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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
Ovulation Process 
www. newscientist.com
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- 
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
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 
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
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.
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
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
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
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.
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.
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 
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.
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)
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.
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 
Eggplant Peanuts 
Red Bean Dates
Foods Nourishes Blood 
Beef Chicken eggs 
Grapes Lamb 
Chicken Fish
Foods that Benefits the lining 
growth 
Kale Spinach 
Apple Appricot 
Cherry Chinese Date 
Lemon Asian Pear 
Sesame seed ( brown) Sesame seed ( black)
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
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 detoxifies 
Shitake 
mushroom 
Snow pea Pumpkin 
seeds 
Sunflower 
seed 
Soybean Olive Rice 
vinegar 
Tea
Foods that Relieves Food Retention 
Bamboo shoots Bell pepper 
Daiko radish Howthone Berry 
Plums Tomato 
Oats Pea 
Parsley Barley Malt syrup
Foods that benefits 
kidney deficiency 
Green beans Mulberry Raspberry 
Black beans Chestnut Lotus seed 
Walnut Honey
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
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 & 2nd male characteristics 
 Lack of the testosterone will result in sexual 
infantilism & sterility.
Testes Malfunction
II. Male organs- Duct System 
 Transport sperm 
from the body: 
1. Epididymis 
2. Ductus deferens 
3. Urethra
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
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 
1. Prostate Urethra 
2. Membranous urethra 
3. 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: 
1. Sperm count: > 20 million/ml/ejaculate 
2. Morphology (shape of the sperm) 
3. 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: 
1. Azoospermia 
2. Oligiospermia 
3. Sperm motility 
decreases 
4. 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; 
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
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
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 
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
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: 
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
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 
Advanced Acupuncture, Inc. 2006, Los Angeles, U.S.A.
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.
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
Our Newest Product
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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Fertility by Acupuncture

  • 1. Integrative Fertility Enhancement Cathryn Hu, Ph.D., O.M.D., L.Ac.
  • 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
  • 3. Celebrating A New Life The miracle baby
  • 4. Human Reproductive System Human Sexuality: Conception from www.abuhmed.org
  • 5. Hormones involves in the Menstrual Cycle
  • 7. Eggs maturation and travel process
  • 8. Ovulation Process www. newscientist.com
  • 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.
  • 10. The objectives of Preparation Phase  Stress relief  Causation of infertility  PMS treatment  Endometriosis  Hormone balancing  Increasing mucus secretion  Sperm quality & quantity improvement
  • 11. 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
  • 12. The Hormonal Imbalanced Conditions  High FSH level  Polycystic Ovarian Syndromes (PCOS)  Luteal phase defect  Endometriosis  Assistant Reproductive Technology (ART)
  • 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
  • 39. Foods that Invigorates Blood Eggplant Peanuts Red Bean Dates
  • 40. Foods Nourishes Blood Beef Chicken eggs Grapes Lamb Chicken Fish
  • 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
  • 49. Part II: Male Factors
  • 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
  • 53. Male Reproductive Organs  Testes (gonads):  Sperm (exocrine)  Testosterone (endocrine)  Ducts  Glands
  • 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
  • 70. Getting Tested  Urologist evaluation  Sperm analysis 2-3 Tx  Defect factors: 1. Azoospermia 2. Oligiospermia 3. Sperm motility decreases 4. Sperm morphology abnormalities
  • 71. 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
  • 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
  • 98. 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

Editor's Notes

  1. Please turn down your cell phone to vibrate mode If you have questions during the lecture, Please write up and pass over to the front.
  2. 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.
  3. 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.
  4. 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
  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.
  6. 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.
  7. F.S.H. &amp;lt;11
  8. 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.
  9. Male: Female:
  10. 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
  11. 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.
  12. 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.
  13. 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.
  14. 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.
  15. 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 %
  16. 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-
  17. 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.
  18. Body temperature 37.C , Testes= 32 C.
  19. 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:
  20. 1. Azoospermia- absence of sperm 2. Oligiospermia-lowered sperm density
  21. Sperm analysis should repeat 2 times if normal and three times if abnormal.
  22. Environment factors- Pesticides, exogenous estrogens, heavy metals may negatively impact spermatogenesis.
  23. 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.
  24. Case report: A 43 male with 3 months of combined treatment Sperm count from &amp;lt; 18 million/ml to 93 million Motility &amp;lt; 50 % to 97% Morphology: Normal &amp;lt;20% to 45 %
  25. Acupuncture has been documented in several studies as having a positive effect on sperm parameter.
  26. Semen is made mostly of water
  27. Studies confirm that male sperm counts are declining Environmental factors: pesticides, exogenous estrogens and heavy metals may negatively impact spermatogenesis.
  28. 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
  29. 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
  30. Berry family contains highest Vit C. for antioxident. A muti-faced
  31. 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.