What are the causes of infertility from a TCM perspective?

Thanks for the D2D. From a TCM perspective, the kidneys, spleen and liver are the most important organs in maintaining fertility. The kidneys play a key role in successful conception and reproduction. The spleen is in charge of producing qi and blood while the liver is responsible for maintaining its smooth flow within the body.

Kidney and spleen deficiency can result in reduced nourishment to the reproductive organs, which may in turn hinder conception. Weak body constitution, poor diet and unhealthy lifestyle are the common causes for deficient kidney and spleen syndrome.

Liver qi stagnation is another common reason for infertility. A fast pace life, demanding jobs and lack of work-life balance is undoubtedly causing mental and physical stress on the body, impacting fertility. Stress affects liver qi, hindering smooth circulation of qi and blood to the entire body, including the reproductive organs.

In the women, it can affect her ovulation and implantation. She may also produce poor quality eggs. In the man, it affects his sperm count and quality. His sexual performance may also decline.

From a TCM perspective, there are two main types of causes for infertility:

1. An abnormality in the reproductive organs, which are not treatable with medication.
2. An imbalance of Yin and Yang in our system, causing dysfunction to our reproductive system.

From TCM perspective, your “kidney" can affect your reproductive system (肾主生殖) and that energy from our “kidney" (qi) is critical in the development of our reproductive abilities. Therefore, the main cause of infertility in both men and women is usually “kidney deficiency” (肾虚). The possible symptoms of these are:

Ladies: Irregular menstruation cycle, frequent nocturia, sore back & etc

Men: Erectile dysfunction, low sex drive, frequent nocturia, sore back & etc

However, we must take note that the term “kidney” in TCM is NOT equivalent to the kidney organ in Western Medicine.

Traditional Chinese medicine explains the concept of kidney mainly from a functional point of view, covering the human body's reproduction, urinary, nerve, bone and other tissues and organs, and it plays a role in regulating human body functions and providing “life force” (元气)that sustain life.

Whereas the kidney in Western medicine refers to the kidney organ, which excretes toxins and metabolites, regulates water, electrolyte, acid-base balance, and regulates red blood cell metabolism. The concepts of these two “kidneys” are completely different.

It is also common that “Kidney Deficiency” syndrome is present together with other syndromes (not exhaustive):

1. “Liver Energy (Qi) stagnation syndrome(肝气郁结)”
   Possible symptoms are mood swings, anger, frustration, anxiety, sadness & etc.

2. “Phlegm and Blood stasis syndrome(痰瘀互结)”
   Possible symptoms are overweight, tend have phlegm, purplish tongue, sub-lingual varicose vein, presence of blood clots in menstrual blood, menstrual cramp, varicocele & etc.

3. “Dampness and heat diffusing downward syndrome(湿热下注)”
   Possible symptoms are feeling damp and itchy around the genital area, having green and/or yellowish discharge from the penis/vaginal, smelly penile/vaginal discharge & etc.

Note: The "liver" in Chinese medicine is totally different from the "liver" in western medicine. The "liver" in Chinese medicine covers not only the digestive functions of the substantial organs, but also the functions of mental emotions, circulatory system, and motor system. It is the overall concept of the heart, brain, nerves, spleen and stomach and other organs. Whereas the "liver" of western medicine is the largest gland with complex functions in the human body, it is an important organ for digestion and detoxification. Hence the “liver’ in Chinese medicine should not be confused with the specific anatomical liver.