I’m an acupuncturist, and this is the most common infertility issue I see

Most heterosexual couples expect to get pregnant quickly. They stop using birth control, learn how to time intercourse to coincide with the woman’s ovulation, and wait for a positive pregnancy test. It’s disappointing when that doesn’t happen straight away, and as time goes by, they look for an explanation. He gives a semen sample, and she has a battery of diagnostic tests, including blood tests to check hormone levels and egg supply, and imaging of the fallopian tubes and ovaries.  They expect to find answers and a solution. Still, in 15 to 30 percent of cases, the diagnosis is a frustrating one: unexplained infertility.

It’s at this point that they often turn to me. I’m a practitioner of Chinese medicine and the author of a book, Making Babies: A Three-Month Program for Maximum Fertility, which I wrote with a reproductive endocrinologist. We wrote the book because we knew from experience that some infertile couples could conceive without any medical intervention by making seemingly small changes to their diet and lifestyle.

At Yinova, my colleagues and I treat all kinds of reproductive problems. Still, the most common issue we see is unexplained infertility. I feel a lot of compassion for these patients and their frustration at not being able to find something to fix. Still, their situation is more hopeful than it feels, because their doctor has found no significant impediment to conceiving. So what’s the problem? The answer is that it’s usually not just one thing, but a series of small issues—none of which would cause infertility on its own, but taken together, they start to gang up on the couple and diminish their chances of conceiving.

That’s when the detective work begins, and it’s one of the things I love most about my job. I do a full intake, ask the patient to keep a chart of her basal body temperature—the body’s lowest temperature when resting, and an important fertility marker—and set about correcting any small imbalances I find. To do this, I make an individually tailored herbal formula and change the ingredients through the menstrual cycle, which allows me to troubleshoot hormone imbalances, circulatory problems, and problems with synchronization.

Synchronization plays a vital role in getting pregnant. A fertilized egg has to reach the uterus just as the lining is at its most receptive in order to successfully implant. And the most common reason for the reproductive system being out of sync is a problem with the luteal phase of the cycle, also known as a luteal phase defect (LPD).

The luteal phase is the time between ovulation and the first day of the menstrual period. It should last for 14 days. A luteal phase lasting less than 12 days is too short for the uterine lining to develop enough to support a fertilized egg properly. A person might also have a regular luteal phase but have progesterone levels that are too low. The result is the same: If there’s not enough progesterone, the endometrium (aka the uterine lining) can’t develop properly, and it’s not ready to receive a fertilized egg. This is why LPDs are associated with infertility and early pregnancy loss.

Chinese medicine considers LPD an imbalance of the whole cycle, not just the luteal phase. The luteal phase is governed by warming yang energy, which results in an increase in progesterone. This yang energy develops from the cooling yin energy that is dominant in the follicular phase, which is when estrogen is at its peak before ovulation. The transformation from yin to yang and estrogen to progesterone happens through the movement of qi and blood at ovulation. An interruption in the flow at any point in the cycle can affect synchronization and show up as LPD.

Once the proper dynamic is discerned, herbal formulas and acupuncture treatments can be designed accordingly. I often recommend my patients with LPD to take chaste tree berry to help lengthen the luteal phase. For other patients, I might recommend they brew a daily cup of red raspberry leaf tea to help improve the blood flow to the uterus. It all depends on their individual needs. 

If you are finding it challenging to conceive, I encourage you to speak with your health-care provider. I also welcome you to consider how Yinova may be able to support you through our virtual wellness and herbal medicine consultations. However you move forward, I wish you good health and the best possible outcome.

Jill Blakeway is a doctor of acupuncture and Chinese medicine and the author of three books on health and healing. She is the founder of Yinova, where she leads a team who offer fertility coaching and herbal medicine virtually by video link as well as treating patients at Yinova’s three centers in New York.