Use of Herbal Medicine improved pregnancy rates as much as 2-fold in just a 4-month period in comparison with fertility drug therapy or IVF (1)

Multiphasic approach in Western herbal medicine usually involves two or three distinct formulas (biphasic or triphasic formulations). The first formula, or follicular formula, is generally begun after menstruation and continued until just before ovulation begins. The second, or luteal formula, is begun at ovulation and continued until menstruation stops. Optionally, a third, or menstrual formula, is given from when bleeding starts until it stops.

Indications for multiphasic prescribing include menorrhagia, lengthened or shortened cycles, female infertility, anovulatory cycles, premenstrual syndrome, dysmenorrhea, uterine fibroids, and endometriosis, among others. Often, it takes multiple cycles for multiphasic formulas to have their full and complete impact. (2)

Most Powerful herbal medicines for Female Infertility:

Vitex agnus-castus (Chaste tree)

The fruits of the Vitex agnus-castus L. shrub, also known as the Chaste tree, have been used for hundreds of years to regulate the functioning of the reproductive organs in women. The ability of Vitex to normalize apparently contradictory conditions suggests that its action is adaptogenic. It may work by exerting control over the pituitary gland.

Clinical uses of Vitex is very high among those practicing herbal medicine in the UK and Ireland to treat female infertility (89.5%) and for female acne (79.7%). It takes four to eight weeks for a patient to respond to treatment with Vitex. 85% of herbalists use a Tincture, prepared by maceration of 1 part dried herb to 5 parts of aqueous alcohol, was cited as the most often used Vitex preparation (3)

All human and animal studies reported in the literature have shown Vitex to be safe and well tolerated at medicinal doses, with no indications of toxic effects

Vitex has been shown to have dopaminergic effects in the pituitary gland, suppressing prolactin levels, which are often associated with premenstrual syndrome, as well as correcting luteal-phase defects (corpus luteum insufficiency or low progesterone secretion in the luteal phase of the menstrual cycle) often seen in women with infertility (4)

A randomized, placebo-controlled, double blinded clinical study found that a vitex berry extract, significantly increased the rate of pregnancy in 96 patients with amenorrhea and luteal insufficiency (5)

Fenugreek seed (Trigonella foenum-graecum)

Polycystic ovary syndrome (PCOS) is characterized by the imbalance of normal female hormones, likely due to ovarian cysts, and may lead to diabetes, heart disease, and infertility

In women taking a water-ethanol extract of fenugreek seed standardized to contain 40% furostanolic saponins, 94% of patients saw improvement in PCOS in some form, whether reduction or elimination of cysts, regular menstrual cycles, or pregnancy (12% of patients became pregnant during the study), showing that daily consumption of fenugreek extract resulted in improvement of PCOS symptoms and characteristics (6)

Ashwagandha (Withania somnifera)

42 scientific studies were reviewed. The human studies all used root extracts, given orally; duration ranged from eight weeks to three months. Most human studies did not observe any side effects for ashwagandha. The herb was found to improve reproductive system function by many ways.WIthania extract improved luteinizing hormone and follicular stimulating hormone balance leading to folliculogenesis maturation of the eggs) and increased gonadal weight (ovary). The herbal medicine was found to enhance sexual behaviors in females (7) and showed a 14% increased rate of success of pregnancy in the partners(8)

Importance of a herbal formula when treating female infertility

Instead of taking just one herbal medicine at a time if infertile, there is great benefit is taking a formula of the best herbs mixed together, like in tincture form, which a traditional herbalist would generally use, and mostly what I dispense at the clinic. The research validated this approach strongly

The research reviewed 30 earlier studies of over 1800 women with infertility and found that “Herbal Medicine achieved, on average, a 60% pregnancy rate over 4 months compared with 30% achieved with standard western drug treatment, or IVF over 12 months (1). Another study of a formula of chineese herbs resulted in higher success rates of pregnancy, with no patient side-effects.

It showed that 56% became pregnant out of a category of patients conventionally classified as having unexplained infertility (9). Post-treatment levels of follicle stimulating hormone (FSH) were significantly lower (P<0.001), which is important because lower FSH levels indicate greater ovarian health and enhanced fertility. Endometrial thickness on Day 21 increased following treatment (P<0.001), creating a better environment for the implantation of an embryo. The authors write that the treatment may help to increase endometrial thickness prior to in vitro fertilization, increasing the chances of implantation

Hormone imbalances

Herbs for follicular phase: there has been little investigation into the effect of herbs exclusively on hormonal levels during the luteal phase. Although several herbs are considered to be hormone balancers for this phase, they have not been researched. Among those are sarsaparilla (Smilax spp.) root, partridge berry (Mitchella repens), and lady's mantle (Alchemilla vulgaris). The main approach to the luteal phase is to remove herbs that are more focused on the follicular phase, to maintain hormone regulators without a cyclic component, and to manage any other symptoms

Among the herbs that should be used throughout the menstrual cycle are those that support normal uterus tone and function. There is little research on these herbs; their use is based on traditional practice. They include aletris (true unicorn; Aletris farinosa) rhizome, blue cohosh (Caulophyllum thalictroides) root, and false unicorn (Chamaelirium luteum). In India's herbal tradition, shatavari (Astragalus racemosa) is employed as a general fertility tonic for men and women. In Australia, shatavari is now a popular substitute for the endangered false unicorn root (Chamaelirium luteum)

Also indicated in women with chronic reproductive problems are pelvic lymphagogues. The most important of these is ocotillo (Fouquieria splendens) bark, although desert ceanothus (Ceanothus greggii) root can be used when ocotillo is not available

References

1)Internal reference Ried K1, Stuart K .Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: a systematic review. Complement Ther Med. 2011 Dec;19(6):319-31

2) Yarnell E, Abascal K. Multiphasic herbal prescribing for menstruating women. Altern Complement Ther. June 2009;15(3): 126-134.

3) Current Use from a Survey of Practitioners European Journal of Herbal Medicine. 1997-1998, Vol. 3 (3):29-45

4) Wauttke W, Jarry H, Christoffel V, et al. Chaste tree (Vitex agnus-castus) pharmacology and clinical indications. Phytomed. 2003;10:348-357

5)Horowitz S. Treating infertility Altern Complement Med. 2006; August:165-171.

6)Swaroop A, Jaipuriar AS, Gupta SK, et al. Efficacy of a novel fenugreek seed extract (Trigonella foenum-graecum, Furocyst™) in polycystic ovary syndrome (PCOS). Int J Med Sci. October 3, 2015;12(10):825-831

7) Azgomi RND, Zomorrodi A, Nazemyieh H, et al. Effects of Withania somnifera on reproductive system: a systematic review of the available evidence. BioMed Res Int. January 2018;2018

8) Mahdi A. A., Shukla K. K., Ahmad M. K. Withania somnifera improves semen quality in stress-related male fertility. Evidence-Based Complementary and Alternative Medicine. 2011;2011:9

9) Wing T, Sidlmeier E. Measuring the effectiveness of Chinese herbal medicine in improving female fertility J Chinese Med. Feb 2006;80:22-28.