This document provides an overview of an integrative fertility enhancement program that takes a holistic approach. It discusses evaluating and treating causes of infertility using acupuncture, herbal medicine, lifestyle changes, and integrating with conventional fertility treatments. The two main phases are preparation to treat underlying imbalances and a trial phase to promote ovulation and uterine lining growth. Treatment protocols address stress, hormones, menstrual cycles and specific conditions. Research supports acupuncture for improving fertility and IVF outcomes.
2. 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
9. 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.
13. 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 %
14. The Causations of Infertility
in Traditional Chinese Medicine
Male-
1. Kidney yin deficiency
2. Kidney yang deficiency
3. Liver qi stagnation
4. Spleen qi deficiency
5. Blood stagnation
Female-
1. Kidney deficiency
2. Cold uterus
3. Blood deficiency
4. Liver depression
5. Stagnant heat
6. Phlegm dampness
15. 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
16. 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
17. 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
18. 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
19. 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
20. 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
21. 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
22. 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
23. Mechanisms of Acupuncture (1)
a clinical observation in Shanghai, China
Highly increase of the
90
egg production
80
70
Regulate the function of
60
hormone levels
50
Influence in the gene
40
30
expression in the brain,
20
normalizing secretion of
10
GnRH, LH, and E2. 0
1st
Qtr
3rd
Qtr
egg pro.
Hormon
e
Brain
24. 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.
25. 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
26. Treatment Protocols (1)
Stress-relieve
Objectives:
1. Reduces stress and minimizes prolactin
2. 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
27. 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
28. 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 64.9 %
of integrative IVF patients at
December, 2007.
29. Acupuncture on the day of
Embryo Transfer
100
80
60
40
20
0
Series 1
Series 2
Series 3
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:
1.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.
30. 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.
31. 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.
32. Herbal Treatment
160
140
120
100
80
60
40
20
0
1st
cyl
3rd
cyl
FSH
Estroge
n
Progest
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.
33. 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.
34. 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)
35. 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
36. 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)
37. Objective Evaluations
Initial evaluation
1. Infertility -causation
2. Consider the etiology in TCM
3. Refer to fertility specialist
4. Evaluates partner’s health conditions
5. 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.
38. 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
41. Foods that Benefits the lining
growth
Kale Spinach
Apple Appricot
Cherry Chinese Date
Lemon Asian Pear
Sesame seed ( brown) Sesame seed ( black)
42. 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
43. 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
44. Foods that detoxifies
Shitake
mushroom
Snow pea Pumpkin
seeds
Sunflower
seed
Soybean Olive Rice
vinegar
Tea
45. Foods that Relieves Food Retention
Bamboo shoots Bell pepper
Daiko radish Howthone Berry
Plums Tomato
Oats Pea
Parsley Barley Malt syrup
46. Foods that benefits
kidney deficiency
Green beans Mulberry Raspberry
Black beans Chestnut Lotus seed
Walnut Honey
47. Food that Strengthen Digestion
Arise seed Brown sugar Cinnamon
Clove Fennel seed Ginger root
Molasses
48. 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
50. 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
51. Male Factors of infertility
Spermophlebectasia
Sperm dysfunction
Sexually transmitted
disease
Physical damage
Genetic disease
Auto immune disease
54. 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.
55. Testosterone Production
Produced by interstitial cells
Stimulated by LH
Testosterone stimulate the male reproductive
organs develop & 2nd male characteristics
Lack of the testosterone will result in sexual
infantilism & sterility.
57. II. Male organs- Duct System
Transport sperm
from the body:
1. Epididymis
2. Ductus deferens
3. Urethra
58. Male Organs- Epididymis
Highly coiled tube 6M
Caps superior of testes
1st 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
59. 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.
62. Male Organs- Urethra
3 main regions
1. Prostate Urethra
2. Membranous urethra
3. Spongy urethra
Carry urine and sperm
to exterior
Ejaculation
63. 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
64. Male Organs- Penis
To deliver sperm into
the female
reproductive tract
Circumcision-surgically
removed
after birth
3 enlarged eretile
tissue
Erection-blood flow
65. Good Sperm Formation
Sperm takes 100 days to develop (70/30)
3 main factors:
1. Sperm count: > 20 million/ml/ejaculate
2. Morphology (shape of the sperm)
3. Motility (How fast and straight the sperm swim)
68. 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.
69. Male Infertility Assessment
Sperm count < 10 million/ml (200 million)
Volume < 5 ml per ejaculate
Sperm motility < 60 %
Sperm Morphology < 50 % normal
72. Sperm abnormalities
Adequate
Aspermia
Azoospermia
Oligospermia
Poor motility & forward
movement
High percent of abnormal
sperm morphology
Anti-sperm antibodies
73. Diagnosis of Male infertility
Medical History
Physical Examination-structure
Secondary sex characteristics evaluation
Endocrine function test
Sperm analysis and morphology
74. 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
75. 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
76. 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
77. 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.
78. 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;
1. The fertility index increased
significantly in the treatment
group (p<or =0.5)
2. Sperm motility and axonema
intactness were highly correlated
(corr:= 0.50, p< or = 0.5)
Siterman S, Israel, 1997
79. 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:
60
50
40
30
20
10
by repeat Sperm analysis
between the acupuncture course. 0
1st 3rd 5th
acup.
herbs
combined
80. 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
81. Acupuncture in the treatment of
Psychogenic Erectile Dysfunction
50
45
40
35
30
25
20
15
10
5
0
1st
Qtr
2nd
Qtr
3rd
Qtr
4th
Qtr
Hormone
IIEF
Regiscan
Randomized placebo-controlled
pilots study,
Austria, 2003
22 patients, satisfactory
response =68.4%
Acupuncture can be
effective option >2/3 of
PED
82. 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.
83. 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
84. 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
85. 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
86. 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
87. 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:
1. AsAb decreased significantly,
(p<0.01)
2. The sperm density and motile
spermatozoa increased significantly
3. The sperm agglutination rate
decreased
4. 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
88. 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)
89. 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
90. 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
Advanced Acupuncture, Inc. 2006, Los Angeles, U.S.A.
91. Modified Jin Suo Gu Jin Wan
(Mental lock pill to stabilize the essence)
70
60
50
40
30
20
10
0
1st
Mon.
3rd
Mon.
5th
Mon.
S.Count
Motility
Morphy.
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
Advanced Acupuncture, Inc. 2006, Los Angeles, U.S.A.
92. 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
93. 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
94. 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
95. Pro-vitamin for Men
Zinc -15 mg/day, (oyster)
Vitamin E 100-400IU (Olive oil, wheat germ)
Calcium 1000mg
Vitamin D 10 mcg
96. Good Sperm Diet
Black berries Blue
berries
Rosen
berries
Kale
Strawberries Brussels
sprouts
Broccoli Red peppers
Grape seed
extract
Pink bark
extract
Garlic Oyster
Please turn down your cell phone to vibrate mode
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How many practitioners here are involving fertility treatment?
1996. Met a patient with lupus.
Fertility enhancement program is not only a treatment but changes people’s life.
Let’s talk about female first.
Before we begin our program, let’s review of some hormones involves in the menstrual cycle.
FSH, LH secreted by posterior pituitary gland.
Estrogen and progesterone produced by ovary.
Simple and easiest way to monitor the hormone levels.
Patients measure their temperature in the morning just wake up.
Catch the ovulation time
Predict the progesterone release
The mean difference before ovulation and after should be more than 0.5
We are working with 6 organization of fertility specialists.
The two phases of treatment not only speed of the conceive process but also increased IVF procedure significantly.
Following the patient’s fertility treatment plan and well communicate with the fertility specialist to have parallel treatment. Focus the weakness and schedules.
Hormonal balance during the ART treatment is most important.
F.S.H. &lt;11
Egg and Sperm become less healthy and poor quality as we age. Thus, women have a diminished ability to conceive. Experience has shown that if the hormonal system is in perfect working order and a woman has clockwork menstrual cycles,, a healthy egg can be released on time. It then has a good chance of becoming fertilized, implanting and making it through embryologic development to become a child.
Male:
Female:
The effects of acupuncture tend to be cumulative. Most effective when given in a series. A course of 10-12 is frequently recommend in order to begin to effect cellular change.
Please do educate your patient understand the their personalized treatment plan from day one. And continue to support and communication during the course.
Pre phase:
1-2 tx/wk X 4 wks/cycle
Minimum 3 cycles to regulating and balancing hormones
Trial phase:
Pre-ovulation:
3tx/wk X 2 wks
Post ovulation:
2tx/wk X 2 wks
Post conceive:
2 tx /wk X 8 wks
1 tx/wk X 4 wks
The hypothalamic-anterior pituitary-ovarian axis function
Acupuncture releases endorphins that mitigate one’s response to stressful stimuli, thus enhancing the possibility of conception. Since the hypothalamus regulates both stress Reponses as well as the sex hormones. It’s easy to see how stress could cause infertility in some women. Excessive stress may even lead to complete suppression of menstrual cycle. This is often seen in female marathon runners, who develop runners amenorrhea. In less severe cases, it could cause an ovulation or irregular menstrual cycles.
When activated by stress, the pituitary gland also produces increased amounts of prolactin. Elevated prolactin could cause irregular ovulation.
Female reproductive tract contains stress-hormone receptors, stress can affect fertility. However more complex mechanisms may be at play.
Research still do not know how stress interacts with the reproductive system.
Stress and the brain play an important role in fertility, because stress can prevent a woman from ovulating entirely, When women under extreme stress often stop menstruation and
Lack of stress often promote fertility. That is why couples often conceive while on a cruise or other relaxing holidays.
GIFT-gamete intrafallopian transfer
ZIFT-zygote intrafallopian transfer in vitro fertilization.
ET- Embryo transfer
Like IVF, these procedures involve retrieving an egg from the woman and re-implanting it, but in GIFT and ZIFT the process goes more quickly. While in traditional IVF the embryos are observed and raised in a laboratory for 3 to 5 days, in ZIFT, the fertilized eggs -- at this stage called zygotes -- are placed in the fallopian tubes within 24 hours. In GIFT, the sperm and eggs are just mixed together before being inserted and, with luck, one of the eggs will become fertilized inside the fallopian tubes.
21 of 80 patients became pregnant in IVF group Success rate= 26.3%
34 of 80 patients became pregnant in the IVF plus acupuncture group, Success rate= 42.5 %.
Acupuncture reduces the uterine contractions that typically occur with embryo transfer and may inhibit implantation.
Acu1=95 on the day Conceived 37 (39%) - 34 ( 36%)
Acu2=91 on the day and 2 days after 25 minutes session 36 % 26 %
Control=87 26 % 22 %
Dang Gui-effect on uterus: to Have a contractile effect when given intravenously to anesthetized dogs and rabbits. Does cause contraction in situ uteri and relaxation in uterus specimens. Use some studies by direct measurement of myometrium, administration of angelicae enabled the contractions of the uterus to be more orderly. This explained may be is the mechanism to treat dysmenorrheal. There is no estrogen effect.
E-Jiao-increase the RBC and Hgb significantly than the control group
Huang Qi-immune Enhancer
Dang Shen-
Sha Ren
Du Zhong
Gou Qi Zi- Protect liver functions, increase liver phosphrous and lower the blood pressure
Huai Shan
Xian Mao-
Xian Ling Pi
Tu Si Zi
Bai Shao-
Testes are approximally 4 cm long and 2.5 cm wide connective tissue capsule
Tunica albuginea, the white coat surrounds each testis
Extension of the this capsule, septa ;ige nto the testis and divide it into a large number of the lobules.
Each lobules contains one to four tightly coild seminiferous tubules where is the site to produces sperm
Each lobe of seminiferous tubules empties sperm into rete testis to the first part of ducts
Epididymis hugs the external surface of the testis/
Lying in the soft connective tissue surrounding the seminiferous tubules are the interstitial cells-produces androgens, most importantly testosterone.
Body temperature 37.C , Testes= 32 C.
Spermatogenesis is the process by which male develop into mature are the mature male in many sexually reproducing organisms. Thus, spermatogenesis is the male version of gametogenesis. In mammals it occurs in the male testes and epididymis in a stepwise fashion, and for humans takes approximately 64 days.[1] Spermatogenesis is highly dependent upon optimal conditions for the process to occur correctly, and is essential for sexual reproduction. It starts at puberty and usually continues uninterrupted until death, although a slight decrease can be discerned in the quantity of produced sperm with increase in age. The entire process can be broken up into several distinct stages, each corresponding to a particular type of cell:
1. Azoospermia- absence of sperm
2. Oligiospermia-lowered sperm density
Sperm analysis should repeat 2 times if normal and three times if abnormal.
Environment factors- Pesticides, exogenous estrogens, heavy metals may negatively impact spermatogenesis.
Acupuncture has documented in several studies as having a positive effect on sperm parameters.
A muti-faceted approach to improving male fertility involves identifying harmful environmental and occupational risk factors while correcting underlying nutritional imbalances to encourage optimal sperm production and functions.
Case report:
A 43 male with 3 months of combined treatment
Sperm count from &lt; 18 million/ml to 93 million
Motility &lt; 50 % to 97%
Morphology: Normal &lt;20% to 45 %
Acupuncture has been documented in several studies as having a positive effect on sperm parameter.
Semen is made mostly of water
Studies confirm that male sperm counts are declining
Environmental factors: pesticides, exogenous estrogens and heavy metals may negatively impact spermatogenesis.
Study shown to improve sperm counts and sperm mobility, including cantinuie, argining, Zinc, selenium and Vit B-12,
Numberous antioxidants be beneficial : Vit C, Vitamin E,Glutathione and co-enyme 10.
Above all daily dosage
Zinc-critical to maintaining optimum semen volume and blood testosterone levels in men.
Vit E: Increasing the sperm motility and viability
Calcium + D- improve male fertility
Berry family contains highest Vit C. for antioxident.
A muti-faced
A muti-faced therapeutic approach to improving male fertility involves1. Identifying harmful environmental and occupational risk factors, correcting underlying
2. Nutritional imbalances to encourage optimal sperm production and function.