Jul
9
Chinese herbal medicine vs gestrinone for endometriosis
Posted by admin in Chinese herbs, Chinese medicine, endometriosis, infertility
Chinese herbal medicine for endometriosis
Flower A, Liu JP, Chen S, Lewith G, Little P
Chinese herbs for endometriosis
Endometriosis is a common gynaecological condition causing menstrual and pelvic pain. Treatment involves surgery and hormonal drugs, with potentially unpleasant side effects and high rates of reoccurrence of endometriosis. This review suggests that Chinese herbal medicine (CHM) may be useful in relieving endometriosis-related pain with fewer side effects than experienced with conventional treatment. However, the two trials included in this review are of poor methodological quality so these findings must be interpreted cautiously. Better quality randomised controlled trials are needed to investigate a possible role for CHM in the treatment of endometriosis.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2009 Issue 3, Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This record should be cited as: Flower A, Liu JP, Chen S, Lewith G, Little P. Chinese herbal medicine for endometriosis. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD006568. DOI: 10.1002/14651858.CD006568.pub2
This version first published online: July 08. 2009
Abstract
Background
Endometriosis is characterized by the presence of tissue that is morphologically and biologically similar to normal endometrium in locations outside the uterus. Surgical and hormonal treatment of endometriosis have unpleasant side effects and high rates of relapse. In China, treatment of endometriosis using Chinese herbal medicine (CHM) is routine and considerable research into the role of CHM in alleviating pain, promoting fertility, and preventing relapse has taken place.
Objectives
To review the effectiveness and safety of CHM in alleviating endometriosis-related pain and infertility.
Search strategy
We searched the Menstrual Disorders and Subfertility Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library) and the following English language electronic databases (from their inception to the present): MEDLINE, EMBASE, AMED, CINAHL, NLH on the 30/04/09.
We also searched Chinese language electronic databases: Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Sci & Tech Journals (VIP), Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS), and Chinese Medical Current Contents (CMCC).
Selection criteria
Randomised controlled trials (RCTs) involving CHM versus placebo, biomedical treatment, another CHM intervention, or CHM plus biomedical treatment versus biomedical treatment were selected. Only trials with confirmed randomisation procedures and laparoscopic diagnosis of endometriosis were included.
Data collection and analysis
Risk of bias assessment, and data extraction and analysis were performed independently by three review authors. Data were combined for meta-analysis using relative risk (RR) for dichotomous data. A fixed-effect statistical model was used, where appropriate. Data not suitable for meta-analysis are presented as descriptive data.
Main results
Two Chinese RCTs involving 158 women were included in this review. Both these trials described adequate methodology. Neither trial compared CHM with placebo treatment.
There was no evidence of a significant difference in rates of symptomatic relief between CHM and gestrinone administered subsequent to laparoscopic surgery (95.65% versus 93.87%; risk ratio (RR) 1.02, 95% confidence interval (CI) 0.93 to 1.12, one RCT). The intention-to-treat analysis also showed no significant difference between the groups (RR 1.04, 95% CI 0.91 to 1.18). There was no significant difference between the CHM and gestrinone groups with regard to the total pregnancy rate (69.6% versus 59.1%; RR 1.18, 95% CI 0.87 to 1.59, one RCT).
CHM administered orally and then in conjunction with a herbal enema resulted in a greater proportion of women obtaining symptomatic relief than with danazol (RR 5.06, 95% CI 1.28 to 20.05; RR 5.63, 95% CI 1.47 to 21.54, respectively).
Overall, 100% of women in all the groups showed some improvement in their symptoms.
Oral plus enema administration of CHM showed a greater reduction in average dysmenorrhoea pain scores than did danazol (mean difference (MD) -2.90, 95% CI -4.55 to -1.25; P < 0.01).
Combined oral and enema administration of CHM showed a greater improvement, measured as the disappearance or shrinkage of adnexal masses, than with danazol (RR 1.70, 95% CI 1.04 to 2.78). For lumbosacral pain, rectal discomfort, or vaginal nodules tenderness, there was no significant difference either between CHM and danazol.
Authors’ conclusions
Post-surgical administration of CHM may have comparable benefits to gestrinone but with fewer side effects. Oral CHM may have a better overall treatment effect than danazol; it may be more effective in relieving dysmenorrhea and shrinking adnexal masses when used in conjunction with a CHM enema. However, more rigorous research is required to accurately assess the potential role of CHM in treating endometriosis.
Jul
5
PCOS: Acupuncture and Sympathetic Nerve Activity in Polycystic Ovary Syndrome
Posted by admin in acupuncture, female infertility, infertility, polycystic ovaries
Acupuncture PCOS
Elisabet Stener-Victorin1*, Elizabeth Jedel2, Per Olof Janson, and Yrsa Bergmann Sverrisdottir3
1 Institution of Neuroscience and Physiology
2 Osher Center for Integrative Medicine
3 inst. neuroscience and physiology
* To whom correspondence should be addressed. E-mail: elisabet.stener-victorin@neuro.gu.se.
Context: We have recently shown that polycystic ovary syndrome (PCOS) is associated with high muscle sympathetic nerve activity. Animal studies support the concept that low-frequency electro-acupuncture (EA) and physical exercise, via stimulation of ergoreceptors and somatic afferents in the muscles, may modulate the activity of the sympathetic nervous system. Objective: The aim of the present study was to investigate the effect of these interventions on sympathetic nerve activity in women with PCOS. Design: Randomized controlled trial. Setting: Sahlgrenska University Hospital, Gothenburg, Sweden. Outcome Measures and Subjects: Twenty women with PCOS were randomly allocated to one of three groups; low-frequency EA (n=9), physical exercise (n=5) or to an untreated control (n=6) group during 16 weeks. Direct recordings of multiunit efferent postganglionic muscle sympathetic nerve activity (MSNA) in a muscle fascicle of the peroneal nerve before and following 16 weeks of treatment. Biometric, hemodynamic, endocrine and metabolic parameters were measured. Results: Low-frequency EA (P = 0.036) and physical exercise (P = 0.030) decreased MSNA burst frequency compared to the untreated control group. Low-frequency EA group reduced sagittal diameter (P = 0.001), while physical exercise group reduced body weight (P = 0.004) and body mass index (BMI) (P = 0.004) as compared to the untreated control group. Sagittal diameter was related to MSNA burst frequency (Rs = 0.58, P < 0.005) in the EA group. No correlation was found for BMI and MSNA in the exercise group. There were no differences between the groups in hemodynamic, endocrine and metabolic variables. Conclusions: For the first time we demonstrate that low-frequency EA and physical exercise lowers high sympathetic nerve activity in women with PCOS. Thus, treatment with low-frequency EA or physical exercise with the aim to reduce MSNA may be of importance for women with PCOS.
Am J Physiol Regul Integr Comp Physiol (June 3, 2009). doi:10.1152/ajpregu.00197.2009
Apr
21
Acupuncture benefits cortisol and prolactin levels in IVF patients
Posted by admin in IVF, acupuncture
Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization–embryo transfer treatment
Paul C. Magarelli, M.D.aCorresponding Author Informationemail address, Diane K. Cridennda, L.Acb, Mel Cohen, Ph.D.a
Received 22 May 2008; received in revised form 24 October 2008; accepted 28 October 2008. published online 31 December 2008.
Corrected Proof
Objective
To determine whether changes in serum cortisol (CORT) and PRL are affected by acupuncture (Ac) in Ac-treated IVF patients.
Design
Prospective cohort clinical study.
Setting
Private practice reproductive endocrinology and infertility clinic and private practice acupuncture consortium.
Patient(s)
Sixty-seven reproductive-age infertile women undergoing IVF.
Intervention(s)
Blood samples were obtained from all consenting new infertility patients and serum CORT and serum PRL were obtained prospectively. Patients were grouped as controls (IVF with no Ac) and treated (IVF with Ac) according to acupuncture protocols derived from randomized controlled trials.
Main Outcome Measure(s)
Serum levels of CORT and PRL were measured and synchronized with medication stimulation days of the IVF cycle (e.g., day 2 of stimulation, day 3, etc.). Reproductive outcomes were collected according to Society for Assisted Reproductive Technology protocols, and results were compared between controls and those patients treated with Ac.
Result(s)
CORT levels in Ac group were significantly higher on IVF medication days 7, 8, 9, 11, 12, and 13 compared with controls. PRL levels in the Ac group were significantly higher on IVF medication days 5, 6, 7, and 8 compared with controls.
Conclusion(s)
In this study, there appears to be a beneficial regulation of CORT and PRL in the Acupuncture group during the medication phase of the IVF treatment with a trend toward more normal fertile cycle dynamics.
Mar
17
Acupuncture improves sperm motility
Posted by admin in acupuncture, male infertility
Arch Androl. 1997 Sep-Oct;39(2):155-61.
Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality.
Siterman S, Eltes F, Wolfson V, Zabludovsky N, Bartoov B.
Institute of Chinese Medicine, Tel Aviv, Israel.
The aim of this prospective controlled study was to assess the effect of acupuncture on the sperm quality of males suffering from subfertility related to sperm impairment. Semen samples of 16 acupuncture-treated subfertile patients were analyzed before and 1 month after treatment (twice a week for 5 weeks). In parallel, semen samples of 16 control untreated subfertile males were examined. Two specimens were taken from the control group at an interval of 2-8 months. The expanded semen analysis included routine and ultramorphological observations. The fertility index increased significantly (p < or = .05) following improvement in total functional sperm fraction, percentage of viability, total motile spermatozoa per ejaculate, and integrity of the axonema (p < or = .05), which occurred upon treatment. The intactness of axonema and sperm motility were highly correlated (corr. = .50, p < or = .05). Thus, patients exhibiting a low fertility potential due to reduced sperm activity may benefit from acupuncture treatment.
Feb
8
Acupuncture improves ovarian morphology in PCOS by regulating overactive sympathetic nervous system
Posted by admin in acupuncture, polycystic ovaries
Acupuncture and exercise restore adipose tissue expression of sympathetic markers and improve ovarian morphology in rats with dihydrotestosterone-induced PCOS
Louise Mannerås,1 Stefan Cajander,2 Malin Lönn,3 and Elisabet Stener-Victorin1
1Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 2 Department of Pathology and Cytology, Sunderby County Hospital, Luleå, Sweden; and 3 Institute of Medicine, Wallenberg Laboratory, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Submitted 22 November 2008 ; accepted in final form 15 January 2009
Altered activity of the sympathetic nervous system, which innervates adipose and ovarian tissue, may play a role in polycystic ovary syndrome (PCOS). We hypothesize that electro-acupuncture (EA) and physical exercise reduce sympathetic activity by stimulating ergoreceptors and somatic afferent pathways in muscles. Here we investigated the effects of low-frequency EA and physical exercise on mRNA expression of sympathetic markers in adipose tissue and on ovarian morphology in female rats that received dihydrotestosterone (DHT) continuously, starting before puberty, to induce PCOS. At age 11 wk, rats with DHT-induced PCOS were randomly divided into three groups: PCOS, PCOS plus EA, and PCOS plus exercise. The latter two groups received 2-Hz EA (evoking muscle twitches) three times/week or had free access to a running wheel for 4–5 wk. In mesenteric adipose tissue, expression of ?3-adrenergic receptor (ADRB3), nerve growth factor (NGF), and neuropeptide Y (NPY) mRNA was higher in untreated PCOS rats than in controls. Low-frequency EA and exercise downregulated mRNA expression of NGF and NPY, and EA also downregulated expression of ADRB3, compared with untreated rats with DHT-induced PCOS. EA and exercise improved ovarian morphology, as reflected in a higher proportion of healthy antral follicles and a thinner theca interna cell layer than in untreated PCOS rats. These findings support the theory that increased sympathetic activity contributes to the development and maintenance of PCOS and that the effects of EA and exercise may be mediated by modulation of sympathetic outflow to the adipose tissue and ovaries.
sympathetic activity; ?3-adrenergic receptor; androgen receptor; nerve growth factor; neuropeptide Y
Sep
24
Acupuncture for male and female infertility – systematic review
Posted by admin in ART, IVF, acupuncture, female infertility, infertility, male infertility, polycystic ovaries
The Role of Acupuncture in the Management of Subfertility
Ng E H et al Fertil Steril. 2008 Jul;90(1):1-13.
Fertility and Sterility
Abstract
OBJECTIVE: To review systematically the use of acupuncture in the management of subfertility.
DESIGN: A computer search was performed via several English and Chinese databases to identify journals relevant to the subject.
RESULT(S): The positive effect of acupuncture in the treatment of subfertility may be related to the central sympathetic inhibition by the endorphin system, the change in uterine blood flow and motility, and stress reduction. Acupuncture may help restore ovulation in patients with polycystic ovary syndrome, although there are not enough randomized studies to validate this.
There is also no sufficient evidence supporting the role of acupuncture in male subfertility, as most of the studies are uncontrolled case reports or case series in which the sample sizes were small. Despite these deficiencies, acupuncture can be considered as an effective alternative for pain relief during oocyte retrieval in patients who cannot tolerate side effects of conscious sedation.
The pregnancy rate of IVF treatment is significantly increased, especially when acupuncture is administered on the day of embryo transfer.
CONCLUSION(S): Although acupuncture has gained increasing popularity in the management of subfertility, its effectiveness has remained controversial.
Feb
10
Systematic review: Acupuncture and IVF: Acupuncture improves rates of pregnancy and live birth
Posted by admin in ART, Chinese herbs, Chinese medicine, IVF, acupuncture, female infertility, infertility, male infertility, polycystic ovaries, stress/anxiety
Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis
Eric Manheimer, research associate1, Grant Zhang, assistant professor1, Laurence Udoff, assistant professor2, Aviad Haramati, professor3, Patricia Langenberg, professor and vice-chair4, Brian M Berman, professor1, Lex M Bouter, professor and vice chancellor (rector magnificus)5
1 Center for Integrative Medicine, University of Maryland School of Medicine, 2200 Kernan Drive, Kernan Hospital Mansion, Baltimore, MD 21207, USA, 2 Department of Obstetrics, Gynecology and Reproductive Services, University of Maryland School of Medicine, 3 Department of Physiology and Biophysics and Medicine, Georgetown University School of Medicine, Washington, DC, 4 Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 5 VU University Amsterdam De Boelelaan 1105, 1081 HV Amsterdam, the Netherlands
Correspondence to: E Manheimer emanheimer@compmed.umm.edu
Objective To evaluate whether acupuncture improves rates of pregnancy and live birth when used as an adjuvant treatment to embryo transfer in women undergoing in vitro fertilisation.
Design Systematic review and meta-analysis.
Data sources Medline, Cochrane Central, Embase, Chinese Biomedical Database, hand searched abstracts, and reference lists.
Review methods Eligible studies were randomised controlled trials that compared needle acupuncture administered within one day of embryo transfer with sham acupuncture or no adjuvant treatment, with reported outcomes of at least one of clinical pregnancy, ongoing pregnancy, or live birth. Two reviewers independently agreed on eligibility; assessed methodological quality; and extracted outcome data. For all trials, investigators contributed additional data not included in the original publication (such as live births). Meta-analyses included all randomised patients.
Data synthesis Seven trials with 1366 women undergoing in vitro fertilisation were included in the meta-analyses. There was little clinical heterogeneity. Trials with sham acupuncture and no adjuvant treatment as controls were pooled for the primary analysis. Complementing the embryo transfer process with acupuncture was associated with significant and clinically relevant improvements in clinical pregnancy (odds ratio 1.65, 95% confidence interval 1.27 to 2.14; number needed to treat (NNT) 10 (7 to 17); seven trials), ongoing pregnancy (1.87, 1.40 to 2.49; NNT 9 (6 to 15); five trials), and live birth (1.91, 1.39 to 2.64; NNT 9 (6 to 17); four trials). Because we were unable to obtain outcome data on live births for three of the included trials, the pooled odds ratio for clinical pregnancy more accurately represents the true combined effect from these trials rather than the odds ratio for live birth. The results were robust to sensitivity analyses on study validity variables. A prespecified subgroup analysis restricted to the three trials with the higher rates of clinical pregnancy in the control group, however, suggested a smaller non-significant benefit of acupuncture (odds ratio 1.24, 0.86 to 1.77).
Conclusions Current preliminary evidence suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing in vitro fertilisation.
Nov
16
Electro acupunture increases ovarian blod flow (PCOS)
Posted by admin in acupuncture, female infertility, infertility, polycystic ovaries
Effect of electro-acupuncture stimulation of different frequencies and intensities on ovarian blood flow in anaesthetized rats with steroid-induced polycystic ovaries
Elisabet Stener-Victorin1 ,2 , Rie Kobayashi3 , Orie Watanabe3 , Thomas Lundeberg4 and Mieko Kurosawa3
1Department of Physiology, Sahlgrenska Academy, Göteborg University, Box 432, SE-405 30 Göteborg, Sweden
2Department of Obstetrics and Gynecology, Sahlgrenska Academy, Göteborg University, Sahlgrenska University Hospital, Sahlgrenska, SE-413 45 Göteborg, Sweden
3Basic Medical Research Centre, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
4Department of Rehabilitation Medicine, Karolinska Hospital, SE-171 77 Stockholm, Sweden
Abstract
Background
Maintenance of ovarian blood flow (OBF) is suggested to be important for regular ovulation in women with polycystic ovaries (PCO). The purpose of the present study was to investigate whether electro-acupuncture (EA) of different frequencies and intensities can improve the OBF of anaesthetized rat in the animal model of PCO.
Methods
PCO was experimentally induced by a single intramuscular (i.m.) injection of estradiol valerate (EV) in rats. Control rats were given i.m. injection of oil. The involvement of the two ovarian sympathetic nerves; superior ovarian nerve (SON) and plexus ovarian nerve (OPN), in OBF responses was elucidated by severance of SON and OPN in both control and PCO rats. How systemic circulatory changes affect OBF was evaluated by continuous recording of the blood pressure. OBF was measured on the surface of the ovary-using laser Doppler flowmetry. Acupuncture needles were inserted bilaterally into the abdominal and hind limb muscles and connected to an electrical stimulator. Two frequencies – 2 Hz (low) and 80 Hz (high) – with three different intensities – 1.5, 3, and 6 mA – were applied for 35 s.
Results
Low-frequency EA at intensities of 3 and 6 mA elicited significant increases in OBF in the Control group compared to baseline. In the PCO group the increases in OBF were significant only when stimulating with low-frequency EA at 6 mA. After severance of the ovarian sympathetic nerves, the increased response of OBF that had been induced by low-frequency EA in both the Control and PCO group was abolished, indicating that the OBF response is mediated via the ovarian sympathetic nerves. High-frequency EA at 6 mA significantly decreased OBF and mean arterial blood pressure (MAP) in the Control group compared to baseline. In the PCO group, the same stimulation produced similar decreases in MAP, but not in OBF.
Conclusion
Low-frequency EA stimulation with a strong intensity (6 mA) increases OBF in rats with steroid-induced PCO whereas less strong intensity (3 mA) induces similar changes in control rats. Severance of the ovarian sympathetic nerves, abolish this OBF increase in both study groups, which suggests that the responses of OBF to EA are mediated via the ovarian sympathetic nerves.
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Oct
31
Acupuncture and Chinese Medicine for Chronic Pelvic Inflammation
Posted by admin in Chinese herbs, Chinese medicine, acupuncture, chronic pelvic inflammation
Hospital of Integrated Traditional and Western Medicine Affiliated to Zhejiang College of TCM, Hangzhou 31000, China.
OBJECTIVE: To observe the therapeutic effect of acupuncture and moxibustion on chronic pelvic inflammation. METHOD: Thirty-six cases of chronic pelvic inflammation were treated with acupuncture, the ancient recipe of Long Dan Xie Gan Tang ([symbol: see text] Decoction of Radix Gentianae for Purging the Pathogenic Fire of the Liver) and medicinal cake moxibustion. RESULT: The treatment resulted in cure in 9 cases, obvious effect in 16 cases, effect in 7 cases and no effect in 4 cases. CONCLUSION: Acupuncture, moxibustion and the ancient recipe Long Dan Xie Gan Tang used together can enhance the therapeutic effects on chronic pelvic inflammation.
Sep
3
How acupuncture stimulates ovulation (the mechanism)
Posted by admin in acupuncture, female infertility, infertility, polycystic ovaries
Clinical studies on the mechanism for acupuncture stimulation of ovulation
Mo X; Li D; Pu Y; Xi G; Le X; Fu Z Zhejiang College of Traditional Chinese Medicine, Hangzhou.
Ovulatory dysfunction is commonly seen in gynecology clinic. It may cause infertility, amenia, functional uterine bleeding and a variety of complications. This research according to TCM theory records treating with acupuncture 34 patients suffering from ovulatory dysfunction. Changes in clinical symptoms and some relative targets are reported, plus findings in animal experiments. The theory concerning the generative and physiologic axis of women, this research involved the following points; Ganshu (UB 18), Shenshu (UB 23), Guanyuan (Ren 4), Zhongji (Ren 3), and Sanyinjiao (Sp 6). The reinforcement and reduction of acupuncture enables it to strengthen liver and kidney. Through the Chong and Ren channels it nourishes uterus to adjust the patient’s axis function and recover ovulation. Treated on an average of 30 times, the patients’ symptoms improved to varying degrees. The marked effective rate was 35.29%, the total effective rate being 82.35%. BBT, VS, CMS, and B ultrasonic picture all improved to some degree. The results also showed that acupuncture may adjust FSH, LH, and E2 in two directions and raise the progesterone level, bringing them to normal. The animal experiments confirmed this result. Results showed that acupuncture may adjust endocrine function of the generative and physiologic axis of women, thus stimulating ovulation. The results of this research will provide some scientific basis for treating and further studying this disorder.
Aug
1
In anovulatory infertility cases the hyperactive sympathetic system can be depressed by electro acupuncture and the function of the hypothalamus-pituitary-ovarian axis can be regulated by electro acupuncture via central sympathetic system
Posted by admin in acupuncture, female infertility, polycystic ovaries
Relationship Between Blood Radioimmunoreactive Beta-Endorphin and Hand Skin Temperature During The Electro-Acupuncture Induction of Ovulation
By Chen Bo Ying M.D. Lecturer of Neurobiology
Institute of Acupuncture Research, and Yu Jin, MD., Prof of Gynecology Obstetricus and Gynecology Hospital Shanghai Medical University Shanghai, People’s Republic of China
Abstract:
Thirteen cycles of anovulation menstruation in 11 cases were treated with Electro-Acupuncture (EA) ovulation induction. In 6 of these cycles which showed ovulation, the hand skin temperature (HST) of these patients was increased after EA treatment. In the other 7 cycles ovulation was not induced. There were no regular changes in HST of 5 normal subjects. The level of radioimmunoreactive beta-endorphin (rß-E) fluctuated, and returned to the preacupunctural level in 30 min. after withdrawal of needles in normal subjects. After EA, the level of blood rß-E in cycles with ovulation declined or maintained the range of normal subjects. But the level of blood rß-E and increase of HST after EA (r=-0.677, P <0.01). EA is able to regulate the function of the hypothalamic pituitary-ovarian axis. Since a good response is usually accompanied with the increase of HST, monitoring HST may provide a rough but simple method for prediciting the curative effect of EA. The role of rß-E in the mechanism of EA ovulation induction was discussed.
KEYWORDS: Electro-Acupuncture (EA), Hand Skin Temperature (HST), radioimmunoreactive beta-endorphin (rß-E), ovulation, radioimmunoassay (RIA).
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Jun
17
Acupuncture, IVF/ICSI and follicle development
Posted by admin in ART, ICSI, IVF, acupuncture, female infertility
Acupuncture Treatment For Infertile Women Undergoing Intracytoplasmic Sperm injection
Sandra L. Emmons, MD
Phillip Patton, MD
Source: Medical Acupuncture, A Journal For Physicians By Physicians
Spring / Summer 2000- Volume 12 / Number 2
"Aurum Nostrum Non Est Aurum Vulgi"
| Table 1. Outcomes for Acupuncture vs Non-Acupuncture Cycles Among 6 Women Undergoing ICSI* | ||||||
|
Patient No.
|
Age, y
|
Non-Acupuncture Cycles
|
AcupunctureCycles
|
|||
| Follicles | Cycles | Follicles | Cycles | |||
| Mean No. | No. | Mean No. | No. | Outcome | ||
| 1 | 29 | 4.7 | 3 | 8 | 1 | IUP |
| 2 | 34 | 2 | 1 | 10 | 2 | SAB twice |
| 3 | 36 | 3 | 2 | 14 | 1 | SAB |
| 4 | 37 | 8 | 1 | 6 | 1 | No pregnancy |
| 5 | 38 | 1 | 1 | 4 | 1 | Cycle canceled |
| 6 | 41 | 2 | 1 | 6 | 1 | SAB |
| Mean (SD) | 3.7 (1.0) | 8.4 (1.3) | ||||
| *ICSI indicates intracytoplasmic sperm injection; IUP, intrauterine pregnancy; and SAB, early spontaneous abortion. P=.02 for overall acupuncture follicles vs non-acupuncture follicles. | ||||||
Jun
16
Chinese herbal medicine – higher success rates of pregnancy, no side-effects
Posted by admin in Chinese herbs, Chinese medicine, female infertility, infertility
Measuring the Effectiveness of Chinese Herbal Medicine in Improving Female Fertility
By: Trevor A. Wing & Elke S. Sedlmeier
Keywords: Infertility, Chinese herbal medicine, ultrasound, hormone levels.
Aim: To determine the relationship between female fertility indicators and the administration of
Chinese herbal medicine (CHM).
Design: A prospective cohort clinical study to measure accepted bio-medical
factors that affect female fertility and to determine if CHM can improve these factors as well as pregnancy outcome.
Setting: A private practice specialising in treating infertility with traditional Chinese medicine (TCM). The study took place between November 2003 and December 2004. Patient(s): Fifty women with the Western medical diagnosis of unexplained infertility.
Interventions: One monitored menstrual cycle measuring pre-treatment fertility factors, followed by treatment with Chinese herbal medicine and subsequent measurement of the changes in the same fertility factors.
Results: Significant differences were observed between the two time points for the majority of factors measured. Pregnancies in the sample group recorded 6 months after commencement of the last treatment were 28, with 11 live births and 7 miscarriages.
Conclusion: The study outcome demonstrates that using Chinese herbal medicine results in higher success rates of pregnancy, with no patient side-effects and a reduction in the category of patients conventionally classified as having unexplained infertility.
Introduction
The research question this study seeks to answer is “Does administering Chinese herbal medicine (CHM) improve the physiological factors affecting human female fertility?†The hypothesis is that administering CHM improves the main physiological factors affecting human female fertility and therefore also the pregnancy
rate. These factors are ovarian follicle number and size, uterine endometrium thickness, uterine artery
haemodynamics, serum follicle stimulating hormone (FSH), serum progesterone levels and corpus luteum
vascularity.
Research aims and objectives
1. Establish a sample group of 50 new patients registering for fertility treatment at a London natural health fertility clinic.
2. Test and record a predetermined group of twelve measurements prior to treatment during one menstrual cycle.
3. Administer CHM in capsule form for one menstrual cycle.
4. Re-test the same parameters in the third cycle of treatment, continue to administer CHM for six months (or until pregnancy is achieved if this occurs in less than six months). Follow up six months after the beginning of the last patient’s treatment
5. To determine the number of pregnancies achieved.
6. Analyse results and discuss findings.
7. Draw conclusions and make recommendations for further practice and study.
Methodology
The challenge for any investigative method when applied to traditional Chinese medicine (TCM) is that
in everyday practice, the same disease in different patients will have a different treatment principle
and herbal prescription. The information collected from the traditional Chinese examination and
assessment determines a diagnosis based on pattern differentiation and hence a treatment principle and
formula which is individualised for each patient. In our treatment of infertility there is, in addition,
a weekly modification of each patient’s formula. As there is thus no standardisation of formulae for
patients it is not appropriate to discuss the formulae themselves in this study, but rather to simply study
the effects of Chinese herbal medicine treatment on female fertility.
The method chosen was a prospective cohort primary study using a sample group of patients registered
with the clinic for TCM infertility treatment.
Patients were selected for the study on the basis that they had no Western medical condition which might have affected their fertility. In other words they were described in Western medical terms as having unexplained infertility. They also entered the study on the condition that data obtained in the course of their treatment could be used in the study anonymously.
Jun
16
Acupuncture – natural labour pain relief
Posted by admin in acupuncture
A retrospective analysis of the results of obstetric acupuncture at Frederiksberg Hospital
[Article in Danish]
Spellerberg E, Smidt-Jensen SL.
Fodeafdelingen, H:S Frederiksberg Hospital, DK-2000 Frederiksberg. eileen@spellerberg.net
INTRODUCTION: The use of obstetric acupuncture in Denmark is increasing but its use in routine clinical practice has not been evaluated. MATERIAL AND METHODS: This retrospective uncontrolled study comprises 691 women who attended Frederiksberg Hospital during pregnancy and delivery. Their mean age was 30.5 +/- 4.3 year, mean parity 1.3 +/- 0.6 (71.8% were primiparous), and the mean gestational age was 39 +/- 3.7 weeks. A total of 563 of the women (81.5%) were in labour. The effect of acupuncture was evaluated by the pregnant women alone for the pregnancy-related indications and by both women and midwifes for labour-related indications. RESULTS: The women had acupuncture based on 997 individual indications (mean 1.4 +/- 0.5). Twenty-two indications were used. 78.8% of all treatments were for pain relief or anxiety. The scores were highly correlated between women and midwives as 42.2 and 40.6%, respectively, indicated “full effect” and 33.3 and 33.4% indicated “some effect”. The midwives’ scores were independent of the women’s age, parity, gestational age and indication(s). One possible side effect was observed (temporary dropfoot). DISCUSSION: In this study, routine obstetric acupuncture was perceived as equally effective by the women and midwifes. The method is simple, inexpensive and without significant adverse effects. It deserves a place in the midwives’ armamentarium.
Ugeskr Laeger. 2003 Mar 3;165(10):1023-7.
May
23
Health care practitioners need to be proactive in acquiring and documenting use of complimentary therapies for infertility
Posted by admin in ART, acupuncture
The use of complementary medicine and therapies by patients attending a reproductive medicine unit in South Australia: A prospective survey
Marcin STANKIEWICZ 1, Caroline SMITH 2, Helen ALVINO 3 and Robert NORMAN 4
1Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders Medical Centre, 2Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, The University of Adelaide, 3Adelaide Hormone and Menopause Centre, Adelaide Fertility Centre Pty Ltd, and 4Discipline of Obstetrics and Gynaecology, Medical School North, The University of Adelaide, South Australia, Australia
Correspondence: Dr Marcin Stankiewicz, Flinders Reproductive Medicine Unit, Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders Medical Centre, Flinders Drive, Bedford Park, SA 5042, Australia. Email: marcin.stankiewicz@fmc.sa.gov.au
Key words : complementary therapies, reproductive techniques assisted, in vitro fertilisation, female infertility, male infertility, vitamins.
DOI: 10.1111/j.1479-828X.2007.00702.x
Abstract
Background: There is limited research describing the use of complementary medicines (CM) and therapies among patients with infertility.
Objective: (i) To examine the use of CM by subjects attending an infertility clinic at their first consultation and six months later; (ii) to examine men’s and women’s views on the effectiveness and safety of these practices; and (iii) to examine the documentation of the use of CMs and therapies in clinical notes.
Design: A prospective survey of 100 consecutive new patients presenting to an infertility clinic. Subjects were requested to complete a self-administered questionnaire at their first visit and six months later. A retrospective audit of 200 patient records.
Results: A response rate of 72% was obtained. Sixty-six percent of patients attending the infertility clinic in South Australia used CMs. Six months following the initial consultation the use of CMs had declined. The most commonly used CMs included multivitamins, herbs, and mineral supplements, and subjects consulted most frequently with naturopaths, chiropractors and acupuncturists. The use of CMs and therapies was poorly documented by clinical staff.
Conclusion: Complementary medicines and therapies are widely used by patients with infertility. Health-care practitioners and fertility specialists need to be proactive in acquiring and documenting the use of these practices. There is a need to provide further information to patients on the use of CMs and therapies. Further research examining the reasons for use of CMs and therapies is needed.
The Australian and New Zealand Journal of Obstetrics and Gynaecology
Volume 47 Issue 2 Page 145 – April 2007
Marcin STANKIEWICZ, Caroline SMITH, Helen ALVINO, Robert NORMAN (2007)
The use of complementary medicine and therapies by patients attending a reproductive medicine unit in South Australia: A prospective survey
The Australian and New Zealand Journal of Obstetrics and Gynaecology 47 (2), 145–149.
doi:10.1111/j.1479-828X.2007.00702.x
May
23
Premenstrual syndrome – PMS and acupuncture
Posted by admin in PMS, acupuncture, stress/anxiety
Using acupuncture to treat premenstrual syndrome.
Habek D, Habek JC, Barbir A.
Department of Gynecology and Obstetrics, Health Centre, Bjelovar, Croatia. dubravko.habek@bj.hinet.hr
More than 60% of the women in both groups suffered from premenstrual syndrome (PMS or PMT) symptoms, such as anxiety, mastalgia, insomnia, nausea and gastrointestinal disorders, whereas a smaller number of women suffered from phobic disorders, premenstrual headaches and migraines. There were three women from the first group and seven women from the second group who continued the medication treatment with progestins, whereas one woman from the first group and nine women from the second group continued to take fluoxetine. In the first group, nine women stopped having PMS symptoms after two AP treatments, eight women stopped having them after three treatments and one woman stopped having them after four treatments. In four women from the first group and 16 women from the second group, PMS symptoms appeared during the following period (cycle) or continued even after four treatments, so the medication was continued. In the first group, one woman had a smaller subcutaneous hematoma after the AP acupoint Ren 6. There was a statistical and relevant reduction in PMS symptoms with the AP treatments in the first group (P<0.001), whereas their reduction was irrelevant in the placebo AP group (P>0.05). The success rate of AP in treating PMS symptoms was 77.8%, whereas it was 5.9%. in the placebo group. The positive influence of AP in treating PMS symptoms can be ascribed to its effects on the serotoninergic and opioidergic neurotransmission that modulates various psychosomatic functions. The initial positive results of PMS symptoms with a holistic approach are encouraging and AP should be suggested to the patients as a method of treatment.
Arch Gynecol Obstet. 2002 Nov;267(1):23-6.
May
23
How acupuncture works: mechanisms of electro acupuncture and clinical application.
Posted by admin in acupuncture, dysmenorrhoea, stress/anxiety
Electroacupuncture: mechanisms and clinical application.
Ulett GA, Han S, Han JS.
University of Missouri-Columbia, School of Medicine, St. Louis 63139, USA.
Acupuncture is an ancient Chinese method to treat diseases and relieve pain. We have conducted a series of studies to examine the mechanisms of this ancient method for pain relief. This article reviews some of our major findings. Our studies showed that acupuncture produces analgesic effect and that electroacupuncture (EA) is more effective than manual acupuncture. Furthermore, electrical stimulation via skin patch electrodes is as effective as EA. The induction and recovering profiles of acupuncture analgesia suggest the involvement of humoral factors. This notion was supported by cross-perfusion experiments in which acupuncture-induced analgesic effect was transferred from the donor rabbit to the recipient rabbit when the cerebrospinal fluid (CSF) was transferred. The prevention of EA-induced analgesia by naloxone and by antiserum against endorphins suggests that endorphins are involved. More recent work demonstrated the release of endorphins into CSF following EA. In addition, low frequency (2 Hz) and high frequency (100 Hz) of EA selectively induces the release of enkephalins and dynorphins in both experimental animals and humans. Clinical studies suggesting its effectiveness for the treatment of various types of pain, depression, anxiety, spinally induced muscle spasm, stroke, gastrointestinal disorders, and drug addiction were also discussed.
Biol Psychiatry. 1998 Jul 15;44(2):129-38.
May
22
Acupuncture pain relief egg retrieval means good pain relief, higher implantation rate, higher pregnancy rate, and take home baby rate
Posted by admin in ART, IVF, acupuncture
A prospective randomized study of electro-acupuncture versus alfentanil as anaesthesia during oocyte aspiration in in-vitro fertilization
Elisabet Stener-Victorin1,4, Urban Waldenström2, Lars Nilsson1, Matts Wikland3 and Per Olof Janson1
1 Department of Obstetrics and Gynaecology, Göteborg University, SE-413 45 Göteborg, 2 IVF Center Falun, SE-791 82 Fallun, 3 Fertility Centre Scandinavia, SE-402 29 Göteborg, Sweden
The aim of the present study was to evaluate the anaesthetic effect during oocyte aspiration of a paracervical block (PCB) in combination with either electro-acupuncture (EA) or intravenous alfentanil. In all, 150 women undergoing in-vitro fertilization (IVF) and embryo transfer were randomized to receive either EA plus PCB or alfentanil plus PCB. Visual analogue scales (VAS) were used to evaluate subjective experiences during oocyte aspiration, and IVF outcome parameters were recorded. No differences in pain directly related to oocyte aspiration, adequacy of anaesthesia during oocyte aspiration, abdominal pain, or degree of nausea were found between the two groups in the VAS ratings. Before oocyte aspiration, the level of stress was significantly higher in the EA group than in the alfentanil group (P < 0.05), and the EA group experienced discomfort for a significantly longer period during oocyte aspiration (P < 0.01). Compared with the alfentanil group, the EA group had a significantly higher implantation rate (P < 0.05), pregnancy rate (P < 0.05), and take home baby rate (P < 0.05) per embryo transfer. In conclusion, EA has been shown to be as good an anaesthetic method as alfentanil during oocyte aspiration, and we suggest that EA may be a good alternative to conventional anaesthesia during oocyte aspiration.
Key words: alfentanil/anaesthesia/electro-acupuncture/implantation rate/oocyte aspiration, ivf
4 To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, Kvinnokliniken, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden
Human Reproduction, Vol. 14, No. 10, 2480-2484, October 1999
© 1999 European Society of Human Reproduction and Embryology
May
21
Acupuncture reduces insomnia and anxiety by increasing night time melatonin
Posted by admin in acupuncture, stress/anxiety
Acupuncture increases nocturnal melatonin secretion and reduces insomnia and anxiety: a preliminary report.
Spence DW, Kayumov L, Chen A, Lowe A, Jain U, Katzman MA, Shen J, Perelman B, Shapiro CM.
Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
The response to acupuncture of 18 anxious adult subjects who complained of insomnia was assessed in an open prepost clinical trial study. Five weeks of acupuncture treatment was associated with a significant (p = 0.002) nocturnal increase in endogenous melatonin secretion (as measured in urine) and significant improvements in polysomnographic measures of sleep onset latency (p = 0.003), arousal index (p = 0.001), total sleep time (p = 0.001), and sleep efficiency (p = 0.002). Significant reductions in state (p = 0.049) and trait (p = 0.004) anxiety scores were also found. These objective findings are consistent with clinical reports of acupuncture’s relaxant effects. Acupuncture treatment may be of value for some categories of anxious patients with insomnia.
J Neuropsychiatry Clin Neurosci. 2004 Winter;16(1):19-28.
May
21
Naturally reduce pain of Dysmenorrhoea (cramps or painful menstruation) with acupressure
Posted by admin in acupressure, dysmenorrhoea
Effects of acupressure at the Sanyinjiao point on primary dysmenorrhoea.
Chen HM, Chen CH.
Assistant Professor, Chung Hwa College of Medical Technology, Tainan, Taiwan.
AIM: This paper presents the findings of a study that assessed the effects of acupressure at the Sanyinjiao point on symptoms of primary dysmenorrhoea among adolescent girls. BACKGROUND: Dysmenorrhoea is the most common gynaecological disorder among adolescents. Traditional Chinese acupressure derived from acupuncture is a non-invasive technique. Despite renewed interest in the use of acupressure, relatively few studies have been undertaken to examine its effects on primary dysmenorrhoea. METHODS: An experimental study was conducted between December 2000 and August 2001. Participants were female students attending a technical college in Taiwan. None of the 69 participants had a prior history of gynaecological disease or secondary dysmenorrhoea, and all were rated higher than five for pain on a visual analogue scale from 0 to 10. The experimental group (n = 35) received acupressure at Sanyinjiao (above the ankle) while the control group (n = 34) rested for 20 min, while the control group underwent rest in the school health centre for 20 min without receiving acupressure. Fifty participants (30 experimental, 20 control) completed the 4-6-week follow-up session. Five instruments were used to collect pretest and post-test data at each session: (1) Visual Analogue Scale for pain; (2) the Short-Form McGill Pain Questionnaire; (3) the Menstrual Distress Questionnaire; (4) the Visual Analogue Scale for anxiety; and, for the experimental group only, (5) the Acupressure Self-Assessment Form. Data were analysed using the chi-square test, two-sample t-test and repeated measures two-way anova. RESULTS: Acupressure at Sanyinjiao during the initial session reduced the pain and anxiety typical of dysmenorrhoea. In the self-treatment follow-up session, acupressure at Sanyinjiao significantly reduced menstrual pain but not anxiety. Thirty-one (87%) of the 35 experimental participants reported that acupressure was helpful, and 33 (94%) were satisfied with acupressure in terms of its providing pain relief and psychological support during dysmenorrhoea.
CONCLUSION: The findings suggest that acupressure at Sanyinjiao can be an effective, cost-free intervention for reducing pain and anxiety during dysmenorrhoea, and we recommend its use for self-care of primary dysmenorrhoea.
J Adv Nurs. 2004 Nov;48(4):380-7.