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Women’s Functional and Integrative Medicine Professional Training

Optimizing Fertility: Specific Botanicals

M O D U L E 1 5

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Specific Herbs for Fertility

Romm, A. Botanical Medicine for Women’s Health. Elsevier, 2017.

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Herbal Medicine for Fertility

• Herbs have been used practically since time immemorial to enhance fertility.

• Categorically included ‘uterine tonics,’ aphrodisiacs, nervines, and adaptogens.

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Vitex• Vitex is beneficial for ovulatory factors

associated with infertility, in particular, modulating the anterior pituitary's production of luteinizing hormone (LH), and reducing hyperprolactinemia.

• Chaste berry should be considered a first-line botanical therapy for infertility associated with secondary amenorrhea, hyperprolactinemia, and luteal insufficiency, and should be given for a duration of at least 3 to 6 months.

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• In an uncontrolled study, chaste berry reduced elevated prolactin levels in 80% of 34 women with hyperprolactinemia at a dosage of 30 to 40 mg per day for 1 month and improved corpus luteum function.

• In another uncontrolled studies involving 45 infertile women with normal prolactin and pathologically low progesterone, 39 of the women achieved pregnancy after 3 months on chaste berry.

• In yet another study involving 31 women with infertility, after 3 months 15 of these women were pregnant. Of these, seven women who became pregnant using chaste berry, seven previously had amenorrhea, four had luteal insufficiency, and four had been diagnosed with unexplained infertility.

• Chaste berry is particularly effective in restoring the menstrual cycle in a woman after years of taking oral contraceptive pills and improving low LH levels.

• Dose: 5 mL tincture or 360 mg dried herb daily.

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“Fertility Blend”• A 2006 double-blind RCT tested the use of the polyherbal supplement

Fertility Blend (FB), containing chasteberry, green tea, L-arginine, vitamins (including folate) and minerals for the improvement of fertility in women.

• 93 women met eligibility criteria (unable to conceive for 6-36 months) and were randomized to receive the supplement or placebo for 3 months. Outcomes measured included BBT, progesterone, menstrual cycle length, and rates of conception.

• The FB group (n=53) experienced more days with BBT higher than 98 deg, high mid luteal serum progesterone, normalization of menstrual cycle length, and 26% of women were pregnant after 3 months. In contrast, the control group (n=40) did not experience changes among these parameters, and a 10% pregnancy rate was observed. The treatment was well tolerated.

Clin Exp Obstet Gynecol. 2006;33(4):205-8.

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Maca• Traditionally used for fertility, as an aphrodisiac

(men and women), and for vitality. Does appear to increase libido, including when SSRI suppressed. Does not appear to be acting hormonally.

• The only evidence investigating a link between Maca consumption and pregnancy is one conducted in mice where 1g/kg lyophilized (2.16g/kg dry weight) Maca, correlating to traditional usage amounts and consumed prior to and shortly after fertilization, noted increased litter size without any influence on gender ratios and not associated with any adverse pup morphology or viability

Reprod Biol Endocrinol. (2005)CNS Neurosci Ther. 2008 Fall;14(3):182-91.

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• In another study, a range of dosages of Maca were given to female rats, ranging from 3 to 30g Maca/kg for a period of 7 weeks prior to the cycle during which the study was performed. During the first half of the rats’ cycle (which would correspond with the first half of the menstrual cycle in humans) a 4.5-fold increase in luteinisinghormone (LH) was observed in rats fed the Maca powder when compared to control rats. It appeared that the LH surge increased with dose, in a similar manner to how a pharmacological drug would work. Luteinizing hormone deficiencies can have serious impacts on ovulation and fertility.

• Dose: 1,500-3,000mg/day

Reprod Biol Endocrinol. (2005)CNS Neurosci Ther. 2008 Fall;14(3):182-91.

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White Peony• Paeonia has been shown to positively influence low

progesterone, reduce elevated androgens (testosterone), and modulate estrogen and prolactin.

• In vitro, the active constituent paeoniflorin has been shown to affect the ovarian follicle by its action on the aromatase enzyme, supporting follicular maturation, ovulation and corpus luteum function, steroid hormone synthesis, and the regulation of conversion of androgens to estrogens.

• In TCM, white peony is used in combination with other herbs. When combined with Glycyrrhiza glabra(licorice), Paeonia lactiflora is considered effective at promoting fertility and improving pregnancy rates in cases of androgen excess.

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Shatavari• Shatavari is a traditional Ayurvedic herb said to “give her capacity to have a hundred

husbands.”

• Shatavari has been used as a nutritive tonic, general female reproductive tonic, fertility tonic, treatment for sexual debility, and as an aphrodisiac. It has also been used traditionally as a tonic for lactating women to improve the quality and quantity of breast milk.

• Pharmacologic research has found the key constituents of shatavari are steroidal saponins, including shatavarin-I, alkaloids, and mucilage. The presence of the steroidal saponins suggest activity as an estrogen modulator and a menstrual cycle regulator.

• Shatavari has adaptogenic and immunomodulating properties and can be used as a tonic herb for women with stress-induced and immune-mediated infertility.

• The daily dose is 4.5 to 8.5 mL of a dried plant extract. There are no known contraindications to the use of shatavari.

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Tribulus• Bulgarian tribulus has become a popular herb for the treatment of infertility,

menopause, and low libido. It is thought to act as a general tonic, aphrodisiac, and is used to restore vitality, reduce the physiologic effects of stress, and as a powerful fertility tonic for both men and women.

• Open-label clinical trials have demonstrated improvements in both male and female infertility.

• When given at a dose of 750 mg per day for 5 days it increased serum FSH and estradiol when compared with baseline in females, and increased LH and testosterone in males, demonstrating an increase in sex hormone production for both men and women. The steroidal saponins are thought to bind and weakly stimulate the hypothalamic estrogen receptor sites.

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• In an open study with 36 infertile women who were given tribulus on days 5 to 14 of the menstrual cycle for 2 to 3 months, 6% became pregnant as a result of normalized ovulation, 61% demonstrated normalized ovulation and no pregnancy, and 33% demonstrated no effect from tribulus within the 2- to 3-month time frame of the study.

• In this same study, another subgroup of women used tribulus concurrently with pharmaceutical ovarian stimulation with the drug epimestrol. Of the 62 women in this group, within 2 to 3 months, 39% had normalized ovulation and resultant pregnancy, 35% had normalized ovulation with no pregnancy, and the remaining 26% had no effect from the combined therapy.

• The daily dose of tribulus is equivalent to 40 g per day of dried leaf or a concentrated extract standardized to contain a minimum of furostanon saponins as protodioscin at 300 to 400 mg per day. It is thought best used on days 5 to 14 of the menstrual cycle for enhanced fertility.

• Tribulus is contraindicated in pregnancy, so discontinue use during the luteal phase and do not resume use if pregnancy is suspected.

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Acupuncture, TCM, and Fertility

Reproductive Endocrinology and Infertility: Integrating Modern Clinical and Laboratory Practice, DOI 10.1007/978-1-4419-1436-1_50, 2010

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Voila! The Fun Part of the Job

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