Natural treatments for female infertility
Natural treatments for female infertility encompass various approaches that aim to enhance fertility through non-invasive means. While many factors can contribute to infertility, including hormonal imbalances, structural issues in the reproductive system, and age, a range of natural remedies have been explored. Among these, acupuncture has a long-standing tradition in addressing infertility, although its effectiveness remains debated, with mixed results from various studies.
Herbal options, such as ashwagandha, black cohosh, chasteberry, and maca, have been examined for their potential benefits, particularly for conditions like polycystic ovary syndrome (PCOS). Some studies suggest that N-acetylcysteine (NAC) combined with clomiphene may improve ovulation rates in women with PCOS. Additionally, bee propolis and vitamins D and C are mentioned as potential aids, though evidence supporting their efficacy is limited and often inconclusive.
Stress reduction techniques are also recommended, as stress can negatively impact fertility. Overall, while there is ongoing interest in these natural treatments, the scientific evidence supporting their effectiveness varies, highlighting the need for further research to validate these approaches.
Natural treatments for female infertility
DEFINITION: Treatment of the inability of a woman or a girl to become pregnant.
PRINCIPAL PROPOSED NATURAL TREATMENTS: None
OTHER PROPOSED NATURAL TREATMENTS: Acupuncture, ashwagandha, bee propolis, beta-carotene, black cohosh, calcium, chasteberry (Vitex agnus-castus), false unicorn, maca, multivitamins, N-acetylcysteine, reducing stress, traditional Chinese herbal medicine, vitamin C, vitamin D
Introduction
There are many possible causes of female infertility. Ovulation issues resulting from conditions like polycystic ovary syndrome (PCOS) or primary ovarian insufficiency (POI), as well as ovulation issues related to age or endocrine issues, cause most cases of female infertility. Tubal disease and endometriosis (a condition in which uterine tissue begins to grow where it should not) also account for many cases of female infertility. Other factors include pelvic inflammatory disease (PID), uterine fibroids, certain cancers, and pelvic adhesions.
An immense industry has emerged to address female infertility using techniques that range from hormone therapy to in vitro (test-tube) fertilization. However, there is considerable controversy about the high cost and low rate of effectiveness of many fertility treatments in general. Sometimes, infertile women eventually become pregnant without medical intervention.
Proposed Natural Treatments
Women with a condition known as PCOS may be infertile. A double-blind, placebo-controlled study evaluated the effectiveness of N-acetylcysteine (NAC) in 150 women with PCOS who had previously failed to respond to the fertility drug clomiphene (Serophene), a commonly used medication to induce ovulation. Participants received clomiphene plus placebo or clomiphene plus 1.2 grams daily of NAC. The results indicated that combined treatment with NAC plus clomiphene was markedly more effective than clomiphene taken with a placebo. Almost 50 percent of the women in the combined treatment group ovulated compared to about 1 percent in the clomiphene-alone group. The pregnancy rate in the combined treatment group was 21 percent, compared to zero in the clomiphene-alone group.
Black cohosh (Cimicifuga racemosa), an herb with estrogen-like effects, drew the attention of researchers who were interested in whether it might be helpful for women with unexplained infertility who were also being treated with clomiphene but had yet to conceive. Roughly 120 women were randomly divided into two groups. Both groups continued to receive clomiphene, but the women in one of the groups also received 120 milligrams (mg) of black cohosh. Pregnancy rates were significantly higher in the black cohosh plus clomiphene group compared to the clomiphene-only group. Further research found that black cohosh aided hormone regulation and endometrial thickness in women with PCOS, but there was a general lack of scientific evidence to support the existence of an improvement in fertility linked to black cohosh.
In a small, double-blind, placebo-controlled trial, using bee propolis at a dose of 500 mg twice daily resulted in a pregnancy rate of 60 percent, compared to 20 percent in the placebo group. This difference was statistically significant. However, further research did not confirm this finding, though some holistic medicine specialists recommend bee propolis for individuals with PCOS.
Because of its effects on the hormone prolactin and its ability to increase progesterone while lowering estrogen levels, the herb chasteberry has been tried as a fertility treatment. However, the only properly designed study of this potential use was too small to return conclusive results. A larger study evaluated a combination containing chasteberry, green tea, arginine, and multiple vitamins and minerals. In this double-blind study, ninety-three women experiencing infertility were given either the combination treatment or the placebo for three months. After three months, 26 percent of the women given the real treatment were pregnant compared to 10 percent of those in the placebo group, a statistically significant difference. Other studies found weak evidence to support chasteberry's use for women experiencing fertility traced to luteal-phase issues.
Weak evidence hints that vitamin D and calcium may also be helpful for infertility. Another small study found some evidence that supplements containing isoflavones may increase the effectiveness of in vitro fertilization (IVF). Another study reported that vitamin C supplements slightly improved pregnancy rates in women with luteal phase defects. However, because researchers failed to give the control group a placebo and instead merely left them untreated, the results are not meaningful. Another study which had severe defects in design reported that multivitamin supplements may slightly increase fertility. Stress may lead to infertility, and treatments for reducing stress might help increase fertility. The herb maca (Lepidium meyenii) is widely advocated as a fertility-enhancing herb. However, the only basis for this claim is a few animal studies.
Caffeine avoidance has also been recommended for improving fertility, but there is little evidence that it helps. Acupuncture has a long history of traditional use for infertility, but the supporting evidence for its use is weak. A few open trials appeared to show that acupuncture can enhance the success rate of IVF. Two better-designed studies, however, failed to find acupuncture more effective than placebo. An analysis of seven randomized trials involving a total of 1,366 women found that, on balance, acupuncture may significantly improve the odds of pregnancy in women undergoing IVF. However, because not all seven studies used sham (fake) acupuncture as a control, the reliability of this conclusion is questionable. Moreover, a second analysis in the same year of thirteen randomized-control trials investigating the effectiveness of acupuncture in 2,500 women undergoing a specialized IVF procedure, in which sperm is injected directly into the egg, found no evidence of any benefit. In a subsequent review of thirteen trials, a different group of researchers concluded that acupuncture may improve the success rate of IVF, but only if it is used on the day of embryo transfer (when the fertilized egg is placed into the womb). According to this study, acupuncture is ineffective when used up to three days after embryo transfer or when eggs are being retrieved from the ovaries. A review of studies of acupuncture's success on female infertility mainly revealed positive results. However, most studies were small, or the study's construction was flawed.
Traditional Chinese herbal medicine also has a long history of use for infertility, but there is little meaningful evidence to indicate that it is effective. One case report has linked the use of a Chinese herbal product with reversible ovarian failure. Other treatments sometimes recommended for female infertility include ashwagandha, false unicorn, and beta-carotene, but scientific confirmation was not achieved.
A review of studies through the early 2020s found eleven primary natural supplements emerged in the literature. Because these herbs contain healing compounds, such as polyphenols, several of these remedies were found to be instrumental in treating a variety of reproductive disorders, such as endometriosis, hyperprolactinemia, and menopausal symptoms, though results were not consistent across demographics, researchers noted the potential of these healing plants and suggested these properties should be further investigated to possibly create effective drugs to treat infertility.
Bibliography
Akbaribazm, Mohsen, et al. “Female Infertility and Herbal Medicine: An Overview of the New Findings.” Food Science & Nutrition, vol. 9, no. 10, 15 Aug. 2021, pp. 5869-82. doi:10.1002/fsn3.2523.
Ali, Ahmad, et al. “The Utilization of Bee Products as a Holistic Approach to Managing Polycystic Ovarian Syndrome-Related Infertility.” Nutrients, vol. 15, no. 5, Feb. 2023, p. 1165, doi:10.3390/nu15051165.
Brown, Mary Jane. "16 Natural Ways to Boost Fertility." Healthline, 25 Apr. 2024, www.healthline.com/nutrition/16-fertility-tips-to-get-pregnant. Accessed 20 Sept. 2024.
Domar, A. D., et al. “The Impact of Acupuncture on In Vitro Fertilization Outcome.” Fertility and Sterility, vol. 91, 2009, pp. 723-726.
El-Toukhy, T., et al. “A Systematic Review and Meta-analysis of Acupuncture in In Vitro Fertilisation.” BJOG: An International Journal of Obstetrics and Gynaecology, vol. 115, 2008, pp. 1203-13.
Fan, Chi Wai, et al. “Systematic Review of Black Cohosh (Cimicifuga racemosa) for Management of Polycystic Ovary Syndrome-Related Infertility.” Journal of Pharmacy Practice, vol. 35, no. 6, 2022, pp. 991-9. doi:10.1177/08971900211012244.
"Female Infertility." Mayo Clinic, 27 Aug. 2021, www.mayoclinic.org/diseases-conditions/female-infertility/diagnosis-treatment/drc-20354313. Accessed 20 Sept. 2024.
Quan, Kewei, et al. “Acupuncture as Treatment for Female Infertility: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Evidence-based Complementary and Alternative Medicine, 16 Feb. 2022, doi:10.1155/2022/3595033.
Shahin, A. Y., et al. “Adding Phytoestrogens to Clomiphene Induction in Unexplained Infertility Patients.” Reproductive Biomedicine Online, vol. 16, 2008, pp. 580-88.
Sparks, Dana. "Home Remedies: Can Herbs and Supplements Enhance Fertility?" Mayo Clinic, newsnetwork.mayoclinic.org/discussion/home-remedies-can-herbs-and-supplements-enhance-fertility. Accessed 29 Aug. 2023.
Westphal, L. M., M. L. Polan, and A. S. Trant. “Double-Blind, Placebo-Controlled Study of Fertilityblend: A Nutritional Supplement for Improving Fertility in Women.” Clinical and Experimental Obstetrics and Gynecology, vol. 33, 2006, pp. 205-08.