Monday, December 21

If you can't get pregnant, IVF is usually the next port of call - but there are alternatives, as Paula Goodyer discovers.

It was 2005, and after nine months of IVF treatment and a positive pregnancy test, 36-year-old Jill King was having a routine ultrasound to check that all was well. But when she turned to the screen, expecting to see a heartbeat, there was just an empty embryonic sac. In a cruel biological hoax, the sac minus its embryo - called a blighted ovum - was causing positive signs of pregnancy. There were more disappointments to come. By the time she discontinued IVF two years later, King had produced 50 embryos, but no babies, at a cost of about $50,000.

"People talk about the grief of miscarriage, and I've experienced that, but to me each embryo was also a potential baby lost," she recalls. "Whenever I had an embryo transfer [where the embryo is passed through the cervix into the uterus], I'd be calculating when its birthday might be."

Finally, she approached Jane Lyttleton, a traditional Chinese medicine (TCM) practitioner in Sydney who specialises in treating infertility. After three months of using Chinese herbs and acupuncture, King conceived naturally and gave birth to a daughter last year. "My message to other couples is be open-minded about alternative treatments," says King. "I know that for many people, IVF is the answer - but when both partners have been tested for all the typical causes and your infertility is still classed as 'unexplained', then Western medicine may not be the best approach. How can it successfully treat a problem it can't diagnose?"

Lyttleton is the first to admit that TCM is no cure-all for infertility, but it can help to normalise hormone levels, thus making ovulation more regular. It also improves the lining of the uterus and helps to prevent endometriosis and polycystic ovary syndrome (common causes of fertility problems in women). Sluggish or abnormally shaped sperm can benefit from Chinese medicine, too. "But it can't help with blocked Fallopian tubes - even if tubes are scarred rather than fully blocked," cautions Lyttleton. "I'd encourage a woman to try IVF in those circumstances."

Some cases of unexplained fertility may have a cause that is overlooked if IVF is used as a first, rather than a last, resort, says Dr Anne Clark, medical director of Fertility First, a clinic in Sydney's Hurstville.

Being overweight, smoking or drinking too much - even a lack of vitamin D or iodine - can sabotage conception or increase the risk of miscarriage, points out Clark. While the clinic offers IVF treatment, 25 to 30 per cent of couples conceive without it after correcting certain lifestyle factors.

"Women are hammered for being overweight or for smoking, but we know that with men, nine kilograms of extra weight can lower fertility by altering hormone levels," she says. "We also know that fragmentation of DNA in male sperm is a common cause of miscarriage, and that factors such as smoking, alcohol and possibly caffeine may be contributing."

Her study in 2008 of 800 men who were attending Fertility First found 58 per cent had sperm damage, but that lifestyle changes and vitamin supplements could help prevent this. "Unlike eggs, which are as old as the woman herself, sperm is freshly made every three months," says Clark. "Because of this, you can often reverse the problem quickly."

This was the case for Matthew Lake, a 34-year-old landscaper whose partner, Amanda, had had three miscarriages by the time she was 29. Test results showed she had no obvious problem, but Matthew had fragmented DNA in 33 per cent of his sperm.

At Clark's suggestion, he reduced his weekly beer consumption from 24 to seven, stopped drinking Coke and took a daily multivitamin. He also took supplements of coenzyme Q10 and vitamins E and C, antioxidants that, according to some research, help reduce sperm damage.
"After six months, the number of fragmented sperm had dropped to nine per cent - a month later I was pregnant," says Amanda. "I don't think people realise the problem can often be with the male partner, and that the solution can be simple."
In Clark's experience, men are often only asked to provide a sperm sample, and if that is problematic, the couple are directed to IVF rather than addressing a man's underlying health problems. The pressure of ageing impels couples towards IVF, too, she says.

Francesca Naish, from the Jocelyn Centre for Natural Fertility Management in Sydney, agrees. "People are in a hurry to conceive, but they need to take about three months to clean up first."
The "cleaning up" regimen recommended by the centre, which employs medical practitioners, naturopaths and an acupuncturist, entails both partners eating whole food - preferably organic - taking herbs and vitamin and mineral supplements, and reducing exposure to environmental toxins.

"Take the example of a hairdresser or a motor mechanic," says Naish. "She's exposed to bleaches and solvents, and he's working with solvents, heavy metals and paints. This doesn't mean hairdressers and mechanics can't make babies together, but if their fertility is already compromised, these exposures can make conception - especially of a healthy baby - harder." Other workers who come into contact with pesticides, such as farmers, may experience problems, too, explains Naish, as can people who spend a lot of time flying (sperm and eggs can be affected by radiation at high altitude). Some studies have linked heavy mobile phone use to reduced sperm count and sperm health. In isolation, these factors may mean nothing, but an accumulation of them, plus increasing age, can make a difference.

Although there's evidence that the miscarriage rate is higher with IVF, says Naish, "this isn't necessarily to do with IVF technology, which is fantastic. Miscarriages can occur because other problems aren't being sorted out first," she says. "IVF helps sperm and egg to meet and then gets the fertilised egg to the uterus, but it doesn't solve underlying problems that can impede a pregnancy."

Anne Clark acknowledges that with IVF offering a monthly pregnancy rate that is two to three times higher than nature, it will always appeal to couples in the stressed-out 21st century. When she recommends waiting until the lifestyle changes kick in, some couples feel pretty thrown to begin with. "But achieving a pregnancy can be a bit like painting a wall," she says. "It's all in the preparation."

East meets West

Acupuncture and IVF might come from opposite sides of the medical fence, but there's growing interest in combining them. Some studies show an improvement in pregnancy rates if acupuncture is used at embryo transfer, says Jane Lyttleton, a traditional Chinese medicine practitioner who works in partnership with IVF clinics. "We need more research to understand how it works," she says. "It may be that acupuncture increases blood flow to the lining of the uterus, creating a better environment for the embryo to grow. It may lower levels of stress hormones or, by having a calming effect on a woman's immune system, it may reduce the chances of her body rejecting the pregnancy."

Source: smh.com.au

Friday, December 18

Acupuncture Could Play A Useful Role In The Treatment Of Female Infertility

Doctors at the Center for Reproductive Medicine and Infertility at Cornell’s Weill Medical College have investigated the potential usefulness of acupuncture in enhancing female fertility.

Traditional Chinese medicine would attribute a disease state, such as infertility, to energy disturbances or imbalances, or organ deficiencies and excesses. Acupuncture is used in this system as a way to correct disruptions in the flow of Qi (energy) and bring the body back to good health. Doctors Chang, Chung, and Rosenwaks examined the current literature on acupuncture from the perspective of Western medicine seeking to determine its impact on the hypothalamic-pituitary-ovarian axis and the pelvic organs, and its potential for easing stress and anxiety.

Connections were found between acupuncture and the production of endorphins, which affect hormones playing a part in the menstrual cycle. In addition, studies were identified indicating that acupuncture can have an impact on ovulation.

Stress and anxiety, which too often accompany infertility, and possibly exacerbate the condition, can be relieved by acupuncture. Studies have been done, as well, on its use in relieving depression. As the impact of anxiolytic drugs and anti-depressants on infertility treatment is unknown, acupuncture presents an alternative for infertility patients.

Based on the preliminary clinical data showing acupuncture’s neuroendocrine effect on the hypothalamic-pituitary-ovarian axis and peripheral impact on improving uterine blood flow and endometrial thickness, the authors feel that clinical trials are warranted to investigate systematically the efficacy of acupuncture in treating various conditions related to female infertility. As the physiologic mechanisms underlying acupuncture are becoming better understood, the technique has been shown in trials to relieve pain, alleviate chemotherapy-induced nausea, and to treat for substance abuse. If trials show that it has a positive effect on the physiology affecting fertility, it could become a useful adjunct to established treatments.

Wednesday, December 16

Acupuncture, massage, and herbal therapy have all been linked with success in treating the symptoms of endometriosis including pain reduction and improved fertility outcomes

An estimated five to seven million American women currently suffer from this endometriosis, according to the Journal of the American Medical Association. Endometriosis is derived from the word "endometrium," which is the lining of a woman's uterus.

In this condition, organs like the ovaries, fallopian tubes, ligaments surrounding the uterus, and possibly the lungs, head, and other locations, can have endometrial cells as well as the uterus. However, unlike the uterus, these cells are not expelled from the body during menstruation, but rather linger and are slowly absorbed into the body. This can cause symptoms ranging from pain during intercourse, painful menstruation, low back pain, nausea, fatigue, and infertility.

Diagnosis is performed via laparoscopy. A laparoscopic procedure requires that a lighted optical tube be inserted through a small incision in the navel.

The causes of endometriosis are still unclear, although many theories have been made with attention to, genetic predispositions, and autoimmune causes.

Acupuncture, massage, and herbal therapy have all been linked with success in treating the symptoms of endometriosis including pain reduction and improved fertility outcomes.

Traditional Chinese medicine considers endometriosis as a condition of qi and blood stagnation and heat, which means that the woman’s blood circulation is not occurring properly and that heat (read autoimimmune attack is built up in the pelvic region.

The TCM treatment for endometriosis attempts to increase circulation and clear internal pathogenic heat.

When acupuncture needles are applied to points influencing the nervous system, organ functions, and endocrine system, balance can be restored and blood stasis improved and heat cleared.

Oriental medicine, in conjunction with Western medical approaches often show improvement in symptoms and conception rates greater than those seen when using one of these modalities alone.

Sources:

1. http://tcm.health-info.org/Acupunture/treatment/endometriosis.htm

2. http://www.endo-resolved.com/index.html

3. Du, Li, Endometriosis Through the Eyes of Tradition Chinese Medicine, New Life Journal, 2003

Tuesday, December 15

EXHALE MIND BODY SPA OFFERS NEW FERTILITY AND REPRODUCTIVE WELLNESS PROGRAM

Exhale Acupuncture Specialists Trained in The Berkley Method of Fertility Treatment to Bring Holistic Approach to Reproductive Health to Exhale Facilities

NEW YORK, NY (October 2009) – Exhale, the highly acclaimed national mind body spa brand, has instituted a new wellness program under the direction of Robert MacDonald, exhale’s Director of Healing, to provide clinical services to families struggling with infertility. Working extensively with Dr. Michael Berkley, founder and director of The Berkley Center for Reproductive Wellness, exhale’s team of seasoned acupuncturists received advanced training in the treatment of infertility and reproductive wellness and now offer that expertise to guests in the tranquil healing environment of exhale’s facilities. The fertility and reproductive wellness program at exhale offers three, six, and nine month programs that follow the “Berkley Method” of holistic infertility treatment.

“Dr. Berkley’s east meets west approach to infertility treatment has proven to be highly successful in helping patients achieve their goals of becoming parents,” said Robert MacDonald. “We’re pleased that we are now able to offer this revolutionary program to our guests that may be struggling with this very sensitive subject.”

Exhale’s fertility and reproductive wellness programs incorporate:

• Acupuncture and herbal medicine provided by highly trained and supported specialists in the natural treatment of infertility

• Nutritional counseling to enhance physical health and wellbeing

• Yoga and exhale’s proprietary Core Fusion® classes, designed to strengthen the body and increase vitality

• Massage therapy to relieve stress and increase circulation to the reproductive organs

Exhale practitioners utilize the techniques behind The Berkley Method to heal the root causes of infertility and provide overall wellness. Acupuncture can improve the function of the ovaries to produce higher quality eggs, increase blood flow to the uterus, relax and de-stress the body, prevent uterine contraction post IVF embryo transfer, reduce side efforts of IVF medications, strengthen the immune system, increase energy and improve sperm count; all factors that can ultimately improve the chances of conceiving.

Similarly, fertility massage improves circulation and encourages relaxation of tense uterine muscles. An increase of blood flow is a very simple and natural way to significantly improve the functions of the uterus, ovaries and fallopian tubes. Exhale acupuncturists underwent extensive training in this kind of massage in order to make the body best ready to conceive and carry out a full term pregnancy.

In addition to acupuncture, massage and nutritional counseling, physical activity such as yoga and exhale’s proprietary Core Fusion® classes are an essential component to each comprehensive reproductive wellness plan. Exhale’s Core Fusion® program is a results-oriented fitness experience that truly transforms the body through a fusion of core conditioning, Pilates, yoga and orthopedic stretching. A sound mind, body and spirit improves overall by incorporating exhale’s fitness modalities into the fertility program, guests will see an improvement in physical health, which enhances overall reproductive wellbeing.

About Robert MacDonald, MS, L.Ac., LMT

Robert MacDonald is the founder of Intentional Health and Wellness (IHW), and exhale’s Director of Healing, responsible for staffing, programming, and operations of exhale's healing department, including program development, product development, marketing and operational protocols, and coordination of all integrated healing department services. Robert also develops proprietary healing products for exhale that are sold in the spas such as the elemental healing teas and the essential oils. IHW is a practice dedicated to guiding people to their highest level of health through self-knowledge and focused intent. He has been helping his patients recover from debilitating dysfunction and disease for more than 15 years. Robert initially trained extensively in deep tissue structural bodywork, various disciplines of energetic work, clinical counseling and hypnotherapy. It is upon this foundation that he builds his work as a practitioner of acupuncture and Oriental Medicine.

Robert has a Master of Science degree in the field, and is Board Certified and State Licensed in New York, Massachusetts and Illinois. He has treated a wide variety of patient conditions in both hospital and clinical settings with a treatment style that is gentle and compassionate. Robert sees his skills and experience as tools to help his patients attain their highest level of health and functionality.

About Dr. Mike Berkley

Dr. Mike Berkley, Founder and Director of The Berkley Center for Reproductive Wellness, in New York City, is licensed and Board Certified in Acupuncture in the states of New York and Connecticut, and licensed as a Doctor of Acupuncture in the State of Rhode Island. Dr. Berkley is also Board Certified in Clinical Herbal Medicine by the National Certification Commission for Acupuncture and Oriental Medicine. Dr. Berkley is the first acupuncturist/herbalist in the United States to work exclusively in the field of reproductive medicine. He has developed unique acupuncture protocols and herbal formulae which have been shown to increase success rates. He works exclusively in the area of reproductive medicine and enjoys working in conjunction with some of New York’s most prestigious reproductive endocrinologists.

Dr. Berkley is a Member, in good standing, of the American Society for Reproductive Medicine (ASRM); Resolve of New York, American Fertility Association (AFA), the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), the Acupuncture Society of New York; and the American Association of Oriental Medicine (AAOM). In addition, he is an Advisory Board member of The InterNational Council on Infertility Information Dissemination, Inc. (INCIID). He is also on the Board of Doctors at ATIME, and he is an Advisory Board Member of the Pacific College of Oriental Medicine (PCOM). Dr. Berkley is also sits on the Advisory Board of the American Board of Oriental Reproductive Medicine (ABORM).

About exhale

Widely recognized for revolutionizing the day spa business, exhale is a brand synonymous with transformation and healing. In just six years, exhale has earned a position as a leading lifestyle brand in the health and wellness space that enjoys a high level of demand from the hospitality and real estate industry.

The Company currently operates 13 locations in key metropolitan markets + the Caribbean, and is opening another 2 properties in August, and within the next year growing to 18 in total by mid 2010. Exhale plans to grow its wellbeing paradigm to 50 locations in prestigious and philosophically aligned resorts, residential hotel developments, and strategic partnerships. For more information please visit www.exhalespa.com.



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Monday, December 14

Protocol: acupuncture twice weeky

Chromosomal abnormalities in the older patient

It is the female reproductive age rather than the FSH level which is the main determinant of egg/embryo quality.

At thirty-years-old about twenty-five to thirty percent of mature eggs/embryos will have structural and numerical chromosome abnormalities (aneuploidy). At forty years of age the incidence is about 60%. At forty-two-years-old approximately seventy-five percent and at forty-five-years old, approximately eighty-five percent.

From a traditional Chinese medicine perspective this is caused by a reduction in the health of the reproductive environment which occurs as a result of decreased blood circulation due to the aging process. With reduced blood flow to the reproductive organs, oxygen, nutrients and hormonal delivery are reduced.

Insofar as IVF is concerned, a progressive increase in the incidence of embryo aneuploidy lies at the root of declining IVF success rates, increased miscarriage rates and an increase in the incidence of birth defects such as Trisomy 21 (Down's syndrome).

One of the most important desired outcomes of acupuncture and herbal medicine treatment from the perspective of treating the individual seeking assistance in conceiving is the enhancement of blood circulation to the reproductive environment.

Significance of improved blood circulation on pregnancy outcomes

Blood delivers nutrients from the digestive system to all parts of the body.

Blood transports oxygen from the lungs to all parts of the body including the fallopian tubes, ovaries and uterus. Acupuncture and herbal medicine facilitate this transport. This action will immediately improve the health of these organs and increase the reproductive function.

Blood transports carbon dioxide from all parts of the body to the lungs for excretion. Since acupuncture and herbal medicine assist in this 'house-cleaning' function, circulation is enhanced, the removal of toxic-waste from your body is increased and your general health and well-being is improved.

Blood transports waste products from cells to the external environment mainly via the kidneys. These waste products are found everywhere in the body including the fallopian tubes, ovaries and uterus. Acupuncture and herbal medicine often seek the 'strengthen' the energy of the kidneys. This action can greatly improve your reproductive health.

Blood transports hormones from the endocrine system to target cells or organs within the body including the hypothalamus, anterior pituitary and ovaries; the three essential organs necessary to achieve pregnancy.

Course of Treatment

By treating hundreds of patients suffering with infertility who have had success after intervention with acupuncture and herbal medicine, we find that the most effective treatment regimen consists of two acupuncture treatments weekly. Acupuncture and herbal medicine treatment have a cumulative effect not unlike that of psychotherapy, physical therapy, dieting and exercise. All of these mentioned modalities are more effective when engaged in at the frequency of two to three times weekly.

This treatment protocol has shown a significant increase in pregnancy outcomes.

We frequently see a reduction of structural and numerical chromosome abnormalities (aneuploidy) with our proprietary acupuncture and herbal medicine protocols, great conception rates and reduced occurrences of miscarriage.

ICSI

At the Berkley Center for Reproductive Wellness we have been treating male factor infertility for many years based on the knowledge of 3000 years of traditional Chinese medicine.

Acupuncture and herbal medicine in conjunction with certain vitamins and amino acids promote significant change in pathologic sperm. We have had excellent results in improving sperm count, improving morphology and motility as well as reducing sperm DNA fragmentation percentages.


The importance of this cannot be overstated. In the typical IVF Center, doctors will note that sperm quality is important in that in its pathological state in may not be able to penetrate the egg and facilitate fertilization. This can be overcome with intra-cytoplasmic-sperm-injection or ICSI. While fertilization with ICSI is possible, a good embryo quite often is not produced and pregnancy does not ensue.

A ‘good’ embryo is created by combining a ‘good’ egg with ‘good’ sperm. Embryos created with poor quality sperm even if fertilization occurs via ICSI are, in my opinion, based on thirteen years of clinical experience, one of the main reasons for failed IVF cycles including donor egg transfers even though fertilization with ICSI is facilitated.

Frequently the doctor will report that the embryo is “beautiful”, yet the cycle fails. You can no more judge the quality of an embryo by visualization than one can judge the health of a person by visualization. For example, the healthiest looking man can be HIV positive. Or, the healthiest looking woman can have breast cancer. One cannot judge a book by its cover.

The best and most reliable means of improving fertility outcomes either as a result of intercourse, IUI, or IVF is to first improve the quality of the components that are responsible for the creation of the embryo; sperm and egg.

See studies below for more information.

Fertility and Sterility_ Vol. 92, No. 4, October 2009 0015-0282/09/$36.00

Copyright ยช2009 American Society for Reproductive Medicine, Published by Elsevier Inc. doi:10.1016/j.fertnstert.2009.02.041

Jian Pei, Ph.D.,a,b Erwin Strehler, M.D.,b Ulrich Noss, M.D.,c Markus Abt, Ph.D.,d

Paola Piomboni, Ph.D.,e Baccio Baccetti, Ph.D.,e and Karl Sterzik, M.D.b

a Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; b Christian-

Lauritzen-Institut, Ulm, Germany; c In Vitro Fertilization Center Munich, Munich, Germany; d Institute for Mathematics,

University of Augsburg, Augsburg, Germany; and e Department of Paediatrics, Obstetrics and Reproductive Medicine, Section

of Biology, Siena University, Siena, Italy

Sunday, December 13

Study Shows Alternative Treatment May Help Male Infertility Problems

Aug. 3, 2005 -- Acupuncture may help some men overcome infertility problems by improving the quality of their sperm, according to a new study.

Researchers found five weeks of acupuncture treatment reduced the number of structural abnormalities in sperm and increased the overall number of normal sperm in a group of men with infertility problems.

They say the results suggest that acupuncture may complement traditional infertility treatments and help men reach their full reproductive potential.

Acupuncture May Ease Male Infertility

An estimated 10% of men are infertile, and the male partner is a factor in up to 50% of infertile couples, write the researchers. In many cases, the cause of male infertility is unknown.

Previous studies of acupuncture and male infertility have suggested that acupuncture can improve sperm production and motility (a measure of sperm movement).

In this study, researchers looked at the effects of acupuncture on the structural health of sperm in men with infertility of unknown cause. The findings appear in the July issue of Fertility and Sterility.

Twenty-eight infertile men received acupuncture treatments twice a week for five weeks, and 12 received no treatment and served as a comparison group.

Researchers analyzed sperm samples at the beginning and end of the study and found significant improvements in sperm quality in the acupuncture group compared with the other group.

Acupuncture treatment was associated with fewer structural defects in the sperm and an increase in the number of normal sperm in ejaculate.

But other sperm abnormalities, such as immature sperm or sperm death, were unaffected by acupuncture.

The researchers write that acupuncture treatment is a simple, noninvasive method that can improve sperm quality.


________________________________________

SOURCE: Pei, J. Fertility and Sterility, July 2005; vol 84: pp 141-147.

Saturday, December 12

Western Reproductive Medicine and Traditional Chinese Medicine – Things You Should Know

Western reproductive medicine can do the following things: promote follicular development with certain medications, promote ovulation with other medications, perform intra-uterine-insemination, and in-vitro-fertilization. Western reproductive surgeons can also perform often necessary surgeries to create a fertile environment where polyps, fibroids, uterine anomalies and cervical anomalies are present. Without these types of interventions many infertile women would never have children.

Traditional Chinese medicine can often regulate systemic dysfunction naturally. That means that TCM can contribute to helping the PCOS patient ovulate without Clomid or perhaps with a lesser amount of Clomid. In the morbidly obese PCOS patient, weight loss is of paramount importance in increasing the ability to conceive because excess fat stores androgens and converts androgens to estrogen thereby creating a hormonal imbalance that is unlikely to enable conception. Acupuncture and herbal medicine along with exercise and life-style changes can make weight loss and its attendant health benefits possible.

Endometriois

In the endometriosis patient, acupuncture and herbal medicine cannot eradicate endometriosis but it can reduce the inflammatory environment associated with this disease. An interesting example of this is the patient with stage 1 endometriosis who does not present with pelvic distortion but cannot get pregnant. Why not? Her husband’s sperm is fine and other than the endometriosis there are no contributing factors that are contributing to the state of infertility. Even other autoimmune disorders have been ruled out as possible contributing factors. The infertility stems from an inflammatory intrauterine environment that either destroys the embryos or makes the uterine lining inhospitable to an embryo which is trying to implant. Acupuncture and herbal medicine can often regulate this environment by reducing this inflammatory process.


Male factor

Many men have low sperm count as a result of a minor vericocele. Surgeons do not operate on minor vericoceles because the benefit does not exceed this risk. The cause of a vericocele is pooling and stagnating and over-heating of blood in the pampiniform plexus. The pampiniform plexus is the veins in the testicles. The sperm- killing-heat is caused by the pooling and stagnating of blood. Acupuncture and herbs can strongly move qi (energy, metabolism, circulation) and blood in the testicles. As a result of this, the blood is less congealed, the blood flow is more functional and the heat is diminished, contributing to increased sperm count. Even in the face of a major vericocele, the surgical outcomes are successful 50% of the time. This means that even with surgery there is a 50% possibility that the count will remain low. One of the reasons for this is that long term blood stagnation and heat in the testicles causes tissue necrosis (death) and sperm cannot be adequately produced. The determination of success can only be made after the surgery. The recovery time after the surgery is six months.

The reason that this is the case is because the inflammation which is caused by the surgery takes that much time to be reduced. Utilizing acupuncture and herbal medicine after a vericocelectomy shortens recovery time by two months making the total recovery time four months instead of six. Men with any sperm anomaly should refrain from taking hot baths, saunas or riding a bicycle for long periods of time as all of these activities facilitate increased testicular temperature.

What about the patient who wants to do an IVF with her own eggs but her FSH is 18 and her doctor states that donor-egg is the only option? The doctor, essentially, is correct. He or she views this patient as one who either will not respond to gonadal stimulation and therefore produce either no eggs or produce too few to justify the continuation of the IVF cycle. So the reproductive endocrinologist offers the donor egg option with full integrity and with the patient’s best interest in mind. But, here is what I have witnessed on more than a few occasions: I will treat the patient with acupuncture and herbal medicine and her numbers will regulate. Not necessarily to a ‘perfect’ level, but to levels which will facilitate having the reproductive endocrinologist have a ‘second-look’. Subsequently many IVF cycles have been completed with a great many successful outcomes and many failures too. But I choose not to focus too much importance on the failures. It is the successes that would have never occurred had acupuncture and herbal medicine not been utilized on the patient who was told that donor-egg was the only option. In other words, inclusion of TCM has only an upside potential.

Implantation failure

Accounts for a substantial amount of infertility. Almost every patient that I have reports that her lining is “beautiful” according to her reproductive endocrinologist. The scientific truth however is that the morphology of the lining is not analogous to intraendometrial vascularization. This means that even though your lining may be thick it does not mean that there is enough blood flow getting to the lining. This is why sometimes even in the absence of any observable or diagnosable pathology, infertility manifests. Acupuncture and herbal medicine have been shown to increase endometrial vascularization and thereby increasing implantation potential.

The idiopathic patient

Idiopathy means ‘no known cause’. What ‘no known cause’ means is that the limited Western medical diagnostic capabilities available today are only able to diagnose what they can, not what they cannot. In other words, there are many subclinical causes of infertility that have yet to be discovered and which, to date, have no remedies. Over time, this will change. This is by no means meant to be a derisive comment of Western reproductive medicine. IVF has brought thousands of children into the world and created thousands of happy families. These successes would not have been possible in the ‘infertile population’ prior to the advent of this incredible technological breakthrough.

Traditional Chinese medicine, based upon its method of diagnosis does not, as part of its medical vocabulary have a word that is analogous to ‘idiopathic.’ In other words, all cases of infertility can be diagnosed and treated. There are no mysteries or impossible cases.

Each and every case can be, analyzed, differentiated, diagnosed and treated.

TCM can often establish a treatment protocol where Western medicine has none to offer other than donor-egg. TCM uses specific herbal formulas prescribed for a particular patient for a particular disorder, taking into consideration the whole patient as well as their pathology. The whole person is treated, not just their disease. What really does the “whole person” mean? It means that if the patient has a bad marriage, has low libido, chronic headaches, arthritis, depression, anxiety, frustration, a history of surgeries, a history of psycho-emotional trauma, a job she hates, a dying mother, low self-esteem, a smoker, a drinker, a stress eater, etc., etc., these things can contribute to her infertility.

How? Because the mind, spirit and body are inextricably connected. Not convinced? Ok, the why when you are very stressed do you get a headache or a stomach-ache. Why is it that when you are very depressed you have no energy? Why is it that when you pray you feel more empowered? Why is it that when you look better, you feel better and when you feel better you have more energy and when you have more energy you are less likely to get sick and when you are not frequently sick you are not chronically depressed?

Because the mind, spirit and body are inextricably connected. This is why TCM doctors treat the whole person; only treating the disease is like treating a cancer patient with aspirin for their pain.
This is why the best case scenario in the treatment of reproductive disorders (as well as all disorders) is to integrate both methods of medical expertise. The TCM application will help the Western reproductive medical protocol succeed in a shorter period of time. Or TCM may be the difference between success and failure in the Western medical setting; remember, IVF has a 30% success rate which means conversely that it has a 70% failure rate.

Herbs

Many doctors tell their patients not to take herbs. Can you imagine why? Go ahead, let your mind swirl around and try and latch on to one word that sticks. How about ‘dangerous’? DID YOU KNOW: there are more than one million hospitalizations per years as a result of dangerous side-effects caused by pharmaceutical products. But pharma is big business and it has the money and power to squelch the media. When is the last time you heard about someone dying or even being hospitalized as a result of taking herbs? I’ll tell when: NEVER. When is the last time you heard about someone getting sick, or being hospitalized or dying from herbal medicine? I’ll leave that answer to you.

My view is that most Western medicine when prescribed by an expert in his or her field is safe and effective and usually there are no harmful side-effects. Why is it so difficult for Western physicians to say the same thing about herbal medicine? Is it perhaps because if a patient conceives as a result of herbs that a $10,000.00 to $15,000.00 IVF cycle would be cancelled?

Again, I’ll let you answer that question.

Herbal medicine, when prescribed by a Board Certified herbalist is not only safe, but safer than Western drugs. Can herbs “interfere” with Western medicine in an IVF cycle? No. I have been giving herbs to patients while they have been taking Western medicine for ten years. All that’s happened is the production of babies. Can the Western medical establishment be threatened by herbs or acupuncture? I’ll leave that for you to answer.

Here is a medical quiz. If you had a choice of doing something that could improve your chances of conception, would it be:

1. Meditating

2. Praying

3. Yoga

4. Acupuncture

5. Herbal medicine

6. Changing your diet

7. Reducing stress

You’re correct; all of these will help. But can you identify the two things above that have a three-thousand-year-old history of successfully treating infertility? There are only two in the list and only two in the world.

What I find amazing is that every infertile couple is not including acupuncture and herbal medicine as part of their protocol to conceive. Some individuals say they “don’t believe in it.” How can you not believe in something that has been scientifically proven to be effective in countless Western scientific studies?

Non-Believers

I’ve had my share of non believers; they were believers nine months later when they sent me tear-stained letters of gratitude for helping them become parents. Come to my office and see the photos on the walls, the photos of families, the photos of joyous moms and dads, the photos of their smiling cherubs; all sent from non-believers. I can assure that they are all converts now. In fact, a large referral source for me is from former ‘non-believer’ patients.

I am a staunch supporter and firm believer in Western reproductive medicine. But, TCM has been successfully treating infertility for 2930 years longer than Western medicine. And I want parity. Not for my ego or for the validation of the medicine that I so proudly practice but because parity will enable real patient care; better patient care than we presently have; more successful outcomes, more families granted to those who should but cannot have them.

Based upon the information I have provided herewith, it is my conclusion that to not use Traditional Chinese Medicine as part of an assisted-reproductive-medical-protocol is very short-sighted indeed.

Your world is a garden from which you can remove weeds of doubt and replace them with seeds of hope.


mike berkley, L.Ac., FABORM

Doctor of Acupuncture (RI)

Founder and Director, The Berkley Center for Reproductive Wellness

Friday, December 11

Acupuncture in IVF Linked to Lower Miscarriage and Ectopic Rates

PHILADELPHIA — Women who receive acupuncture during the stimulation phase of an in vitro fertilization cycle and again immediately after embryo transfer have a higher live-birth rate than do controls, according to the first acupuncture study with this end point.

“Other studies have looked at pregnancy rates, but what is really important is whether or not there is a baby,” said Paul C. Magarelli, M.D., who reported his findings at the annual meeting of the American Society for Reproductive Medicine.

The retrospective study included 131 women who were undergoing standard in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). All of these women were considered good prognosis candidates for IVF/ICSI and were given the choice of having acupuncture.

A total of 83 women declined (controls) and 48 accepted.

There were no significant differences between the two groups in terms of infertility diagnoses, demographics, and treatment protocols, except that sperm morphology was slightly better in the partners of women receiving acupuncture (7.3% vs. 5.9 % normal forms with strict criteria evaluation), and the average uterine artery pulsatility index was lower in the acupuncture group (1.57 vs. 1.72), said Dr. Magarelli of the department of ob.gyn. at the University of New Mexico, Albuquerque.

The study found that pregnancy rates per embryo transfer were not significantly different between the two groups (50% in the acupuncture group and 45% in controls).

The miscarriage rate was almost halved in the acupuncture group (8% vs. 14%).

In addition, the rate of ectopic pregnancies was significantly lower in the acupuncture group—0 of 24 pregnancies (0%) vs. 2 of 37 pregnancies (9%), said Dr. Magarelli, who is also in private practice in Colorado Springs and Albuquerque.

Thus, the live-birth rate per IVF/ICSI cycle was significantly higher in the acupuncture group than in controls (21% vs. 16%).

“The live-birth rate per pregnancy is an even more telling number, since some cycles get cancelled. There was a 42% live-birth rate per pregnancy in the acupuncture group, compared to a 35% rate in the nonacupuncture group,” Dr. Magarelli said in an interview with this newspaper.

“We believe that what we are doing is improving the uterine environment such that implantation is improved,” he added.

The study used two acupuncture protocols.

The Stener-Victorin electrostimulation protocol—which has been shown to reduce high uterine artery blood flow impedence, or pulsatility index (Hum. Reprod. 1996;11:1314-7)—was used for eight treatments during ovarian stimulation.

The second acupuncture technique—the Paulus protocol, which has been associated with improved pregnancy rates (Fertil. Steril. 2002;77:721-4)—was used within 24 hours before the embryo transfer and 1 hour after.

“This protocol has demonstrated reductions in uterine contractility, so by relaxing the uterus before the embryo transfer and immediately after, we felt we were setting up a better environment for implantation,” Dr. Magarelli said.

For more information on IVF and acupuncture, visit www.berkleycenter.com


877-965-BABY

Thursday, December 10

Study of 5,800 IVF cycles shows a trend toward decreasing success rates with increasing BMIs.

Encourage Healthy BMI in Patients Before IVF

PHILADELPHIA — Patients considering in vitro fertilization should be encouraged to aim for a healthy body mass index before they start treatment, results of a large retrospective study suggest.

“There was a trend toward decreasing success rates with increasing BMIs,” reported lead investigator David Ryley, M.D., of Beth Israel Deaconess Medical Center, Boston, and Boston IVF, a private fertility clinic.

The study reviewed more than 5,800 fresh, non-donor in vitro fertilization (IVF) cycles at Boston IVF in which the patient's BMI had been recorded, he reported at the annual meeting of the American Society for Reproductive Medicine.

Patients were divided into five groups according to BMI: under 20 kg/m2, 20-24.9 kg/m2, 25-29.9 kg/m2, 30-34.9 kg/m2, and more than 35 kg/m2. Women with a BMI of more than 40 kg/m2 are not allowed to undergo IVF at the center, he said.

There was no difference between the groups with respect to the number of mature follicles, number of oocytes retrieved, number of mature oocytes, the number of cycles per patient, and the number of embryos transferred. Still, patients in the highest BMI category had a significantly lower implantation rate and clinical pregnancy rate, compared with the other BMI groups.

Although the clinical pregnancy rate ranged from about 27% to almost 33% in the lower BMI categories, it was not quite 22% in the highest BMI category.

Similarly, the implantation rate ranged from 18% to 20% in the lower BMI categories, but it was only 13% in the highest BMI category.

Unlike previous published studies on this topic, the current study did not find an association between extremely low BMI and poor IVF success rates, Dr. Ryley said.

“The best data in the literature suggest that severely low BMIs under 20, or under 18, affect the hypothalamic-pituitary axis, such that patients have irregular menstrual cycles and, therefore, have an impaired chance of fertility,” he told this newspaper. “But in our study the patients with the lowest BMIs actually had the highest pregnancy rates—although the difference was only significant when compared with the highest BMI category.”

The study's findings are consistent with other reports of how excess weight can impact hormonal balance and the quality of oocytes and embryos, he said. Weight loss can often correct problems such as hyperinsulinemia and polycystic ovarian syndrome, which can in turn increase fertility.

But physicians should also know how to manage an IVF cycle in an overweight patient who has not lost weight.

“We know that patients with high BMIs require higher doses of medications, particularly gonadotropins, to stimulate folliculogenesis, and they often require longer cycles,” Dr. Ryley said. “By increasing the doses of these medications, you can often get an adequate number of oocytes. However, in many of these patients, hormonal imbalances may have a deleterious effect on the quality of oocytes you get.”

Find out how you can lose weight. Visit...

http://www.berkleycenter.com/

Wednesday, December 9

Acupuncture & Infertility Q & A




Q. What is acupuncture?

A. Acupuncture is the insertion of ultra-thin, sterile needles into specific acupuncture points which reside on ‘channels’ or ‘meridians’ which are pathways which traverse both the exterior and interior of the body. These points, when needled can alter the way in which the body functions. Alter really should be read as ‘regulates’. In other words, acupuncture can support that which is hypo or under-functioning (hypothyroidism) or reduce that which is hyper or over-functioning (hyperthyroidism).

Q. Can acupuncture be used to treat infertility?

A. Yes. Acupuncture, frequently combined with herbal medicine has been used for centuries to treat infertility. Infertility, of course describes the manifestation of an underlying cause rather than the cause itself. As such, acupuncture and herbal medicine can be used to treat certain causes of infertility, though not all. For example, acupuncture and herbs will not be effective in resolving dense tubal adhesions which can occur as a result of pelvic inflammatory disease or endometriosis. In this case the best outcome for the patient will probably be achieved through in vitro fertilization with embryo transfer. This particular patient would still benefit from acupuncture and herbs though because of its positive effect on improved ovarian and follicular function. Additionally, it has been shown that acupuncture can increase blood flow to the endometrium helping to facilitate a thick, rich lining.

Q. When should I start getting treated with acupuncture to enhance my fertility?

A. Acupuncture, similar to physical therapy or psychotherapy is a ‘process’ oriented modality of medical intervention. It is better to do more than less. Typically we like to treat patients for three to four months before an insemination, IVF or donor-egg transfer. This period of treatment seems to have a therapeutic effect.

We do see patients sometimes for acupuncture pre and post embryo transfer which coincides with the information put forth in the study by Elisabet Stener-Victorin, Urban Waldenstrรถm, Sven A. Andersson and Matts Wikland at the Department of Obstetrics and Gynaecology Fertility Centre, Scandinavia. Department of Obstetrics and Gynaecology and Department of Physiology, University of Gothenburg, Gothenburg, Sweden.

Based upon my experience, the best results in treating the infertile couple arrive when combing acupuncture, herbal medicine and Western medical intervention. It is not infrequent however, that natural pregnancies occur after undergoing acupuncture and herbal medicine alone.

Q. When should I stop getting acupuncture?

A. Typically most miscarriages occur within the first three months of pregnancy. Therefore, we continue to treat our patients until week thirteen to help prevent miscarriage.

Q. Are the acupuncture points different after an insemination or after an IVF or donor-egg transfer than before?

A. Yes. Absolutely. Your acupuncturist should not place needles in the abdomino-pelvic area after insemination or transfer. There are 6 contraindicated acupuncture points which should not be needled when the patient is pregnant or pregnancy is suspected.

Q. Are there any dangers to using acupuncture?

A. Not usually. If the incorrect acupuncture points are used when a woman is pregnant, miscarriage can occur. This is one reason why those wishing to include acupuncture in their treatment regimen should only be treated by one who specializes in treating fertility disorders. Acupuncture is not contraindicated for anyone not matter what their pathology and no matter what medications they are taking.

Q. What types of fertility patients typically get acupuncture?

A. Acupuncture can be used to treat any type of fertility disorder including spasmed tubes(spasmed tubes are often de-spasmed with acupuncture though blocked tubes will not respond to acupuncture). We use acupuncture (with herbs) to treat elevated FSH, repeated-pregnancy-loss, unexplained (idiopathic) infertility, luteal phase defect, hyperprolactinemia (when not caused by a prolactinoma), PCOS with annovulatory cycles and male factor including men affected with sperm-dna-fragmentation.

Q. Is acupuncture a licensed profession. Yes; in most states. You can visit www.nccaom.org to find a licensed and Board certified acupuncturist in your area. Of course being licensed and Board certified does not imply expertise in reproductive disorders.

Q. Where can I find acupuncturists who specialize in the treatment of infertility?

A. aborm.org

Best wishes on your journey!
Dr. Berkley

Tuesday, December 8

Cool Photos of The Berkley Center!







PCOS-Case Report



Ovulation After Acupuncture In PCOS Patient

EXETER, ENGLAND — A course of acupuncture was followed by ovulation in a 32-year-old woman with oligomenorrhea and primary infertility of 6 years' duration, Dr. Jin Xu said at a health care symposium sponsored by the University of Exeter.

Before undergoing acupuncture, the patient had “very infrequent” menstrual periods, and transvaginal ultrasound revealed polycystic ovaries. The patient's luteinizing hormone to follicle-stimulating hormone ratio exceeded 3:1, as is typical in polycystic ovary syndrome, and her testosterone level was elevated at 3.7 nmol/L.

Five daily sessions of electroacupuncture were performed on acupoints Guanyuan (Ren 4), Zhongji (Ren 3), Zigong (Extra 16), and Sanyinjiao (Sp 6), said Dr. Xu of the University of Oxford (England). Each acupuncture session lasted 25 minutes.

After the course of acupuncture, endometrial thickness increased from 4.5 mm to 8 mm by day 16, and a menstrual bleed was induced, Dr. Xu said.

Treatment was repeated in the next menstrual cycle, and the patient subsequently began to have regular periods. Three months later, she conceived and delivered a healthy baby girl at term, Dr. Xu said.

“It is likely that the hypothalamus-pituitary-ovary axis is involved in acupuncture-driven ovulation induction, but the mechanisms involved remain unclear,” he said.

Limited research has been conducted in this area, and it is unclear whether an actual effect on ovulation exists, Dr. Xu cautioned, adding that a clear need exists for randomized, controlled trials.

For more information on infertility, acupuncture and herbal medicine, visit www.berkleycenter.com

Monday, December 7

New Study on Fertility Improvement with Acupuncture

Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization–embryo transfer treatment

Paul C. Magarelli, M.D.a, Diane K. Cridennda, L.Ac.b, Mel Cohen, Ph.D.a

Received 22 May 2008; received in revised form 24 October 2008; accepted 28 October 2008. published online 31 December 2008.

Objective

To determine whether changes in serum cortisol (CORT) and PRL are affected by acupuncture (Ac) in Ac-treated IVF patients.

Design

Prospective cohort clinical study.

Setting

Private practice reproductive endocrinology and infertility clinic and private practice acupuncture consortium.

Patient(s)

Sixty-seven reproductive-age infertile women undergoing IVF.

Intervention(s)

Blood samples were obtained from all consenting new infertility patients and serum CORT and serum PRL were obtained prospectively. Patients were grouped as controls (IVF with no Ac) and treated (IVF with Ac) according to acupuncture protocols derived from randomized controlled trials.

Main Outcome Measure(s)

Serum levels of CORT and PRL were measured and synchronized with medication stimulation days of the IVF cycle (e.g., day 2 of stimulation, day 3, etc.). Reproductive outcomes were collected according to Society for Assisted Reproductive Technology protocols, and results were compared between controls and those patients treated with Ac.

Result(s)

CORT levels in Ac group were significantly higher on IVF medication days 7, 8, 9, 11, 12, and 13 compared with controls. PRL levels in the Ac group were significantly higher on IVF medication days 5, 6, 7, and 8 compared with controls.

Conclusion(s)

In this study, there appears to be a beneficial regulation of CORT and PRL in the Ac group during the medication phase of the IVF treatment with a trend toward more normal fertile cycle dynamics.

The Stirrup Queen

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Melissa of The Stirrup Queen has devoted her life to helping those ttc by creating such an amazing forum for communication and discovery.

Please visit http://www.stirrup-queens.com/a-whole-lot-of-blogging-brought-to-you-sorted-and-filed/ and see for yourself! You'll be happy you did!

Best wishes.
Dr. Berkley

Sunday, December 6

New Berkley Center Affiliate!

I am pleased to announce that Patti Safian has become a Berkley Center affiliate. This means that Pattie has undergone substantial training with me and is now highly qualified to treat those suffering with the challenge of infertility.

Patti's practice is located in Upper Montclaire, New Jersey.

Patti's information is:
The Acupuncture Center for Fertility and Women’s Health – New Jersey
A BerkleyCenter Affiliate
70 Park Street Suite #1 Montclair, NJ 07042
973-512-4466

Best wishes to all!
Dr. Berkley