In Singapore, we are pretty familiar with Traditional Chinese Medicine (TCM) as a form of alternative healthcare. In fact, there are numerous physicians and clinics all over the city that are frequented often, and are especially helpful during instances where we experience ailments that Western medicine cannot adequately address.
TCM has been around for thousands of years and was first introduced to the masses in Singapore by early migrants from mainland China. Today, it has become more recognised and has won the general public for its holistic approach and effective cures. Given the number of successful results TCM garners, it should not be ignored or discounted.
What we should understand is that traditional Chinese medicine and Western medicine are not entirely opposing forces but in fact, two sides of the same coin — providing a holistic approach to health care. This is particularly true for TCM fertility treatments, which can be used as a stand-alone treatment or used in tandem with Western fertility treatments, such as IVF, to increase the success rate for aspiring mommies and daddies.
In this article, experienced TCM practitioner, Physician Tay, walks us through everything we need to know about TCM fertility treatments in Singapore for both men and ladies, the various costs of treatment and what to expect during your visit.
What is Infertility from a TCM perspective?
In the context of traditional Chinese medicine, infertility is often distinguished as an individual who is sexually active for two years or more and is still unable to conceive. This can happen to both men and ladies, and could be due to a variety of lifestyle habits or injuries.
Infertility in Men
According to World Health Organization (WHO) data, general semen quality has been deteriorating globally over the years. In a study reported in 2017, scientists at the Hebrew University of Jerusalem found that sperm counts among men in the West have more than halved in the past 40 years.
While there is a lack of nationwide data regarding male reproductive health, doctors say rising male infertility rates here mirror the global phenomenon of declining sperm quality in the last 40 years .
A drop in sperm count due to bad lifestyle habits can cause infertility in men. Researchers have found that the testicular function is temperature-dependent and requires a temperature of around 2 - 4°C below body temperature.
Elevated scrotal temperature was found in men with occupations and lifestyles associated with high temperature exposure, hot bath and sauna users, men wearing tight jockey shorts and suspensories, and car driving.
Multiple human studies have confirmed the harmful effects of scrotal hyperthermia (having a higher scrotal temperature that is greatly above normal) on the production and development of mature spermatozoa. Hence, men are advised to wear loose clothing for their male genitalia to function optimally .
This is just one of the few factors that contribute to infertility in males. Many other factors often point towards bad diet and lifestyle habits such as smoking and excessive alcohol consumption. Being overweight, inactive, consistently using a laptop on one’s lap and even stress or depression can also contribute to a lower sperm count in males. The common contributing factors are:
From a TCM perspective, male infertility is usually associated with various forms of “kidney” deficiency and this occurs naturally as one ages. As far back as about 2000 years ago, the earliest TCM text 黄帝内经 (Huangdi Neijing, Inner Canon of the Yellow Emperor) detailed how one’s age will affect his fertility.
This corresponds amazingly well with modern medical science as research has found that the sperm concentration, motility, morphology and seminal volume decline as age increases .
Infertility in Ladies
The issue of infertility is more complex when it comes to ladies. Having a more biologically complex reproductive system, ladies can suffer from infertility for a plethora of reasons.
The first point of note for the TCM physician is to examine the menstrual cycle of the patient. Traditional Chinese medicine believes that the “kidney”, “liver”, and “spleen” affect the likelihood of conception as imbalance in these organs will disrupt the menstrual cycle of a lady. This is especially true for the “kidney” as TCM believes that “kidney” stores our “reproductive essence”.
TCM theory had long held that irregular menstrual cycles are one of the most important causes of infertility. This ties in well with modern medical science as irregular menstrual cycles are usually associated with ovulatory dysfunction (meaning ovulation fails to occur, or occurs on an infrequent or irregular basis).
TCM herbal medicine and acupuncture would then be used to help regulate the lady’s menstrual cycle to improve her chances of conceiving.
Questions concerning one’s work and lifestyle would also be asked as TCM believes that “the way the human body functions is interlinked and closely related to the natural world” (天人相应). Different environments that people live and work in, coupled with the differences in the individual’s ability to adapt to the environment, have an effect on the constitution of the person.
Therefore, when TCM physicians are diagnosing and treating the same disease, they will pay more attention to the season, place, and individual conditions, instead of viewing everyone as being the same.
This is especially relevant to Singapore. This is because as our society advances, many ladies are working long hours or are holding jobs that are stressful in nature. TCM theory had long stated that Liver Qi stagnation (a potential cause of infertility) is closely associated with stress and various negative emotions.
Also read: How stress affects your fertility
This corresponds well with a research conducted by US National Institutes of Health, Ohio State University and the University of Oxford on how stress alone might reduce a lady’s chance of conceiving by 12% .
Here is a list of causes (non-exhaustive) that TCM believes can hinder a lady’s ability to conceive:
- Kidney-Yin deficiency （肾阴虚）
- Kidney-Yang deficiency （肾阳虚）
- Blood and Qi deficiency （气血两虚）
- Blood and Qi stagnation （气血瘀滞）
- Liver Qi stagnation （肝气郁结）
- Phlegm and dampness （痰湿中阻）
It is important to note that in Traditional Chinese Medicine, the concept of yin and yang serves as a foundation for understanding health, as well as diagnosing and treating illnesses. This concept applies to diagnosing infertility as well.
What are the Traditional Chinese Medicine treatments for infertility?
Traditional Chinese Medicine takes on a different approach when it comes to the treatment of diseases and body constitutions. Centered around the idea of yin and yang, it believes in balancing the internal elements of the body to help all of its organs function properly. Hence, when something is out of order, it will usually be compensated for with its polar opposite to help restore balance in the system.
To do so, acupuncture and herbal medicine are usually used.
Acupuncture is the treatment involving the insertion of very long and thin needles through a person’s skin at specific points of the body.
TCM physicians are experts trained in anatomy and can pinpoint specific areas of the body that require acupuncture to treat different diseases. In doing so, they help regulate the flow of energy or life force (Qi) along the various meridians, and in the long run, are helping to maintain balance in the body.
The practice of TCM also believes in using herbs to help preserve the balance in the body. As such, herbal products are also often used together with acupuncture to help give the body the boost it needs to compensate for a shift in balance . The physician will also recommend a change in diet to suit your needs.
For example, patients that often feel cold in their extremities are encouraged to consume more lamb meat and beef to warm one’s body. Ginger-red date tea is also another substitute if meat is not an option in the diet.
In the case of fertility treatments, In-Vitro Fertilisation (IVF) and Intrauterine Insemination (IUI) can be complemented by TCM treatments. IVF acupuncture is a treatment that helps to improve the rate of pregnancy for ladies who are trying to conceive through IVF .
Chinese herbal medicine can also be prescribed by the TCM physician to prepare the body for conception and 1 treatment cycle will typically last 3 menstrual cycles. TCM fertility treatment will require the physician to follow up with the patients regularly during the course of the treatment.
This is because the herbal medication prescribed will be adjusted according to the symptoms manifested during each menstrual cycle, hence we can say that every treatment is tailored to each individual’s needs.
How is TCM a natural fertility treatment?
Couples trying to conceive should consider trying out TCM as a form of natural fertility treatment and this is especially so if the lady is below the age of 38 and her ovarian reserve is still relatively high. This is because women with the above attributes tend to have a good chance of conceiving naturally through TCM treatments .
Some TCM clinics do refer their patients to laboratories for diagnostic testing so that patients are able to check their sperm count, sperm motility, sperm morphology, ovarian reserve, and hormonal profile through semen analysis and blood tests before deciding on a treatment plan.
It is worth noting that IVF treatment requires the lady receiving the treatment to receive daily hormonal injections and do multiple transvaginal ultrasound scans over the course of the treatment. These procedures tend to create a lot of stress and anxiety for the patient involved, not to mention the fact that undergoing IVF treatment can be quite costly .
TCM physicians can complement IVF treatments by prescribing TCM herbal medicine and acupuncture to help prepare the body before the IVF treatment to help increase the chances of success. This process usually takes 3 to 6 months and there are a number of patients who got pregnant naturally during this process.
TCM can also help with unexplained infertility by measuring the internal balance of the individual. Oftentimes, patients will enter the clinic feeling “wrong” without knowing exactly what is wrong with them. In such cases, TCM physicians may help schedule a laboratory test as a primary diagnosis.
However, in certain cases, some couples are still unable to conceive, even though the diagnostic tests may indicate that everything is fine. In such occasions, TCM believes that the body may have an imbalance of elements, resulting in the person’s constitution being either “too cold” or “too warm”.
Through asking a series of diagnostic questions, a TCM physician will be able to determine one’s type of constitution, and will then go on to prescribe individualised treatment plans for the couple.
How effective are TCM fertility treatments?
The effectiveness of TCM fertility treatments not only depend on the couple’s medical condition, but also on how committed they are in adhering to their treatment plan. It is important to note that TCM treatment is not a one-time solution to your infertility issues and will require continuous treatment over a period of time.
TCM treatments take time to restore the body back to its balance. As such, fertility treatment plans in TCM normally range from about 3 - 6 months and can go on for as long as a year or two for serious cases (1 TCM treatment cycle is 3 menstrual cycles).
It is worth mentioning that there were a number of cases where the couples managed to conceive naturally within 3 menstrual cycles after following my instructions closely. Unfortunately, many patients tend to stop treatment within 1 - 2 months when they are not able to see instant results.
Efficacy for Ladies
For ladies, patients of the younger demographic (under 35) will most likely see faster results, with many patients within this demographic conceiving naturally after adhering to the treatment plan for 3 - 6 months.
The length of time and efficacy of TCM fertility treatment is largely dependent on age and if the treatment does not yield results after 6 months, patients would be given the suggestion to try IVF treatment, this is especially so for ladies above the age of 38 whose ovarian reserves are depleting fast .
Efficacy for Men
For men, herbal medicine and acupuncture is normally provided. Due to the physiology of the male testicles, male infertility is easier to treat as the main goal is mainly to stimulate the testicles to produce more sperms and improve their motility. TCM fertility treatment is usually able to improve semen quality as long as one’s testicles retain the ability to produce sperms .
One cycle of TCM fertility treatment for men typically takes 3 months as on the average, sperm production takes 74 days from start to finish . Clinical research done by Tainan Municipal Hospital in Taiwan between 2013 to 2016 found that TCM treatment significantly improved semen quality.
In this study, it was found that TCM users account for 92.5% of the total semen improvement subjects, the other 7.5% is up to TCM nonusers. The TCM users had 10.7-fold better semen improvement than TCM nonusers after adjustment for age, duration of infertility, BMI, history of smoking and alcohol use, and infertility type .
It is important to note that this only applies to men who are infertile due a low sperm count and/or low sperm motility. Men suffer from obstructive azoospermia or testicular azoospermia (azoospermia is the medical condition of a man whose semen contains no sperm) might require intervention in the form of surgery and/or testicular biopsies, which are typically performed in a hospital .
That being said, researchers have found that acupuncture may be a useful, non-traumatic treatment for men with azoospermia, especially for those who have had a history of genital tract inflammation .
Erectile dysfunction can also be treated with TCM through medication and acupuncture as it would allow for improved blood flow to the penis and help stimulate energy flow in the meridian.
Therefore, it is paramount that you trust your TCM physician and work together with them in crafting a treatment plan that would best suit your needs.
What can I expect when I visit a TCM physician?
When going to a TCM physician for a fertility consultation, patients should bear in mind that although its treatment methods are different from Western medicine, the diagnosis and process remains the similar:
A TCM physician would typically ask for your medical history and relevant diagnostic lab reports.
Questions regarding menstrual cycle, erectile dysfunction, nature of work, lifestyle, stress level/ emotional wellbeing would also be asked.
The physician will do preliminary diagnostic tests such as pulse taking and checking your tongue to see if you are healthy and if the elements in your body are balanced.
**Patients could be referred for further diagnostic testing (typically ultrasound scan, blood or semen analysis) if there are information gaps to be filled.
The physician will then decide on the necessary steps and construct a personalised treatment plan that would best suit you.
Couples are encouraged to consult a TCM physician together when seeking fertility treatments. This is because the husband would be able to provide emotional support for his wife and help her feel a sense of ease during the course of treatment. Furthermore, men have just as much chance of being infertile as the ladies and in certain cases, the husband only discovered that he had poor semen quality after being advised by the TCM physician to go for semen analysis .
What is the cost of TCM fertility treatment in Singapore?
The cost of TCM fertility treatments in Singapore depends on the types of treatment recommended by the physician.
Different medicinal herbs may vary in prices, with most of them costing between $15 - $30 a day, depending on if the medication prescribed are traditional herbal decoction (boiling herbs) or scientific TCM medicine (powders, syrups and pills). It is important to understand that traditional herbal decoctions are typically more costly.
It is also worth knowing that TCM medication for fertility treatment tend to be more costly because tonics such as ginseng and deer velvet antler (鹿茸), could be prescribed depending on the nature of the patient’s condition .
As TCM restores the imbalances in the body over a period of time, the effects of the medicinal herbs are to be observed over a span of 3 to 6 months (with 3 menstrual cycles being 1 treatment cycle).
Other procedures such as acupuncture and massages vary in cost with some TCM clinics charging higher prices. Unfortunately, TCM fertility treatments are not Medisave claimable as of yet.
You should definitely consider TCM fertility treatments if you desire to conceive naturally.
Acupuncture and herbal medicines date back at least 2,200 years with the earliest recorded use of it being in the 3rd century BCE. TCM has been healing the Chinese people since then and is now being practiced worldwide today. Its effectiveness is now observed by various clinical studies that are being conducted around the world.
As such, patients looking for alternative fertility treatments should consider Traditional Chinese medicine as an option, or as a complementary treatment to IVF and IUI. Perhaps natural healing and strengthening your body may be just what you need to conceive.