Integrative approach 4

Integrative Fertility Enhancement Cathryn Hu, Ph.D., O.M.D., L.Ac .

Conflict of Interest and Financial Disclosure
Integrative Fertility Enhancement
Cathryn Hu, Ph.D., O.M.D., L.Ac.
President of Advanced Acupuncture, Inc.
Professor of Advanced Acupuncture Institute
None

Celebrating A New Life The miracle baby

Human Reproductive System Human Sexuality: Conception from www.abuhmed.org

Hormones involves in the Menstrual Cycle

Basal Temperature Record

Eggs maturation and travel process

www. newscientist.com Ovulation Process

Fertility Enhancement Program -an integrative approach
Two phases of treatment in our integrative program:
1. Preparation phase:
Treating the causation of infertility, nourishing the reproductive organs and their functions.
2. Trial phase:
Promoting the ovarian functions of follicle maturation and increasing the lining of the uterus.

The objectives of Preparation Phase
Stress relief
Causation of infertility
PMS treatment
Endometriosis
Hormone balancing
Increasing mucus secretion
Sperm quality & quantity improvement

The objectives of Trial Phase
Stimulating follicles maturation
Promoting the ovulation
Balancing FSH, Estrogen, LH and Progesterone
Integrative with IVF procedures
Integrative with IUI procedures

The Hormonal Imbalanced Conditions
High FSH level
Polycystic Ovarian Syndromes (PCOS)
Luteal phase defect
Endometriosis
Assistant Reproductive Technology
(ART)

Other Causations of Infertility
Stress-
-Flight-or-fight response
-Glucocorticoids can raise its level and weaken the reproductive system, potentially making infertility condition worse. (Prolactin)
Age-
Conception rate : 30’yrs, 40’yrs, decline 5-10 % each year
Developing chromosomal abnormalities:
< 35yrs -the rate of is 1:2000 compare to >35yrs,1: 400
Miscarriage: <30 yrs = 15 %, >40yrs =40 %

The Causations of Infertility in Traditional Chinese Medicine
Male-
Kidney yin deficiency
Kidney yang deficiency
Liver qi stagnation
Spleen qi deficiency
Blood stagnation
Female-
Kidney deficiency
Cold uterus
Blood deficiency
Liver depression
Stagnant heat
Phlegm dampness

Kidney Yin deficiency signs & symptoms
Scanty, dark discharge at the end of the period or amenorrhea
Severe lumbago, dizziness, tinnitus
Cold sensation in the lower abdomen, loose stools, copious, clear urine
Dark facial complexion
Tongue is pale with thin white coating
Pulse is deep, thread and weak

Cold Uterus
Prolonged menstrual discharge but scanty in volume and mixed with dark clots
Cold lower abdominal pain relieved by warmth
The tongue coating is thin and white
The pulse is deep and slow

Blood deficiency signs & symptoms
Withered, sallow complexion
Scanty menstrual discharge during the last days of the period but light in color, dizziness, blurred vision, dry skin, constipation
Insidious pain after menstruation.
Tongue is pale
Pulse is thready and weak

Liver depression signs & symptoms
Early or late menstruation, scanty in volume and dark in color
Abdominal distention
Premenstrual breast distention
Mental depression, eructation and sighing
Tongue is red with a thin coating
Pulse is wiry and rapid

Stagnant Heat signs & symptoms
Scanty menstrual volume, red purplish in color and mixed with clots.
Distention and pain in the lower abdomen, especially along the sides, which refuses palpation.
History of lumbar soreness
Distension & pain of the chest and hypochondrias
Tongue is red with a thin coating
Pulse is wiry and rapid

Phlegm dampness signs & symptoms
An obese constitution
History of excessive phlegm
Pallor or puffiness
Delayed menstruation or amenorrhea and excessive leucorrhea
Tongue has a thin, white coating
Pulse is wiry and slippery

Individualized Treatment Plan
Individualized treatment plan based on etiology
Acupuncture:
EA for follicle phase
MA for Luteal phase
Herbal formula: Individualized
Raw herbs
Granules
Pills/tablets
Decoctions
Moxibustion
Cupping

Frequencies & Lengths of Acupuncture Treatment
Cumulative effect of series
10-12 sessions to begin cellular change.
Pre-cycle: 1-2/wk X 3-6 cycles
Trial phase: 2-3/wk X 6-9 cycles
Average: 6-12 cycles
Less frequency with herbal prescription
Speed of improvement proportional to the length of time of imbalance

Mechanisms of Acupuncture (1) a clinical observation in Shanghai, China
Highly increase of the egg production
Regulate the function of hormone levels
Influence in the gene expression in the brain, normalizing secretion of GnRH, LH, and E2 .

Researches for acupuncture that benefits the fertility
Sandra Emmons, M.D:
-Oregon Health Science University
Acupuncture before the IVF, improve the success rate of pregnant woman.
Rate significantly higher in the patients combine the herbal treatment .
Cornel University’s
Weil Medical College:
Summed up acupuncture’s positive effect o infertility issues.
There is sufficient evidence of acupuncture’s value to expand its use into conventional medicine and treatment of female infertility.

Role of acupuncture in female infertility The institute of East-West Medicine, New York, USA , 2002
Acupuncture are mediated through endogenous opioid peptides in the central nervous system, particularly in Beta-endorphine.
These neuropeptides influence gondotropin secretion through their action on GnRH
In IVF patient, undergo IVF, besides its central effect, the sympathoihhibiitory effects of acupuncture may impact on uterine blood flow.

Mechanisms of acupuncture (2) - a study in Harvard,
Endorphins releases
Mitigate one’s response to stressful stimuli, enhance the possibility of conception
Minimize prolactin
Elevated prolactin could
cause irregular ovulation

Acupuncture and Herbal Medicine in IVF: a review of the evidence for clinical practice -Cheong Y. Nardo LG, Rutherford T, Ledger W. DOHaD, UK, 2010
14 trials o f 2670 subjects
Acupuncture & Herbal medicine in ART
Outcome measuring rate of pregnant, birthrate, & miscarriage
Results provide evidence of benefit in the use of acupuncture assisted conception.

Integrative Acupuncture Tx
Reduces stress
Enhances hormone regulation
Regulates the menstrual cycle
Promotes the ovarian functions
Invigorate the sperm qualities
Treats PMS, Amenorrhea, Endometriosis and blocked fallopian tubes
Increases the effectiveness of IVF, GIFT, ZIFT, and ET. Procedures
Protects the fragile embryo
Strengthen the immune system

Treatment Protocols (1) Stress-relieve
Objectives:
Reduces stress and minimizes prolactin
By release certain chemicals and neuron-transmitter, such as endorphin, ekenephilin and serotonin, specially benefits the ART patient go through their procedure smoothly
Tx Protocols :
Acupuncture: Shenmen, P 6, Sp-6
Herbal formula: Suan Zao Ren Tang
(Sour jujube decoction)
Frequency:
Combine with other treatment

Acupuncture & IVF procedures -Research in Christian Lairize Institute in Germany
160 women getting IVF
Acupuncture before & after the embryo transfer
50% of the patients increased successful implantation.
IVF group= 26.3 %
IVF plus acupuncture
= 42.5 %
AAI successful rate is 68.9 %
of integrative IVF patients at December, 2008.

Acupuncture on the day of Embryo Transfer
Acu1= 95, on the day 36%/34%
Acu2 =91, on the day and 2 days after 36%/26%
Control=87, no acupuncture. 26%/22%
Conclusion:
Acupuncture on the day of ET significantly improves the reproductive outcome of IVF/ ICSI. Compare to no acupuncture.
2. Repeating acupuncture on ET day and 2 days after provided no additional benefit
Westergaard LG , Mao Q , Krogslund M , Sandrini S , Lenz S , Grinsted J.
Fertility Clinic Tranglen, Hellerup, Denmark.
Fertil Steril . 2006 May;85(5):1341-6. Epub 2006 Apr 5.

Pain Relieve During Oocyte Retrieval
EA has proven analgesic effect
Frequency at 80/20/2 Hz
Study of 152 cases
Conclude that
No differences in EA
Frequencies.
Humaidan P . Brock K Bungum L . Stener-Victorin E.
The fertility clinic, Vyborg Hospital, Skive, DK7800 Skive, Denmark,
Reprod Biomed. Online, 2006 Jul; 13, (1):120-S.

Acupuncture & Protection of Embryo
Acupuncture boost blood flow to women’s reproductive organs and providing better nourishment.
Improve the lining of the uterus, enhance the embryo becomes embedded after conception.
Improve implantation and prevent the risk of miscarriage.

Herbal Treatment
Affects many parts of the reproductive cycle by triggering the bodies own natural processes.
Trigger the hypothalamus and pituitary to release hormones that stimulates the production of FSH and LH
Individualized herbal formula
is most effective
Follow up monthly objective evaluation of hormone test.
Aware of the ART treatment and drug interactions.

Individualized Herbal Treatment
Mainly to nourish the reproductive organs, enhance ovarian function, promote follicles maturation and increase linings of the uterus.
Classic Herbal formula
Individualized herbal formula modification
Length of treatment various from 2 to 6 cycles
Safe for early pregnancy and prevent miscarriage.

Herbs that Benefits Fertility Angelicae Sinensis (Dang Gui) Asini Gelatinum ( E Jiao) Astragali (Huang Qi) Condonopsis (Dang Shen) Amomi (Sha Ren) Eucommiae (Du Zhong) Lycii Chinensis (Gou Qi Zi) Dioscoreae Oppositae (Huai Shan) Carculiginis (Xian Mao) Epimenddi (Xian Ling Pi) Sm. Cuscutae (Tu Si Zi) White Paeoniae (Bai Shao) Hetrophylii (Yi Mu Cao) Actinolitum (Yang Qi Shi) Epimedii (Yin Yang Huo) Gecko (Ge Jie)

Classic Herbal Formulas Benefits Fertility
1. Yu Lin Zhu- kidney deficiency
2. You Gui Wan- kidney deficiency
3. Wu Zi Yan Zong Wan- kidney deficiency
4. Ai Fu Nuan Gong Wan- cold uterus
5. Ren Shen Yang Rong Tang- Blood deficiency
6. Yang Jing Zhong Yu Tang- Blood deficiency
7. Chai Hu Shu Gan San- liver depression
8. Kai Yu Zhong Yu Tang- liver depression
9. Qi Re Xiao Yu Tang- Stagnant heat
10. Xiao Zhi Mo Dao Tan Tang- Phlegm dampness
11. Qi Gong Wan- Stagnant heat

Herbal Treatment Prevents Miscarriage -a Study from Fudan University of Shanghai, 2001
The process of conception and pregnancy involves a suppression of the T-help immune response
Herbal medicine could inhibit specific immune injury, reprogram the immune system to not react to self-tissue, allow the normal suppression involved in implantation to occur.
Individualized herbs: Du zhong
Classical Formulas: Dingxiang shi di tang (Clove and Persimmon Calyx decoction)

Chinese herbal medicine for subfertile women with polycystic ovarian syndrome - Reproductive endocrinology of Sichuan University medical school, China, 2010
RCTs, 344 patients of PCOS
CHM + Clomiphene vs. Clomiphene
There was evidence improving pregnancy rate

Chinese Herbal Medicine and Clomiphene citrate for Anovulation: RCTs by acupuncture Kitchen, San Francisco, CA, 2011
14 studies from Review of 1009 studies between 2000-2006
CHM+CC vs. CC
4 studies (28.6%) reported 14% higher BBT
6 studies (42.9%) reported 18% increase in OV rate
2 studies (14.3% reported 78% increase in endometrial lining > 6 mm
13 studies (92.9%) reported 50 % increase in pregnancy rate

Objective Evaluations
Initial evaluation
Infertility -causation
Consider the etiology in TCM
Refer to fertility specialist
Evaluates partner’s health conditions
Release medical records for the history of illness
Follow up evaluation:
Monthly hormonal tests:
Day 2/3: FSH, Estrogen, prolactin
During ovulation: Basal temperature chart, mucus and ovulation kits
Day 21 or 7 days post ovulation: Progesterone
Ultrasound:
Day 2: # of follicles & size
Day12/13: sizes of follicles
Follow up with fertility physician’s plan closely and report any unexpected reactions.

Food Flavors Recommendation
Sweet -Tonifies and harmonizes and relaxes.
Pungent - Dispersing and invigorating, promote circulation, moves Qi, blood, & body fluid.
Sour Astringent -Absorbing, consolidating
Bitter - Dries damp, disperses, often clears, damp, edema and heat
Salty -softens and dissolves hard masses. Moistens and lubricates the intestines
Bland - diuretic, promotes urination and relieves edema

Foods that Invigorates Blood Week 1 of the cycle Eggplant Peanuts Red Bean Dates

Foods Nourishes Blood Week 2 of the cycle Beef Chicken eggs Grapes Lamb Chicken Fish

Foods that Benefits the lining growth (Week 3 of the cycle) Kale Spinach Apple Appricot Cherry Chinese Date Lemon Asian Pear Sesame seed ( brown) Sesame seed ( black)

Foods that benefits Kidney deficiency ( Week 4 of the cycle) Green beans Mulberry Raspberry Black beans Chestnut Lotus seed Walnut Honey

Food for clear the heat Papaya Lemon Cucumber Cantaloupe White rice Asparagus Carrot Sweet potato Fig Lenti Bok choy Celery Cucumber Peach Mung bean Red/green cabbage Chard Banana Pineapple White fungus

Foods that detoxifies Shitake mushroom Snow pea Pumpkin seeds Sunflower seed Soybean Olive Rice vinegar Tea

Food for drain dampness Alfalfa sprout Chinese Chive Onion or leek Parsnip Pumpkin and winter squash Turnip Winter melon Dried papaya Barley Rice bran Wheat bran Adzuki bean Beef Fish Cardamom seed

Foods that Relieves Food Retention Bamboo shoots Bell pepper Daiko radish Howthone Berry Plums Tomato Oats Pea Parsley Barley Malt syrup

Food that Strengthen Digestion Arise seed Brown sugar Cinnamon Clove Fennel seed Ginger root Molasses

Prenatal Vitamins-Woman
Folic Acid - 400mg/day- development of baby’s brain and spinal cord (fortified cereals, green leafy vegetables, citrus, grapefruit)
Calcium - bone develop
Iron -prevent anemia ( green leaf vegetable, red meat)
Fibers - 30-35g/day (unrefined grains, whole wheat, beans, fruits and vegetables

DHEA(dehydroepiandrosterone)
Is an endogenous hormone, made in human adrenal gland
Serve as precursor to make androgens and estrogens
Level decreases due to disease or drugs
Evidence of use DHEA to treat
adrenal insufficiency, depression, induction of labor and lupus.
Side effect: increase the risk of hormone sensitive cancers
Under professional guidance.
- Mayo Clinic.com

Part II: Male Factors

Infertility isn’t just the woman’s problem anymore
40-50 % male infertility
Inadequate # of sperm
Inhibited ejaculation
Retrograde ejaculation
Failure of descend into the scrotum
Antibodies to the sperm

Male Factors of infertility
Spermophlebectasia
Sperm dysfunction
Sexually transmitted disease
Physical damage
Genetic disease
Auto immune disease

Male Reproductive Anatomy

Male Reproductive Organs
Testes (gonads):
Sperm (exocrine)
Testosterone (endocrine)
Ducts
Glands

I. Male Organs-Testes
Size: 4 cm X 2.5 cm
Connective tissue capsule
Tunica albuginea
Seminferous tubules
Rete testis
Duct system
Epididymis
Interstitial cells -produces androgens & testosterone.

Testosterone Production
Produced by interstitial cells
Stimulated by LH
Testosterone stimulate the male reproductive organs develop & 2 nd male characteristics
Lack of the testosterone will result in sexual infantilism & sterility.

Testes Malfunction

II . Male organs- Duct System
Transport sperm from the body:
Epididymis
Ductus deferens
Urethra

Male Organs- Epididymis
Highly coiled tube 6M
Caps superior of testes
1 st part of male duct
Storage site of immature sperm
Mature in 20 days
Ability to swim
Walls of epididymis contract to expel the sperm to ductus deference

Male organs - Ductus Deferens
Enclosed tube along with blood vessels & nerves in sperm cord
Propel live sperm into urethra by peristaltic waves rapidly squeeze the sperm forward
Scrotal Sac
Vasectomy- cauterizing the vas deferens. Sperm is still produced but no longer reach the outside
Sterile- testosterone still produced and libido remained.

Sperm Ascending

Vas Deferens Blockage

Male Organs- Urethra
3 main regions
Prostate Urethra
Membranous urethra
Spongy urethra
Carry urine and sperm to exterior
Ejaculation

Male Organs-Scrotum
Providing the testes with a temperature that is below body temp.
Cold->scrotum wrinkled ->testes closer to the body to maintain viable sperm production

Male Organs- Penis
To deliver sperm into the female reproductive tract
Circumcision- surgically removed after birth
3 enlarged eretile tissue
Erection-blood flow

Good Sperm Formation
Sperm takes 100 days to develop (70/30)
3 main factors:
Sperm count: > 20 million/ml/ejaculate
Morphology (shape of the sperm)
Motility (How fast and straight the sperm swim)

Spermatogenesis

Functions of Sperm

Macho Sperm Theory
Damage fertilized eggs.
Some toxins may alter the sperm’s DNA. Damaged chromosomes still carry genetic information
Results in infertility, miscarriage, birth defects, learning disabilities, childhood cancer and kidney cancer.

Male Infertility Assessment
Sperm count < 10 million/ml (200 million)
Volume < 5 ml per ejaculate
Sperm motility < 60 %
Sperm Morphology < 50 % normal

Getting Tested
Urologist evaluation
Sperm analysis 2-3 Tx
Defect factors:
Azoospermia
Oligiospermia
Sperm motility decreases
Sperm morphology abnormalities

Normal Sperm Analysis
Volume= 3 ml (2-6ml)
Concentration=20M/ml
Motility: 50 %> 2 hrs
Morphology: >60 %
Viscosity
Ejaculate normally liquefies < 1hr
pH= 7-8

Sperm abnormalities
Adequate
Aspermia
Azoospermia
Oligospermia
Poor motility & forward movement
High percent of abnormal sperm morphology
Anti-sperm antibodies

Diagnosis of Male infertility
Medical History Physical Examination-structure
Secondary sex characteristics evaluation
Endocrine function test
Sperm analysis and morphology

Causes of Male Infertility
Radiation
Environment toxins
Undescended testis
Varicocele
Traumatic injury
Infectious injury
Testicular atrophy
Drug effects
Alcohol, nicotine, marijuana, cocaine Prolonged fever
Endocrine disorders
Congenital abnormalities
Surgery of the lower abdominal region
Tight underwear
Stress, lack of sleep

Acupuncture Treatment
Acupuncture can stimulate histamine release to dilate the blood vessels, therefore to improve the blood circulation, thus reduces varicose veins in the region
Most commonly selected points are located on the back and leg areas.
Frequency at 1-2 tx/wk or
based individualized treatment plan

Responses of TCM treatment
Case report:
A 43 male with 3 months of combined
treatment
Sperm count:
From < 18 million/ml to 93 million
Motility : from < 50 % to 97%
Morphology: from normal <20 % to 45 %
Hu,C. etl . Advanced Acupuncture, Inc. 2006
Los Angels, U.S.A

Acupuncture & Sperm Quality Improvement
Acupuncture effects on sperm production and quality without causing any changes in behavior and sexual desire.
Study of 28 men who ere diagnosed with idiopathic infertility received acupuncture twice a week over 5 weeks, significantly increase the quantities of normal sperm and equally reduces in structural defects.
Hu,C. etl
Advanced Acupuncture, Inc. 2006, Los Angeles, U.S.A.

Effect of Acupuncture on Sperm Parameters
16 subject were coanalyzed before & 1 month after treatment
(Two times/week for 5 weeks)
16 subject of controlled, untreated for comparison
Evaluated by semen analysis and ultramorphyological observations.
Conclusion;
The fertility index increased significantly in the treatment group (p<or =0.5)
Sperm motility and axonema intactness were highly correlated
(corr:= 0.50, p< or = 0.5)
Siterman S, Israel, 1997

Protocols improves sperm count and motility
Electro-acupuncture:
Points: UB-23, 25, K5, Sp 6
Frequencies: 2 tx/wk X 5 weeks.
Lengths: 2-3 courses until sperm analysis become normalized
Herbal formulas:
Jin Gui Shen Qi Wan
Evaluation:
by repeat Sperm analysis between the acupuncture course.

Chinese Medicine improves semen morphology, motility, & count
Randomized clinical trial in Sydney, Australia, 2004
Acupuncture and herbal medicine
Improve sperm normal form: p<0.038
Improve semen motility: p<0.008
Improve count: mean increase 220 million sperm

Acupuncture in the treatment of Psychogenic Erectile Dysfunction
Randomized placebo-controlled pilots study, Austria, 2003
22 patients, satisfactory response =68.4%
Acupuncture can be effective option >2/3 of PED

Artificial Insemination (IUI)
The sperms are collected and send to sperm wash
More concentrated sperm count without semen.
Inject to female, let sperm surround with egg to penetration.
Option for male infertility
Alternative procedure when IVF did not respond well.

Intracytoplasmic sperm injection ICSI
For low sperm count & male infertility
Sperm & eggs are retrieved
Inject 1 sperm into an egg
Fertilized egg is then implanted
www. medfix.com

Spermophlebectasia (varicose vein of the spermatic cord)
Increases blood in the vein of the spermatic cord  increases temp. in testicle  decrease live sperm count and activity
Prolonged presence of the varicosity can result in poor blood circulation to the area & shrinkage/or dysfunction of the testicle  unable to produce healthy sperm

Symptoms of Spermophlebectasia
Male age 20-30
Chief complain-pain
Heaviness of scrotum
Pain at testicles, groin and lower abdomen
Standing and walking aggravates.
Resting in supine position alleviates
Signs: Scrotum enlarged and loose
Vein is enlarged and purple
Varicose veins are also present in the groin and inner thigh
Press vein, it shrinks or disappears

TCM treatment for Spermophelebectasia
Acupuncture
Acupuncture can stimulate histamine release to dilate the blood vessels to improve the blood circulation, thus reduces varicose veins in the region
Herbal Formula
Individualized formulas based on the etiology to improve blood circulation, resolve blockage, and promote healthy sperm

TCM Treating Male Immune Infertility
Observation of “Yikang Tang” (decoction) to treat 100 pt with immune infertility
Compare with 100 cases treated with prednisone
Results:
AsAb decreased significantly, (p<0.01)
The sperm density and motile spermatozoa increased significantly
The sperm agglutination rate decreased
The improvement rate of the symptoms and stability of the therapeutic effect were more dramatic in the treatment group.
Has more stable effect for male immune infertility than Prednisone .
-Sun Z. Bao Y. 2006,Honzhong, China

Herbs That Benefits for Sperm Ginseng (Ren Shen) Tribulus ( Bai Ji Li ) Epimedii (Yin Yang Huo) Sm. Cuscutae (Tu Si Zi) Curculiginis Orchioidis (Xian Mao) Actinolitum ( Yang Qi Shi) Fr. Rubi (Fu Peng zi) Fr. Rosae Laevigatae (Jing Yin Zi) Eucommiae Ulmoidis (Du Zhong)

Classic Herbal Formulas
Modified Jin Gui Shen Qi Wan
Main ingredients : Ginseng, Deer horn, Sea horse, Hokuo, Epimedii, Angelica, Cinnamomi, Poria cocos
Used for low sperm count, low motility and morphology
Modified Jin Suo Gu Jin Wan
Main ingredients :
Eucommiae, Epimedii, Achyrabthis,Cistanches,
Cynomorii, Cuscutae.
Used for impotency, low libido and early ejaculation

Modified Jin Gui Shen Qi Wan (Kidney Qi Pill from Golden Cabinet)
87 male pts. were treated and observed in our clinic
Comparison made before and after treatment 3-6 months.
Measured by routine semen analysis
3 months enhanced function significantly, spouse pregnant rate =56% (49/87)
Sperm analysis improvement after 6 months= 68.40%
This formula influences regulatory function in FSH, LH, Testosterone, Coticosterone level
Hu C. Etl

Modified Jin Suo Gu Jin Wan ( Mental lock pill to stabilize the essence )
82 male patients were treated and observed
The length of treatment is 3-6 months
The sperm count improves 67.4 %
The activity rate of sperm markedly improved after treatment.
Hu,C. etl

Making Good Sperm
Eating Healthily
Taking Vitamins
Drinking more water
Copping Stress
Staying active
Enjoying regular sex
Sleeping enough
Liver Detox
Weekly acupuncture
Stop smoking
Cut down alcohol
Avoid drug intake
Minimize caffeine

Things to avoid
High temperature
( best at 32 degrees C)
Stress ( testes malnourished)
Alcohol ( interferes of testosterone secretion)
Smoking (40 % sperm damage by free radicals)
Environmental Estrogen
(meat, microwave plastics)
Drugs ( reduces testosterone & libido)
Caffeine (impair sperm production & cause chromosomal abnormalities)
Toxins (pesticides, heavy metals)
Pollutants

Nutrients for Sperm Altern Med Rev. 2000 Feb;5(1):28-38. Green Valley Health, Hagerstown, MD 21742, USA Amino Acids 500 mg Vitamin A 700mcg Vitamin B6 1.4-500mg Vitamin B12 1.5mcg Folic Acid 200-400mcg Vitamin C 500- 1000 mg Vitamin E 400 IU Selenium 75 mcg Manganese 1.4 mg Zinc 10-30 mg Coenzyme Q 10- 90 mg Essential Fatty Acids 2000 mg

Pro-vitamin for Men
Zinc -15 mg/day, (oyster)
Vitamin E 100-400IU (Olive oil, wheat germ)
Calcium 1000mg
Vitamin D 10 mcg

Good Sperm Diet Black berries Blue berries Rosen berries Kale Strawberries Brussels sprouts Broccoli Red peppers Grape seed extract Pink bark extract Garlic Oyster

Resources
Fertilityfriend.com-my chart
Resolve.com- A nonprofit organization
Making babies-Book by M.D.

Questions? Contact information Cathryn Hu, Ph.D., O.M.D., L.Ac . Phone: 310-458-2848 Fax: 310-458-2899 Web: www. Advancedacupuncture.com Email: Advanced_Acupuncture @ Yahoo.com

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