Dr. George Lu, L.Ac, DAOM, is an infertility specialist serving northern & southern California for more than 20 years and currently teaching at Five Branches University of Traditional Chinese Medicine at San Jose Campus. In Dr. Lu’s clinic, he works with Bay Area fertility specialist and Bay Area Reproductive centers to optimize patient’s success in pregnancy. Throughout these years of experiences, Dr. Lu is going to share some of the stories or cases with us during the webinar. There will be discussions like when should you start acupuncture, should you do IVF or IUI, or what kind of lab tests that are needed, etc.
Debbie: We are going to talk about Women’s health and specifically infertility. If you are still on your way get yourself ready. Take out your note book and pens, we are going to have a very fruitful discussion.
Debbie: Hello everyone welcome to our September webinar. Today’s topic is women’s health and specifically in infertility. We are so honor to welcome Dr. Lu. I have been know you since 2010, and you have already taught at Five Branches University. And you already have your own clinic and you are also specialized in infertility at that time. But I seems haven’t ask you before. What make you decided to specialized in infertility.
Lu: Since like while I was still in college back in 1989 fortunately I have interest in Chinese medicine and follow a well known practitioner in San Francisco her names is doctor Angela Lu. She is my mentor and she is specialized in treating HIV with TCM as well as infertility and pain management. But later, I found fertility reward is more joyful. That’s why I know after I graduated then I moved on to focus on infertility instead. Yeah I stayed focuses you know I also like it a lot in pain management as well but you know getting older I think that is less.
Debbie: So in the field you are about you want to discuss how TCM can do for you infertility patients and now its your time may be you can elaborate more like how TCM can help
Lu: Basically, the difference between TCM and western medicine. Many of you know that western medicine is based on evidence. But the thing is they are very focused on the order numbers like the hormone numbers even like you BMI. you know it’s numbers. So from years of experience in infertility that I deal with all pretty much every single fertility specialists in the bay area some of them refer to me the hormone numbers everything is perfect but to them it is prefect and is still not getting pregnant. Then they concerned as an unexplainable case. You know if they are focus on IUF or IUI in a couple treatment they couldn’t tell they are just consider and say ok move on the donor they never find out the root cost. The term that you may hear from the doctors a lot you have a low ovarian reserve. But for the Chinese medicine we are kinda listen to the patients body internal voice and look at the body basic signs and sometime we are able to do a forecast for doing the preventive treatment. In the past you know even right now I often like when I do the treatments for the patients by taking their pulse and sometime the patients will be amazed by telling them that Oh you probably overlying soon even for some of the patients who have irregular menses or tell them your menses will start and or some pregnant women try to get the genders the only thing they can do is like an ipt around 10 weeks or you have to od the 18 weeks ultrasound to find out the gender sometime by 6 to 8 weeks as long as they have the heart beat so by the pulse we can tell they are pretty much coming without surprise.
Debbie: so this is the joyful part?
Lu: Yea. Sometime they ask me if we just listen to what they said and then make a guess. I said no. you know what when they came up with the answer at the end like after eight weeks or they have the IPTV result come out I shown them what I wrote before about the gender.
Debbie: How about today we are not only focusing on fertility but also discuss other problem like others women health problems that cause infertility. What us your opinion about that.
Lu: if you what to fix your infertility issue. First of all you have to kind of like look at the menstrual cycle history. Many of time the first thing we heard is the menstrual cramp another is dysmenorrhea. And then for the western med when you have like natural cramp, even from 16 or 17 so the doctor just put them on the pills may be put them on IUD just to fix the issue. But it is actually shutting down their hormone but in the long term that may be causing dysmenorrhea or make the menses doesn’t come up. But on the other side that what Chinese medicine can do is that we look at the physical signs for examples we ask them you have a pain but what kind of pain. For example, the patients can said I have a dull pain or sharp pain but even if it’s a dull pain we ask them the dull pain is more the abds or it’s more the back. For example if the dull pain is on the lower abds in Chinese medicine we like you may be in a blood deficiency. or if its on the back you may be running out of your body essence. But if it’s a sharp pain we are looking at the same thing that I will ask some simple questions like does the heat pad help if the patient said the heat pad does help then we can further elaborate are you eat a lot of cold or icy stuff or drink cold water all the time. But if the heat pad doesn’t help then we know it may be cause by the qi stagnation the we can tell the patients may have a lot of internal stress related.
Debbie: So we can differentiate the causes of the problem.
Lu: Another issue that I see a lot in the clinic is uterus fibroid but in this cause sometime they went to the Western medicine doctor to check up or sometime they don’t but still the western medicine doctor will still use the born control pill or something they use the surgical embolization. But even they take out the fibroid surgically if they didn’t treat the root issue most of the time it will come back. So in Chinese medicine we look at different cause of it. We are kinda of root-based medicine or known as philosophical so we put the patient in a better stage to become fertile instead of like we try to fix just the problem we face now. In TCM that if you have a fibroid so is it from heat or you have qi deficiency. In TCM different patient even they have same fibroid issue we offer different treatment plan or different lifestyle or diet change in order to help them.
Debbie: So when you treat the infertility patients the consultation part is very important so you have look more detail into the root of the issue instead of just look the symptoms. May be the symptoms of it is the same but the cause of it is different. A lot of patients come to us and ask what is EBT basal temperature. What is your opinion about that. They want to hear the opinion from TCM doctor and western medicine doctor.
Lu: Back in the old day, I think the first basal temperature is like 1868. And then the ovulation predict kit the doctor using today only start 1970. so that means the basal temperature have a hundred years ahead of the ovulation prediction kit. The ovulation kit that the doctor use today is base on tracking the ovulation and then because of the basal temperature take some of the factors like lifestyle, like the people who waking up at the different time or the patients are feel stress about it. So most of the doctor do not suggest you to do the basal temperature but it is a very useful tool. It’s because if you don’t go to the western medicine doctor to draw blood every day. But by looking back the basal temperature chart you can get a lot of hints about why your hormones level are out of balance. We see the patients come to us and tell us that the doctor told me that I am not ovulating this cycle. I said well because you have a false negative. By reviewing the basal temperature chart, that we will find that they are ovulation but they are just have a slow climbs on temperature to an ovulation time. In this case is simple, for the western medicine doctor can actually we should look it back that may be a simple way is getting like a trigger shot. Or for the same thing in Chinese Medicine, acupuncture, Moxa to help to boost up the ovulation at that time and make sure they will be better. Most of the time the western medicine doctors like okay so what do my progesterone level so instead of do that 5,6 days before ovulation. But when we look at the basal temperature closely suppose we need to have a good temperature climb may be about 1°F within three days. If it’s 5,6 days yet the progesterone level reached but it lose the chance for the endometrial lining to get to the certain level. It’s a very good tool but for people who are stressful or have a lot of un-interpretable temperature changes, they may not be a good candidate for this tool. Otherwise if you have a complete basal temperature for two to three cycle. You can present to the Chinese Medicine doctors. TCM doctor like me we can do a lot of reading from the chart. And we will help you to interpret. So even if you have a shift in temperature, we may be able to use TCM method to help you.
Debbie: What is your suggestion for the diet and lifestyle change?
Lu: You know it is more like Western diet vs Chinese diet. Western diet is more about nutrition but the TCM diet we based on top of that plus we get more of the property that is something the western medicine doesn’t care about. For example, during my clinic consultation to patients, I often go from two sides, on is lifestyle modifications which means that first please sleep by 11 pm. In Chinese Medicine, 11pm is the time that Liver and Gall Blabber start working and the bone marrow start producing the blood. Liver and Gall blabber start detoxification. So it will give you a better quality of blood which will be filled into your ovary and also into your uterus later. At the same time even for male, if they have sleep issues. A lot of time we see here you may run into a morphology issue which is the abnormal shape of the sperms. That’s the number one thing I will tell. The number 2 thing that I heard is people said exercise is good. But the problem is when they think it’s good they start over exercise. When people do too much exercise, they will lose too much sweat which is the essence from TCM point of view. It’s good to exercise, but for women over 30 years old probably you should do something more mild. A little sweat is good but excessive exercise is not recommended.
Debbie: What exercise will you suggest?
Lu: I will said walk number one. Yoga is probably one of the best. It is because yoga encourage you do to more breathing exercise though you lower abdomen area which all the reproductive organs are located in that area. So by breathing deep into the lower abds. Then your body will pump more energy and the blood into the lower abdominal area. But for people who do a lot of cardio exercise they may have a concaved abds, and the lower abd also firm. It means the uterus muscle may be also tight which may not have a good chance for implementation. Put it this way, if you have two 20inch thick mattress, one is hard and one is soft. If there is a bowling ball which consider as the embryo dropping into the mattress. Which one will catch first? the soft one. Thats why it is important for us to work on something that will increase the blood flood to the abdomen area and increase the softness. In chinese medicine we said the blood actually nourish the muscles.
Debbie: What about swimming?
Lu: Swimming is ok but swimming involved a lot of water so you know in chinese medicine damp kick in. So I think once per week lap swim is good enough. But I will still suggest walk, yoga & meditations or something similar to that. Now we go to the diet part, the number one thing, no ice, no cold, no raw please. Thats another western medicine problem that we see is people with endometriosis. When we trace back their history, most of them have the habit of drinking ice water or they like to eat more tropical fruits which have cold temperature or cold property. So what happen in the long term, they will cause the uterus to contract. By the time of the menstrual flow, it will shut down or make the blood flow harder. So you don’t have a good outflow. When the blood flow back it some of it are actually the endometrial tissue thats what make the endometriosis happens. Either inside or outside of the uterus. So I will recommend you anything that put into your mouth room temperature or more. So people will start asking what about salad. Yes in any USA family, they will properly have salad in their meal. My recommendation is if you want to eat salad try to eat it at room temperature. Not the salad directly out from the fridge. But there are a few vegetable, I will recommend you to take that out. Number 1 cucumber and number 2 is tomato. They are very cold in nature from TCM point of view. If you want to have a cup of hot tea and hot soap go together with the salad that will be great.
Debbie: How about ginger tea?
Lu: Ginger is good but you have to look at the ginger tea ingredients. Some of the ginger tea involved like caramel, mint or some extra ingredients that may not be a good idea. If you just cut some slides of ginger and soak in the water that will be great.
Vegetarian population has increased. It’s ok as long as you have enough protein in the system. So one thing they try to do is drinking milk. Milk is good but something milk give you the Chinese medicine phlegm which may be one of the cause of fibroid or sis. In TCM view, milk is cold in nature. if you can cook the milk a little bit before you drink them that will be great.
Debbie: What about spicy food and deep fried food?
Lu: it’s ok as long as you have a tolerance. You know some people eat a lot of spicy food in their culture. But what I will suggest patients is if they would like to get pregnant , they are recommended to cut down those food. Because if you take too much spicy food, it will eventually causing too much heat in your body system. It will cause blood heat or eventually drain your essence. It’s due to your body will use a lot of fluid to balance the heat in the body.
Debbie: When should a infertility patient start acupuncture?
Lu: In order help the fertility process, I will suggest the couple start the treatment 16 days ahead.
Debbie: do you suggest the husband also do the acupuncture ?
Lu: Since the female will be the host for the following 36 weeks, so the treatment definitely focus on the mother. But for the male part, if they have a more relaxed mind, it can help them to produce better quality sperms. Acupuncture can definitely help them to relax. But male can also have infertility issue. We have to be fair, you know, not only women have to take all the responsibility. We have the male factors too. Some of the male factors are the low sperms counts or low mobility. For the morphology issue even TCM can help but both western and Chinese medicine is not have a very clear direction for the treatment of this issues. But I do see the trend that people nowadays people like to stay up late. And some people need to stay up at night because they need to work with oversea stuff. It could be a factor that affect both female and male. Clinically I suggest male patients to take a lot of antioxidant supplement may be hopefully it can help with the morphology issue.
Debbie: Do you have any case that you want to share with us?
Lu: Years back, there was a girl , she’s only about 30 or 31 years old. And she was referred to me by one of the director in the fertility center saying that she did 2 previous IVF. She has less than 20% fertilization rate and nothing to preserve like day 5 to be transferred or to be frozen. And most of them only can get 1, 2 embryo to be transfer. And have a hard time to get the lining up. At that time you is already taking Chinese medicine from other TCM practitioner. Because it’s referred by the fertility center, I was responsible for the acupuncture part for her. After two months of treatment, we give her a green light to go back to do another IVF cycle. That cycle she have approximate 14 follicles. Those follicles are not from both because one of ovary was removed. We have a tough time to recover the health of the remaining ovary at that time. And surprisingly there are 14 follicles are stimulated out. And surprisingly she has a 70% fertilization rate. And it’s the first time she is able to do the day 5 transfer. But unfortunately, this time is still unsuccessful. I start getting curious that what Chinese medicine she is taking from the other TCM practitioner. She showed me the bag and I add some more herbs to eat in order to clear the heat in her body. After she took the modified herbal formula for a month, she go to do the IVF again. And now her little boy is one of our family friend. He and my daughter are actually at similar age.
Debbie: This is the joyful part that we are talking about.
Lu: The director ask me what we have done, and I said I just do a modification in the herbal formula. Its because the IVF drugs are actually causing the accumulation of heat in the body. When the IVF just keep pushing the ovary will just quit. It’s just like a machine if it doesn’t have a good cooling system, it will at some point just quit on you. So with acupuncture and the herbal to help , it actually make the ovary better.