The Berkley Center for Reproductive Wellness has scheduled a meet up to discuss how acupuncture and herbs, when combined with A.R.T. can significantly improve pregnancy rates and reduce miscarriage rates.
Click here to find out more information and to register.

http://meetu.ps/s/.0/lHQD8/f

Couples Ideal for Acupuncture Fertility Treatment

Those who have structural infertility caused by tubal blockage and those with premature ovarian failure are unlikely to do well with acupuncture alone and may consider using acupuncture only as an adjunct to ART.  Those men with low sperm counts who have a shortage of time (acupuncture and herbs may take three to twelve months, if successful) will also need to consider ART as the primary treatment modality.  Good candidates for acupuncture for infertility include:

• Couples who are having difficulty conceiving but are not ready for ART. Some will conceive using acupuncture and others will move on to ART.
• Women who have done IVF and are taking a break and preparing for another cycle  and are seeking acupuncture to improve their probabilities.
• Women who have done 3 to 5 cycles of IVF without success and women who have been advised not to undergo IVF by their doctor.
• Couples who prefer natural medicine or have concerns about ART and are young enough to undergo the longer preparation period usually required for acupuncture.
• Women going through IVF cycles. By the time you get to retrieval there will be a good chance that your egg, lining and/or sperm quality will be vastly improved thereby improving your chances for a positive outcome.

Remember this: when trying to conceive you need one good egg, one good sperm and a healthy lining. Acupuncture and herbal medicine have been shown through research to positively affect egg, sperm and lining quality.

For more visit  http://www.berkleycenter.com

Acupuncture After IVF?

Acupuncture should be continued after embryo transfer and confirmed pregnancy at the frequency of two times weekly for 13 weeks to help reduce the chances of 1^st trimester miscarriage.

There are many causes of miscarriage. The most frequent cause is poor egg and/or sperm quality creating a chromosomally abnormal embryo. By order of natural selection and survival of the fittest, pregnancies that occur with these embryos frequently abort.

Photo via etsy.com

Another common cause of miscarriage is poor hemodynamics or blood flow. Strong blood flow is important throughout the entire pregnancy but poor blood flow at the beginning of a pregnancy often results in miscarriage as a result of initial lack of nutrient delivery to the implanted blastocyst and then, later  on, lack of nutrient delivery to the placenta.  Placentation typically occurs between weeks 5 and 9 during  an on-going pregnancy.

The job of the placenta is two-fold:  1) to transport nourishment to the developing fetus; 2) to excrete waste matter from the developing fetus.  If the placenta fails to maintain its functional integrity, a miscarriage will ensue. One of the reasons that placental demise occurs is because of poor blood-flow or inferior hemodynamics. Acupuncture improves blood-flow.

We know acupuncture improves blood-flow because when women have transvaginal ultrasound examinations with a color doppler before and after acupuncture treatment, there is frequently more blood available and visible at the level of the uterus after acupuncture intervention. A color doppler is a medical device which measures and visualizes blood flow.

The result of poor blood-flow to the placenta is intra-uterine-fetal-demise; the fetus stops developing and miscarriage manifests.

As 90 percent of miscarriages occur within the first trimester, I treat for 13 weeks or, one week past the first trimester to help ensure an on-going pregnancy.  Of course there are 2^nd and 3^rd trimester miscarriages, but most miscarriages are first trimester events.

Based on the above data, it is, in my clinical estimation, important to continue to receive acupuncture after an embryo transfer and when pregnancy is confirmed to help reduce first trimester miscarriages.

Treating Infertility with Herbal Medicine

Herbal medicine has been used to treat internal disorders including infertility for thousands of years.

               

Practitioners of Chinese herbal medicine rarely use a single herb in treatment. Chinese herbs are formula based; many herbs are mixed together to create the perfect ‘concoction’ specifically designed for the individual patient.

Some formulae contain two herbs and some thirty or more herbs. Each herb has many functions. Each herb has its own flavor, nature, temperature and trophism.  Prescribing the right and the safe herbal medicinals requires training and clinical experience.  Herbal medicine is an extremely complex form of medicine which requires many years of arduous study and clinical experience to master. 

Self medicating with herbal medicine presents a dual dilemma. At best the herbs will be useless, as the key to correct formula prescription is an accurate differential diagnosis which can only be made by a licensed, board certified, experienced practitioner. At the worst case, self prescribing of herbal medicine may prove harmful or fatal.

A good example of this is Ma Huang/Ephedra.  Ma Huang is an herb prescribed on a daily basis by hundreds of TCM practitioners to thousands of patients safely. 

That several people have died as a result of taking Ma Huang has very little to do with the dangerous properties of the herb inasmuch as it has to do with individuals self-medicating.  Aspirin can prove fatal if taken by a hemophiliac.  This is not an indication that Aspirin should be banned or that it is a dangerous drug.   It is totally safe if used appropriately.

Herbal medicine is totally safe if prescribed by a knowledgeable expert. Not only is herbal medicine safe, it is highly effective in treating many pathologies without the concomitant harmful side-effects which often accompany pharmaceutical drugs.   There are greater than one million hospitalizations per year as a result of drug induced side-effects; not so with herbal medicine.

photo via youbeauty.com

Infertility

There are many causes of infertility which include but are not limited to elevated FSH levels, PCOS, endometriosis, luteal phase defect, hyperprolactinemia; pituitary adenoma, blocked tubes, uterine anomalies, sperm anomalies, stress, and, infertility which is diagnosed as idiopathic. 

Traditional Chinese Medicine has, for more than three thousand years, successfully treated infertility; and it still does so today.

Nancy is thirty-nine years old and she wants to compete as an Olympic triathalete; she is five feet in height and weighs three hundred and thirty pounds.  Can she compete?  Let’s see.  She asks her best friend, Alice, for a recommendation for a nutritionist. Alice raves about Teresa J., a fabulous nutritionist who “changed her life”. So Nancy makes an appointment with TJ and has a consultation. Nancy listens attentively to TJ, takes notes and leaves TJ’s office full of enthusiasm, commitment and motivation.

Starting the next day Nancy begins implementing the new dietary regimen which TJ has prescribed.  Next, Nancy joins a local health club, hires a personal trainer and works out three to four days per week.  Finally, Nancy joins a meditation group and meditates daily.

What happened?  In twelve months, Nancy lost one hundred and fifty pounds, put on solid muscle, developed a ‘six-pack’ abdomen and can run twenty-five miles per week. She is in the best condition of her life!  Can she now compete in the Olympics? Well, I’m afraid not. To be an Olympic athlete requires a life-time commitment of training and nutritional guidance.  Nancy has, however, become healthier, stronger and happier than ever before!   What if Nancy wanted to get her reproductive system in Olympic condition? 

The proper life-style counseling which includes nutritional changes and perhaps an exercise routine and acupuncture and herbal medicine can get a women’s reproductive system in the best possible condition that it can be in at the present moment.  Your TCM practitioner should be able not only to treat you with acupuncture and the appropriate herbal formula but should also give you guidance regarding diet, exercise and life-style changes which will positively impact your health.

Many women undergo three to five unsuccessful IVF procedures. Often these procedures are unsuccessful for the same reason that Nancy could not even begin to be athletic – overall poor health and specifically, poor reproductive health. 

Women who are over thirty years old need to get their reproductive system in the best condition possible to achieve pregnancy either naturally or via an A.R.T. procedure.

photo via redbookmag.com

As we grow older our circulation becomes less patent. In addition to the frequent complaint of cold hands and feet, another effect of inhibited blood flow is that the quantity of blood flow to the uterine lining, ovarian tubes and ovaries is less.  Acupuncture and herbal medicine have a stimulatory effect on the blood circulation.  An example of impeded blood circulation is blood clots in the menstruate. Though in and of itself, menstrual clotting may not be an issue, it does indicate a circulatory dysfunction which can be both a manifestation of an illness (circulatory inhibition) and the cause of an illness (blood stagnation [i.e., endometriosis], causing infertility).

Acupuncture and herbal medicine can be an important aspect of one’s healthcare routine, used to assist in achieving the goal of better health in general and better reproductive health in particular.

Under the care of a licensed and board certified acupuncturist/herbalist who is experienced in treating the infertile person there are no negative or dangerous side-effects associated with acupuncture or herbal medicine; there is only upside potential.   Using acupuncture and herbal medicine as part of the regimen to achieve a healthy reproductive system is a fertile idea.

Infertility Increases Risk of Serious Psychiatric Illness

Infertility Increases Risk of Serious Psychiatric Illness


Published: July 16, 2012Multiple small studies have demonstrated a link between infertility and psychological distress, reporting high rates of anxiety and depressive symptoms among women with infertility. These studies have evaluated psychiatric symptoms or psychological distress; however, less is known about the prevalence of more significant psychiatric disorders in this population.

Data from the largest study to date of women with infertility was recently presented at the annual meeting of ESHRE (European Society of Human Reproduction and Embryology) by Dr. Birgitte Baldur-Felskov.

Danish investigators were able to examine the records of 98,737 Danish women evaluated for infertility between 1973 and 2008. They found that women who remained childless after their first investigation for infertility had more hospitalizations for psychiatric illness than women who had at least one child following their investigation. The most common discharge diagnoses were “anxiety, adjustment and obsessive compulsive disorders” followed by “affective disorders including depression.”
In another study (also from Denmark), investigators examine a cohort of 51,221 women with primary or secondary infertility who had been referred to hospitals or private fertility clinics in Denmark between 1973 and 1998. Each woman was followed from the date of her initial fertility evaluation until 2006.

In this study, they discovered that women who did not have a child after initial fertility evaluation had a greater than twofold risk of suicide (HR: 2.43; 95% CI: 1.38-3.71) than women who had at least one child after evaluation. Women with secondary infertility, i.e. women who had a child before a fertility evaluation but did not succeed in having another child after evaluation, also had an increased risk for suicide (HR: 1.68; 95% CI, 0.82-3.41), although this finding was not statistically significant.

These two reports extend our understanding of the impact of infertility and its treatment on risk for serious psychiatric illness. While future studies will help to determine which women are the most vulnerable to illness in this setting, these two large studies highlight the need for adequate screening for psychiatric illness and appropriate interventions in women who are evaluated for infertility.

[Mike Berkley writes: Acupuncture and herbal medicine have been shown to effective treatment modalitites for anxiety and depression.]







Ruta Nonacs, MD PhD



Kjaer TK, Jensen A, Dalton SO, et al. Suicide in Danish women evaluated for fertility problems. Hum Reprod. 2011;26(9):2401-7.



Read more: Childless Women With Fertility Problems at Higher Risk of Hospitalization for Psychiatric Disorders (Science Daily)

A new perspective on infertility treatment

How many failed IUI's and IVF's have you had? Four? Five? Seven? Have you heard this "you are producing beautiful embryos, your lining looks great and your husbands sperm is off the charts"?  How many failed donor egg cycles have you had?

You may be a victim of poor diagnosis.  For example, how many of you have had a fluid ultra sound? If you have not, raise your hand.  Did you know...one polyp residing in the uterine cavity can prevent implantation? Did you know that frequently a transvaginal ultra sound cannot detect a polyp but a fluid ultra sound always can?

Let's look at a common scenario together. You are thirty-nine years old and you have an fsh of 17 and you have endometriosis. Your doctor thinks that you are not getting pregnant because you have an inflammatory disorder (endometriosis), and that you have poor egg quality, and low ovarian reserve indicated by your age and fsh levels respectively. But, if you have a regular period, the odds are that you still have some good eggs and may have a chance to conceive, else why would your doctor be willing to proceed with an IVF embryo transfer.

The fact that you have been diagnosed with endometriosis indicates that you have had it surgically addressed and so now its clinical relevance is diminished. Now its down to egg quality and ovarian reserve. If you still menstruate regularly, you still have some good eggs even if your fsh is 17. 

So why are you not conceiving? Perhaps because of a physical obstruction, i.e., a polyp or worse, multiple polyps. Polyps are easilly, painlessly and quickly removed via a hysteroscopy.  So, instead of continuing to have ivf after ivf and failure after failure why not rule out possible hidden causes of your problem with simple procedures?  I am not trying to insinuate that all infertility stems from improper diagnosis; sometimes woman can't conceive for reasons which are beyond the scope of current diagnostic tools. I am, however, suggesting that many cases of infertility can be successfully treated where heretofore, they have not.

Did you know that day 3 embryos with less than 6 cells and more than 10 cells are often indicative of poor sperm quality?  Yes I know: your husband had a normal semen analysis. But, has he had a sperm dna fragmentation assay? This test can reveal a  hidden sperm pathology that may be contributing to your inability to conceive?

If his sperm tests normal from the perspectives of volume, count, motility, and volume and you are producing day 3 embryos with less than 6 cells or more than 10 cells, he should have this test. Frequently this test is not performed because your doctor doesn't believe in this test and wouldn't know what to do with the results anyway.  Doctors will tell you that the only challenge that sperm with fragmented dna poses is their inability to penetrate an egg, so the answer is simple: do icsi. ICSI is a process whereupon the sperm is injected into the egg enabling forced fertilization. So your egg is being fertilized with a sperm that couldn't, on it's own, have done this. Essentially, by default, you are ending up with a less than optimal embryo which may yeild a pregnancy which may either result in miscarriage or produce a male child with the same problem as his dad with his future familiy planning requiring IVF with ICSI.

So, are we not, through these 'band-aid' procedures facilitating a nation of weakened children and actually contributing to a generation of infertile couples?

You're wondering what the solution is.  Well that begets a question. If you had type 2 diabetes and were very overweight and had insulin resistance you could do two things to get better: 1) take Metformin and possible other medications or you could change your diet, lose weight, exercise and cure your-self.

One approach is a 'band-aid' approach and one approach is to address the problem at its root.  The solution lies ahead.

Back to sperm dna fragmentation. Before we can hope to address a 'root' treatment we first need to know what causes the problem. Reactive oxidative species or 'ROS' causes fragmentation of the dna in the sperm. ROS is caused by environmental assault such as exposure to certain chemicals, toxins, etc., which can come from smoking marijuana or cigarettes, testicular injury or testicluar surgery allowing antibodies to enter the testicular environment and cause damage.

The severity of DNA fragmentation is determinied by the amount of sperm that is affected. 0 to 15% is indicative of good outcomes in IVF procedures; 15% to 29% means that chances are fair to good; numbers above 29% usually do not result in live births.

In the idiopathic (no known cause) infertile couple, a full diagnosis has not been rendered without a sperm dna fragmentation test. What is the cure? The eradication of free radicals which manifest as a result of ROS.

How? acupuncture ( stimulates blood to the testis helping to send more oxygen and nutrients and dispel dead cells), herbs which have anti oxidant properties, vitamins C and E which have strong anti oxidant properties and daily intake of wheatgrass juice. There is no traditional Western medical approach to the successful treatment of sperm dna fragmentation.

Is medical ego perhaps a contributing factor to the paucity of testing done for this significant pathology?  In other words: if the doctor doesn't 'believe' in the test then it won't be done.  Can you see air? Can you see microorganisms? Can you see God? Can you see energy? No, no, no and no. Do you believe in their existance?  Is your day to day behavior not based upon your belief in these entities even though you have never seen even one of them? 

There are some people that do not believe in the existance of God or microorganisms. Does their lack of belief indicate the lack of existance of these things? It is the wise person who, though belief may not be held, understands that there is a  possibility of existance nonetheless.

Did you know that endometriosis is an autoimmune disease than can cause infertility even in the absence of damaged fallopian tubes? Another interesting thing that you should be aware of is that when one has an automimmune disease such as endometriosis there are often other autoimmune factors which can contribute to infertility which have not been diagnosed; but they should have been. I always recommend a full autoimmune evaluation when one of my patients presents with a known automimune disease to rule out the posibility of other, asymptomatic autoimmune disorders which can cause infertility.

The reason for the paucity of testing for autoimmune disorders which are known to contribute to infertility is that many doctors don't believe that autoimmune disorders can contribute to infertility. The terms yin and yang according to traditional Chinese medicine, means, among other things balance. Balance, according to the traditions of Chinese medicine is required for health, and imbalance is what leads to sickness. Would you agree that an immune system which acts innapropriately against it's host represents an imbalance? And, does it make clinical sense to try to rebalance the behavior of organ/endocrine systems to re-institute health?

Let me tell you an interesting story: when the surgeon general first advised the nation  that there was a direct link between lung cancer and other cancers with cigarette smoking, most doctors who smoked (many, many did) continued to do so becasue they didn't believe what the surgeon general said. Now, years later, most physicians don't smoke because they became convinced of the validity of the surgeon general's report. So, perhaps, years from now, many reproductive endocrinologists will finally understand the clinical significance of certain autoimmune disorders in so far as their role in infertility is concerned.

An example of an autoimmune disorder which can cause infertility is activated natural killer cells. These cells are meant to kill cancer in the uterus. They do so by spraying something called TNF-alpha or tumor necrosis factor on tumors, killing them, and in the best case scenario, saving the patient from endometrial cancer. 

However, in one with an autoimmune mitigated hyperactivity of activated NK cells, these cells spray TNF-alpha on the embryos, instantly killing them causing infertility.  This again is a hidden pathology as it presents with no signs or symptoms. 

The appropriate treatment is intralipid therapy or intravenous immunoglobulin therapy, both of which have been shown to positiviely effect pregnancy outcomes in patients presenting with highly activated NK cells. 

Again, this is the band-aid approach and, in many cases a band-aid approach is not a bad thing; if it works, it works and at the end of the day that's all we want.

To include a modality of medicine which can regulate immune function so that the body can behave normally again also makes sense. Acupuncture and herbal medicine can frequently manifest in this regulation of the immune system.  This is how acupuncture and herbal medicine helps patients who are HIV+ or in full blown AIDS to feel better and stronger - by immune function regulation to whatever extent possible.

Infertility treatment is still in its infancy stage. There have been more than three million babies born as a result of IVF. But this is similar to the concept that many people with cancer have been saved by medical intervention. Both are true, yet the fact remains many more people die from cancer than who are saved and many  more IVF's have been done without the production of a baby.

As time goes on, more and more research will yield better treatment approaches and perhaps one day  infertility will not exist.  In the mean time however it is my contention that all testing, even testing that may present a greater insight into the cause of a couples infertility should be rendered and, the root cause of the problem should simultaneously be treated with natural medicine such as acupuncture and herbs.

Western medicine is superior to Chinese medicine in treating the manifestation of an underlying disregulation or lack of harmony in the functioning of the body but traditional Chinese medicine is, in my opinion (based on clinical experience and three thousand years of data) superior in treating the human body and spirit at the deepest levels.  Therefore, the best approach to treatment of the infertile couple is to employ both modalitities of intervention.  This is the solution!

Mike Berkley, L.Ac. is in the News!

Many within the field of assisted reproductive technology have embraced this 3,000 year old practice and the trend of East Meets West IVF clinics is becoming popular nationwide. One such integrated practice is Batzofin Fertility Services in New York City. According to Joel Batzofin, M.D. "There is a myriad of ways to travel the road to fertility success, and everyone's situation is unique". The location of Batzofin's practice is adjacent to The Berkley Center for Reproductive Wellness, where TCM and acupuncture are administered to infertility patients.

New Study 'Acupuncture Fails to Improve IVF Outcomes'

Acupuncture has been used to treat infertility for three thousand years usually in conjunction with herbal medicine.

The current study done in the U.K. which states that the studies found no efficacy in helping couples conceive with the addition of acupuncture contradicts a previous study reported by The British Medical Journal. The synopsis of the study follows.


"February 8, 2008

Vittorio Hernandez - AHN News Writer

London, England (AHN) - Seven scientific trials among 1,366 women of different ages who found it difficult to conceive showed that having acupuncture at the same time the embryo was placed inside the womb during an in vitro fertilization procedure more than doubles the chance of the woman becoming pregnant.

The study was made by researchers at the University of Maryland School of Medicine and the VU University Amsterdam. It compared results of women who underwent acupuncture, those who were given fake needle treatments and those who had no extra therapy.

Those who received acupuncture increased their chances of conceiving by 65 percent, the study said. The British Medical Journal published the result of the medical breakthrough Friday.

While the study did not clearly explain how acupuncture aids fertility, experts theorized it could possibly be the relaxing effect of acupuncture on the IVF procedure, considered extremely stressful.

Compared with repeated fertility treatment cycles which costs $7,785 (4,000 pound) per cycle in Britain, the acupuncture therapy is easier on the pocket.

One percent of births in the U.K. or 11,000 babies out of 32,000 IVF procedures are born every year in the U.K. The findings will be particularly significant for many western nations grappling with dwindling populations."

I have questions as to the new and negative study:
1. Was the acupuncture performed by experts in the field of acupuncture and infertility? This is as important as being treated by a physician who is an expert in the treatment of infertility, i.e., a reproductive endocrinologist, not a generalist.
2. How long was the acupuncture performed pre embryo transfer and at what frequency? Through treating thousands of patients over a span of thirteen years I have found that treating twice weekly for three months prior to IVF ET and twice weekly for 13 weeks post IVF ET is the efficacious protocol.

From my own experience I can share that I have treated thousands of infertile couples, hundreds of whom conceived while under my care but were unsuccessful without it. I have also had many failed cases. This type of outcome is not dissimilar to that of the typical reproductive endocrinologist.

IVF Et fails 65% to 70% of the time. Many of the ‘failed cases’ go on to conceive on their own without assisted reproductive medicine proving that there is more to a successful conception than that which is solely provided by A.R.T. alone.

I urge the readers not to have a ‘knee-jerk’ reaction to this recent bad press and think logically about the points that I have elucidated in this article.

The other thing that I’d like to state is that herbal medicine is the medicine which most reproductive endocrinologists tell their patients not to use. Most of my patients use a combination of acupuncture and herbs while under my care and they have successful outcomes frequently. This is not an indication that acupuncture alone won’t help; it obviously does. Want proof? Simply ask the thousands of patients who have conceived with the implementation of acupuncture who did not conceive prior to its use.

My point about the herbs is that without them it is similar to having a reproductive endocrinologist do an IVF ET with a patient using clomid only. Yes; there would be positive outcomes but not nearly as many as would have occurred had the reproductive endocrinologist been allowed to utilize all the tools at her or his disposal.

The use of acupuncture and herbal medicine for fertility treatment has been extant for thousands of years; the first in vitro fertilization techniques occurred in the U.K. in the 1970’s.

There are many Chinese medical books written on the subject. In China today many infertile patients use both Western and Chinese medicine together when treating for infertility and most other disorders. This is typically recommended by the Chinese medical doctor handling the case.

Here is another question which I frequently ponder: the doctor states that the patient has beautiful blastocysts and a perfect lining. The patient does not conceive and the doctor then states “I just don’t understand it.” This speaks to the fact that much of infertility is a mystery and many interventions which are successful are also quite mysterious. For example, there are probably ultra- structural defects in sperm and/or egg which are currently beyond the scope of available diagnostic tools. These defects render the “beautiful blastocyst” not, in fact, not so beautiful.

Perhaps when acupuncture or acupuncture and herbs are included in the protocol, and success manifests it is because the Chinese medicine is addressing these ultra structural defects which Western medicine cannot.

Contrary to this single study, there are many studies all over the internet which attest to the efficacy of acupuncture in the arena of increasing take home babies.

I would also like to say that ALL IVF business is down through the United States because of changing demographics and due to a poor economy. I am wondering if the individuals who were involved in putting this study together might have some financial motives in mind by ‘steering’ more money to their practices. I say this with caution as the reproductive endocrinologists whom I know are all men and women of the highest integrity. But, at the end of the day, IVF is a business.

I always tell my patients to use all legitimate materials they have at their disposal to increase the odds of a successful outcome. These tools include dietary changes, exercise, meditation, acupuncture, herbs, and IUI or IVF when appropriate. I caution those who are willing to give up tools with a history of success in creating families.

Mike Berkley, L.Ac., FABORM
Founder and Director, The Berkley Center for Reproductive Wellness

IVF Florida - a great bunch of IVF Docs!

I recently returned from a wonderful trip with my associate, Robert Macdonald from Margate Florida where we visited with Drs. Ory, Maxson, Barrionuevo, Hoffman and their fantastic office manager, Clayton Lawrence. What a team!

First of all, these guys have an amazing facility, state-of-the-art is an understatement.

We know that more and more couples faced with the challenge of infertility are seeking complementary medicine to support their journey through IVF; IVF Florida recognizes their patients needs and supports their use of acupuncture. This in and of itself makes them ahead of state-of-the-art. Their 'integrative' approach to fertility enhancement represents the direction that many in-the-know IVF clinics are pursuing.

Kudos to all of you for your recognition of the fact that an East Meets West approach to fertility enhancement makes sense.

Dr. Mike Berkley