Fertility Enhancement by Acupuncture & Chinese Medicine

1. Fertility Enhancement by Acupuncture & Chinese Medicine Cathryn Hu, Ph.D., O.M.D., L.Ac. Advanced Acupuncture, Inc.

2. Hormones in the Menstrual Cycle

3. Eggs Maturation and travel process

4. Celebrate New Life

5. Fertility Enhancement Program-an integrative approach • Two phase of treatment in Chinese Medicine 1.Preparation phase: Treating the causation of infertility, nourishing the reproductive organs 2. Trial phase: Promote the ovarian functions, follicle maturation and increase the lining of the uterus

6. Preparation phase • Hormone Balancing • Sperm quality & quantity improvement • Increasing mucus secretion • Stress relief • PMS treatment • Endometriosis • Causation of infertility

7. Integrative Trial phase • Promote follicles maturation • Promote the ovulation • Balance FSH, Estrogen, LH and progesterone • Acupuncture & IVF procedures • Acupuncture & IUI procedures

8. Male- Kidney Yin deficiency Kidney Yang deficiency Liver Qi stagnation Spleen deficiency Blood stagnation Female- Kidney deficiency Cold uterus Blood deficiency Liver depression Stagnant heat Phlegm dampness Causations of Infertility in Chinese Medicine

9. The Hormonal imbalanced conditions: • High FSH level • Luteal phase defect • Polycystic Ovarian Syndromes (PCOS) • Endometriosis • Assistant Reproductive Technology ( ART)

10. Other causations of infertility • Stress- -Flight-or-fight response -Glucocorticoids can raise its level and weaken the reproductive system, potentially making infertility condition worse • Age- 30’s, 40’s, decline 5-10 % each year for conception > 35-the rate of develop chromosomal abnomalities is 1: 400 compare to 1:2000 < 35 • Miscarriage- <30 ( 15 %) >40 (40 %)

11. Kidney 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

12. 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 sunken and slow

13. 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 thread and weak

14. 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

15. 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 hypochondrium • Tongue is red with a thin coating • Pulse is wiry and rapid

16. 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

17. Acupuncture treats infertility • Regulating the menstrual cycle • Invigorate the sperm qualities • Enhancing the ovarian functions • Healing PMS, Amenorrhea, Endometriosis and blocked fallopian tubes • Balance the hormone • Increase the effectiveness of IVF, GIFT, ZIFT, and ET. procedures

18. Acupuncture Enhances Fertility by • Enhance hormone regulation • Regular menstrual cycles • Protect the fragile embryo • Reduces stress • Strengthen the immune system

19. Acupuncture Mechanism- 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.

20. Mechanisms of acupuncture in treating infertility - a study in Harvard • Endorphins releases mitigate one’s responses to stressful stimuli, enhance the possibility of conception • Minimize prolactin Elevated prolactin could cause irregular ovulation

21. 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.

22. Acupuncture & IVF procedures-Research in Christian Laurizen 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 64.3% as of 2006.

23. IVF procedure Approximately $ 15,000 per cycle Acupuncture Fertility Enhancement program Approximately $ 1,500 per cycle Cost Effective

24. 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. Researches for acupuncture benefits the fertility

25. Acupuncture & Sperm Quality Improvement • 35-40 % of infertility are caused by male factors • 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.

26. Sperm

27. Acupuncture & Stress Relieve • Reduce stress and relaxes the body • By release certain chemicals and neuro-transmitter, such as endorphin, ekenephilin and serotonin. • Benefits the ART patient go through their procedure smoothly

28. Length of acupuncture treatment • Cumulative effect of series • 10-12 sessions to begin cellular change. • Speed of improvement proportional to the length of time of imbalance. • Regulate cycle: 3-6 cycles • Trial phase: 6-9 cycles • Average 6-12 cycles • Frequency at 2-3 /week • Less frequency with herbal prescription

29. Acupuncture Treatment Plan • Individualized treatment plan based on etiology • Minimum 3 cycles to regulating and balancing hormones • During Trial cycles average 2 to 4 treatments before ovulation and 3-6 post ovulation.

30. Recommendations during menses • Avoid fear, anger and excessive emotional outbursts • Dwelling on negative thoughts or emotions • Avoid eating cold and raw foods • Guard against external pathogenic cold • Avoid sexual intercourse during menstruation • Avoid strong an vigorous exercises • Maintain regular sleeping and waking hours • Avoid spicy and stimulating foods • Being happy is the best way to regulate the menses

31. 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

32. Herbs that Benefits Fertility

33. 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.

34. Herbs can improve sperm count and motility • A 43 male with 3 months of herbal treatment • Sperm count from < 18 million/ml to 93 million • Motility < 50 % to 97% • Average treatment 3-6 month

35. Classic Herbal Formulas: • 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. 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.

37. Prenatal Vitamins • 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

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

39. Food Flavors • Sweet-Tonifies, 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

40. Food for clear the heat

41. Foods that Invigorates Blood

42. Food for Drain dampness

43. Foods that detoxify

44. Foods that Relieves Food Retention

45. Foods that benefits kidney deficiency

46. Foods Nourishes Blood

47. Foods that Benefits the lining growth

48. Food that Strengthen Digestion

49. Food Recommendations-men • Oyster • Pumpkin seeds • Coffee

50. Basal Temperature Record