Chasteberry and fertility

An added bonus for those trying to conceive

Chastetree, vitus-agnus-castus
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While reading about chasteberry for other gynecologic issues, one of the review papers mentioned a secondary effect of influencing both follicle stimulating hormone and luteinizing hormone, both hormones important in ovulation (Roemheld-Hamm, 2005).  This led me to look into the potential effect of chasteberry on fertility.

One reason that many patients find their way to my office is when they’ve been trying to have a baby without success.  At least being able to offer another option for women trying to conceive, when unable or unwilling to pay for more invasive infertility treatment methods, is a bonus.

I only found 3 randomized controlled studies evaluating chasteberry for fertility, two of which were published in Germany and one that was published in the United States.  If anyone found others, please share!

In 1993, a German study of 52 patients found that women taking chasteberry normalized the second half of their menstrual cycle by improving luteal phase progesterone and estradiol levels.  However, this study didn’t note any fertility outcomes (Milewicz et al, 1993).

Another study of 96 women suggested those individuals taking chasteberry in the form of Mastodynon® (a German product not available in the US containing 5 additional herbs – cyclamen, tiger lily, ignatius bean, blue cohosh and iris) became pregnant more often than those taking a placebo.  In women with amenorrhea or luteal phase problems, pregnancy occurred in the active treatment group twice as often as the placebo.  Of note, however, is that the absolute percentage of women conceiving over the three-month study was small (16%)(Gerhard, 1998).

After finding benefits with a pilot study, the final study performed by Stanford School of Medicine found Fertilityblend®, a United States nutritional supplement, led to more pregnancies.  It contains chasteberry, but also other antioxidants, vitamins, and folic acid.  This study evaluated 93 women, ages 24-42, who had been trying to conceive 6-36 months, one group received Fertilityblend and the other a placebo.  Mid-luteal progesterone levels, luteal-phase basal temperatures, and pregnancy outcomes were recorded over 3 months.

The group characteristics were very similar.  After 3 months of supplementation, those taking the supplement had an increase in mid-luteal phase progesterone levels, especially noted in those with the lowest values.  This also translated into normalized cycle lengths in those taking the supplementation. Interestingly, however, in their graph there was also an increase in the placebo group’s progesterone levels after 3 months (although not significant), which you would expect to stay relatively stable.  Made me wonder if the placebo group had some patients actually doing something different?

In terms of actual fertility outcomes, after 3 months those taking Fertilityblend® were more likely to conceive.  Twenty six percent (14 of 53 women) in the supplement group became pregnant compared to 10% (4 of 40) of the women in the placebo group.

Following completion of the study, the supplement was offered to both groups with 3 additional pregnancies in the remaining 17 (18%) women in the continuing supplement study compared to 4 of 36 (11%) of women who had previously been in the placebo group.  This value is significantly lower than would be expected based on the initial 3 months with the treatment group.

It’s difficult to make any conclusions about the open-label study based on these final results because they mention that not all women continued for an additional 3 months.  It would be interesting to know how many of the women in both groups actually continued with open-label supplementation with Fertilityblend® vs. went on to more intensive treatment or stopped trying all together.  The open-labeled segment of the study may demonstrate benefit of longer supplementation or may suggest that something may be different with the entire group that was in the initial placebo group, something not accounted for in their review of the characteristics initially.

Still, it seems in women who are not ready or able to move on to more invasive fertility treatments this offers an alternative by taking supplements.  From prior research, if nothing else, this may regulate their cycles, reduce breast tenderness during their periods, and potentially decrease symptoms of premenstrual syndrome (PMS).

In terms of pregnancy, younger women with irregularities of their periods or reduced progesterone levels may benefit most from chasteberry.  In older women with fewer follicles remaining (less eggs), more aggressive treatment will likely still be necessary. However, for some of my younger patient’s, with otherwise normal work-ups but short second halves of their cycles, I am going to start recommending chasteberry, in the form of Fertilityblend®.

REFERENCES:

1.  Gerhard I, Patek A, Monga B, Blank A, Gorkow C.  Mastodynon ® bei weiblicher Sterilitat Forsch Komplementarmed 1998; 5:272-8.

2.  Milewicz A, Gejdel E, Sworen H, Sienkiewicz K, Jedrzejak J, Teuher T, et al.  Vitex agnus castus extractin the treatment of luteal phase defects due to latent hyperprolactiemia.  Results of a randomized placebo controlled double-blind study [in geran].  Arzneimitteiforschung 1993; 43:752-6

3.  Roemheld-Hamm B (2005).  Chasteberry.  Am Fam Physician; 72,5:821-824.

4.  Westphal LM, Polan ML, Sontag T. (2006).  Double-blind, placebo-controlled study of Fertilityblend®: A nutritional supplement for improving fertility in women.  Clin Exp Obstet Gynecol, 33(4):205-8.

 

DISCLAIMER:  **Speak to your own gynecologist before starting any medication, as this product hasn’t been FDA approved.  Your personal physician should evaluate potential causes of your infertility before recommending management.**

 

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