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Fertility and acupuncture
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Maggie Ju (2014) Current opinion in acupuncture on stroke rehabilitation
The Journal of Chinese Medicine And Acupuncture Volume 21 Issue 2 September 2014 P9
Maggie Ju. (2015) What Part Does Acupuncture Play in IVF?
The Journal of Chinese Medicine And Acupuncture Volume 22 Issue 1 March 2015 P21
Maggie Ju (2020) The Potentiality of COVID-19 Treatment with Chinese Herbal Medicine in the UK
The Journal of Chinese Medicine And Acupuncture Volume 27 Issue 2 November 2020 P9
Monday, 20 August 2012
Fu B et al J Tradit Chin Med (2005) 25:186-9
Friday, 10 August 2012
How long it takes for you to get pregnant. This is difficult to say. There is an average time for a couple to conceive. Within one month, 30% couples get pregnant; within three months, 60% get pregnant, within 6 month, 80% get pregnant, within one year 85% get pregnant. Within two years 92% get pregnant. This is only a guide. Many factors affect the figures. For example age is obviously an important factor and it takes longer to conceive, if you have age disadvantage, but it is not impossible.
When do you need to get your fertility tested?
You need to get your fertility tested, if you have tried to get pregnant for a year without success or if you are over 35 year old and you have tried for 6 months without success. Basic fertility tests are to check your egg quantity and quality, your ovulation and your tubes and uterus. These include day 3 FSH (follicle stimulating hormone) and E2 (estradiol) test, AMH (anti-mullerian hormone) test which could be done at any day of a woman’s cycle, antral follicle count to measure and count small follicles. Your ovulation could be tested by ovulation prediction kit, BBT (basal body temperature) chart, ultrasound scan and day 21 progesterone tests. HSG (Hysterosalpinggogram) is used to test your tube and uterine cavity.
There are a few things you can do to improve your fertility.
Keep a healthy weight
Obesity is associated with a number of health problems, such as cardiovascular diseases and diabetes. Obesity which causes hormone imbalances and ovulation problem associated with infertility is extensively agreed. A healthy weight is important for women who want to conceive. Obesity is associated with reduced female fertility. Women with obesity are more likely to suffer dysfunction of hypothalamic-pituitary-ovarian axis, irregular period cycle and anovulation. Hormone balance to regulate follicular development and egg maturation is disturbed. Endometrial development and implantation are also affected by obesity. Weight loss will restore normal period cycle and ovulation and improve the chance of conception.
Obesity is also associated with reduced male fertility. It reduces semen quality, changes sperm proteomes, contributes to erectile and induces other physical problems related to obesity including increased scrotal temperatures. Obesity affects hormone balance. Weight loss may restore fertility in male.
Low body weight is also linked to infertility. Keep normal body weight can optimise your fertility. Body mass index (BMI kg/m2) which is body weight over height is used to measure healthy weight. Normal BMI is 20-25. High or low BMI is abnormal. BMI higher than 30 is obese. Numerous studies showed that it takes longer time for women with high or low body weight to conceive. For example, a study involved in 87 obese women with infertility showed the impact of obesity on ovulation. 80% of women before weight loss were anovulating; after 6 months of a weight loss programme, average weight loss of the women was 10.2 kg/m2 and 90% of them were ovulating spontaneously. 77.6% of those women became pregnant and 67% achieved a live birth. Abnormal body weight in men is associated with reduction of sperm count which causes male infertility. Many studies showed that IVF success rate for women with obesity is 50% less than that for women with normal BMI. Increased risk of early pregnancy loss results in lower live birth rate in women with obesity compared to women with normal BMI.
Keep a balanced diet. A balanced diet should provide about 2000 kilocalories each day. About 200 kilocalories more would be requested during pregnancy.
What is well balanced diet? When it comes to a healthy diet, balance is the key, which means eating a wide range of foods in the right proportions to achieve and maintain a healthy body weight. If you are overweight or obese which means you eat more than you need and should eat less; and vice versa. Healthy eating does not have to be complicated; it can be really straightforward. All the food we eat can be allocated into five groups. They are
1, Fruit and vegetables: They are main source of vitamins and minerals for the body. They also contain fibers. Five portions of a variety of fruit and vegetables a day will provide enough vitamins and minerals for body needs. How much is one portion? Just one apple, banana, pear a slice of pineapple or melon or one similar-sized fruits is one portion. Three heaped tablespoons of vegetables is another portion. This is not hard to achieve.
2, Starchy foods, such as rice, pasta, bread and potatoes, cereals: They are main source of energy and calories which are fuels of the body. They also contain some vitamins, minerals and fibers. This group of foods should make up around one third of everything we eat. Or meals are based on these foods.
3, Meat fish, eggs and beans: This group of foods is good source of protein, which are fundamental for growth and repair of the body. They also have a variety of vitamins and minerals. Meat provides vitamin B12. At least two portions of fish per week are very healthy.
4, Milk and dairy foods: These are a good source of protein and calcium. These four groups of foods are healthy foods from which a range of foods should be chosen.
5, Foods containing fat and sugar: Fat and sugar provide energy for the body. If there is too much sugar and fat, it will lead to overweight. Fat can be divided into saturated fat and unsaturated fat. Saturated fat can raise blood cholesterol and increase risk of heart disease. However unsaturated fat can help lower cholesterol and provides body with essential fatty acids which help body stay healthy. Oily fish, nuts, seeds, vegetable oils and olive oils are main sources of unsaturated fat.
Try to control fat and sugar intake and eat foods contain unsaturated fat.
Do you need to take vitamin and mineral supplements?
Most people can get all the vitamins and minerals they need by eating a balanced, varied diet. You don’t have to take supplements if you don’t have symptoms of deficiency. If you choose to take supplements, be careful not to take too much otherwise it would be harmful. There are two types of vitamins: water-soluble or fat- soluble. There are 9 water-soluble vitamins: 8 vitamin Bs and vitamin C. For water-soluble vitamins your body will choose what is needed and the rest will be excreted. But for fat-soluble vitamin, thing is different. There are 4 types of fat-soluble vitamins A, D, E, and K. They are ready to store in the body. If intake is more than need, the excessive amount of vitamin will not be excreted from the body, and they will stay in the body for a long time and will be toxic to the organs.
Be careful with what you drink if you want to get pregnant
Stop drinking alcohol.
Do you drink alcohol? Drinking alcohol, especially large amount of alcohol is associated with reduced fertility and spontaneous abortion. This was agreed by many researches. One drink per week might be associated with reduced fertility. The mechanism that alcohol affects fertility is not clear, but it may alter hormone levels causing follicle development, ovulation, and implantation problems. Both men and women drinking alcohol affects success rate of assist reproductive treatment. Women drinking alcohol increased miscarriage in early pregnancy.Excessive consumption of alcohol disturbs hypothalamic-pituitary function leading to ovulation disorder. Too much alcohol can damage sperm quality. Infertility improved with stop of alcohol consumption. Drinking alcohol during early pregnancy can cause severe developmental abnormalities in the baby, such as retardation and physical malformation.
You might say that I don’t drink alcohol at all; what else could affect my fertility. Do you drink a lot of coffee, tea or soft drinks? Do you know what the component of them? In this drinks, caffeine is one of the important components. Caffeine is a stimulant of the brain. It has been reported to prolong the time to pregnancy, but the mechanism for this is not clear. It may affect female reproduction by changing hormone levels. This results in ovulatory problem and corpus luteal dysfunction. There was a study of 104 women on links between pregnancy and caffeine consumption. They found that women who drank less than a cup of coffee a day were two times as likely to get pregnant compared with the moderate coffee drinkers. A reduced chance of conception was found with increased coffee consumption. Large amount of caffeine consumption is associated with delayed conception. Also it causes higher spontaneous abortion in early pregnancy. For women undergoing assist reproductive treatment, caffeine might decrease live birth rate.
Stop smoking. The metabolites of cigarette smoking are toxic to eggs (causing oxidative damage to mitochondrial), sperm and embryos (causing miscarriage). Smoking decreases the chances of conceiving. Increasing numbers of cigarettes consumption per day significantly decreased fertility. If smoking during pregnancy, miscarriage risk is doubled and premature labour is increased 50%. Low birth weight baby and interurine retardation and perinatal mortality are also increased. Stopping smoking is another step to take to be ready for pregnancy.
Sleep well. Good sleep is important to get your mind and body rested to keep healthy. Sleep loss may affect your hormones levels.
Do regular exercises to improve eggs and sperm quantity and quality
Reduce stress. Stress can alter hormones causing fertility problems. Keeping stress free is very important. Severe stress may affect ovulation and sperm production. Prolonged stress makes some part of your body not function properly including reproductive system. Try to relax. Try to eat regularly and get good sleep which could help your body relaxed and healthy. This is very important. If your body healthier and stress free, your fertility improves and you may get pregnant naturally or it may improve your chance of IVF success, if you decide to go through the IVF treatment.
Getting pregnant seems so easy for most of women; however wanting to have a baby seems unreachable for those who suffer from infertility for years. It is hard to imagine what they have been going through, physically and emotionally. Many people don’t realise that infertility is a disorder that occurs in women’s reproductive systems. There are many underlying causes such as polycystic ovarian syndrome (PCOS), endometriosis and premature ovarian failure etc that could explain why infertility happens. Even if it is unexplained infertility, there may be a reason. The reason cannot be explained, only because science is not advanced enough to know why it happens. It is still unclear how pregnancy happens in many ways physiologically and biochemically.
Do you know acupuncture boosts your fertility?
It does not help if only asking why me? One has to do something to solve the problem. Many women recognize that acupuncture could help their fertility treatment and this is their chance. Bovey et al (2010) performed a survey of acupuncture practitioners to study acceptance of acupuncture for infertility treatment in the UK. They found that 15% of 861 practitioners responded support fertility issues; patients with infertility comprise a large part of their cases. 60% of these practitioners had specialist training. They stated that the benefit of acupuncture treatment for infertility included stress reduction, relaxation, regulation of menstrual cycle and of course, emotional support. Hopton et al (2012) conducted a survey in surrey, UK. They showed that women seeking infertility treatment with acupuncture increased 5% from 2.5% in 2002 to 13% in 2009. Most commonly these were treated by independent acupuncturists. There was a survey in the US about women with infertility seeking complementary and alternative treatment. They showed that during 18 months 22% had tried acupuncture, 17% herbal therapy, 5% a form of body work and 1% medication.
Acupuncture is originated from ancient China. Not only because of its history, but also because of evidence from current scientific research, acupuncture becomes very popular. Acupuncture can boost your fertility and help you conceive naturally by stimulating nerve endings and regulating reproductive system physiological function. Needles inserted into particular acupoints stimulate nervous system. Acupuncture decreases sympathetic nerve activity, as a result, it helps improve blood flow of the ovaries and uterus to develop high quality eggs to be fertillized and better uterine lining to get ready for implantation. It also helps relax fallopian tubes and uterus to provide an uninterrupted passageway and a fertile environment for egg and embryo. It also helps regulate hormone balance to improve ovulation and support pregnancy. Acupuncture can also reduce fertility related stress to help you conceive.
Success rate is what many people concern about. I would say that it is difficult to calculate success rate for infertility with acupuncture treatment though there is some research showing over 60% success rate. Human body is a living biological body. Our body does not work like computer which run the same programme if you give it the same command. Everyone is different which is responding differently to the treatments. This is why no treatments for any diseases have 100% success rate. Acupuncture is different from IVF which has clear cycles. It is easy to see whether it is successful or not. Acupuncture has accumulating effects. Some people may need three month treatments, while others may need six months and some need 1 year. If you give it a cut off time, like research does, this does not reflex actual success rate. Women with infertility may have other symptoms, such as chronic backache or abdominal pains; their chosen acupuncture points must be different. How can you compare success rate between them? Some people see acupuncturist for treating other diseases such as chronic pelvic pain, as a result, they end up getting pregnant. Acupuncture can also treat underlying causes of infertility and improve overall health to benefit fertility.
Acupuncture supports IVF as well. If you do want to go ahead for IVF, acupuncture also can help. There is no conflict between IVF and acupuncture. Manheimer E studied effects of acupuncture on pregnancy rates and live birth among women undergoing IVF by analysing seven trails involved in 1366 women. They suggested that acupuncture given with embryo transfer improves pregnancy rates and live birth among women undergoing IVF. Recently, there is a randomized controlled trial of study conducted in Western Sydney. They examined the effectiveness of acupuncture for reducing infertility-related stress. The effect of acupuncture group was compared with a waiting-list control group. The patients involved were 32 women aged 20-45 years, with a diagnosis of infertility or a history of unsuccessfully trying to conceive for over 12 months. Six sessions of acupuncture over 8 weeks were given. The result showed that women in acupuncture group have significantly reduction of infertility stress compared with those in the waiting-list control. Women described the experience and impact of acupuncture as positive relating to a sense of relaxation and intervention with few negative side effects. A research conducted by Balk et al studied the effect of acupuncture on perceived stress levels in women on the day of embryo transfer (ET), and to determine if perceived stress levels at embryo transfer correlated with pregnancy rates. They found that women who received this acupuncture achieved pregnancy 64.7%, whereas those without acupuncture achieved pregnancy 42.5%. Those who received acupuncture had a low stress scores before and after ET. They concluded that lower perceived stress at the time of embryo transfer may play a role in an improved pregnancy rate.
Smith CA J Altern omplement Med (2011) 17:923-30
Balk J et al Complement Ther Clin Pract. (2010) 16:154-7
Manheimer E et al BMJ (2008) 336:545-9
Homan GF et al Human Reproduction Update (2007) 13:209-223
Monday, 6 August 2012
Changes of the thyroid function can lead to infertility both in male and female. In male, hyperthyroidism is associated with low sperm count and low sperm motility. Erectile function is also affected by thyroid function. These factors may contribute to male infertility. Restore of thyroid function after treatment results in sperm count increased and sperm motility improved. Erectile function is also improved after treatment. Hypothyroidism may cause testicular pathology, low testosterone levels and sperm abnormality.
Thyroid dysfunction and autoimmunity are common among women in reproductive age. In women with hyperthyroidism blood hormone levels including testosterone, adrostenedione, oestrogen (E2), luteinizing hormone (LH) and follicle stimulating hormone (FSH) are increased. Abnormal period is noted in women with hyperthyroidism. Absence of period is very common. Reduced infertility is found in women with hyperthyroidism. Likewise hormonal changes and period cycle disturbances are also present in women with hypothyroidism.
The prevalence of thyroid dysfunction during pregnancy is about 2-3% and is mainly caused by chronic autoimmune thyroiditis. Thyroid auto-antibodies are found in 5-15% of women in reproductive age with or without thyroid dysfunction. Either thyroid dysfunction or thyroid autoimmunity is associated with negative pregnancy outcomes during pregnancy. Emmyvan den Boogaard et al conducted a systematic review on the clinical significance of thyroid dysfunction and thyroid autoimmunity prior to conception and in early pregnancy. They found that subclinical hypothyroidism (with high Thyroid stimulating hormone-TSH and normal free T4) in early pregnancy was associated with hypertension in pregnancy and perinatal mortality. Presence of thyroid antibodies was associated with an increased risk of unexplained subfertility, miscarriage, recurrent miscarriage, preterm birth and maternal post-partum thyroiditis.
More recently acupuncture was reported in regulating thyroid function and treating thyroid function disorders. There was a report of effectiveness of acupuncture on hyperthyroidism. This was involved in 125 patients. After acupuncture treatment symptoms were controlled completely in 71 patients which were 56.8%. Other 41 patient’s symptoms were partly controlled. Recent study by Lyzina KE et al investigated the effect of acupuncture in 27 female patients with subclinical hypothyroidism. The treatment period was 3-4 month. They found that after the treatment, the initial clinical symptoms decreased significantly; TSH level decreased to normal range; the quality of life was improved. They concluded that acupuncture may be an alternative therapy for patients with subclinical hypothyroidism.
Acupuncture is used to treat hyperthyroidism as an adjunct therapy
Hyperthyroidism or overactive thyroid is a common hormonal condition in which too much thyroid hormone is produced in the thyroid gland. Excessive thyroid hormones can speed up metabolism causing a series symptoms. These include that anxiety, irritability and nervousness, insomnia, fatigue, muscle weakness, sensitive to heat, excessive sweating, weight loss, frequent passing stolls and urination, light periods or infrequent periods or missing periods, infertility. Physical signs include that enlarged thyroid gland, fast heart beat, tremor, warm skin, redness on the palms of the hands, hives, hair loss twitching in the face and limbs. Blood tests show that low level of thyroid-stimulating hormone (TSH) and high level of thyroxine and triiodothyronine (the thyroid hormones). The most common used medication is thionamides, such as carbimazole and propylthiouracil. In China, acupuncture is used as adjunct therapy together with these medications to increase the effect of medications and reduce the side effect of medications. As early as 1934 acupuncture was reported to treat thyperthyroidism. In 1970s, there were more researches on this subject. Now many researches were done and provided the evidence that acupuncture improves metabolism, improves symptoms, reduces side effect of the medications and reduces recurrence rate. For example, there was a report with 125 cases of hyperthyroidism. After acupuncture treatment, the symptoms were controlled in 71 cases, improved in 41 cases, no effect in 13 cases. More recently a research studied the therapeutic effect and side effect of treatment on hyperthyroid exophthalmos with the combination of acupuncture and medication. Fifty-two cases were randomly divided into an acupuncture and medication group (27 cases) and a medication group (25 cases). Acupuncture in combination of oral taking of Thiamazole and Euthyrox were adopted for the acupuncture and medication group. And acupoints such as Jingming (BL 1), Chengqi (ST 1) and Sizhukong (TE 23) etc. were selected. Western medication for oral taking was applied as the only treatment for the medication group. The results have shown that the improvement of the objective marks of eye syndrome in the acupuncture and medication group was better than that in the medication group. There were 4 cases with hypoleucocytosis, 3 cases with rash and 3 cases with aggravated symptom of exophthalmos in the medication group during the treatment, while no case with side effects was observed in the acupuncture and medication group.
Emmyvan den Boogaard et al Human Reproduction Update (2011) 17:605-619
Vopr Kurortol Fizioter Lech Fiz Kult (2011) 5:29-33
Xia Y et al Zhongguo Zhen Jiu (2010) 30:806-9
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