Fertility Support with Chinese Herbal Medicine Part IV: Herbs I Use in Fertility Treatment
- Sean Dugan
- Sep 20
- 7 min read
Introduction
This article is intended to provide more information on my treatment methods when using Traditional Chinese Herbal Medicine for fertility. I know that since Chinese Medicine is unfamiliar in the US, there can be anxiety and stress around what to expect, including what herbs I might prescribe for you. This article is to give you a little more context.
This is not intended as a guide to use for self-diagnosis or treatment. Chinese herbal medicine practice requires years of study and years more of clinical work to master. This article is intended to provide context and education, so that you can have a deeper understanding of my treatment strategies, should you choose to work with me.
Using Effective Herbs
Before I get into the specific formulas and herbs I use in fertility, it’s important to make sure you understand the three fundamental principles of effective herbal medicine.
Choosing the right herbs. This is the most difficult part as it requires an understanding of herbal medicine chemistry and diagnosis of illness. Herbal medicines have specific action and direction in the body. Choosing the right herbs will move your body in the direction of better health. Choosing the wrong herbs can do the opposite, or simply do nothing.
Using an effective dosage. Once you’ve chosen the right herbs, you have to use an effective dosage. We have thousands of years of records, from millions of case studies, on what effective dosage is. Using the raw herb weight or raw herb weight equivalent, a medicinal dose of herbs is 30 to 100 grams/day. Most supplements on the market, including herbal capsules, Chinese teapills (the little black pills), looseleaf teas, or teabags, average 2 to 5 grams/day in dosage. That is simply not enough to make meaningful changes in significant health challenges like infertility.
Using safe, high quality herbs. This third principle I almost forget to mention because I would never consider doing anything but this. But if you’re reading this you may go searching on Amazon to see what kind of a deal you can get on Gui Zhi Fu Ling Wan teapills, and so the importance of herb safety and quality must be stated. The Chinese herb market is like any business, there is a wide range in price and quality. What we are after most of all is quality, and by that I mean sourcing from herb companies using herbs that are potent (this is influenced by herb growing practices and extraction methods), and herbs that are pure. It’s important not just to use herbs that are tested for heavy metals and contaminants, but also herbs that are screened for toxic pesticides and herbicides.
You can read more about Chinese herb safety, quality, and testing here. I source capsules from Classical Pearls, granule extracts from Evergreen Herbs, and raw herbs from Spring Wind. These are the best herb suppliers in the US, and provide the best herbs you can buy. Another reason I use Classical Pearls for capsules is that they provide the most concentrated encapsulated herbal extracts on the Chinese herb market.
Cost effectiveness comparison for Gui Zhi Fu Ling Wan
Classical Pearls capsules use a 10:1 granule extract. With 90 capsules per bottle, that’s 450 grams of raw herb equivalent per bottle. With Classical Pearls you’re getting a 30 gram raw herb equivalent dosage with 6 capsules/day. $60 per bottle can sound steep, but let's look at other common options.
An average bottle of Gui Zhi Fu Ling Wan teapills (the little black round pills) costs just $20 for 200 teapills. The bottle contains only 35 grams of raw herb equivalent. Taken at the standard dosage of 24 pills/day you are only getting 2.5 grams of raw herb equivalent. So while these seem cheaper, they are actually seven times more expensive per gram when you compare cost to raw herb equivalent. This will be similar with companies selling compressed tablet formulas. On top of this, most teapills and tablet manufacturers are not putting their herbs through the rigorous pesticide and herbicide screening that Classical Pearls, Evergreen Herbs, and Spring Wind do to ensure safety and purity. And at 2.5 grams of herbs per day, you are unlikely to see any significant changes.
Formulas and Single Herbs for Fertility
Okay, let’s get into it. In this section I will reference Chinese Medicine Pattern diagnoses that correspond with herbs and formulas I use in my clinical practice. You can refer to this article to learn more about Pattern diagnosis.
Gui Zhi Fu Ling Wan is one of the most important formulas in my clinic for treating infertility. This formula was first recorded in the Jin Gui Yao Lue (Essentials from the Golden Cabinet) in 200 C.E. for the treatment of female reproductive disorders including ovarian cysts and painful menses. Gui Zhi Fu Ling Wan treats Blood Stagnation and Phlegm patterns. These patterns are especially common in women under 35. Gui Zhi Fu Ling Wan is one of the most important formulas in my practice, and I have used it to treat a wide range of conditions including PCOS, ovarian cysts, uterine fibroids, endometriosis, insulin resistance, painful and irregular periods.
For more severe Blood Stagnation patterns, I will use Gui Zhi Fu Ling Wan as the base formula and add herbs like San Leng, E Zhu, Yi Mu Cao, Dang Gui, Chuan Xiong, and Dan Shen to increase the blood invigorating effect of the formula.
Dang Gui Shao Yao San is another essential formula in TCM gynecology. Recorded by master herbalist Zhang Zhong Jing in the Han dynasty, Dang Gui Shao Yao San is still one of the most widely used formulas in women’s health today. In Asia it is commonly used to treat infertility and prevent misscarriage. This formula treats Blood Deficiency patterns with Spleen Qi deficiency and water accumulation. These patterns are most common in women age 30-45. Fatigue, pale complexion, feeling worse after menstruation, poor digestion, bloating, loose stool, and water retention are some of the common indications for Dang Gui Shao Yao San.
Jin Gui Shen Qi Wan and Water Pearls both treat Kidney Essence deficiency and Kidney Yang deficiency. These are common patterns that can arise in women at any age, but are more common in women over 30. Common signs of Kidney Essence and Kidney yang deficiency include low libido or sex drive, fatigue, hot flashes, short luteal phase.
In my practice I use both Jin Gui Shen Qi Wan and Water Pearls, but I often favor using custom formulas for Kidney Essence and Yang deficiency. Water Pearls is based on Jin Gui Shen Qi Wan, and Jin Gui Shen Qi Wan contains two herbs that can be challenging for some people. Shu Di Huang / Sheng Di Huang (Rehmannia root) is a potent Kidney Essence tonic herb, but it is rich and sweet and can be difficult to digest. I often replace Shu Di Huang with tonic herbs that are better tolerated like Ba Ji Tian, Tu Si Zi and Sang Ji Sheng. Jing Gui Shen Qi Wan also contains Fu Zi (processed aconite). Fu Zi is a powerful Kidney Yang tonic herb, and it can be very important in fertility treatment. But it is a warming and stimulating herb and is not always appropriate for people with insomnia or anxiety. So I often replace Fu Zi with herbs like Yin Yang Huo, Xian Mao, or Lu Rong.
Additional Kidney Tonic herbs. I often use Yin Yang Huo and Xian Mao to improve sex drive, and sperm and egg quality.
For more advanced Kidney Essence Deficiency I may use some herbs that come from animals like Lu Rong (deer antler), E Jiao (gelatin), and Bie Jia (turtle shell). These animal substances can be more effective than plant herbs in certain cases because of their unique chemistry. I only use animal herbs when patients are open to it, and I only source animal herbs from CITES compliant sources. In other words, there are no endangered species being used, and no wild-harvested animals.
Xiao Yao San based formulas like Ease pearls are not primary formulas that I use in fertility treatment, but they can be helpful. Xiao Yao San treats Liver Qi stagnation patterns. This is a very useful approach for generalized anxiety and stress, and it is a great formula for addressing that aspect of the fertility journey. In women with no signs of Blood Stagnation, Phlegm, or Kidney Essence deficiency, it is possible that Liver and Heart Qi Stagnation can contribute to infertility. This would be women under 35 who have regular periods (28-30 days) with zero pain, no dark colored blood or clots, and have a moderate to high sex libido but have significant anxiety and stress. Most fertility patterns are more complicated than Liver and Heart Qi Stagnation, but it can be a significant part of the picture.
And many more herbs and formulas
The formulas and herbs I’ve covered in this article are some of the most important in my clinical practice, but this list is by no means exhaustive. I use over 400 different herbs when making custom formulas, and draw from a wide variety of formula combinations to meet each individual exactly where they are at.
Ready to get started with herbal medicine for fertility support?
Visit my herbal clinic page to schedule your first consultation, find more information on the treatment process, cost, herb quality, and more.
Sincerely, Sean Dugan L.Ac.
Sean Dugan L.Ac. is a licensed and board-certified herbalist and acupuncturist. He holds a Master’s degree in Chinese Medicine from the Oregon College of Oriental Medicine as well as a Diplomate in Chinese Medicine from the NCCAOM. He has studied under many Master Herbalists including Dr. Guohui Liu, Dr. Jimmy Wei-Yin Chang, Dr. Fang Zhang, Dr. Greg Livingston, and Dr. Darren Huckle. Sean’s herbal medicine practice draws from both Traditional Chinese Medicine and Classical Chinese Medicine treatment methods, with a focus on clinical efficacy above all. He has been treating patients with Chinese Herbal Medicine since 2013.
Sean works with clients all over the US through the Folkwise Herbal Clinic. In-person appointments are available at our Boise, Idaho clinic.
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