitioners who devote lots of time and energy to constantly better their skills while there are others that are happy with what they already know and don’t put much effort into increasing their knowledge.

Acupuncture for the treatment of infertility has received a lot positive of press in the past couple of years .  As a result of that, more and more practitioners of Chinese medicine are deciding to advertise infertility treatment as part of their practice.   The truth is, most practitioners of Chinese medicine receive very minimal training in treating infertility. Chinese medicine schools don’t offer specialties, so if an acupuncturist calls him/herself  “specialist”  in any area, that does not necessarily mean that they received years of extra training in that particular area.  It is not equal to a “specialist” title in Western medicine which usually required years of extra medical training.

Clinical doctorates in Chinese medicine are a recent offering to practitioners who wish to receive more training in a particular area of interest.  Some colleges offer focused study on cancer therapies, women’s health, geriatric medicine etc.  Those programs definitely offer a more in depth study in particular areas and there is a lot of interest in Chinese medicine field in making a doctorate degree a standard education requirement for future incoming students.  That process may take a long while to become effective since most acupuncture schools are small and operate on non profit basis.

When I graduated with the Master’s degree in Chinese medicine in 2003, I started out as a general practitioner who treated anybody who would come through my door.  As time went by I started receiving more and more phone calls and interest from patients who were asking me if I treated infertility.  My answer was simple: “Sure, I treat infertility, no problem.”

The truth is, I didn’t even know how much I didn’t know about treating infertility.  I only knew the basic information that was presented to us in school which (now I realize) was not nearly enough to create a comprehensive treatment plan.  As I realized that I really enjoyed working with women and helping them with their infertility problems I decided to do more research, take continuing education classes, read more books, enroll in doctorate program …I was constantly amazed with the wealth of information available on the subject of infertility and I definitely learn something new every single day.  So, how does this information help you?

When trying to chose a practitioner who can help you with your fertility concerns you should be proactive and not be afraid to ask them questions.  Here are some of the examples that may help:

-How much of your practice focuses on infertility treatment? A practitioner who devotes most of his/her time to treating infertility is most likely more knowledgeable in that area.  A practitioner who sees an occasional infertility patient may not have enough experience or expertise to offer the best treatment available (which does not mean that they can not be helpful at all).

-Did you receive any extra training in infertility treatment? Where, how much and by whom? I think that this is an important piece of information since extra training is definitely needed in this particular field.

-Where you trained in herbal medicine? Some colleges offer programs in acupuncture only which do not include herbal training.  In China, herbal medicine has been the main therapy for treating infertility throughout the centuries.  Acupuncture is considered an adjunct therapy that is usually not used as a sole therapy for infertility.  Most of the time, it is common for women to have to take different herbal formulas at different parts of their menstrual cycle depending on their individual condition.  Don’t be surprised if you get 4 different herbal prescriptions to take throughout the month.

Just like with any medical treatment, you should be encouraged to ask questions and understand your treatment plan and options. Chinese medicine has a completely different way of looking at the human body. Sometimes it can be challenging to understand the theory behind it but your practitioner should explain to her/his best ability what it would take to treat your condition and what would be a reasonable prognosis.

Your practitioner should encourage you to get evaluated by a reproductive endocrinologist in order to get a clear picture of your condition. For example, if you have severe fallopian tube obstruction your only option may be the use of Western medicine in order to conceive. In that case, Chinese medicine can be used as an adjunct therapy to prepare you for assisted reproductive treatments like IVF. However, if your practitioner is unaware of that diagnosis you could be wasting precious time pursuing natural treatment.

Things to stay away from:

-Practitioners who give you promises that sound too good to be true e.g. “You can get pregnant in a month”. Nobody can really guarantee any results for sure. However, it is common for natural treatments to take longer in order to be successful. Three months of treatment are the minimum amount of time that you should consider. Some patients may require as much as one year of treatment. If you have been treated for over a year without success it is definitely time to consider other options.

-Practitioners who list unreasonably high success rates e.g. “75-80% of all my patients get pregnant”. It is important to know how big is their sample size. If somebody treated 3 infertility patients and all 3 happened to get pregnant that their success rate is 100%! Are the practitioners who list success rates counting live births or just pregnancies? Are practitioners counting patients who went through IVF and had acupuncture as their success stories? All of this questions are important when determining whether listed success rates are useful or not.

-Practitioners who claim that they have one and only special secret method that will bring you success. Needless to say, there isn’t a secret acupuncture point or herb that will cure your infertility. A successful treatment will probably have to include various diet and lifestyle changes, use of herbal medicines that are available to any practitioner and set of acupuncture points that every practitioner had to study.

I hope that these guidelines will be helpful for you and that you will be able to find the practitioner that meets your needs. I wish you all the best in your journey to become a parent!

“Prebirth acupuncture refers to a series of treatments in the final weeks of pregnancy to prepare women for childbirth.  Research has demonstrated that the mean duration of labor in a group of women giving birth for  the first time was reduced from eight hours and two minutes in the control group (7o women) to six hours and 36 minutes in the group of 70 women who have received prebirth acupuncture.   In clinical practice acupuncture is an ideal method to help women prepare themselves to have the most efficient labor possible.  Feedback suggests that prebirth acupuncture offers a range of positive effects that goes beyond reducing the time spent in labor, with midwives reporting a reduced rate of medical intervention.”

Since ancient times, Chinese medicine, including acupuncture and herbal medicine, has been used to help women during pregnancy, labor and postpartum period.  Modern research is validating its efficacy especially in the period leading up to labor and during labor.  Expectant mothers may be experiencing symptoms which include heart burn, fatigue, insomnia, anxiety, bleeding gums, back ache (to name a few) which are considered normal.  Western medical approach during last 2-3 weeks of pregnancy includes weakly visits to a gynecologist in order to monitor fetal position and heart beat but unfortunately has very little to offer for relief of these  bothersome symptoms.  Acupuncture on the other hand, is not only able to prepare a woman’s body for more efficient and shorter labor but it is also able to relieve pregnancy induced symptoms including increased worry and anxiety.

Whether you are expecting your first child or third child, if you are interested in increasing your chances of natural birth and delivery, acupuncture is definitely a gentle and  safe treatment method for you to consider.

Source:  The Essential Guide to Acupuncture in Pregnancy and Childbirth by Debra Betts

The hormone responsible for the production of fertile cervical mucous is estrogen and its production peaks at about 6 days before the actual ovulation starts.  However, not all mucous is created equal!  There are four types of fertile mucous and while some types facilitate the movement of sperm others tend to block it.  The mucous that is produced by the cervical glands during infertile times is called G-type and its quality is thick, pasty and impenetrable.  As the ovulation time gets closer, estrogen levels increase which makes the mucous more stretchy and slippery.  L-type mucous causes the woman to feel a more sticky and wet sensation in her vaginal area but it is not until S-type mucous appears that the woman can actually notice a discharge which usually resembles an egg white consistency.  Finally, as the ovulation is imminent, P-type mucous is secreted from the top of the cervical canal and even though it does not appear as stretchy as S-type mucous, it is extremely lubricative and rich in potassium (thus the name P-type).  “The last day that P mucous is produced is the most fertile day of the whole cycle i.e. the day before the egg is released or the day it is released. “

The importance of paying close attention to the changes in woman’s cervical mucous production lies in the fact that it proceeds ovulation and alerts a woman of her most fertile days.  “Producing the fertile mucous to facilitate the sperm’s journey up the cervix in the days before ovulation is aimed at getting these sperm inside the female reproductive tract well before the egg is released.  This is because this largest single cell in the body is one of the shortest lived, being fertilizable for only 6-12 hours.  Some of the millions of lively little sperm cells, on the other hand, have been known to survive for 5 days  in the female reproductive tract, although they are most able to fertilize the egg in the first 48 hours after delivery to vagina […]  Some studies have indicated that the day for sexual intercourse which then leads to the highest conception rate is in fact 2 days before ovulation.”

Chinese medical practitioners frequently ask questions about vaginal discharge in order to determine the yin status of the body.   Yin energy within the human system corresponds to all the fluids flowing within our bodies including blood, urine, sweat as well as vaginal discharge in women.   If the woman does not notice any vaginal discharge during any part of the cycle or if the discharge seems to be very scant and never reaches the stretchy and egg like consistency, she is usually diagnosed with some form of yin vacuity. In Chinese herbal medicine there are herbs which are given to tonify the yin and stimulate the production of fluids.  The results of more mucous production should be seen within 3 months of herbal and acupuncture treatment.  However, I frequently encounter patients who have vaginal discharge throughout the whole month which tends to be thin and watery.  In those cases, more questions should be asked about digestive health and herbs that strengthen Spleen and Stomach energy can be helpful.  Patient should also be evaluated for a possible infection.
Medications that can potentially dry up the cervical mucous include clomid and  antihistamines,   Also taking a large dosage of vitamin C can potentially make the mucous too acidic and therefore hostile to the sperm.

Foods which increase the production of yin and fluids in the body and therefore increase the production of cervical mucous are:  all dark colored beans e.g. black beans, eggs, dairy, small amounts of pork and duck meat, asparagus, seaweeds, leafy green vegetables, berries like: blueberries, strawberries, blackberries and raspberries.  Over consumption of spicy foods and stimulating drinks can lead to dryness.  Staying well hydrated is important since women (and men) with yin vacuity have a tendency toward thirst and dryness.

Smoking has a drying effect on the body and should be avoided especially if you are planning a pregnancy.   Not getting enough sleep, overworking and high levels of stress tend to injure the yin so making sure you are getting enough rest while trying to keep your stress in check should be the first steps to take toward a healthy conception and pregnancy.

You can check out www.fertilityfriend.com for more info on how to determine your  fertile days

Directions
It’s easier to perform femoral massage if somebody else does it for you.  However, it is possible to do it alone as well.  If you are planning to do it alone, I recommend that you use a tennis ball instead of using your hands and lay on your abdomen instead of laying face up.

Locate the femoral artery in your groin area.  It is a large artery just beneath the crease in your groin between your thigh and lower abdomen.  Search around the groin area for a pulsing sensation.
Once you have located the femoral artery, apply pressure over it with your fingertips.  You want to apply enough pressure to stop the pulsing of the artery.  Hold the pressure for 30-45 seconds.  The blood is now backing up and increasing the pressure in the iliac arteries, forcing more blood into the pelvic organs.
Release the pressure and let the blood flow normally.  When the hold is released, you should feel a warm sensation rushing down your leg as the blood supply returns to the lower extremity.
Repeat on the opposite side.  Perform this femoral massage sequence 3 times in a row, twice a day, before ovulation time.

Cautions
Do not perform femoral massage if you are or might be pregnant.  Also, do not practice this technique if you have high blood pressure, heart disease, circulatory problems, or a history of strokes or detached retinas.

Acupuncture is another great treatment technique that can decrease overall stress, normalize hormonal secretions, increase blood flow to the pelvic organs and strengthen the immune system.  In combination with Chinese herbal medicine it is a powerful, natural and safe way to enhance fertility and increase overall health.

Why is this a reason for concern?

Well, there is nothing innately wrong with cow’s milk. The problem lies in the methods of production, preparation and amount of consumption. In the U.S., milk is usually served cold, unspiced, homogenized and in large amounts. Cows at the industrial farms are milked most of the day which makes them develop infections. In order to keep the production going, cows are given antibiotics as well as growth hormones so guess what?  All of that ends up in the milk that you drink. You would be shocked to know that FDA allows a certain percentage of pus from the infected udders to pass into the milk that you drink every day. And not to mention that these animals are kept indoors sometimes never seeing the sunlight and are given genetically modified grains and other foods that nature never intended for them.
Human beings are the only species that drink milk from another animal. However, since I am not an extremist in any sense, I think that people don’t have to completely give up the consumption of milk in order to stay healthy. As long as you are not allergic to it or notice symptoms such as: gas, bloating, diarrhea, constipation or increased phlegm production (to name a few) you should use it skillfully and in small amounts.

Here are some tips for your next milk shopping:

- Make sure that the milk that you are buying is not homogenized. Homogenization process denatures the milk of its natural enzymes that help its digestion. In the old days, milk used to be praised for the thickness of the cream that it contained on the top. The farmer that had the thickest cream on his milk used to be able to charge more money for it. Homogenization process disperses the fat and does not allow the cream to form on the surface. It is a completely unnecessary process and it makes the final product look nothing like real milk.

-Buy only organic and hormone free milk. Why would anybody add growth hormones and antibiotics to their body? There is absolutely no good reason for it.

-Fermented milk products like yogurt and kefir are easier on your digestive tract and have added benefits of adding friendly bacteria to your guts. The more friendly bacteria you have the better since it keeps the bad guys (unfriendly bacteria) in check. In many cultures people consume small amounts of fermented milk products every day in order to keep their digestive system healthy.

-Avoid pasteurized milk if possible. Pasteurization process has made mass-produced milk consumption safer in terms of eliminating bacterial contamination. However, pasteurization does not make the milk more digestible nor does it eliminate the risk of potential viral contamination. The incomplete heating of pasteurization seems to cause the partial breakdown of milk proteins into tangled coils. These disorganized tangles are difficult for digestive enzymes to hold on to and break down. For some people, this may be why pasteurized milk causes them to be constipated, while boiled raw milk does not (raw milk refers to the milk that has not been pasteurized nor homogenized and is hard to obtain in majority of stores unless you live in California, if you are motivated enough to look for it please see the websites listed on the bottom).

-If you are able to find raw milk, it is always good to boil it before consumption. You don’t need to boil it for long periods of time, it is enough if it boils once and then you can take it off the flame (make sure you watch it closely since it can boil over very fast).

-Since milk has cold energetic nature, it is always good to warm it up and add warming spices to it like cinnamon, ginger, cardamom and black pepper. After warming, you can add a little bit of honey to enhance its healing properties.

Useful sites:

http://www.pcrm.org/ – Physicians Committee for Responsible Medicine

http://www.realmilk.com/ – A Campaign for Real Milk, distributors of raw milk

Sources:

http://www.alternet.org/story/13557/

The Ayurvedic Cookbook by Amadea Morningstar and Urmila Desai

More info: Weston Price Foundation