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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
Friday, 19 September 2014
If you have been trying for conceiving for long time without success, the semen should be tested to check if sperm are good. Sperm are tested by semen analysis. What is semen? Semen is the thick, white fluid released during ejaculation which comes from three sources: the vas deferences, the seminal vesicles and prostate. This liquid protects sperm cells which are comprised in semen. What are sperm cells like? Sperm cells are unique. They have head, neck and tail. The sperm head is oval shape containing highly compact DNA and enzymes required for penetrating egg shell for fertilization. The tail is responsible for sperm movement. Head and tail is connected by neck. Sperm parameters include sperm count over 20 million per ml or more. Over 50% of sperm should show normal forward movement 1 hour after collection. Over 30% of sperms should be in normal shape. Total semen volume is 1.5 ml to 6 ml. Normal semen pH range from 7.2-7.8. Liquefaction time is 20-30 min after collection. There are no white blood cells or bacteria in the semen.
Do you know that semen quality is related to life expectancy?
Semen quality is known to be a marker of fertility, and a sperm concentration of up to 40 million/mL has been found to increase the probability of conception in a menstrual cycle. Is there association between semen quality and long-term health effects? The Copenhagen Sperm Analysis Laboratory analysed semen samples from 51543 men between 1963-2001 and they found that mortality decreased as the sperm concentration increased up to a threshold of 40 million/mL and no further decrease in mortality above the threshold. Mortality decreased as the percentages of motile and morphologically normal spermatozoa increased in a dose-response manner. They suggested that good semen quality may be a more general biomarker of overall health.
Which hormones are involved in sperm production?
Sperm production is hormonally driven. There are four hormones involved in sperm production: gonadotropin-releasing hormone (GnRH), follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone. GnRH is produced in hypothalamus and acts on pituitary gland stimulating FSH and LH releasing. FSH is produced in pituitary gland (a part of the brain) and acts on testis stimulating sperm production. LH is also produced in pituitary gland and acts on testis stimulating testosterone production. Testosterone is produced in the testis and it supports sperm production. Without testosterone sperm will not develop and the matured sperm will not be released.
How to boost male fertility?
Male fertility can be reduced by stress. The stress includes emotional, physical and financial. Stress level will increase from frequent travelling, a long illness, long working hours and major life changes. How to get rid of stress? Many things can help reduce stress to help your body relax. For example, exercise, massage or of course acupuncture on a regular basis. Other some simple things are also help reduce stress such as eating well, sleeping well, stop of smoking and stop of drinking alcohol, reducing coffee consumption, losing some weight if you are overweight, avoid hot bath etc.
Keeping good nutrition and balanced diet is the best way to improve male fertility. Whole grains, plenty of fruits and vegetables and plenty of nuts, low fat and low sugar help improving male fertility. Don’t forget acupuncture increases sperm count.
What food and supplements are good to boost male fertility?
One in six couples have difficulty to conceive. Male factors contribute half of the cases. To boost male fertility, some food and supplements can help based on recent research.
Organic food: it is better to go for organic or hormone free food and avoid hormone containing diary products and meats. Synthetic estrogens are widely used in the livestock, poultry, and dairy industries. The synthetic estrogen, diethylstilbestrol (DES), affects male fertility. For example, DES was prescribed from 1945 to 1971 to millions of women during pregnancy. Male offspring from those women had a higher incidence of developmental problems of the reproductive tract, as well as diminished sperm volume and sperm count. Exogenous estrogens impact fetal development by inhibiting the development of Sertoli cells, which determine the lifelong capacity for sperm production. Circulating estrogens also inhibit enzymes involved in testosterone synthesis and may directly affect testosterone production.
Omega-3: A study with two hundred thirty-eight infertile men with idiopathic oligoasthenoteratospermia investigated the effect of omega-3 on fertility. A 32 weeks treatment has shown significant improvement of sperm cell total count and sperm cell concentration in the omega-3 group suggesting the benefit of omega 3 on male fertility.
Zinc: Zinc is essential for normal functioning of the male reproductive system. Enough zinc intake ensures proper sperm motility and production. Zinc deficiency is associated with decreased testosterone levels and sperm count. There was a trend observed for a lower Zn levels in seminal plasma of smokers compared with nonsmokers. Seminal Zn in fertile and infertile (smokers or nonsmokers) males correlated significantly with sperm count and normal morphology of sperm. Poor Zn nutrition may be an important risk factor for low quality of sperm and idiopathic male infertility. Zinc levels are generally lower in infertile men with diminished sperm count. Studies have found supplemental zinc may prove helpful in treating male infertility. Some studies have suggested that male patients with infertility given zinc treatment significantly increased testosterone levels and sperm count, sperm motility and normal sperm morphology.
Vitamin C: Lower levels of vitamin C may lead to infertility and increased damage to the sperm’s genetic material. Study has suggested that reducing vitamin C intake in healthy men increased sperm DNA damage.
Vitamin E: Vitamin E is an antioxidant and has been shown to inhibit freeradical-induced damage to sensitive cell membranes. It improved sperm motility and improved sperm function in the zona binding assay, therefore enhancing the ability of the sperm to penetrate the egg in vitro.
Glutathione/Selenium: Glutathione and selenium are essential to the formation of an enzyme present in spermatids which becomes a structural protein in mature sperm. Deficiency of these two could damage sperm motility.
Coenzyme Q-10: Recent data from patients with idiopathic asthenozoospermia has shown that CoQ10 improves sperm counts and motility.
Vitamin B12: Deficiency of Vitamin B12 has been associated with decreased sperm count and motility.
Keep scrotum cool, if you want to get pregnant
Sperm is produced in testis located in scrotum attached to the body. In this place testis could be kept in low temperature( a few degrees lower than body temperature) which is required for sperm production. This is vital for sperm production in male. If anything elevates the temperature, it could damage sperm production.
If you want to get pregnant, you need to keep the scrotum cool. The question is how? There are some approaches you could take:
1, Wear a loose underwear to keep scrotum away from your body to avoid body heat.
2, Keep laptop away from your thigh to avoid heating up scrotum.
3, Stop riding bycycles to avoid heating up scrotum.
4, Treat varicocele veins to speed up blood circulation to maintain low temperature.
5, Lose weight to reduce excessive fat which warms up testis.
6, Acupuncture can relax scrotal muscles and improve blood circulation to keep temperature down.
Exercises affect sperm count
Physical activity has benefits for human’s general health however its association with male fertility remains unclear. Some researchers have proposed strenuous exercise as a risk factor for male factor infertility because it has been seen there was a reduced semen quality in long-distance runners and endurance cyclists. A recent research from Harvard School of Public Health studied if paternal physical activity associated with semen quality parameters and with outcomes of infertility treatment. In this study, most physical activity was moderate and heavy outdoor activities (38%), followed by running and jogging (24%), weightlifting (16%), bicycling (16%), swimming laps (3%), playing tennis or squash (2%) and aerobics (1%). They found that higher sperm count is related to higher levels of moderate to vigorous physical activity while sperm motility (total and progressive) and morphology were not related to physical activity. They also studied whether specific physical activities were associated with sperm concentration. Men in the highest category of outdoor activity (≥1.5 h/week) and weightlifting (≥2 h/week) had higher sperm concentrations than men with 0 h/week. Bicycling, in contrast, was inversely associated with sperm concentrations. Men who reported bicycling ≥1.5 h/week had lower sperm concentration compared with men who reported no bicycling. Time spent walking, running, jogging or in other specific physical or sedentary activities was not associated with sperm concentration. They also studied the relationship of paternal physical and sedentary activities with outcomes of infertility treatment. They did not find an association between time spent in moderate-to-vigorous or sedentary activities and clinical pregnancy or live birth rates following IUI or ART.
Some modern techniques might decrease your sperm quality
Exposure to radiation, both ionizing and nonionizing, has been shown to be a hormone disruptor. People may not realize that when you are using modern techniques, you are exposed to radiation significantly. Study on cell line has shown that exposure to mobile phone radiation altered gene and protein expression in cell lines. In a recent study, patients who used a cell phone showed significantly higher free testosterone and lower LH levels than those who did not, and sperm quality was negatively affected. A review has suggested that the use of mobile phones may decrease sperm concentration, motility (particularly rapid progressive motility), normal morphology, and viability. The abnormalities seemed to be directly related to the duration of mobile phone use. However, present evidence is inconclusive.
Effect of mobile telephones on sperm quality
Mobile phones produce radiation which may affect male fertility. Another study has shown that donor normozoospermic samples, which were exposed for four hours to a wireless internetconnected laptop showed a significant decrease in progressive sperm motility and an increase in sperm DNA fragmentation. The researchers advised against locating a laptop near the testes. There was a study from the UK has investigated that the effect of mobile phones on sperm quality. In this study, the participants were 1492 from fertility clinic and research centers. There were ten studies included. The findings were exposure to mobile phones was associated with reduced sperm motility and viability. The results from in vitro and in vivo studies suggest that mobile phone exposure negatively affects sperm quality.
Get sperm quality improved before IVF/ICSI
In about 50% of cases, male factors play a role in a couple's infertility. Medical science still has problems determining when and whether a sperm problem is the primary or contributing cause for problems with fertility. Lifestyle, environmental, and psychological factors may affect sperm quantity and quality. A recent study involved in 3106 couples showed that high-level sperm DNA fragmentation has a detrimental effect on outcome of IVF/ICSI, with decreased pregnancy rate and increased miscarriage rate. This study indicated that high sperm DNA damage was related to lower pregnancy rates in IVF but not in ICSI cycles, whereas it was associated with higher miscarriage rates in both IVF and ICSI cycles. It is suggested that before clinical high tech clinical treatments start, changes in lifestyle and environmental and psychological factors in male would improve male fertility, such as stop smoking, stop drinking alcohol, avoiding hot bath and cycling, reducing stress, losing weight et al. Acupuncture can help with improving sperm quantity and quality and reducing stress.
Chronic prostatitis and male infertility
Chronic prostatitis is a very common disease in the male genitourinary system. Some research has shown that chronic prostatitis was linked to male fertility. It was reported that chronic prostatitis was associated reduced sperm production and impairment of semen quality and sperm morphology and motility. Also very recently it was found that men with prostatitis and varicocele had significantly higher DNA fragmentation compared with men in the control group. There was a negative impact of these diseases on the concentration and the percentage of motile sperm cells in the ejaculate. Prostate secretion meets sperm cells during ejaculation and the sperm damage could occur in the short time during ejaculation. Or a direct effect of inflammation on the testis and epididymis could contribute to the damage.
Does prostate abnormality induce antisperm antibody?
There are three major prostate abnormalities namely, prostatitis, benign prostatic hyperplasia (BPH) and prostate cancer. . In all these abnormalities, infection/inflammation has been involved. As infection/inflammation of the male genital tract can also be involved in production of antisperm antibodies (ASA), Does prostate abnormality induce ASA. There was a study with healthy man and man with prostatis, BPH and prostate cance. They found that chronic prostatitis, BPH and prostate cancer do not induce antibodies to spermatozoa, sperm-specific antigens and seminal plasma components.
Acupuncture can help with prostatitis by improving the local blood flow and reducing inflammation. As a result, it could improve the fertility.
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Monday, 8 September 2014
If a woman is pregnant, vaginal bleeding is abnormal. This often occurs in early pregnancy and is often associated with miscarriage or ectopic pregnancy. Ectopic pregnancy is one of the most severe pregnancy related conditions in women with abnormal uterine bleeding. Threatened miscarriage and miscarriage also present abnormal uterine bleeding.
Benign endometrial and cervical diseases: Fibroids is benign smooth muscle tumors in uterus which is either asymptomatic or presenting abnormal uterine bleeding. Endometrial polyps are a significant cause.
More frequent vaginal bleeding could be caused by pelvic inflammatory disease which is caused by sexually transmitted diseases such as Chlamydia or gonorrhoea. This causes inflammation in the uterus. Endometriosis can also cause more frequent vaginal bleeding. Polycystic ovary syndrome is also the underline causes of abnormal uterine bleeding. Irregular interval of vaginal bleeding could be caused by oral contraceptive pills and perimenopause.
Abnormality presents as duration, interval and amount of the bleeding, if a woman is not pregnant and ovulates regularly.
Very heavy vaginal bleeding: This could be caused by benign conditions including uterine fibroids, endometrial polyps, adenomyosis, intrauterine devices, hypothyroidism, an autoimmune disorders, blood clotting disorders and medications disturbing blood clotting.
Lighter vaginal bleeding could be caused by hyperthoroidism, oral contraceptive pills.
Bleeding between periods could be caused by contraceptive pills, intrauterine device, psychological stress and anticoagulant medications.
If a woman does not ovulate reduction of periods or period blood flow could be seen in some conditions, such as, some chronic conditions and physical and psychological stress, hypothalamus dysfunction, anorexia nervosa, and polycystic ovarian syndrome.
Majority of women with abnormal uterine bleeding do not have structural and histological abnormalities fortunately. Dysfunctional uterine bleeding is not due to certain pelvic disease, complications of pregnancy or systemic illness but mostly related to hormonal dysfunction. These affect 30% of women in reproductive age. Dysfunctional uterine bleeding is a common condition in women in reproductive age. This could be caused by psychological and/or physical stress, malnutrition, or systematic disorders which affect hypathalumic-pituitary-ovarian axis. They present with heavy abnormal uterine bleeding patterns: longer bleeding days, heavy blood loss, more frequent period cycles. In such cases, it is likely associated with aovulations. Changes of normal menstrual cycles are normally caused by disturbances of the hypothalamus-pituitary-ovarian axis. Most cases of anovulatory bleeding are caused by estrogen withdrawal or estrogen breakthrough bleeding. This could present midcycle spotting or intermittent spotting. This also could present irregular or prolonged heavy bleeding. In the case of no ovulation, the uterine endometrium at the presence of estrogen stimulation reaches abnormal heights and lacks structural support and it becomes fragile. The fragile endometrium breaks down and bleeding occurs. The fundamental issue in anovulatory bleeding is that the ovary does not function well causing hormonal imbalance. If a woman with anovulatory bleeding is trying to conceive, she would have difficulty to get pregnant because of anovulation. Improving ovary function is the key to treat anovulatory bleeding.
In Traditional Chinese Medicine (TCM) dysfunctional uterine bleeding can be divided into three types
1. Spleen and kidney yang deficiency, the symptoms include prolonged uterine bleeding, heavy periods, light red without clot, excessive vaginal discharge, tireness, lower back pain, feeling cold, cold hands and feet, diarrhoea, swelling tongue with light white coating, and week and sink pulse.
2. liver and kidney yin deficiency, the symptoms include irregular periods, prolonged uterine bleeding, red blood, dizziness tinnitus, lower backpain, dry mouth, red tongue, week and sink pulse.
3. kidney deficiency and liver stagnation, the symptoms include irregular periods, breast pain, lower back pain, lower tummy pain, excessive vaginal discharge, light tongue and week and sink pulse.
Apart from medication and surgery treatments, acupuncture is an effective treatment for dysfunctional uterine bleeding
Acupuncture could stimulate nerve end to improve ovarian blood circulation. This could improve ovarian function, restore hormonal balance and ovulation and stop abnormal vaginal bleeding and improve fertility.
Zeng et al conducted a controlled trial to investigate effectiveness of acupuncture on dysfunctional uterine bleeding. It was involved in 252 patients. These patients were divided into three groups acupuncture group, Chinese medicine group and conventional medicine group with 84 patients in each group. The result showed that acupuncture has the best effect compared with Chinese medicine and conventional medicine groups. Dr Cheng reported 90 cases of dysfunctional uterine bleeding treated with acupuncture or acupuncture and moxbustion. These women were aged between 16-46, most of them were 25-35. Uterine bleeding days were from 9 days to 65 days. They found that acupuncture and moxibustion are effective treatments for women with dysfunctional uterine bleeding.
Hickey M et al. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD001895.
My article is out now. The Potentiality of COVID-19 Treatment with Chinese Herbal Medicine in the UK
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