While diminished ovarian reserve (DOR) is more common in women as they get older, it can be an issue for younger women as well. The reasons for DOR are numerous, including age, cysts, endometriosis, high body mass index, history of tumours or radiation, or family history. While many of these causes are a result of an identifiable situation, it is still true that at 37 years old, a woman will have about 25,000 eggs remaining, and at menopause less than 1000. This is compared with approximately 400,00 eggs at puberty.
As a means of testing for DOR, there are three tests that should be done and looked at together. Follicle stimulating hormone (FSH), anti-mullerian hormone (AMH), and antral follicle count (AFC). With a diminished reserve, FSH levels will rise to above 10, AMH levels decrease below 0.9-1.0, and the AFC decreases. Assessed as a group these values can indicate a decrease in ovarian reserve and give women and couples an idea of how to proceed with regards to their fertility. If the information collected tells us that ovarian reserve is diminished, then conceiving naturally may not be possible (or very unlikely) and families can make informed decisions about how to proceed, whether it be to consider adoption or move onto assisted reproductive technologies (ART).
From a Chinese medicine perspective, DOR can often be seen as Kidney essence deficiency – a reduction in our reproductive energy that can result in a depletion of resources in both men and women. By boosting our production of Qi and Blood by focussing on digestion, supplements, lifestyle choices and working with acupuncture, we can improve our chances of conception and a healthy pregnancy.
How can acupuncture and Chinese medicine help?
1. Repair imbalances in reproductive health. We don’t view diminished ovarian reserve as an inability to conceive, but rather an indication of poor reproductive health, reflected in various symptoms and patterns as seen with each individual patient.
2. If assisted reproductive technologies, such as IVF or PGD (preimplantation genetic diagnosis) is being considered, Chinese medicine offers support and optimization for success.
3. Committing to 6-12 months of Chinese herbal medicine can often improve reproductive potential.
Acupressure Point for Daily Home Application:
Acupressure is a useful and accessible way to treat yourself at home or on the go. Apply firm pressure on the point with your middle finger or thumbs, at a 90 degree angle from the surface of the skin for about 3 minutes, 3 or 4 times a day on both sides. If you find that your fingers are getting weak or sore, you can substitute a golf ball, pencil eraser or other appropriate object.
CV4 – Conception Vessel 4 – GuanYuan – “Gate of Origin”
CV4 is a commonly needled point in clinic and most beneficial for home acupressure. It’s functions are numerous and include fortifying the original Qi and benefitting the essence, as well as tonifying and nourishing the Kidney and Spleen. It can also benefit the bladder and restore physical collapse in more severe situations.
Take home tips:
1. Focus on an anti-inflammatory diet, which could be contributing to this diminished reproductive essence and hormonal imbalance.
2. If it is an option, consider assisted reproductive technologies (ART) sooner than later.
3. Don’t give up! Perseverance is key, as this may take time.