Hi John,

I am currently treating a 41 year old woman who really wants to get pregnant. She is definitely yin deficient and has liver qi stagnation. I have her on Wu Ji Bai Feng San. She has just been coming a couple of months. Any suggestions.

                                   - Santa Cruz Acupuncturist

Dear Santa Cruz Acupuncturist,

I will send you a draft of the new book that I am working on to explain how to treat fertility using Chinese Medicine.

With kidney yin xu and liver qi issues I usually do a 4 formula per month protocol.  Assuming a 28 day cycle it might be divided up like this:  Not exactly this but the idea of this pattern.

1.A blood moving formula  during menstruation. day 1-5

2.A yin and blood formula day 5-12

3.A liver depression/heart formula day 13-15 (always do acupuncture here!!!!!!!

4.A kidney yang (with some yin) formula for days 16-28.

Would definitely want to get a BBT chart.  Need at least two months so that you can see the patterns clearly.  Obviously keep treating in the meantime to get it all in balance, but once you have the BBT charts it is so easy.

In a woman this age there will be lot of weak eggs.  These may only be viable for 6-12 hours despite what textbooks say.  So, if you wait for the temperature to rise, indicating ovulation, it may be too late.  This is a very common problem that many acupuncturists often don't catch.

Optimal intercourse is 1 day BEFORE temperature rise

2nd best is the day of the temperature rise

3rd best is two days before temperature rise

The sperm will be viable for around 24 hours so best to have them on site when the egg gets there, or just after it gets there.

Need about a 12 day temperature peak in the luteal phase to indicate adequate progesterone or Kidney yang levels.  The rise and fall should be quick around the 12 day peak.

I like your choice on the the herbs.  Wu Ji Bai Fang is very yin enriching with qi and blood tonics, so I would really see using it during phase 2 of the cycle.  I would probably (depending on the BBT) want more yang added during phase 4.  I would certainly add Tu Si Zi as a minimum at phase 4 and likely at phase 2 also.

Good luck.  I find the fertility part of my practice to be extremely rewarding and exciting.

                         - Dr. John Nieters, L.Ac. DAOM, FABORM