Jing, Essence and Egg Qualityby Hyoun Bae on 02/11/19
Improving Egg Quality: ART (Assisted Reproductive Technology) and TCM, Part 1
At a roundtable discussion with Dr. Yuning Wu (Wu, 2013), a Beijing based TCM fertility expert offered:
“Western medicine is good at promoting ovulation, and Chinese medicine is good at supporting good quality blood and jing, and to prevent thinning of the endometrium. Chinese medicine can also help the follicle to rupture properly – this is very important when the patient is taking Clomid because it can cause luteinising unruptured follicle syndrome where the follicle does not rupture successfully… “
The conversation included a Western, reproductive endocrinologist and TCM specialists discussing integrative approaches. They covered the value of working integratively – and for Dr. Wu this was especially importantly for woman over 38 – along with treating male factor fertility concerns and working with both partners through acupuncture.
Dr. Wu shared some perceptions that our cultural experience harbors – the stress and reality of age-related concerns around our fertility, especially as many focus on professional needs and increasingly turn to reproductive medicine later in life, often after 35 to 38 years.
Here is where TCM comes in.
For Dr. Wu and others, bloodwork such as FSH and AMH can indicate much about ovarian reserve, but the common denominator in TCM is the treatment value of addressing the status of the blood and vital essence, or jing, in relation to other diagnostic factors a clinician might recognize through the pulse.
This is just as relevant whether one is going through IVF or attempting to conceive naturally, or without assistance. Indeed, whether in between cycles, during treatment or without, TCM approaches consider the state of the body and any underlying imbalances as the basis of acupuncture care or herbal administration. These imbalances are often addressed first, such as with many cases of PCOS or endometriosis, which can indicate dampness or blood stasis findings.
The case of jing and its promotion is worth mentioning.
There is no exact equivalence to the notion of jing essence, the root of our vitality and reproductive health, in Chinese medicine and biomedical terms or categories. Yet, in approaches to improve egg quality and follicular development, strengthening the kidneys and benefitting the jing are primary focuses of treatment – directly or indirectly.
Discussions within our field tend to weigh bloodwork findings in relation to specific TCM diagnostic criteria. The best integration of each approach perhaps recognizes that each discipline is considering the same issues from different angles. Certain numbers, within ranges, can be interpreted uniquely.
TCM relies upon something called pattern differentiation, wherein we note factors of imbalance and to better understand individuals, their history and their underlying presentation.
In some instances, FSH levels do not tally directly with ovarian response during IVF treatment. Egg quality and quantity are privy to age-related concerns and examining these values can indicate much about ovarian function and act as a screening requirement, at many clinics.
TCM looks upon jing essence and the functioning of the qi and blood, relative to these parameters and the thickening of the endometrial lining. While we routinely request bloodwork, we also take into account primary Chinese medicine criteria and many can attest to positive outcomes irrespective of ‘daunting’ bloodwork values.
For this reason, acupuncture and Chinese herbs may be administered before, during and in-between IVF treatment to promote fertility according to its unique perspectives.
Following, we’ll discuss considerations of menopause, jing essence, egg quality and ovarian stimulation during ART. For this, a more critical analysis of what is meant by jing, and the methods to promote it may be of value. For those of you familiar with Ayurveda, and the concept of ojas, one can draw a similar parallel as it relates to reproductive health and concerns of longevity and immunity, as well. It may be of value to address this assumed relationship, as often conversations revolve around more specific criteria, and understanding TCM and Asian medicine approaches on their own terms makes for a more fruitful integration.
In my experience, these perspectives are important for navigating timing, expectations and weighing differences of approach and knowing when and how to utilize each approach.
Wu, Y. (2013). The Treatment of Infertility with Chinese and Western Medicine, JCM. (101), 9.