The Connection Between Sleep, Melatonin, acupuncture Chinese medicine and Fertility
Sleep plays a crucial role in our overall well-being, and recent research has shed light on its importance in the context of fertility. Studies have shown that women who experience better sleep patterns may have an increased chance of conceiving, particularly through in vitro fertilisation (IVF). One key factor that contributes to restful sleep is the hormone melatonin. In here we will explore the relationship between a good night’s sleep, melatonin, and fertility, and also delve into how acupuncture and Chinese herbal medicine can further aid in promoting restorative sleep.
Understanding Melatonin and Its Sleep-Inducing Benefits
Melatonin is a naturally occurring hormone produced by the pineal gland in humans. Its primary role is to regulate the sleep-wake cycle and promote a state of drowsiness. The hormone’s secretion is influenced by natural light exposure, with production increasing in response to darkness and decreasing when exposed to light. Beyond its role in sleep regulation, melatonin also acts as a potent antioxidant, helping to repair cellular damage caused by stress and oxidation.
Melatonin’s Impact on Fertility
Recent research presented at the World Congress of Fertility and Sterility and published in the Journal of Pineal Research has revealed the link between melatonin and fertility. Women who were given melatonin showed promising results, with significantly increased melatonin concentrations in their follicles and decreased concentrations of the damaging compound 8-OhdG. Consequently, the melatonin group had a higher success rate of 50% for successful transfer of follicles into the womb, compared to 22.8% in the control group. Furthermore, pregnancy rates in the melatonin group were 19%, compared to 10.2% in the control group.
Naturally Boosting Melatonin Levels
If you’re looking to improve your chances of conception and overall sleep quality through increased melatonin levels, there are several natural approaches you can consider:
Establish a Consistent Sleep Schedule: Going to bed early and waking up early can significantly improve your sleep quality. Aim to go to bed at 10 pm for at least four nights a week, and gradually adjust your bedtime if you are used to sleeping later.
Embrace Morning Sunlight: Exposing yourself to natural sunlight in the morning helps inhibit melatonin production, signalling to your body that it’s time to wake up. Engaging in activities like yoga or tai chi during this time can further enhance your overall well-being.
Include Melatonin-Rich Foods: Certain foods contain naturally occurring melatonin, such as green vegetables, fish, turkey, whole grains, lentils, and bananas. Incorporating these foods into your diet may help support melatonin production.
Reduce Stress: High-stress levels can disrupt sleep patterns and melatonin production. Practicing relaxation techniques, mindfulness, and meditation can be beneficial in reducing stress.
Limit Light Exposure at Night: Minimise exposure to artificial light at night, including electronic devices like phones and laptops. Avoid turning on lights when using the bathroom during the night to prevent interference with melatonin production.
Acupuncture & Chinese Herbal Medicine for Sleep
In addition to these lifestyle changes, traditional Chinese medicine offers effective methods to improve sleep quality. Acupuncture, an ancient practice involving the insertion of thin needles into specific points on the body, has been shown to help regulate the sleep-wake cycle and promote relaxation. It can also address underlying imbalances that may contribute to sleep disturbances.
Chinese herbal medicine, with its rich history of promoting overall well-being, includes various herbs known for their calming and sleep-inducing properties. Combining acupuncture with Chinese herbal medicine can create a synergistic effect, helping individuals experience more restful and rejuvenating sleep.
Conclusion
A good night’s sleep is not only essential for our daily functioning but can also play a vital role in fertility. Melatonin, the hormone responsible for regulating our sleep-wake cycle, has been found to positively impact fertility outcomes, particularly in IVF treatments. By adopting natural methods to boost melatonin levels and incorporating practices such as acupuncture and Chinese herbal medicine, individuals can further enhance their sleep quality and overall well-being. If you are experiencing persistent sleep issues, consider consulting a healthcare professional or an acupuncturist experienced in treating sleep disorders to explore personalised solutions and embark on a path to better sleep and improved fertility.
References
Vickets (2010) Melatonin could improve women”s IVF success, found at http://www.ivf.net/ivf/melatonin-could-improve-women-s-ivf-success-o5387.html, sited 3/9/12
B Best (2012) Melatonin, http://www.benbest.com/nutrceut/melatonin.html, sited 3/9/12
A Hunter (2012) How to increase your natural melatonin production, http://www.livestrong.com/article/510836-how-to-increase-your-natural-melatonin-production, sited 3/9/12
31-year-old Sarah came to see me at Almond Wellness Centre, our acupuncture Chinese medicine clinic. Sarah had been trying to get pregnant for over a year without any success, and was concerned that her short menstrual cycles might be hindering her chances.
Sarah’s period was so short that she almost had two periods in one month. Her first period lasts for 5 days, normal flow with mild cramping and some PMS. She then has another period a few days later. The second “period” is light or spotting only, with clear stretching discharge and some cramping or sharp pain on the sides of lower abdomen.
I suggested her to do ovulation test and check her basal body temperature (BBT). From her BBT and ovulation history we discovered that she was not actually having two periods in one month, but was experiencing ovulation bleeding instead.
So, what is ovulation bleeding?
Ovulation bleeding is light bleeding or spotting that occurs during ovulation.
The exact cause of ovulation bleeding is not clear, but it is thought to be related to changes in hormone levels that occur during ovulation. The surge in oestrogen and luteinising hormone that triggers ovulation can cause some women to experience spotting or light bleeding.
Does ovulation bleeding affect fertility?
Ovulation bleeding is generally not a concern; however, it may affect chances of getting pregnant. For instance, Sarah thought that she was having period. She avoided having intercourse during that period time, therefore missed her fertile windows and had difficulty to get pregnant.
Chinese medicine and ovulation bleeding
In Chinese medicine, ovulation bleeding is seen as a sign of disharmony in the body’s energy, or qi. This disharmony can be caused by a variety of factors, including stress, poor diet, and hormonal imbalances. A Chinese medicine practitioner will work to identify the root cause of the problem and develop a customised management plan. In addition, dietary and lifestyle changes may be recommended to support your overall health and improve your chances of getting pregnant.
Because Sarah was avoiding intercourse during her bleeding time, she was actually missing her fertile windows, which made it more difficult for her to conceive. After following her treatment plan and other advice, her period became more regular and her ovulation bleeding stopped. She could “time it right” – having intercourse during her fertile windows. A few months later Sarah successfully became pregnant, much to her delight and relief.
So, if you are experiencing two periods in one month, with light flow or unusual spotting or discharge, you may actually be experiencing ovulation bleeding. Don’t let ovulation bleeding or any other menstrual irregularities get in the way of your dreams of becoming pregnant. With the right treatment and care, you can improve your chances of conception and start your journey towards motherhood.
It’s worth noting that while some people respond positive to Chinese medicine treatment on fertility outcomes, others have found no significant benefits. You should consult with your fertility specialist and registered Chinese medicine practitioner before start any treatment.
An estimated 15% of couples in the world suffer from infertility. According to a survey in 2013 by the National Institute of Health and Clinical Optimization (NICE) in the United Kingdom, male factors have become the main reason for infertile couples to use assisted reproductive therapy (ART).
Male infertility is mainly diagnosed by routine semen analysis (WHO standard), including semen volume, concentration, vitality and morphology.
Although studies have shown that semen quality and ART outcome are correlated, until now, we have not found a conventional semen threshold that can predict the success of ART.
Recent studies have shown that sperm DNA fragmentation (SDF), including sperm DNA single-strand breaks and double-strand breaks, are all related to male infertility factors, which can adversely affect the male reproductive system and increase the risk of genetic diseases in offspring .
Two previous Meta-analysis studies have shown that SDF is related to ART failure and repeated pregnancy loss.
However, human sperm itself does not have DNA repair activity (DRA). Once fertilised, DRA mainly depends on the transcripts produced during the maturation of the oocyte to repair it. The ability of oocytes to repair SDF depends on the degree of fragmentation of SDF and the quality of oocytes.
Therefore, reproductive medicine researchers from Sao Paulo, Brazil, conducted research on women’s age and SDF and the outcome of intra-cytoplasmic sperm injection (ICSI) assisted pregnancy.
Amanda Souza Setti et al. collected 540 couples who underwent ICSI at the centre from May 2017 to December 2019, and divided the ICSI cycle into three groups according to the age of the woman: ≤36 years old (285 cases), 37-40 years old ( 147 cases) and >40 years old (108 cases).
Sperm chromatin diffusion test was used to evaluate the SDF of semen specimens.
For each age group, according to the SDF index, the ICSI cycle is divided into two subgroups: low fragmentation index (SDF <30%) and high fragmentation index (SDF ≥ 30%).
Summarised and analysed the outcome indicators such as embryo implantation rate, pregnancy rate and abortion rate.
The study found that: for young patients (36 years old) and patients between 37-40 years old, whether SDF <30% or SDF ≥ 30%, the laboratory and clinical results of the ICSI cycle were not significantly different.
When female patients are older than 40 years old, compared with SDF<30%, in an ICSI cycle with SDF ≥ 30%, the rate of D3 high-quality embryo acquisition (54.4% vs 33.1%) and the rate of blastocyst formation (49.6% vs 30. 2%), pregnancy rate (20.0%vs7.7%) and implantation rate (19.7%vs11.9%) were significantly reduced, while miscarriage rate (12.5%vs100.0%) increased.
Results
This study showed older oocytes, when injected with sperm derived from samples with high SDF (Sperm DNA Fragmentation) index, develop into embryos of poor quality that lead consequently to lower implantation and pregnancy rates and higher miscarriage rates, in intracytoplasmic sperm injection cycles from women with advanced maternal age.
The results of this study are of great significance to clinical work:
Women’s age cannot be changed, but male SDF can be improved through diet, environment, lifestyle changes, antioxidant and other therapies.
This study may provide new ideas for improving the ART pregnancy rate of elderly couples and reducing the abortion rate.
Reference:
Oocyte ability to repair sperm DNA fragmentation: the impact of maternal age on intracytoplasmic sperm injection outcomes
Fertility and Sterility (IF7.329), Pub Date : 2021-02-13, DOI: 10.1016/j.fertnstert.2020.10.045
Amanda Souza Setti, Daniela Paes de Almeida Ferreira Braga, Rodrigo Rosa Provenza, Assumpto Iaconelli, Edson Borges
Is maternal caffeine intake associated with neonatal anthropometry?
Findings
In this cohort study of 2055 women from 12 clinical sites, measures of caffeine consumption (plasma caffeine and paraxanthine and self-reported consumption) were associated with neonatal size at birth.
Increasing caffeine measures were significantly associated with lower birth weight, shorter length, and smaller head, arm, and thigh circumference.
A study has found that caffeine consumption during pregnancy, even in amounts less than the recommended 200 mg per day, is linked to smaller neonatal anthropometric measurements.
The longitudinal cohort study in JAMA Network Open concluded that compared to women who drank no, or very little caffeine, women who drank the most caffeine (a plasma caffeine level of ≤ 28 ng/mL) had neonates who weighed 84 g less, were 0.44 cm shorter in length, a 0.28 cm smaller head circumference, a 0.25 cm smaller arm circumference, and a 0.29 cm smaller thigh circumference.
“Most of the research on caffeine and neonatal size at birth focuses on birthweight and length, while relying on self-reported measures of caffeine consumption.,” said senior author Katherine Grantz, MD, an investigator in the Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, in Bethesda, Maryland.
The current study analyzed data from the NICHD Fetal Growth Studies–Singletons, which enrolled 2,055 nonsmoking women at low risk for fetal growth abnormalities with complete information on caffeine consumption from 12 U.S. clinical sites between 2009 and 2013.
“In the NICHD Fetal Growth Studies, we have rich data on multiple measures of neonatal anthropometry to more specifically characterize neonatal size, as well as objective measures of plasma concentrations of caffeine and its primary metabolite, paraxanthine,” Grantz told Contemporary OB/GYN.
The two main sources of caffeine were coffee and soda, which accounted for 35% and 41% of caffeine intake, respectively.
Caffeine was evaluated by both plasma concentrations of caffeine and paraxanthine and self-reported caffeinated beverage consumption measured/reported at 10 to 13 weeks gestation.
Caffeine metabolism was defined as fast or slow, based on genotype information from the single nucleotide variant rs762551.
“Prior caffeine studies have observed lower birthweight after consumption of higher amounts of caffeine — usually 200 to 300 mg, or 2 to 3 cups of coffee, daily,” said Grantz, who served as a co-principal investigator of the NICHD Fetal Growth Studies.
Before starting their analyses, the current authors knew that the average consumption in the sample was much lower, about 35 mg/day, and only 16 women reported drinking more than 200 mg/day.
Because of this low consumption, we were uncertain we would see any significant results, so it was surprising that we still found that increasing caffeine consumption, even at low levels, was associated with some smaller anthropometric measures in the offspring,” Grantz said. “Also, the finding that the decreases in birthweight were manifested by decreases in bone and muscle measures, but not skin folds and fat mass, were unexpected. These findings may indicate decreases in lean tissue as caffeine consumption increases.”
The clinical implications of the study are unknown, considering there were only small reductions in some neonatal anthropometric measures, Grantz said. “Other evidence suggests that even small amounts of caffeine intake during pregnancy (50 mg/day) could be associated with a higher risk of excess growth in infancy and childhood that could put children at higher risk of later cardiometabolic disease,” she said.
“Therefore, our results could indicate some disruption in normal fetal growth patterns, but will require more research to confirm.”
Although the study authors are unable to make recommendations based on the results of their single study, “we encourage pregnant women to talk to their providers about caffeine consumption, and suggest that caution may be warranted,” Grantz said.
The next step for the investigators is to evaluate the serial ultrasounds and fetal volumes conducted throughout pregnancy by the NICHD Fetal Growth Studies to determine when changes begin in fetal growth in relation to caffeine measures, and how these changes may be manifested in fetal volumes.
Disclosure
Grantz reports no relevant financial disclosures.
Reference
Gleason JL, Tekola-Ayele F, Sundaram R, et al. Association between maternal caffeine consumption and metabolism and neonatal anthropometry: a secondary analysis of the NICHD Fetal Growth Studies–Singletons. JAMA Network Open. Published online March 25, 2021. doi:10.1001/jamanetworkopen.2021.3238
broccoli is the star but eating plenty of green vegetables of the cruciferous family help the liver metabolise oestrogen.
Other cruciferous vegetables include: Bok-Choy, Brussels sprouts, Cabbage, Cauliflower, Chinese cabbage, Daikon radish, Horseradish, Kale, Radish, Turnip and Watercress.
Eat high fibre foods to help oestrogen bind in the bowel and assist elimination.
One source suggests that eating 1/2 cup of raw grated carrots can be enough fibre to assist in elimination
Decrease alcohol consumption
Assist the liver by drinking St Mary’s Thistle and Dandelion tea
Avoid soy
Eat a no sugar and no gluten diet
sugar and gluten are both highly inflammatory in susceptible people so should be avoided when possible
Be mindful of too many vitamins, supplements, medications and even caffeine that all need to be processed by the liver, where possible space them out through the day.
Chinese herbal medicine
Some Chinese herbal medicine /formula may help assist in balance your hormone. You may contact us for details.
Natural Ways to Increase Progesterone
Reduce stress
google progesterone steal if you are more interested in how stress affects progesterone levels
Supplements:
750 mg vitamin C per day (increased progesterone 77% and improved fertility)
600 mg vitamin E (increased progesterone in 67% of patients)
6 g L-arginine (increased progesterone in 71% of patients)
Increasing beta carotene in your diet, as found in:
Apricots, Asparagus, Broccoli, Carrots, Chinese cabbage, Chives, Dandelion leaves, Grapefruit, Herbs and spices – chilli powder, oregano, paprika, parsley, Kale, Onions, Peas, Peppers, Plums, Pumpkin, Spinach, Squash, Sweet potatoes. So again, get onto those carrots!
Supplementing with
Vitex Agnus Castus 1000mg daily
Black Cohosh or as we call it in Chinese Medicine ‘Sheng ma’ on days 1 to 12 (increases progesterone and fertility).
Weight loss
Improving insulin sensitivity (for example metformin increases progesterone levels 246%, chromium supplementation can help in regulating blood sugar in combination with a low sugar and low carbohydrate diet)
Replacing saturated fat in the diet with unsaturated fat
Eating a high protein, low carbohydrate diet
Lowering TSH levels in subclinical hypothyroidism
Chinese herbal medicine
Some Chinese herbal medicine /formula may help assist in balance your hormone. Contact us for details.
31-year-old Sarah came to see me at Almond Wellness Centre, our acupuncture Chinese medicine clinic. Sarah had been trying to get pregnant for over a year without any success, and was concerned that her short menstrual cycles might be hindering her chances.
In Chinese medicine, ovulation bleeding is seen as a sign of disharmony in the body’s energy, or qi. This disharmony can be caused by a variety of factors, including stress, poor diet, and hormonal imbalances. A Chinese medicine practitioner will work to identify the root cause of the problem and develop a customised management plan. In addition, dietary and lifestyle changes may be recommended to support your overall health and improve your chances of getting pregnant.
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