Infertility - Male and Female Case Study
Calming the Sea of Life and Building Good Seed
This article is an excerpt from Master Tung’s Magic Points: The Clinician’s Best Friend, soon to be published by Susan Johnson and Eric Renaud. The topic of fertility treatment is more pertinent than ever, as young adults today are finding it increasingly difficult to conceive due to the effects of long-term stress, lack of sleep, Electromagnetic field (EMF) exposure, environmental toxins, and so many other reasons that create hormonal disruption and imbalance.
Some of you may have already studied Master Tung’s Points with Susan Johnson and will readily recognize the points listed in the beginning of this article, however there are many sources of Tung’s Acupuncture these days, so if they are unfamiliar to you, please find a point book (see: www.tungspoints.com) in order to study up on point location, needling technique, functions, indications, and loads of commentary, too much to publish here. In the content that follows, you will find TCM diagnoses, treatment principles, and multiple modalities of treatment, including moxa, cupping, and bleeding, in addition to Tung’s Points, as well as some very stellar TCM herbal formulas that you will find extraordinarily useful for the rest of your professional life in clinical practice.
- 11.06 Return to the Nest on one side
- 11.24 Gynecological Points on the other side
- (alternate sides daily for two to three months; stop after conception).
Note: Because these points are used for infertility, they are therefore safe in pregnancy. Once the woman has conceived, they are no longer necessary as the body will regulate its own hormones appropriately. This means that if a woman does not know that she has conceived, these points will not be harmful to her pregnancy.
Additional options (added to the above):
Points to strengthen and regulate Spleen, Liver, and Kidney (all bilaterally needled):
- 88.04-88.06 Three Sisters.
- Three Plum Blossom (needled from period to ovulation, but not after ovulation).
- 88.09-88.11 Kidney Passing Points.
- 77.18-77.21 Three Emperors.
- Open the Chong Mai (Sea of Blood): Needle right side Master Point 66.11 Fire Chrysanthemum (Tung’s SP4) and left side Couple Point PC6 Nei Guan (Inner Courtyard).
- Bleed any small dark veins found between SP6 San Yin Jiao and the medial malleolus (Dr. Young, 2008).
- DT.17 Up-Shooting Heaven, bled.
Points to open blocked fallopian tubes:
- 66.02 Wood Wife, 11.06 Return to the Nest, 11.24 Gynecological Points, each unilaterally needled, 88.04-88.06 Three Sisters, bilaterally needled.
Infertility due to deficiency or cold accumulation:
- In addition to acupuncture, moxa on the following points is very useful: ST36, SP6, UB23, DU4, REN4-REN8. See additional comments below.
Infertility due to damp heat accumulation or stagnation:
- Three Plum Blossom is needled to clear uterine stagnation and clean the womb.
- Bleed any small dark veins found between SP6 San Yin Jiao and the medial malleolus.
- Bleed DT.17 Up-Shooting Heaven.
Premenopausal (extending fertility):
- 11.06 Return to the Nest on one side, 11.24 Gynecological Points* on the other side, bilaterally needle 88.04-88.06 Three Sisters.
Blocked fallopian tube and general infertility:
- Open Tube Formula (Tong Guan Tang): This is a formula created by Dr. Wei-Chieh Young (see: https://tungspoints.com/lineage/), and contains 3 Tao Ren, 3 Hong Hua, 3 Chuan Xiong, 3 Dang Gui (this part is Si Wu Tang); add 2 Hui Xiang, 3 Lian Qiao, 3 Xiang Fu, 3 Chi Shao, 3 Dan Shen, 1.5 Zhi Gan Cao.1 Good for many types of infertility, this formula moves the Blood and disperses Phlegm, along with Xiang Fu to regulate the Qi. If you are not sure if the fallopian tube is blocked, use this formula for three to four weeks and then proceed to the next formula for male or female infertility. Although the proportions are listed in whole herbs above, I tend to mix the herbs in a granulated format for delivery, as it is easier for those who require long-term treatment.
Tonifying Liver and Kidney:
I have had outstanding results with the following formulas. Consider one or the other combinations (but not both):
- You Gui Wan with Yu Lin Zhu (Fertility Pearl)
- 6-2-5 (can be used for both males and females): 6 = Nourish Essence Formula (Liu Wei Di Huang); 2 = Two Immortals Formula (Er Xian Tang); 5 = Five Seeds (Wu Zi Yen Zhong Tang: Tu Si Zi, Fu Pen Zi, Che Qian Zi, Wu Wei Zi, Gou Qi Zi).2
Comments: Oddly enough, a short little finger (one that does not reach the crease formed by the distal phalanx of the ring finger) is diagnostic of infertility and indicates a congenital Kidney deficiency; however, most infertility is hormonally related. Many women experience an irregular menstrual cycle due to exhaustion, overwork, cold damp, or wet heat accumulation in the uterus. For chronic infertility, herbs must be taken for at least 3 months and up to 6 months. Treating infertility with Asian medicine has multiple benefits: there is less likelihood of Down’s Syndrome or birth defects, and due to tonifying the Liver and Kidney, the child may be more intelligent, because both relate to the brain. As a result of treatment, the woman will be stronger, and so the baby will deplete her less.
Whenever I treat a woman for infertility, I ask her to avoid conception for at least three months while I sort out the problem. If for example we are treating a Damp-heat condition, we will need to clean the womb, whereas a Damp-cold condition needs tonification and warmth. If the woman conceives before these problems are addressed, they will affect the pregnancy and be harder to treat because of it. There is also a good possibility that they will cause the woman to miscarry again, if she previously did. Some people are anxious to try again immediately after a miscarriage, but always advise them to wait when their body needs attention. Proper diet is absolutely essential (please see Healthy Pregnancy in the introduction to this section in my book). Patients at risk of miscarriage, as well as those who are receiving fertility treatment, need to avoid climbing stairs, bouncing (e.g., aerobics), excessive exercise, overwork, and insufficient sleep.
Return to the Nest, Gynecological Points and Three Sisters are the points we most frequently choose to treat infertility, and as you won’t always know when a patient has conceived, we can trust them to be safe during pregnancy. Though herbal treatments will vary depending upon the reason for infertility, the above points are always utilized, even in non-hormonal cases such as a blocked fallopian tube. Other causes of infertility might be Kidney and Liver deficiency, Qi and Blood deficiency, Chong and Ren deficiency, or a combination of these, any of which could result in a malformed uterus, an unstable pregnancy, or a nonviable fetus.
Regular treatment can resolve infertility in most cases. Some practitioners teach their patients or their patient's partner how to needle Return to the Nest and the Gynecological Points, at home. With the patient laying face up on the table, a practitioner may do this sitting in a chair at the head of the table, and by holding the patient's hands to guide them through the process of needling themselves. This training will take the fear out of needling and build the kind of confidence that encourages daily home treatment, which is optimal. Return to the Nest and the Gynecological Points, when received daily for up to three months, can virtually guarantee conception. Once the woman has conceived, they are no longer necessary, as the body will appropriately regulate its own hormones. Remember, if a woman is peri-menopausal and wishes to extend her fertility, Three Sisters combined with Return to the Nest and Gynecological Points will accomplish just that, in most cases.
Infertility due to blocked fallopian tube: Inflammation of the cervix and fallopian tubes is often due to Liver qi and blood stagnation. To treat this kind of inflammation, you will need to soothe the Liver, regulate the Qi, activate the Blood, and release the stagnation. Needle the points above for opening blocked fallopian tubes and prescribe the Open Tube Formula to free the blockage and harmonize the Liver and Spleen. Sticky Phlegm may also cause a blockage of the fallopian tubes, phlegm herbs may be added to the Open Tube Formula.
Infertility due to deficiency or cold accumulation: A white coating or pale tongue with teeth marks indicates damp cold. This requires the tonification of Qi, and the clearing of Dampness, while warming the whole body, specifically the uterus. A patient who habitually miscarries just after her period was due may be rejecting the sperm and will need tonification. Usually, patients who habitually miscarry will predictably do so at the same time, such as two weeks after conception.
Infertility due to damp heat accumulation or stagnation: When a woman has heat stagnation in her uterus, her tongue is red with a greasy coating; when the tongue is dark purple, it is quite severe. A thick yellow coating is also indicative of Damp Heat accumulation. Though the herbal treatment is different than it would be for a deficient cold picture, the Tung’s acupuncture treatment is the same. However, I may initially use Three Plum Blossom more than Three Sisters to clear uterine stagnation and clean the womb. Every woman I have treated for infertility due to damp heat has immediately conceived after three months. Once conception is being attempted, I am very careful not to needle Three Plum Blossom post-ovulation, just in case the woman has already conceived. Even if she has not conceived, it is also better to use Three Sisters after ovulation, rather than Three Plum Blossom, in order to encourage a 'calm Sea of Life' (womb). Also see Infertility (threatened miscarriage), below.
Case history (five years of trying to conceive):
A couple came to my clinic, both of whom were diagnosed as infertile. They were in their mid-thirties and had already unsuccessfully been trying to conceive. While the woman had wet heat in her womb (as diagnosed by her red tongue with a yellow coating), the man’s tongue was pale with teeth marks. He also had a serious marijuana addiction, as well as low sperm count and motility. I advised them to postpone any attempt to conceive for three months, until I could sort them both out, but I required that he discontinue his marijuana use if they were to work seriously with me, which he did. While needling Three Plum Blossom with her and seeing that Return to the Nest and Gynecological Points were needled daily, I used a Lower Jiao deep cleaning formula to address the heat and stagnation. Once the tongue was no longer red, the yellow coating gone, and her pulse had returned to a normal jump and strength, we were able to move on to the 6-2-5 formula listed above, for a total of three months.
Her husband received tonification treatments in the form of a Dr. Miriam Lee's Ten Great Needles modified with the addition of 77.18 Shen Guan (Kidney Gate). I also gave him moxa to strengthen his Kidneys and required that he stop partying, get more sleep, eat a perfect diet, and get serious about being a father. I remember telling him that if he really wanted to be a good father, he needed to start right now. I required him to think about it seriously and report back to me his decision the following week. He kept his vacation plans with his buddies in Las Vegas the following week and came home having decided that his foolish ways (drugs and alcohol) were over. I cleaned his DT.01-DT.02 Toxin Areas by cupping it until it no longer colored and began the 6-2-5 formula with him as well. This formula is marvelous for both male and female infertility, once any pathogenic factors have been addressed and resolved.
The first time they tried to conceive after the three months of contraception, they were successful. A few months later, they moved out of the area. Six months later, I received a happy postcard announcing the birth of their baby girl.
Bleeding treatments for infertility:
Bleeding SP6 to the medial malleolus: There is a very convenient treatment for lower jiao stagnation, taught to me by Dr. Young Wei Chieh. Look for the small veins (even spider veins) found in the area between SP6 and the medial malleolus. Bleeding these smaller vessels, usually with a lancet or hypodermic needle tip, is very effective for infertility, bladder infections, genital herpes outbreaks, and lower jiao conditions caused by wet heat. When treating a bladder infection, though the above treatment may be helpful, bleeding Koryo Hand Therapy A-line (at the hand/heel points) is extraordinarily effective (See Interstitial Cystitis for further information).
- Caution : It is difficult to avoid tapping the tibia with the tip of your bleeding needle. Be very conscious of this, and if you must contact the bone, be sure to do it extremely gently. For this reason, I usually avoid using a spring-loaded lancet in this area, and instead use a hand-held instrument and puncture at a 45-degree angle.
- Bleeding DT.17 Up-Shooting Heaven: Because bleeding the abdomen is not recommended, we can bleed the back to treat the front for both male and female infertility. This treatment is also appropriate for any other kind of Lower Jiao stagnation or blockage, including intestinal disease, and gynecological issues such as amenorrhea, or ovarian disease.
While visiting Dr. Wang Xiu Zhen (my bleeding teacher) in He Fei, China, I saw her bleeding a male patient’s sacrum, Tung’s DT.17. He was being treated for infertility. A few weeks later, there was a big commotion in the courtyard of the hospital as this man led his parade of family and friends holding a large sign decorated with crackling fireworks, announcing his wife’s pregnancy.
I do not cup the patient’s lower back if she is trying to conceive or during her first trimester, to keep a very calm Sea of Life in the Lower Jiao for implantation. When the lower back is cupped, the patient can feel a pulling in the front. After the second trimester (of a complicated pregnancy) or the first trimester (of a normal pregnancy), gentle cupping may be helpful. In a normal pregnancy, I always cup the lower back and sacral area two weeks before delivery. This prepares the mother for labor and may make delivery slightly easier, should it involve “back labor” (when the descending baby digs their heels into the lumbar vertebrae or sacrum).
I always suggest that a woman dealing with infertility acquire what is called a Fertility Lens. This device, also known as a female ovulation microscope, measures fertility through assessment of saliva. It is a small lipstick-shaped device with a built-in light source and a glass slide on which a small amount of saliva is placed. Once dried, saliva with a ferning pattern indicates ovulation, whereas outside of the 48- to 72-hour fertility window, there will be no visible striations. This device is quite helpful when a woman is attempting to conceive. Also, it is my opinion that every fifth-grade sex education class should include learning about the Fertility Lens, so that girls and women can know the wisdom of their bodies from an early age and avoid unwanted pregnancies.
Taking Charge of Your Fertility, by Toni Weschler, is a great book about ovulation, fertility, and female reproduction in general. If women are uninformed, I usually recommend that they read this book. Women who are receiving IVF treatments are usually quite informed and utilize various devices for measuring their hormonal activity.
Footnotes: 1 Amounts indicated are for loose herbs measured in qian (1 qian = 3 grams). 2 Amounts indicated are for loose herbs measured in qian (1 qian = 3 grams).