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
Showing posts with label acupuncture. Show all posts
Showing posts with label acupuncture. Show all posts
Tuesday, April 25
Wednesday, April 19
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
Monday, May 12
Does Acupuncture Hurt?
- A Acupuncture treatments do not hurt. The acupuncture needles used by our acupuncturists are extra thin, acupuncture needles and we use gentle insertion methods. We use only sterilized, disposable acupuncture needles. The needles are extremely thin, and unlike a hypodermic needle, do not have a beveled, cutting edge and therefore, do not feel painful, like getting blood drawn. Some people report barely feeling the needle go in and once the needles are in, patients usually feel at ease and relaxed.
image via theguardian.com
Article reposted from http://acupuncture4fertility.com
Monday, March 31
March is Endometriosis Awareness Month
Acupuncture has been shown to help idiopathic couples, women
with PCOS, endometriosis and poor egg quality due to advanced maternal age.
Let's start with PCOS. These patients typically have double
the miscarriage rate of patients in the non pcos population and are often
infertile; the etiology of both of these dynamics occurs as a result of poor
egg quality as a result of ovarian hyperandrogenism.
Acupuncture improves hemodynamics to the uterus and to the
ovaries there by facilitating an improved excretion of androgen from the
ovaries leaving the ovaries with a less challenged estrogenic milieu. This can,
in some case, improve egg quality and therefore help to improve pregnancy
outcomes while simultaneously reducing miscarriage due to aneuploides.
Furthermore, acupuncture, along with exercise and life-style
counseling can often improve weight loss, which, in and of itself, lowers the androgen
profile of these patients.
Acupuncture has also been shown to facilitate ovulation in
some of these patients but I believe that an east meets west approach to care
is best as clomiphine citrate (clomid) or injectables can almost guarantee
ovulation - but not improved egg quality. The utilization of both modalities
therefore potentiates the effect of both with a concomitant advantage to the
patient.
On to endometriosis: this is an autoimmune, inflammatory
disorder that is mostly (though not always) diagnosed via laparoscopic
intervention. When laparoscopy is performed fertility quotients often improve
even in cases where there is no tubal pathology. Why is this? It is because
when endometriotic implants are resected, the origin of pro-inflammatory
cytokines is eliminated and the uterine milieu is improved and perhaps (I don't
know for sure) pinopode behavior and manifestation is improved.
It is a fact that even though endometriosis in inherently a
disease that is not of the uterus, uterine linings in woman with endometriosis
are often clinically or sub-clinically affected. So not only are there uterine
inflammatory processes occurring but implantation failure may also be a
contributing factor. None of this has anything to do with the tubes. When a
laparoscopy is executed it is probable that not all of the endometriosis is
resected because 1)some endometriosis has the same color as normal tissue and
2) some endometriosis is located in areas that are either unavailable to the
surgeon or are hidden behind various pelvic structures. As a result, some pro
inflammatory cytokine activity may sill be manifest even after laparoscopic
intervention. Since acupuncture improves hemodynamics, once again the
utilization of acupuncture may serve to help excrete these unwanted cytokines
improving uterine receptivity and environment creating a more hospitable
environment for an embryo.
Some woman status-post resection still have severe pelvic
pain and remain infertile (and I am taking age and other confounding
pathologies out of the equation). Why is this? Probably because there remain
ectopic endometrium with concomitant pathology at the level of the uterus. Acupuncture
often helps these patients for the reason(s) I stated above.
In the case of the idiopathic patient, the acupuncturist,
through his or her diagnostic evaluation will often uncover factors that are
not taken into consideration during the Western medical evaluation. These
issues (clots in the menstruate, severe pelvic pain with menses, night sweats,
cold pelvis, severe stress and more) lead the practitioner of traditional
Chinese medicine to arrive at what is known as a 'pattern of disharmony' and
that pattern is then treated. Often, pregnancy results. Though the language and
paradigm of traditional Chinese medicine are different from this of Western
medicine there must be some biological, metabolic, endocrinological, neurologic
effect occurring in response to the acupuncture which often, though certainly
not always results in pregnancy.
Stranger
stories have been told. For example: take the patient who has undergone 6 IUI's
and 6 IVF's (even with PGD or CGH) and have never conceived and the couple
gives up. Four years later, she conceives with intercourse and has a live birth
of a healthy baby.
The point is, as you can imagine, Western diagnostic
capabilities are excellent but not complete nor all encompassing. Certainly
fertility evaluations will be different 50 years from now. There are reasons
for infertility that none of us are aware of and only a few that we are.
The use of acupuncture may be touching upon areas that
Western medicine is not looking at or paying attention to. This is not a
criticism but a scientific fact. We know what we know, we don't know what we
don't know, but we must know that we don't know; in time, we will know more but
never all.
I hope this helped to elucidate the use and
mechanism-of-action of acupuncture in the setting of the infertile patient.
Best wishes.
Mike Berkley, L.Ac.
Friday, March 28
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 1st 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 2nd and 3rd 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.
Friday, October 14
Embryo Grading
I never understood the presumed science behind embryo grading. In fact the 'science of embryo grading' may be an oxymoron. Embryo grading is theoretical but not scientific. It is my experience that embryo grading gives patients fall hopes and also lowers hopes of patients inappropriately. There have been many 4 cell embryos transferred on day two back in the 1980's in the U.S., which resulted in live births. There are many 6 cell embryos with up to 25% fragmentation which yield live births. There are countless grade A blastocysts which do not yeild a pregnancy or do, but with resultant miscarriage. Yes, if an embryo has > 45 or 50% fragmentation it can be safely assumed that won't result in a pregnancy or live birth. But without such an extreme presentation, it is really not possible to predict an outcome.
I would rather the 'line' that reproductive endocrinologists offer their patients be "we have transferred 3 embryos successfully into your uterus. In 2 weeks we will know if you are pregnant. Let's keep our fingers crossed and hope for the best." This way the patient has no expectation other than the fact that she will or will not become pregnant. This is an issue of 'patient management' and one, which in my opinion, should be adhered to.
It is possible to determine a poor embryo. For example a 3 cell embryo with 40% fragmentation probably won't yeild a pregnancy or a live birth. However, it is impossible to determine a good quality embryo if by good quality it means that a reasonable expectation of pregnancy can be expected. The underpinnings of what makes a good embryo good have yet to be parsed out scientifically. This is equivalent to an acupuncturist feeling a pulse and telling the patient that they are pregnant. The acuracy of this endeavor is rarely experienced. However, a very experience acupuncturist probably can tell by pulse palpation whether a patient is pregnant before a reproductive endocrinologist can prognosticate the outcome of an IFV ET based upon visual inspection of an embryo.
The take-home message is this: do not be excited when you have an IVF-ET and your doctor raves about the beauty of your embryos just transferred, nor be dismayed when you are told that they are a grade C. You must clear your mind of expectation and 'be' and wait. It is very difficult to go through the day without an expected outcome. Expected outcomes are derived from your output which typically yeilds a result. This is an example of 'control' which we all thrive on and feel so lost without. In the case of IVF-ET your output nor that of your doctor has any prognostic value. You must 'be' and wait and have no expectation. You can hope; and that's it.
This is also the case of the endometrium. Your doctor will tell you that you have a "beautiful 10 millimeter lining." You are 30 years old and so is your husband. His sperm is healthy, you are hormonally within-normal-limts and both you and your husband are anatomically normal. You have tried to conceive for two years with intercourse, you have done 4 intrauterine inseminations and two invitro-fertilization-embryo-transfers and you have never gotten pregnant. There is a good possibility that your endometrium is defective and can only be properly diagnosed via an endometrial biopsy. Remember the things needed for a successful pregnancy and a live-birth are good egg, good sperm, good lining, anatomic normalcy and absence of pathology which can mitigate conception. Pathology which can mitigate conception is often under-diagnosed. A perfect example of this is endometriosis. The mean-time to diagnosis for endometriosis in 10.3 years. Imagine this: a couple is idiopathic meaning that there is no known casue for their inability to conceive. After multiple attemps via assisted-reproductive-technology-interventions the reproductive endocrinologist states "it's time for you to consider using a donor egg" You are devastated, but you MUST HAVE THAT BABY! So you proceed and the transfer is negative. Then, after six years of trying, a doctor recommends a diagnostic laparoscopy to rule out endometriosis and you are found to have stage four endometriosis which is why, all along, you have not been able to conceive. But now you're forty-years old. So even though the endometriosis has been resceted, you have 40 year old eggs and your chances of conceiving with your own eggs are about 8-10%. You were robbed of your opportunity to conceive becasue of the ultra-conservitism, ignorance or ego of your doctor. I am not suggesting that at the drop of a hat a diagnostic laparscopy should be scheduled. What I am suggesting is that many reproductive endocrinologists (just as is the case with acupuncturists and every other type of health-care-provider) are too conservative and think-out-of-the-box when it's too late.
I had a doctor tell me recently that mild endometriosis doesn't interfere with conception. This is not true; it does. "Endometriosis is likely the most the common cause of endometrial receptivity defects, especially in cases of minimal or mild disease for which mechanical reasons do not explain the loss of fertility." This is from the September, 2011 issue of Fertility & Sterility, Vol 96, No 3, page 524. When I brought this to the attention of the doctor, he replied with "Fertility & Sterility is a lousy journal." It is not. In fact, most American reproductive endocrinologists read it and respect it.
It is very difficult to find a good doctor in any field. I know most of them, especially in New York City. If you would like guidance in finding one with an open mind, an agressive outlook and that has you in mind rather than protecting his or her ego I wouuld be happy to offer it to you.
Mike Berkley, L.Ac., FABORM
http://www.berkleycenter.com/
212-685-0985
I would rather the 'line' that reproductive endocrinologists offer their patients be "we have transferred 3 embryos successfully into your uterus. In 2 weeks we will know if you are pregnant. Let's keep our fingers crossed and hope for the best." This way the patient has no expectation other than the fact that she will or will not become pregnant. This is an issue of 'patient management' and one, which in my opinion, should be adhered to.
It is possible to determine a poor embryo. For example a 3 cell embryo with 40% fragmentation probably won't yeild a pregnancy or a live birth. However, it is impossible to determine a good quality embryo if by good quality it means that a reasonable expectation of pregnancy can be expected. The underpinnings of what makes a good embryo good have yet to be parsed out scientifically. This is equivalent to an acupuncturist feeling a pulse and telling the patient that they are pregnant. The acuracy of this endeavor is rarely experienced. However, a very experience acupuncturist probably can tell by pulse palpation whether a patient is pregnant before a reproductive endocrinologist can prognosticate the outcome of an IFV ET based upon visual inspection of an embryo.
The take-home message is this: do not be excited when you have an IVF-ET and your doctor raves about the beauty of your embryos just transferred, nor be dismayed when you are told that they are a grade C. You must clear your mind of expectation and 'be' and wait. It is very difficult to go through the day without an expected outcome. Expected outcomes are derived from your output which typically yeilds a result. This is an example of 'control' which we all thrive on and feel so lost without. In the case of IVF-ET your output nor that of your doctor has any prognostic value. You must 'be' and wait and have no expectation. You can hope; and that's it.
This is also the case of the endometrium. Your doctor will tell you that you have a "beautiful 10 millimeter lining." You are 30 years old and so is your husband. His sperm is healthy, you are hormonally within-normal-limts and both you and your husband are anatomically normal. You have tried to conceive for two years with intercourse, you have done 4 intrauterine inseminations and two invitro-fertilization-embryo-transfers and you have never gotten pregnant. There is a good possibility that your endometrium is defective and can only be properly diagnosed via an endometrial biopsy. Remember the things needed for a successful pregnancy and a live-birth are good egg, good sperm, good lining, anatomic normalcy and absence of pathology which can mitigate conception. Pathology which can mitigate conception is often under-diagnosed. A perfect example of this is endometriosis. The mean-time to diagnosis for endometriosis in 10.3 years. Imagine this: a couple is idiopathic meaning that there is no known casue for their inability to conceive. After multiple attemps via assisted-reproductive-technology-interventions the reproductive endocrinologist states "it's time for you to consider using a donor egg" You are devastated, but you MUST HAVE THAT BABY! So you proceed and the transfer is negative. Then, after six years of trying, a doctor recommends a diagnostic laparoscopy to rule out endometriosis and you are found to have stage four endometriosis which is why, all along, you have not been able to conceive. But now you're forty-years old. So even though the endometriosis has been resceted, you have 40 year old eggs and your chances of conceiving with your own eggs are about 8-10%. You were robbed of your opportunity to conceive becasue of the ultra-conservitism, ignorance or ego of your doctor. I am not suggesting that at the drop of a hat a diagnostic laparscopy should be scheduled. What I am suggesting is that many reproductive endocrinologists (just as is the case with acupuncturists and every other type of health-care-provider) are too conservative and think-out-of-the-box when it's too late.
I had a doctor tell me recently that mild endometriosis doesn't interfere with conception. This is not true; it does. "Endometriosis is likely the most the common cause of endometrial receptivity defects, especially in cases of minimal or mild disease for which mechanical reasons do not explain the loss of fertility." This is from the September, 2011 issue of Fertility & Sterility, Vol 96, No 3, page 524. When I brought this to the attention of the doctor, he replied with "Fertility & Sterility is a lousy journal." It is not. In fact, most American reproductive endocrinologists read it and respect it.
It is very difficult to find a good doctor in any field. I know most of them, especially in New York City. If you would like guidance in finding one with an open mind, an agressive outlook and that has you in mind rather than protecting his or her ego I wouuld be happy to offer it to you.
Mike Berkley, L.Ac., FABORM
http://www.berkleycenter.com/
212-685-0985
Monday, June 20
We are all headed towards a state of ignorance which comes from the pursuit of knowledge.
For a long time now I have been privy to brilliant and articulate writings and research on the efficacy or lack thereof of traditional Chinese medicine. You can find all the research you want on the Internet. Some research shows efficacy in treating certain pathomechanisms of infertility and some research denies efficacy.
In Western medical approaches to the treatment of infertility there is much research that points to the efficacy of PGD and much research that denies its value. Many doctors promulgate intercourse the night before IVF, many don’t. Many doctors give patients antibiotics before a transfer, many don’t. Many doctors believe in IVIG or intralipid therapy, many don’t. There is lots of research on the deleterious effect of autoimmune mitigators of infertility including natural killer cells but there are many doctors who think this is all hogwash.
Many doctors believe in going straight to IVF after two failed IUI’s, though many believe that one should do four to five IUI’s before engaging in the first IVF.
Many IVF doctors believe in this protocol and many believe in that protocol. Many doctors believe that obesity interferes with fertility outcomes (there is research attesting to this!) and many doctors will do an IVF on a three hundred pound woman.
There was a time when I was very interested in research, which would prove the value of acupuncture in the treatment of the infertile patient.
There is a parable that tells the story of a Zen master talking to his student and pointing at the moon. The student looked at the master’s finger and was summarily dismissed by the master. Have we, as practitioners become too focused on the finger?
It is my contention that we are all headed towards a state of ignorance which comes from the pursuit of knowledge; an incorrect type of knowledge. Knowledge or lack thereof of regarding why something works does not confer or negate efficacy. I remember when I was a student at Pacific College of Oriental Medicine in Dr. Yan Wu’s class when a student asked Dr. Wu a question as to why, when a needle was inserted at a particular point, did it have the intended effect. Dr. Wu’s reply was “who cares – it just does”. Dr. Wu is a master physician with more than 30 years of clinical TCM experience under his belt. It is in the West that we care about cause and effect, but in TCM the effect is what counts.
I am now less inclined to be interested in research regarding TCM and it’s efficacy. I am interested more in learning TCM and its theories and applications. Those of you who are spending years and years doing research on how TCM mitigates a pro-inflammatory state may be fooled into thinking that you are learning something of value. This is debatable. True value is measured by our success rates. The way to higher success rates is attained through learning the medicine that we practice. Most of you, and certainly I, know very little about TCM just as reproductive endocrinologists know very little about why women conceive and why they do not.
If you want to help patients to conceive then learn your medicine.
Want facts? Here’s one: I can look any patient or doctor in the eyes and state that acupuncture and herbal medicine have been used continuously for the past three thousand years to treat infertility; sometimes successfully. It was used in China before the advent of Western medicine and is now used in China in conjunction with Western medicine to treat infertility.
I think that many of us (including me when I was a mere tadpole) felt that we needed the nod from Western medical practitioners and researchers to validate TCM. Now that I am a frog, I realize that my own legs are strong enough to propel me forward.
Study Chinese medicine and study Western medicine and then integrate the two in a way that works for you.
Be able to defend your ideas and treatment protocols; be sure that your ideas have integrity.
Treat as many patients as you can so you may positively impact many lives.
I am through with sitting on the edge of my seat waiting for an REI to say, “Acupuncture seems to offer some value to those trying to conceive” and jump up and down shouting yea! I don’t mean to seem trite or competitive, I assure you, this is not my intention, but here goes: we were successfully treating any and every pathology which existed long before Hippocrates was a twinkle in his momma’s eye.
I believe in the value of IVF – but not for all its research. Indeed with all its research it still has far more failed cases than successful ones. But it does have some successful cases, and that demands respect – as do acupuncture and herbs. So don’t show me research – show me take home babies.
Knowledge is doing. You can study martial arts for years and analyze the dynamics of kicks, punches, thrusts and parries, and take - downs, and joints locks – but that does not mean that you can fight. If you can’t fight, then you do not know martial arts – you research them only. Outcomes are all that matter.
I have not renewed my memberships with AFA and Resolve. When they honor an acupuncturist for his or her work in the field of reproductive medicine I’ll re-join. In the mean time, they will, one again, undoubtedly honor Zev Rosenwaks. Dr. Rosenwaks, what is your success rate for the thirty-nine year-old women with ovarian resistance? Is it any better than mine? I don’t think so.
I’m going to study herbs now.
Tuesday, December 14
A great embryo - or is it?
There is no way a doctor can determine that an embryo is of good quality with today's diagnostic capabilities. This is why when a doctor says "you have a beautiful embryo and a beautiful lining" these are merely words of encouragement with no substantive clinical value.
The reasoning behind my statement is based on my experience. Thousands of patients have perfect blastocysts transferred and get pregnant and miscarry or don't get pregnant.
Thousands of patients have 5 cell embryos with some percentage of fragmentation manifest and conceive and deilver a healthy child.
Why is this? Probably becuase there are many processes and hormones, chemicals and other biochemical components that need to be in perfect balance before conception will occur.
Most doctors don't want to do embryo transfers on women whose linings are less than 9 mm but there are many documented pregnancies which occur with 5mm linings.
The role of acupuncture and herbal medicine is, essentially, one of balancing, or harmonizing - facilitating a state as close to homeostasis as possible. This is why when patients include acupuncture and herbal medicine into their IVF embryo transfer protocols success is often found where previous failures were ongoing.
I had a patient today who has had 4 failed IVF cycles. She has been getting acupuncture and I suggested that she take herbs. She informed me that her doctor didn't want her to take herbs; I asked her what her doctor has done for her so far. She then decided to take herbs.
If IVF were the answer, the success rates would be higher than 25-35%. If acupuncture and herbal medicine were the answer, there would be no need for IVF. But, when these two modalities are used together, the results are frequently better than that achieved when using one of them alone.
Many doctors don't want their patients to take herbs becasue there hasn't been enough scientific research done on herbal medicine and they don't have proof of it's efficacy. Do you have proof that God exists? Yet you have faith that he(or she) does. And, interestingly, many doctors and scientists believe in God though there is absolutely no evidence to prove the existance of God. I would say this may represent a double standard in these individuals.
Am I asking too much of my patients to have faith in herbs? After all, there is greater evidence of their efficacy than there is of the existance of God. Herbs have been ingested and have helped heal millions of people for thousands of years. You can see, touch, taste, feel and smell herbs. And you can see their immediate effect. Can you state the same about God?
I think the proof is in the pudding. IVF is only as good as it's positive outcomes and that doesn't mean pregnancies it means take home babies. Until IVF can provide a 100% success rate, patients and doctors alike are foolish to shun herbs.
Want more proof? Just ask any of my success patients about how acupuncture and herbs changed their lives by helping to facilitate an ongoing pregnancy.
I believe in integrative medicine, not egocentric, segrated, fear-based medicine. Isn't interesting how the practice of Western medicine is a microcosm of the world in which we live. Full of in-fighting, and egos, and ignorance?
Chinese medicine is far more inclusive. For example, in China today, most hospitals use both Western and Chinese medicine to treat in-patient and out-patient cases.
In Germany, homeopathy is wide-spread and is used in conjunction with Western traditional medicine. In France, acupuncture has been used for 400 years.
What is wrong with the mind, heart and soul of the American medical instituion?
Did you know that a 10mm lining provides absolutely no assurance of its health nor its ability to recieve and nurture an implanted embryo? Some 10mm linings are pathologic and some 5mm linings are perfectly physiologic. Did you know that by doing a transvaginal ultra-sound with a color doppler a doctor can determine if there is adequate blood flow to the lining? Did you know that if there is inadequate blood flow to the lining a pregnancy will not occur? Did you know that acupuncture and herbal medicine can greatly increase blood flow to the lining?
I'll leave you with these thoughts for now. Think carefully about what I have written.
The reasoning behind my statement is based on my experience. Thousands of patients have perfect blastocysts transferred and get pregnant and miscarry or don't get pregnant.
Thousands of patients have 5 cell embryos with some percentage of fragmentation manifest and conceive and deilver a healthy child.
Why is this? Probably becuase there are many processes and hormones, chemicals and other biochemical components that need to be in perfect balance before conception will occur.
Most doctors don't want to do embryo transfers on women whose linings are less than 9 mm but there are many documented pregnancies which occur with 5mm linings.
The role of acupuncture and herbal medicine is, essentially, one of balancing, or harmonizing - facilitating a state as close to homeostasis as possible. This is why when patients include acupuncture and herbal medicine into their IVF embryo transfer protocols success is often found where previous failures were ongoing.
I had a patient today who has had 4 failed IVF cycles. She has been getting acupuncture and I suggested that she take herbs. She informed me that her doctor didn't want her to take herbs; I asked her what her doctor has done for her so far. She then decided to take herbs.
If IVF were the answer, the success rates would be higher than 25-35%. If acupuncture and herbal medicine were the answer, there would be no need for IVF. But, when these two modalities are used together, the results are frequently better than that achieved when using one of them alone.
Many doctors don't want their patients to take herbs becasue there hasn't been enough scientific research done on herbal medicine and they don't have proof of it's efficacy. Do you have proof that God exists? Yet you have faith that he(or she) does. And, interestingly, many doctors and scientists believe in God though there is absolutely no evidence to prove the existance of God. I would say this may represent a double standard in these individuals.
Am I asking too much of my patients to have faith in herbs? After all, there is greater evidence of their efficacy than there is of the existance of God. Herbs have been ingested and have helped heal millions of people for thousands of years. You can see, touch, taste, feel and smell herbs. And you can see their immediate effect. Can you state the same about God?
I think the proof is in the pudding. IVF is only as good as it's positive outcomes and that doesn't mean pregnancies it means take home babies. Until IVF can provide a 100% success rate, patients and doctors alike are foolish to shun herbs.
Want more proof? Just ask any of my success patients about how acupuncture and herbs changed their lives by helping to facilitate an ongoing pregnancy.
I believe in integrative medicine, not egocentric, segrated, fear-based medicine. Isn't interesting how the practice of Western medicine is a microcosm of the world in which we live. Full of in-fighting, and egos, and ignorance?
Chinese medicine is far more inclusive. For example, in China today, most hospitals use both Western and Chinese medicine to treat in-patient and out-patient cases.
In Germany, homeopathy is wide-spread and is used in conjunction with Western traditional medicine. In France, acupuncture has been used for 400 years.
What is wrong with the mind, heart and soul of the American medical instituion?
Did you know that a 10mm lining provides absolutely no assurance of its health nor its ability to recieve and nurture an implanted embryo? Some 10mm linings are pathologic and some 5mm linings are perfectly physiologic. Did you know that by doing a transvaginal ultra-sound with a color doppler a doctor can determine if there is adequate blood flow to the lining? Did you know that if there is inadequate blood flow to the lining a pregnancy will not occur? Did you know that acupuncture and herbal medicine can greatly increase blood flow to the lining?
I'll leave you with these thoughts for now. Think carefully about what I have written.
Wednesday, November 3
A Day of Peer Groups and Professionally Led Support, Education and Roundtable Discussions for the Third Party Reproduction and Parenting Community
The NYC Gathering November 14, 2010
Upper West Side, 12:30-5:30pm
~Considering and Creating Strong Families~
A Day of Peer Groups and Professionally Led Support, Education and Roundtable Discussions for the Third Party Reproduction and Parenting Community
Topics Include:
Disclosure for Ages and Stages of Development ~ Family Communications
Known and Unknown Donation ~ Acupuncture for Fertility ~
Traveling for Donor IVF~ART Patient as ART Legal Client
Children’s Book Review ~ Creating Your Own Photo-Story book
Choice Parenting and Donor Selection ~ Nature and Nurture
Attachment and Identity Formation in Family Building
~Disclosure for Blended Families~
Participation by Clinicians, RN’s, Doctors, Agencies, Attorneys, Parents Engaging Discussion Groups
Families Sharing Support, Education, and Resources
Registration ~12:15-12:30
Lunch & Introduction ~12:30-1:00
Q&A ~1:00-2:00
Roundtable I~2:00-3:00
Roundtable II~3:15-4:15
Q&A and Closing~4:15-5:15
Workshop $75 pp includes lunch, 2nd or more adults $50, Creative Sitters Childcare $45 for the day in the Discovery Gym (adjacent to workshop).
Contact Saxel95@aol.com for registration
~Considering and Creating Strong Families~
Roundtable Leaders and Topics:
Nancy Kaufman, LCSW-Introduction to Professsionally Led Support Group: The Third Party Parenting Network. Nancy is a Clinician in Private Practice in NYC with an expertise in Infertility, Family-building and Disclosure.
Patricia Mendell, LCSW and Co-Chair of The AFA-Disclosure and Professionally Led Support Group. Patricia is a Clinician in Private Practice and group practice with a focus on Disclosure as the founder of The Family Building Network.
Nancy Freeman-Carroll, PsyD-Childrens Book Review & Nature vs Nurture Nancy is a Clinician in NYC with Group and Private practice in Parenting and Infertility with a focus on Womens Health, Parenting After ART and Family Counseling. She has presented at ASRM and The NYC Gathering and is a DE Mom.
Mary Fusillo, RN, De Mom, The Donor Solution Agency Owner and Healthcare Professional Former Clinic Donor Program Coordinator, and Mom to 12 yo daughter who is also attending. Mary is a volunteer through Donormoms of Houston and has presented at ASRM and The NYC Gathering.
Dr Susan Treiser, MD,PHd (attending with Nursing Staff) Co-founder and Co-director of IVF NJ to introduce clinic and lead discussion on Donor Egg and Third Party Reproduction at IVFNJ, PVED.ORG Executive Board Member and Board Certified Reproductive Endocrinologist. Resolve Award Winner.
Rosalind Hoffman, MD- DE/DS/SMC-Decision-making and donor selection for Choice Moms and general SMC Support. Long Island Resolve Peer Group Member.
Amy Demma, JD. When an ART Patients is also an ART Law Client: a practical discussion about navigating collaborative reproduction from the “parentage” perspective. Amy is a New York State licensed attorney working in assisted family building, primarily third-party and donor collaboration. Amy is a Vice President on the Executive Committee of RESOLVE of New England and serves on the ARTs Law Committee of the American Bar Association.
Rev. Susy Nason-Child Development and Family Communication Expert to introduce and discuss the How To Talk So Kids Will Listen, and Listen So Kids Will Talk method.
Lisa Schuman, LCSW-General Support Group Lisa is on staff at RMA NY and in Private Practice in the field of Infertility,Third-party Reproduction and Parenting. She is an Adoption Consultant specializing in Disclosure, Decision-making, and Child Development and has presented at ASRM.
Mike Berkley-Acupuncture for Fertility- Mike Berkley is the Director of The Berkley Center for Reproductive Wellness, the first center of complimentary medicine to specialize in the treatment of infertility. He has been in practice for 13 years as a fertility practice.
Ingrid Maurer-Traveling for Donor IVF - Ingrid is a member of our community that has participated in numerous capacities in peer-support, as a guest speaker for Resolve, as a member of PVED.Org andTPPN and of course, The NYC Gathering.
Lori Goldkind-General Peer Support-Lori is a member of our on-going Womens DInner in Midtown and is a new mom via egg donation. Lori has been involved in The NYC Gathering and is a member of PVED.Org. Lori will be available to share her insights, support and experience with others who are considering or parenting via de.
Joann Paley Galst,Ph.D-Attachment, Identity Formation and Family Building: How and Why It Is Safe To Disclose. Joann is a clinician in private practice in NYC. Please see the June 2009 recap here on DONORGROUPSNYC about wonderful The AFA Teleconference that Joann led with Patricia Mendell.
Carolyn N. Berger, LCSW-Disclosure in Blended Families:When Children Come into the Family through Adoption And/Or Third Party And/Or Are Genetically Related. Carolyn is a clinician in NYC and Westchester with a practice devoted to Fertility, All Forms of Family Building and Adoption.
Judy Kottick-LCSW-Known vs Unknown Donors & Disclosure Judy is a Clinician in Private Practice facilitating Donor Parenting groups, is on staff at IVF NJ facilitating Donor and Recipient Screenings, has presented at ASRM and The NYC Gathering.
Long Island Parents via DS-will show us their photo story books, discuss their experience meeting donor sibling family, and share their journey with us.
REGISTER NOW. Contact saxel95@aol.com
Upper West Side, 12:30-5:30pm
~Considering and Creating Strong Families~
A Day of Peer Groups and Professionally Led Support, Education and Roundtable Discussions for the Third Party Reproduction and Parenting Community
Topics Include:
Disclosure for Ages and Stages of Development ~ Family Communications
Known and Unknown Donation ~ Acupuncture for Fertility ~
Traveling for Donor IVF~ART Patient as ART Legal Client
Children’s Book Review ~ Creating Your Own Photo-Story book
Choice Parenting and Donor Selection ~ Nature and Nurture
Attachment and Identity Formation in Family Building
~Disclosure for Blended Families~
Participation by Clinicians, RN’s, Doctors, Agencies, Attorneys, Parents Engaging Discussion Groups
Families Sharing Support, Education, and Resources
Registration ~12:15-12:30
Lunch & Introduction ~12:30-1:00
Q&A ~1:00-2:00
Roundtable I~2:00-3:00
Roundtable II~3:15-4:15
Q&A and Closing~4:15-5:15
Workshop $75 pp includes lunch, 2nd or more adults $50, Creative Sitters Childcare $45 for the day in the Discovery Gym (adjacent to workshop).
Contact Saxel95@aol.com for registration
~Considering and Creating Strong Families~
Roundtable Leaders and Topics:
Nancy Kaufman, LCSW-Introduction to Professsionally Led Support Group: The Third Party Parenting Network. Nancy is a Clinician in Private Practice in NYC with an expertise in Infertility, Family-building and Disclosure.
Patricia Mendell, LCSW and Co-Chair of The AFA-Disclosure and Professionally Led Support Group. Patricia is a Clinician in Private Practice and group practice with a focus on Disclosure as the founder of The Family Building Network.
Nancy Freeman-Carroll, PsyD-Childrens Book Review & Nature vs Nurture Nancy is a Clinician in NYC with Group and Private practice in Parenting and Infertility with a focus on Womens Health, Parenting After ART and Family Counseling. She has presented at ASRM and The NYC Gathering and is a DE Mom.
Mary Fusillo, RN, De Mom, The Donor Solution Agency Owner and Healthcare Professional Former Clinic Donor Program Coordinator, and Mom to 12 yo daughter who is also attending. Mary is a volunteer through Donormoms of Houston and has presented at ASRM and The NYC Gathering.
Dr Susan Treiser, MD,PHd (attending with Nursing Staff) Co-founder and Co-director of IVF NJ to introduce clinic and lead discussion on Donor Egg and Third Party Reproduction at IVFNJ, PVED.ORG Executive Board Member and Board Certified Reproductive Endocrinologist. Resolve Award Winner.
Rosalind Hoffman, MD- DE/DS/SMC-Decision-making and donor selection for Choice Moms and general SMC Support. Long Island Resolve Peer Group Member.
Amy Demma, JD. When an ART Patients is also an ART Law Client: a practical discussion about navigating collaborative reproduction from the “parentage” perspective. Amy is a New York State licensed attorney working in assisted family building, primarily third-party and donor collaboration. Amy is a Vice President on the Executive Committee of RESOLVE of New England and serves on the ARTs Law Committee of the American Bar Association.
Rev. Susy Nason-Child Development and Family Communication Expert to introduce and discuss the How To Talk So Kids Will Listen, and Listen So Kids Will Talk method.
Lisa Schuman, LCSW-General Support Group Lisa is on staff at RMA NY and in Private Practice in the field of Infertility,Third-party Reproduction and Parenting. She is an Adoption Consultant specializing in Disclosure, Decision-making, and Child Development and has presented at ASRM.
Mike Berkley-Acupuncture for Fertility- Mike Berkley is the Director of The Berkley Center for Reproductive Wellness, the first center of complimentary medicine to specialize in the treatment of infertility. He has been in practice for 13 years as a fertility practice.
Ingrid Maurer-Traveling for Donor IVF - Ingrid is a member of our community that has participated in numerous capacities in peer-support, as a guest speaker for Resolve, as a member of PVED.Org andTPPN and of course, The NYC Gathering.
Lori Goldkind-General Peer Support-Lori is a member of our on-going Womens DInner in Midtown and is a new mom via egg donation. Lori has been involved in The NYC Gathering and is a member of PVED.Org. Lori will be available to share her insights, support and experience with others who are considering or parenting via de.
Joann Paley Galst,Ph.D-Attachment, Identity Formation and Family Building: How and Why It Is Safe To Disclose. Joann is a clinician in private practice in NYC. Please see the June 2009 recap here on DONORGROUPSNYC about wonderful The AFA Teleconference that Joann led with Patricia Mendell.
Carolyn N. Berger, LCSW-Disclosure in Blended Families:When Children Come into the Family through Adoption And/Or Third Party And/Or Are Genetically Related. Carolyn is a clinician in NYC and Westchester with a practice devoted to Fertility, All Forms of Family Building and Adoption.
Judy Kottick-LCSW-Known vs Unknown Donors & Disclosure Judy is a Clinician in Private Practice facilitating Donor Parenting groups, is on staff at IVF NJ facilitating Donor and Recipient Screenings, has presented at ASRM and The NYC Gathering.
Long Island Parents via DS-will show us their photo story books, discuss their experience meeting donor sibling family, and share their journey with us.
REGISTER NOW. Contact saxel95@aol.com
Sunday, October 31
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!
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!
Thursday, September 16
Conception is a process - Or...don't microwave your dinner
Process
Conception, pregnancy and parturition are a process. One definition of process is “a series of actions, changes, or functions bringing about a result”. Any natural process is better in every way than an artificial one. A good example is cooking. There is the process of cooking which is a slow, mindful act and there is microwave cooking which is basically a non-participatory act without natural process. There is no relationship between the chef and the outcome of the meal. Which meal tastes better? And, which is healthier to eat?
The process of conception is quite complicated and requires the perfect balance and function of many components all working in a coordinated and harmonious fashion. Sperm must be attracted to egg, it must find the egg, and it must penetrate the egg. The egg has be high quality and so too must be the sperm. The lining must have qualitative integrity. The embryo must find the lining and must be able to penetrate it. The placenta must develop and nourish the developing fetus and rid the fetus of waste matter. The placenta must protect the fetus from immunological attack. The cytokines, proteins, immune function, blood flow, gycoproteins, hormones must all be in balance and not under or over functioning. There must be absence of pathological mitigators which can contribute to infertility or promote miscarriage. Each and every player in the orchestra of conception must be in tune. One sour note and pregnancy will not occur or miscarriage will ensue.
Chinese medicine which consists mainly of acupuncture and herbal medicine does not work by adding to that which is deficient or reducing that which is in excess; Western medicine is good at that. For example, a common practice in treating a deficiency syndrome, i.e., hypothyroidism is to ADD synthroid. Or a common method at reducing excess insulin is by prescribing Metformin. These medicines which add or suppress or reduce have changed the face of civilization. Without the intervention of Western medicine and surgery our life-span would probably not exceed 40 years of age and three million babies would not have been born as a result of IVF. How many couples however, have remained childless even though they have undergone multiple IVFs? I am guessing more than three million.
Here is why: Just as a microwave oven can cook a meal, IVF can create a baby. But, as the microwave does not supplant the relationship between the chef and the food and the process of creating a meal, IVF cannot, in all its glory, in all cases, replace the natural process which is necessary to occur for conception and a take-home-baby to ensue.
The alternative
Acupuncture and herbal medicine are essentially used to create a state as close to homeostasis as possible. Homeostasis is when everything in the body and mind work perfectly. Obviously, this is impossible. But, acupuncture and herbs attempt this and by attempting it a greater state of systemic and psycho-emotional health is achieved. This is why, in many cases, acupuncture and herbs work to help one achieve pregnancy when IVF fails. Because the greater one’s physical and psycho-emotional health is, the more likely that they will be able to conceive.
Based upon fourteen years of clinical experience in the field of infertility it is my professional opinion that the best case scenario for the infertile patient is to utilize Western medicine in conjunction with acupuncture and herbal medicine. The reason for this is quite simple. When the reproductive endocrinologist retrieves eggs and fertilizes them with sperm the resulting embryo is as good as its constituent components, egg and sperm. Most IVFs that fail do so because of poor egg quality and/or poor sperm quality. The reproductive endocrinologist cannot improve egg or sperm quality; acupuncture and herbs frequently can.
Blood
I saw a thirty four year old patient today. She has conceived three times with intercourse only to miscarry each time. She did get pregnant and delivered a baby as a result of insemination. She had one subsequent failed IVF. Now her doctor recommends donor egg with IVF. The patient has cold hands and feet, a pale complexion, low energy and gets dizzy. Obviously she has poor hemodynamics. Blood is what carries FSH and LH from the brain to the ovaries; blood nourishes the endometrial lining; blood carries oxygen, electrolytes and nutrition to the entire reproductive system and removes waste matter from the reproductive environment. When cells die which they constantly do, they are ‘eaten’ up by macrophages. If the immune function is not functioning normally and debris are not removed, the outer layer of the dead cells breach and the internal toxic substance circulates within the ovarian milieu causing degradation in ovarion/egg quality. Acupuncture and herbal medicine increase blood flow and as a result, can, in many instances, improve the target tissue, the ovaries and endometrial lining.
Why are you not using acupuncture and herbs?
It is difficult for me to understand why all infertile patients don’t include acupuncture and herbal medicine in their protocols. Why would they not? There has been so much research elucidating the efficacy of acupuncture in the treatment of infertility that acupuncture is no longer referred to as ‘alternative’ medicine but rather ‘complementary’ medicine. Herbs have a three-thousand year history of positive clinical outcomes.
Herb safety
Regarding the safety profile of herbs I have this to say: there are at least one million hospitalizations per year in America alone which occur as a result of bad reaction to Western medicine. Many of these hospitalizations result in death. This does not happen with herbal medicine.
It is ironic therefore, that many (but no longer all!) doctors don’t want their patients on herbs because “they don’t know what’s in them”. Do you know what’s in Lupron? Or Gonal F? Did you know that ovarian hyper stimulation even from clomid can be fatal?
Don’t misunderstand, I am 100% pro IUI, IVF and donor egg-IVF protocols. But to not partake of a modality with proven results which may change the course from a negative outcome to a positive one especially in the patient who has had multiple IUI/IVF failures is a clinical error.
Mike Berkley, L.Ac.
Conception, pregnancy and parturition are a process. One definition of process is “a series of actions, changes, or functions bringing about a result”. Any natural process is better in every way than an artificial one. A good example is cooking. There is the process of cooking which is a slow, mindful act and there is microwave cooking which is basically a non-participatory act without natural process. There is no relationship between the chef and the outcome of the meal. Which meal tastes better? And, which is healthier to eat?
The process of conception is quite complicated and requires the perfect balance and function of many components all working in a coordinated and harmonious fashion. Sperm must be attracted to egg, it must find the egg, and it must penetrate the egg. The egg has be high quality and so too must be the sperm. The lining must have qualitative integrity. The embryo must find the lining and must be able to penetrate it. The placenta must develop and nourish the developing fetus and rid the fetus of waste matter. The placenta must protect the fetus from immunological attack. The cytokines, proteins, immune function, blood flow, gycoproteins, hormones must all be in balance and not under or over functioning. There must be absence of pathological mitigators which can contribute to infertility or promote miscarriage. Each and every player in the orchestra of conception must be in tune. One sour note and pregnancy will not occur or miscarriage will ensue.
Chinese medicine which consists mainly of acupuncture and herbal medicine does not work by adding to that which is deficient or reducing that which is in excess; Western medicine is good at that. For example, a common practice in treating a deficiency syndrome, i.e., hypothyroidism is to ADD synthroid. Or a common method at reducing excess insulin is by prescribing Metformin. These medicines which add or suppress or reduce have changed the face of civilization. Without the intervention of Western medicine and surgery our life-span would probably not exceed 40 years of age and three million babies would not have been born as a result of IVF. How many couples however, have remained childless even though they have undergone multiple IVFs? I am guessing more than three million.
Here is why: Just as a microwave oven can cook a meal, IVF can create a baby. But, as the microwave does not supplant the relationship between the chef and the food and the process of creating a meal, IVF cannot, in all its glory, in all cases, replace the natural process which is necessary to occur for conception and a take-home-baby to ensue.
The alternative
Acupuncture and herbal medicine are essentially used to create a state as close to homeostasis as possible. Homeostasis is when everything in the body and mind work perfectly. Obviously, this is impossible. But, acupuncture and herbs attempt this and by attempting it a greater state of systemic and psycho-emotional health is achieved. This is why, in many cases, acupuncture and herbs work to help one achieve pregnancy when IVF fails. Because the greater one’s physical and psycho-emotional health is, the more likely that they will be able to conceive.
Based upon fourteen years of clinical experience in the field of infertility it is my professional opinion that the best case scenario for the infertile patient is to utilize Western medicine in conjunction with acupuncture and herbal medicine. The reason for this is quite simple. When the reproductive endocrinologist retrieves eggs and fertilizes them with sperm the resulting embryo is as good as its constituent components, egg and sperm. Most IVFs that fail do so because of poor egg quality and/or poor sperm quality. The reproductive endocrinologist cannot improve egg or sperm quality; acupuncture and herbs frequently can.
Blood
I saw a thirty four year old patient today. She has conceived three times with intercourse only to miscarry each time. She did get pregnant and delivered a baby as a result of insemination. She had one subsequent failed IVF. Now her doctor recommends donor egg with IVF. The patient has cold hands and feet, a pale complexion, low energy and gets dizzy. Obviously she has poor hemodynamics. Blood is what carries FSH and LH from the brain to the ovaries; blood nourishes the endometrial lining; blood carries oxygen, electrolytes and nutrition to the entire reproductive system and removes waste matter from the reproductive environment. When cells die which they constantly do, they are ‘eaten’ up by macrophages. If the immune function is not functioning normally and debris are not removed, the outer layer of the dead cells breach and the internal toxic substance circulates within the ovarian milieu causing degradation in ovarion/egg quality. Acupuncture and herbal medicine increase blood flow and as a result, can, in many instances, improve the target tissue, the ovaries and endometrial lining.
Why are you not using acupuncture and herbs?
It is difficult for me to understand why all infertile patients don’t include acupuncture and herbal medicine in their protocols. Why would they not? There has been so much research elucidating the efficacy of acupuncture in the treatment of infertility that acupuncture is no longer referred to as ‘alternative’ medicine but rather ‘complementary’ medicine. Herbs have a three-thousand year history of positive clinical outcomes.
Herb safety
Regarding the safety profile of herbs I have this to say: there are at least one million hospitalizations per year in America alone which occur as a result of bad reaction to Western medicine. Many of these hospitalizations result in death. This does not happen with herbal medicine.
It is ironic therefore, that many (but no longer all!) doctors don’t want their patients on herbs because “they don’t know what’s in them”. Do you know what’s in Lupron? Or Gonal F? Did you know that ovarian hyper stimulation even from clomid can be fatal?
Don’t misunderstand, I am 100% pro IUI, IVF and donor egg-IVF protocols. But to not partake of a modality with proven results which may change the course from a negative outcome to a positive one especially in the patient who has had multiple IUI/IVF failures is a clinical error.
Mike Berkley, L.Ac.
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