“Nourishing the kidney” and the treatment of recurrent pregnancy loss using traditional Chinese medicine

Traditional Chinese medicine (TCM) refers to recurrent pregnancy loss as the “slippery fetus” and its etiology is believed to arise from deficiency of the kidney. TCM believes that a strong kidney can protect stamina, preserve energy, nourish the blood, improve circulation, strengthen essential vitality, increase sexual drive, and enhance immunity. It believes that any deficiency of the kidney can lead to a series of problems with the reproductive system and is particularly detrimental to fertility. TCM considers that the basis of conception stems from the kidney and the source of nourishment comes from the spleen. The spirit of the fetus is linked to both organs and any deficiency loosens this connection and causes fetal development to becomeunstable (pregnancy loss). According to TCM, the human body is embedded with a network of hidden channels, through which energy (qi) and blood circulates to nourish the visceral organs. Disruption to these channels will cause disease. The Ren and Chong channels control women’s blood and fertility. Ren is directly linked to the uterus and ovaries and is particularly responsible for holding the fetus—it is thus referred to as the conception channel. Chong is directly related to menstruation and fertility. Weakness in both qi and the blood causes disruption to the Ren and Chong channels and leads to recurrent pregnancy loss. TCM considers that noxious heat in the blood system causes restless fetal movement or fetal “irritability,” manifesting as recurrent pregnancy loss. The numerous causes of noxious heat in the blood system include overeating, overindulgence in sex, spicy food, and liver system dysfunction. According to TCM, heat in the blood allows “Yang” to prevail over “Yin” and damages the harmonious circulation of the channels, which is particularly detrimental to conception. The symptoms of heat in the blood can manifest as skin flushing; oily and acne prone skin; quick temper; hot palms and soles of the feet; menstrual period occurring more than seven days early, with excess blood that is dark red or purple in color; or a relatively long menstrual period. TCM believes that women with recurrent pregnancy loss often have a history of induced abortion.When the pregnancy is terminated, either by medical or surgical means, redundant blood is produced. This causes blood stasis, which occupies the uterus and causes deviation of blood from the channels, loss of fetal nourishment, fetal irritability, and finally pregnancy loss. Deficiency of the kidney is one of the major causes of blood stasis. In TCM, the kidney is the essence of nature, while the spleen is the root of nurture. Deficiency of these organs and instability of the Ren and Chong channels are the primary causes of recurrent pregnancy loss. This is consistent with the syndromes in modern medicine of positive anticardiolipin antibodies (ACA) and blood group antibodies. Measures to nourish the kidney, strengthen the spleen, fulfil essential qi, and replenish the marrow could effectively inhibit the production of these antibodies. Typical TCM prescriptions based on these principles include Cuscuta chinensis (Chinese dodder seeds), Viscum album (mistletoe), Paeonia lactiflora (white peony root), fried Atractylodes lancea, Eucommia ulmoides (Eucommia bark), Dipsacus asperoides (teasel root), Perilla frutescens (perilla leaf), Scutellaria galericulata (common skullcap), and one piece of fresh placenta (washed and dried). TCM believes that psychological disorders such as anxiety or depression are common in women with recurrent pregnancy loss and this mental disturbance may interfere with conception. TCM believes that the heart controls the spirit and blood channels and has an effect on the uterus and fetus, and therefore fertility. The uterus is where the heart and kidney meet, thus any disturbance to the heart will harm the functions of the kidney and, accordingly, a woman’s ability to conceive. Therapies that nourish the kidney and pacify the heart include ingredients to clear noxious heat, purge pathogenic fire, sooth the heart, and tranquilize the spirit. Typical prescriptions include fried Rhizoma coptidis, Nelumbo nucifera (lotus), Ziziphus jujube (jujube seed), Schisandra chinensis (schisandra fruit), Albizia julibrissin (silk tree), Wolfiporia cocos with hostwood, turtle shell, oyster, and crushed fossilized teeth. International Journal of Gynecology and Obstetrics 127 (2014) 90–93