The Relationship Between Infertility and Deficiency of Both Liver and Kidney
Infertility may be primary or secondary. Primary infertility is hard to treat, while secondary infertility is relatively easier. Generally speaking, primary infertility mostly belongs to insufficiency of original yang and a constitutionally deficient endowment; in ancient TCM it was called "total childlessness" (quan wu zi). Secondary infertility mostly belongs to deficiency of liver and kidney and damage to the Conception and Penetrating vessels; this was anciently called "interrupted succession" (duan xu) and is relatively easy to treat.
The kidney governs reproduction; it stores essence and governs the bones and generates marrow. When the kidney is deficient, the body's essence and qi are not stored and original yang is insufficient, so it naturally loses its reproductive function. Therefore, in treating infertility, TCM almost always begins by tonifying the kidney. Most infertility patients suffer from insufficiency of kidney yang, so treatment mainly warms and tonifies kidney yang.
Some infertility cases, however, are organic lesions. In such cases one must differentiate the pattern in detail, integrate Western-medicine examinations with TCM pattern differentiation, comprehensively judge the patient's constitution, and adopt corresponding measures: some may need blood-activating, stasis-resolving herbs to unblock the meridians; some need spleen-strengthening, dampness-draining herbs; some need qi-mechanism-regulating herbs to dredge the triple burner.
Clinically, female infertility is most often of dual liver-kidney deficiency, or of mixed deficiency and excess. The kidney governs storing essence and the liver governs free growth; in women they are both the congenital root. When a woman's liver-kidney yin-blood is insufficient, it directly affects the Conception (Chong) and Penetrating (Ren) vessels and the uterus. Only when liver and kidney essence and blood are abundant, the Chong and Ren vessels are free and flourishing, and the uterus is warmed can it govern the blood sea and nurture pregnancy.
Conversely, if liver-kidney yin-blood is deficient, essence and blood are not vigorous, the Chong and Ren vessels lose nourishment, and the uterus is not warmed, it is hard to receive the male seed and conceive. Therefore, clinically, treating infertility often uses herbs that tonify liver and kidney — such as dodder (Tusizi), epimedium (Yinyanghuo), Morinda (Bajitian), deer-horn glue (Lujiaojiao), goji (Gouqizi), and Solomon's seal (Huangjing) — to support the root, and on this basis, according to each patient's condition, appropriately add some pathogen-expelling Chinese medicines. Only by simultaneously supporting the root and expelling pathogen can efficacy be guaranteed.