Markers of Ovarian Reserve Viewed Through the Lens of Chinese Medicine

Estradiol   FSH – Follicle Stimulating Hormone

Inhibin B   AMH – Antimullerian Hormone

“Ovarian reserve” testing can be intimidating and daunting. The results often feel like a fertility death sentence. When viewed through the eyes of Chinese medicine, however, these laboratory markers of ovarian potential can actually make diagnostic sense, and help determine the best natural therapeutic course for you.

It will be helpful to understand a little reproductive physiology first.

Brain Hormones:

The pituitary gland, which sits behind your eyebrows, emits FSH (follicle stimulating hormone) in response to messages translated by the hypothalamus, which secretes Gonadotropic releasing hormone (GnRH) in response to the hormone levels in your blood, and your emotional response to your environment. This hormonal command post, like all of the hormones in your body, responds to internal chemical messages conveyed through the blood, and emotional interpretations of your external environment.

These external and internal messages determine how the pituitary hormones interact with and are able to communicate with your ovaries, and how the ovarian output communicates back to the hypothalamus and pituitary gland.

Ovarian Hormones:

Activin and Inhibin B are protein complexes within the ovarian follicule. Activin enhances FSH secretion, cellular proliferation and plays a role in menstrual regulation. Inhibin B, on the other hand, down regulates and inhibits GnRH from the hypothalamus, and FSH secretion from the pituitary gland.

When the system is in sync, the hypothalamus secretes GnRH to trigger the pituitary gland to release small amounts of FSH during the last few days of the previous menstrual cycle, which rise until the beginning of the next follicular phase. FSH recruits Graafian (or antral) follicles, which have been growing within the ovary for the better part of a year.  Around three months before these follicles are ovulated, they enter the tonic growth phase, where protein synthesis occurs.  Follicles that have interacted optimally with the internal environment have the potential to become dominant follicles, primed by FSH. They then secrete estrogen, and express LH receptors, which allow the chosen dominant follicle to mature and become capable of ovulation.

Higher levels of Inhibin B indicate that the ovarian follicle is doing its job of putting out adequate estradiol. Inhibin B provides negative feedback to the hypothalamus and pituitary gland to let them know to turn down the GnRH and FSH, as output is sufficient.

The Fertile Soul Method ® is proven to maximize your reproductive potential. Most of our patients are 40 or over; most have high FSH, low AMH, other hormonal abnormalities, or have been diagnosed with poor ovarian reserve, poor egg quality, endometriosis, or recurrent miscarriages. Most have not found their answers solely within Western reproductive medicine. Most have been able to rectify their internal energetic imbalances through our program, and produce new life.

Dr. Randine Lewis is the founder of The Fertile Soul, the president of the Continuing Excellence in Fertility Professionals, the author of The Infertility Cure, and The Way of the Fertile Soul. Find out more about Dr. Lewis’ retreats at www.thefertilesoul.com.