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

Don't put up with wristpain.


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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>

Ankle pain solution?


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Monday, 23 May 2022

Infertility and hormones, how can acupuncture help?

If you are having difficulty to conceive, what could go wrong? Things could go wrong either in women or in men or both. About one-third of infertility is caused by women’s problem. Another one third is due to men’s problem. The remaining one third is caused by both women and men.

Egg and sperm quality
High quality of eggs is essential for conceiving. Women are born with millions of follicles. These follicles stay in the cortex of ovaries where they will develop and some of them will be mature and released. This is a long process and it takes about a year for an egg to develop and to be released. The original follicles are preantral type of follicles. These follicles are in deep sleep stage. Some of them will wake up and be recruited to develop. This is preantral development which is a slow process and it takes about 10 months. This process is hormone independent. After 10 months of development, some of them will be selected to develop to dominant follicles. It takes about 2 months for these dominant follicles to develop to a preovulatory stage. This stage is hormone dependent. And then one of the follicles will be mature and released in 15-20 days which is highly depending hormone balance.

Hormonal balance is the key in human reproductive system. In women, there are five hormones involved in reproductive function: gonadotropin-releasing hormone (GnRH) produced in hypothalamus (a part of the brain), follicle stimulating hormone (FSH) and luteinizing hormone (LH) both produced in pituitary gland (another part of the brain), and oestrogen and progesterone both produced in ovaries located in pelvis. To be fertile, these five hormones have to be well balanced, which means they have to be at the right level at the right time. If the balance is disturbed at any points in a cycle, this would affect fertility. Most of the infertility in women is caused by imbalanced hormones. Hormonal imbalance could cause poor egg development; as a result, poor quality egg is produced (fertilization is affected) or no egg is released in the mid-cycle. Hormonal imbalance could also cause poor uterine lining affecting implantation and causing early pregnancy loss.

The hormonal system is very sensitive, even a slightly change can disrupt hormonal production leading to anovulation. Common causes related to hormonal imbalance include stress, anxiety and eating disorders which are associated with inhibition of GnRH production in hypothalamus. Polycystic ovarian syndrome (PCOS) is the most common cause of infertility which is associated with hormonal imbalance. Excessive male hormones (androgens) were produced in women with PCOS. Another hormonal imbalance is excessive production of hormone LH which is involved in stimulating ovary to produce hormones.

Sperm production in men is different. Sperm production and maturation takes about 74 days. Sperm production takes place in testicles where temperature is lower than body temperature. This process is hormone dependent and follicular stimulating hormone (FSH) and Luternizing hormone (LH) are involved in the process. This process takes about 60 days. Sperms produced then mature in epididymis where they obtain motility and it take about 14 days.

In men there are four hormones involved in reproductive function: GnRH, FSH and LH produced in brain, and testosterone produced in testicle located in scrotum. Hormonal imbalance in men causes poor sperm development resulting in low sperm count and/or poor sperm quality. Stress can disturb hormonal balance affecting men’s fertility.

To improve fertility, correcting hormonal imbalance is the key. It takes time (at least a few months) to restore hormonal balance; sometimes it takes much longer than you expected. So determination and patience are needed to achieve the goal. Acupuncture treatment could help restoring hormonal balance by stimulating sympathetic nerve and lowering sympathetic activity. Balanced diet and regular exercises could also help.

Local chronic inflammation is another important factor causing infertility. In women inflammation in pelvic area could cause fallopian tube spasm which blocks the eggs passing through. After lower abdominal surgery, or following pregnancy loss, inflammation could occur in pelvic area. Endometriosis causes inflammation in pelvic area surrounding the misplaced tissue affecting ovulation, egg transportation. Endometriosis is another common cause for infertility. In men inflammation in scrotum could impair sperms. Reducing local inflammation can significantly improve fertility in relatively short time, if there is no hormonal imbalance involved in infertility. Acupuncture can help reducing local inflammation by stimulating nerve endings and improving local blood flow.

Low AMH
AMH is short for anti-mullerian hormone. It is a substance made by small follicles in women’s ovaries. When the follicles grow bigger, they are no longer producing AMH. Since AMH is produced only in smaller follicles and its blood levels are constant, AMH has been used to measure the size of the pool of growing follicles in women. AMH blood levels reflect the size of the remaining egg supply. If your AMH is low, it means your egg supply is poor. With increasing women’s age, the size of their pool of remaining small follicles decreases. Their AMH levels and the number of ovarian small follicles visible on ultrasound also decrease. Some women may have problems of recruitment and development of follicles; in this case they have fewer follicles developed and their AMH tends to be low. Women with low AMH would have less chance to have good quality eggs. So they may have difficulty to conceive naturally. Women with low AMH level are likely to have poor response to ovarian stimulation for IVF and have fewer eggs retrieved. This reduces their chance to conceive via IVF.

Read more about how acupuncture can help to balance hormones at <drmaggiejuacupuncture.co.uk>

Low progesterone to get pregnant, How?


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Sunday, 22 May 2022

No periods? Acupuncture can help

Absence of menstrual periods and acupuncture treatment

Regular menstrual periods are a sign of well functioned reproductive system in women. Menstrual cycles are very important in women not only for reproduction but also for general health. If a woman’s periods are missing, this could cause infertility as well as some other health problems such as cardiovascular problems and osteoporosis.

Absence of menstruation is called amenorrhea in medical field which is a condition that menstrual periods have stopped for more than three cycles. This is not rare condition and many factors affect menstruation. If your periods are missing, If your periods disappeared for some time, you need to get it checked with your doctor and you need to rule out of pregnancy and menopause depending on your age. If you are not pregnant and you don’t have periods, it is most likely that your ovary is not working.

Common conditions that could cause absent periods are those affecting hypothalamus, pituitary gland, ovarian axis. These cause hormonal level changes responsible for reproductive function. For example, extreme weight loss, emotional or physical stress, high intensive exercise and severe illness could affect the hypothalamus and cause absent periods; pituitary gland conditions lead to increasing level of hormone prolactin, hypothyroidism causing missing periods; If you are under extreme stress, this could be the reason for disappeared periods. Though it has long been recognised, there are no specific diagnostic tests for this and diagnosis is usually made by exclusion. The mechanisms how psychological stress affects the women’s period cycle are still not clear. But it is widely accepted that it is linked to hypothalamic pituitary axis. In the situation of stress, corticotrophin-releasing hormone (CRH) production from hypothalamus is increased. The effects of increased CRH on the hypothalamic-pituitary axis reduce circulating luteinising hormone (LH) levels. Absence of period cycle caused by psychological stress may last from a few months to many years. Women with stress related absence of period cycle have increased basal plasma cortisol and decrease response to CRH administration. In many cases, normal periods return after the psychological problems are overcome. But in other cases, missing periods could cause new stress and help is needed to get periods return.

Ovarian conditions can also cause absence of periods, which include premature ovarian failure, polycystic ovary syndrome. It is very common that menstrual period does not return after stop taking contraceptive pills in three months. Infertility is one of the complications of absence of periods. Treatments are also depending on the causes. Correcting hormone imbalance is the target of the treatments to reestablish menstrual cycles and prevent complications.

In traditional Chinese medicine (TCM), missing periods are divided into five types according to the symptoms:

1 kidney and liver deficiency, symptoms include missing menstrual periods or light or less frequent periods, feeling week, lower back pain, dizziness, tinnitus, red tongue and week pulse.

2 qi and blood deficiency, symptoms include missing menstrual periods, dizziness, blur vision, short of breath, tiredness, pale, light tongue and week pulse.

3 yin deficiency, symptoms include missing menstrual periods, hot flashes, fever, night sweating, cough with blood, red tongue, week pulse.

4 qi and blood stasis, symptoms include missing menstrual periods, depression, feeling anger, feeling bloated, lower tummy pain, dark tongue, floating pulse.

5 dampness and phlegm blockage, obesity, cough with phlegm, swelling, excessive vaginal discharge, thick tongue coating, and slippery pulse.

Acupuncture could help correcting hormonal imbalance, reducing stress level and resuming menstrual cycles by stimulating nerve ends at particular acupuncture points and improving hypothalamus function.

There were some researches showing that effectiveness of acupuncture on resuming menstruations. Here are some examples.

There was a study with women with premature ovarian failure. 11 women had absence of periods. They received 3 month acupuncture treatments. 10 women had resumed their periods.

There was a random control clinical trials with women diagnosed with polycystic ovarian syndrome. 16 weeks of acupuncture treatment, menstruation frequency is increased.

There was a case report from China. In this report, 33 women aged from 23 -45 had absence of periods for 3 months to 3 years. They were received acupuncture treatments and 29 women out of 33 resumed their periods; 4 women did not respond to acupuncture treatments. About 63% had regular periods during the course of 6 months followup and about 24% had irregular periods during that time.

Stop taking the pills and no periods, acupuncture could help

When will your periods come back after you stop taking the pills? This is a good question. This is may vary depending on individuals. It could take a while for your periods to come back after you stop taking the pill. Most women will have a period two to four weeks after stopping the pill. It could take longer. Your periods may not be regular when you first stop the pills and this could take six months to become normal again. If your periods never come back, this may suggest a problem in your ovaries and you need to see your doctor to investigate what is wrong. Contraceptive pills suppress ovulation and follicle developments. Acupuncture could help ovarian blood flow to help restoring ovarian function when stopping the pills. Regular periods indicate that your ovaries are functioning well. If your ovaries are functioning well, your periods would come back and become regular.   

References

Zhou K Evid Based Complement Alternat Med (2013) 2013:657234

Jedel E et al Am J Physiol Endocrinol Medtab (2011) 300:E37-45   

Han Y J Trads Chin Med (2004) 24:42-43 

 

Saturday, 21 May 2022

How too make Barley tea.

 

Roast Barley to brown and store in an air tight container. To make tea, add one spoon of roasted Barley and boiling water to a cup and leave it for 10 min.

Benefits of Barley tea. It contains vitamins along with antioxidants. Good for digestion, reducing bloating, anti-inflammatory and antiaging.

Read more about acupuncture at drmaggiejuacupuncture.co.uk

Hope for women with premature ovarian failure.


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Sunday, 8 May 2022

Can't cope with excessive stress? Acupuncture can help

 

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Saffron tea, Chinese herbal tea


Saffron is a spice that comes from the flowers of crocus sativus Linné. Like many other herbs and spices, saffron can be prepared as a tea. The benefits of saffron tea include good for heart and lowing blood pressure, urinating problem, menstrual issues, eye disorders, stomach issues, mental health antidepressant
Read more acupuncture at drmaggiejuacupuncture.co.uk

Monday, 2 May 2022

Three bean tea, an ancient recipe, Chinese herbal teas


Three bean tea, an ancient recipe from China is a famous Chinese medicine formula as well as food remedy. This formula contains three beans including small read beans, black beans, as well as green beans. It nourishes skin and helps skin problems such as spots, skin patches itchiness etc. It nourishes blood too and good for fertility and pregnancy.

Cooking methods

No1,

1, Soak equal amount of three beans which you can get from Chinese supermarkets in warm water for a couple of hours.

2, Boil the beans in plenty of water in low heat for a couple of hours.

3, It is ready to drink. You can add honey, if you have sweet tooth.

No2,

1, Soak three beans in the warm water as above.

2, Grand the mixture and boil it.

3, It is ready to drink. You can add honey, if you have sweet tooth.

Visit drmaggiejuacupuncture.co.uk to read more about acupuncture. 

Sunday, 1 May 2022

Mint tea, Chinese herbal tea

 



Mint tea benefits:

Relief cold and flu symptoms, release upset stomach symptoms, release skin rashes and itchiness, sooth and calm, release tension headaches, muscle soreness and pain,release menstrual pain.

Read more about acupuncture at drmaggiejuacupuncture.co.uk 

Rosebuds tea, Chinese herbal tea


Roses have been used as tea, one of Chinese teas for thousands of years. Rose tea is made from the fragrant petals and buds of rose flowers.

The health benefits of rose tea are improving Qi and blood circulation, alleviating menstrual pain, antiaging effects, reducing allergic reactions, improving liver and heart health, anti inflammatory and anti arthritic effects, reducing stress, calming, soothing and anti depression, reducing fatigue, helping wound healing etc.

Read more about acupuncture at drmaggiejuacupuncture.co.uk 

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 ...