Doctor who is passionate about acupuncture

Doctor who is passionate about acupuncture

Welcome to my blog

Leading acupuncture specialist for facial rejuvenation, pain relief, stress and anxiety relief, fertility and miscarriage, fatigue, acne and insomnia
Based in London Kensington, Chelsea and Richmond . Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Many year research and clinical experiences. This blog is for information only.

Friday, 27 May 2022

How many eggs retrieved in IVF are good numbers?

How many eggs retrieved in IVF are good numbers?

IVF becomes a popular technique for infertility treatment since it was invented 30 years ago. During the procedure it is difficult to predict the side effect and success for individuals. IVF success rate is related to egg number retrieved in the procedure. What is the optimum number of eggs for IVF? Is there a connection between egg numbers and live birth rate (LBR)? Ji J et al analysed the data from 2007 and 2011 from total 2455 patients who was undergoing first cycle of IVF treatment. All patients had normal menstrual cycles and were stimulated with a long GnR agonist protocol. Associations between egg number and LBR and miscarriage rate and the rate of moderate-severe ovarian hyperstimulation syndrome (OHSS) were analysed. These patients were divided into four groups according to the egg number retrieved: 0-5, 6-10,11-15 and >15. The fresh embryo transfer LBR and cumulative LBR were assessed. Their data suggested that for IVF cycles stimulated with a long protocol the optimal number of eggs for achieving a live birth is between 6-15. With increased egg number, the incidence of moderate-severe OHSS was increased. There was no significant difference in the miscarriage rates among the patient groups.

There was another research studied the association between egg number and the rates of ovarian hyperstimulation syndrome (OHSS) and live birth in fresh IVF cycles. In this research they analysed data from 256381 IVF cycles. Patients were divided into five groups according to the egg numbers retrieved. The data showed that the LB rate increased up to 15 eggs, then levelled (0-5: 17%, 6-10: 31.7%; 11-15: 39.3%; 16-20: 42.7%; 21-25: 43.8%; and >25 oocytes: 41.8%). While the rate of OHSS became much more clinically significant after 15 eggs (0-5: 0.09%; 6-10: 0.37%; 11-15: 0.93%; 16-20: 1.67%; 21-25: 3.03%; and >25 oocytes: 6.34%). These data showed that retrieval more than 15 eggs significantly inceases OHSS risk without improving LB rate in fresh IVF cycles.

Acupuncture reduces pain in IVF egg retrieval

Acupuncture has been used to assist IVF. There are different approaches for the use. Using acupuncture on the day of egg retrieval could help reduce pain. There was a study on this subject to observe analgesic effect and safety of acupuncture in egg retrieval. In this study 316 patients undergoing IVF were divided into two groups acupuncture plus anaesthesia group (146 patients) and a simple anaesthesia (control) group (170 patients). The treatments were carried out 30 min before egg retrieval. They found that pain rating and pain score were significantly better for acupuncture group than that for control group. The incidence rate of abdominal pain at 1hour and 2-5 hour after egg retrieval was lower for acupuncture group. There was no side effect found. Recently there was another study on the effect of acupuncture on pain in egg retrieval. In this study there were 90 patients participated the study. The treatments were also carried out 30 min before egg retrieval. Pain rated index (PRI), visual analogy scale (VAS) and present pain intensity (PPI) were used to measure pain. The result showed that PRI, VAS and PPI immediate after and 1 hour after egg retrieval were significantly lower for acupuncture group than that for control group. They also found that neuropeptide level in follicular fluid is higher in acupuncture group which may be the mechanism of acupuncture analgesic effect on egg retrieval.

References

Nedeljkovic M et al Forsch Komplementmed (2013) 20:112-8

Manheimer E et al (2008) BMJ 8: 545-549

Zheng CH et al Evid Based Complement Alternat Med (2012)2012:543924

Kong FY et al Zhongguo Zhen Jiu (2012) 32:113-116

Chen J et al Zhongguo Zhen Jiu (2009) 29:775-9

Cui W et al Zhongguo Zhen Jiu (2011) 31:687-691

Dieterle S et al Fertil Steril (2006) 85:1347-51

Isoyama D et al Acupunct Med (2012) 30:85-8

Balk J et al Complement Ther Clin Pract (2010) 16:154-7

Villahemosa et al Acupunct Med 2013 31:157-62

Meng P et al Zhongguo Zhen Jiu (2008) 28:451-5

Zhang J et al J Tradit Chin Med (2013) 33:294-7

Steward RG et al Fertil Steril (2014) S0015-0282

Ji J et al Hum Reprod (2013) Jul 25

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Wednesday, 25 May 2022

How to check your ovulation? What is the easiest way?

What is basal body temperature? Basal body temperature (BBT) is the lowest body temperature during rest. It is usually measured in the morning as soon as you wake up and before you engage any physical activity. In women, BBT changes with the menstrual cycles. If you make a daily BBT chart in a full menstrual cycle you can see the BBT chart is biphasic which means there are two temperature phases. Ovulation increases BBT for about up to 0.5 degree Celsius. The average BBT is 36.37 ±0.12 ºC during follicular phase (the phase prior to ovulation) and 36.72 ±0.12 ºC in luteal phase (the phase after ovulation). If conception does not occur, the temperature goes down and then the next menstrual cycle starts. If the conception occurs, the temperature stays at the higher level until the end of first trimester of the pregnancy.

If you are trying to conceive, making your BBT chart is the easiest way to know if or when you are ovulated precisely, though it does not predict ovulation. Your BBT chart also can tell if your body is the best form and is ready to sustain a pregnancy. BBT was regulated by hormones estrogen and progesterone which produced by ovaries. High levels of estrogen lower BBTs while high levels of progesterone increase BBTs. If your BBT chart is normal, this means your ovaries are functioning well and you are ready for pregnancy.

If you have difficulty to conceive, it may reflex on your BBT chart. For example, if you are not ovulating, your BBT chart does not have two phases. If you have short luteal phase which is difficult to sustain your pregnancy it shows a disturbed BBT chart. If your first three day’s BBT is greater than 36.6 ºC, this may be associated with endometriosis. 

Read more about acupuncture for fertility <drmaggiejuacupuncture.co.uk>

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How many eggs retrieved in IVF are good numbers?

How many eggs retrieved in IVF are good numbers? IVF becomes a popular technique for infertility treatment since it was invented 30 years ...