Chinese herbs – higher success rates of pregnancy (unexplained infertility)

Measuring the Effectiveness of Chinese Herbal Medicine in Improving Female Fertility

By: Trevor A. Wing & Elke S. Sedlmeier

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 Read more

Combination of western and Chinese medicine is the most effective method in treating tubal obstruction

FALLOPIAN TUBE DYSFUNCTION AND CHINESE HERBAL MEIDCINE

A study was carried out in Guangzhou, China, to find an effective treatment for tubal obstruction. The results of 120 women divided into three treatment groups were compared. One group received a combination of Western medical treatment and Chinese herbal medicine, one group received Chinese herbal medicine only and another group received Western medical treatment only. After treatment, the fallopian tube patency rate 86.7% and the pregnancy rate 85.0% in the TCM/ WM group, 66.7% and 63.3% in the TCM group and 53.3% and 50% in the WM group respectively. The effectiveness in the combination group was significant. The authors conclude that the combination of western and Chinese medicine is the most effective method in treating tubal obstruction.
Kang JL, XIa W, He QY.'[Clinical study on treatment of oviduct obstruction by integrative traditional Chinese and Western medicine]. Zhongguo Zhong Xi Yi Jie He ZaZhi. 2001, 21 (6): 416-8.

Luteal-phase acupuncture improves outcomes of IVF/ICSI

fertility and sterility acupunctureDieterle S, Ying G, Hatzmann W, Neuer A.

Fertil Steril. 2006 May;85(5):1347-51. Epub 2006 Apr 17.

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Witten/Herdecke, Dortmund, Germany. Dieterle@IVF-Dortmund.de

OBJECTIVE: To determine the effect of luteal-phase acupuncture on the outcome of IVF/intracytoplasmic sperm injection (ICSI). DESIGN: Randomized, prospective, controlled clinical study.

SETTING: University IVF center.

PATIENT(S): Two hundred twenty-five infertile patients undergoing IVF/ICSI.

INTERVENTION(S): In group I, 116 patients received luteal-phase acupuncture according to the principles of traditional Chinese medicine. In group II, 109 patients received placebo acupuncture. MAIN OUTCOME MEASURE(S): Clinical and ongoing pregnancy rates.

RESULT(S): In group I, the clinical pregnancy rate and ongoing pregnancy rate (33.6% and 28.4%, respectively) were significantly higher than in group II (15.6% and 13.8%). CONCLUSION(S): Luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI.

Chinese medicine/herbs and PCOS

Clinical observation on treatment of 43 women with polycystic ovary syndrome based on syndrome differentiation

[Article in Chinese]

Jia LN, Wang XJ.

Department of Gynecology of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.

OBJECTIVE: To investigate the therapeutic effect of treatment based on syndrome differentiation and its influence on the serum levels of testosterone and insulin in women with polycystic ovary syndrome (PCOS). METHODS: Forty-three women, diagnosed with PCOS as well as syndrome of kidney yin deficiency or syndrome of spleen qi deficiency, were enrolled in the study. Twenty-five PCOS women with syndrome of kidney yin deficiency were treated with traditional Chinese herbs for nourishing yin to reduce fire (nourishing yin group), and 18 PCOS women with syndrome of spleen qi deficiency were treated with herbs for invigorating spleen and replenishing qi (replenishing qi group). Body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC), and the serum levels of insulin and testosterone before and after treatment were detected. RESULTS: Among the 43 cases, 20 cases had high serum testosterone level, in which 13 cases with syndrome of kidney yin deficiency, 7 cases with syndrome of spleen qi deficiency, but the difference had no statistic significance; 17 cases had high serum insulin level, in which 11 cases with syndrome of spleen qi deficiency, 6 cases with syndrome of kidney yin deficiency, the difference had statistic significance (P<0.05). In nourishing yin group, the serum levels of insulin and testosterone declined after treatment (P<0.05), and BMI, WHR and WC showed no significant changes. In replenishing qi group, the serum level of insulin declined after treatment (P<0.01), and BMI, WHR, WC and the serum level of testosterone showed no significant changes. CONCLUSION: Traditional Chinese herbs for nourishing yin to reduce fire can significantly reduce the serum levels of testosterone and insulin in PCOS women with syndrome of kidney yin deficiency, and herbs for invigorating spleen and replenishing qi can significantly reduce the serum level of insulin in PCOS women with syndrome of spleen qi deficiency. Zhong Xi Yi Jie He Xue Bao. 2006 Nov;4(6):585-8.

Acupuncture on the day of IVF/ICSI embryo transfer significantly improves the outcome

Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial
National Institute of Environmental Health Sciences

Vienna, Austria: There was heartening news today (Wednesday 3 July) for would-be parents worried because they had difficulty conceiving. A new study being presented to Europe’s leading reproductive medicine conference shows that most healthy couples concerned because the woman was not pregnant after a year of trying will conceive during the second year.

A US team from the National Institute of Environmental Health Sciences in North Carolina who analysed data on 782 couples from seven European cities1, concluded that even when the woman was aged between 35 and 39, fewer than 1 in 10 failed to conceive after 2 years unless the male partner was over 40.

Lead investigator Dr David Dunson suggested that couples should be patient and doctors should not intervene too fast with assisted reproductive techniques unless there are known reasons for a couple not conceiving naturally within a year.

He told the annual conference of the European Society of Human Reproduction and Embryology that recent research undertaken by his team showed that fertility in women started to decline as early as the late 20s and for men from their late 30s2 . But, this was due primarily to declines in the per menstrual cycle conception rate and not to an increase in the proportion of couples unable to achieve an unassisted pregnancy.

Now his team has extended their research using data from the European Fecundability Study to see what the implications are for fertility rates overall.

“On average the time to pregnancy increases with the age of the woman. The percentage failing to conceive within a year ranged from 8% for 19-26-year-olds to 13 to 14% for 27 to 34-year-olds to 18% for 35-39-year-olds.”

“But, regardless of age, most of the women who failed to conceive within the first 12 cycles conceived in the next 12. Only 3% of 19 to 26-year-olds, 6% of 27 to 34-year-olds and 9% of 35 to 39-year-olds failed to conceive in the second year, provided the male partner was aged under 40. Starting in the late 30s though, male age was also important: it meant that the percentage of failures after one year for women aged 35 to 39 rose from 18% to 28% if the male partner was over 40. After the second year the figure was 9% with male partners under 40 and 16% with male partners over 40.”

Dr Dunson said there were clear increases with age in the number of menstrual cycles needed to achieve pregnancy and in the probability of being classified as clinically infertile – a definition applied after a year of trying to conceive.

But, their research had clearly shown that among outwardly healthy couples with no known conditions associated with infertility, most who failed to conceive naturally within the first year will conceive naturally in the second year – regardless of age.

“So, in the absence of clinical indicators of infertility in addition to a long time to pregnancy, it may be appropriate to delay assisted reproduction until the couple has failed to conceive naturally in 18 to 24 months. There is a large amount of normal variability in fertility and many couples having below average, but normal fertility may fail to conceive within a year. This is particularly true for older couples, many of whom fail to conceive within the first year but are successful in the second.”

He said it was important for doctors to avoid recommending assisted reproduction too soon due to well-documented side effects. “Fertility treatment, such as IVF and ICSI, can result in an increased risk of multiple pregnancies, pregnancy complications, low birth weight, major birth defects and long-term disability among surviving infants. In addition, the chance of success with ART decreases with age, while the side effects increase in prevalence.”

1 Data were drawn from a large multinational study – the European Study of Daily Fecundability. It enrolled 782 women aged between 18 and 40 from seven centres – Milan, Verona, Lugano, Dusseldorf, Paris, London and Brussels. The participants kept daily records of basal body temperature and recorded the days on which intercourse and menstrual bleeding occurred. Data on 7,288 menstrual cycles contributed to the study.

2 Changes with age in the level and duration of fertility in the menstrual cycle. Human Reproduction. D. Dunson et al. Vol. 17. No 5. pp 1399-1403

Coffee linked to doubled fetal death rates

Coffee linked to doubled fetal death rates
American Journal of Epidemiology 2005; 162: 983-90

Investigating whether coffee consumption during pregnancy is associated with late fetal death.

Women who drink eight or more cups of coffee a day are twice as likely as women who do not drink coffee to miscarry or have a stillbirth, a survey suggests.

While adjusting for other risk factors attenuated the association, the researchers think the results justify advice for pregnant women to drink no more than three cups of coffee a day.

Coffee drinking has been repeatedly associated with adverse pregnancy outcomes, and plausible mechanisms have been proposed to explain the link; yet some people still question its risks, explained lead author Bodil Hammer Bech from the University of Aarhus in Denmark.

To investigate, Bech and colleagues surveyed 88,482 pregnant women enrolled in the Danish National Birth Cohort about their coffee intake and potential confounding factors, at 16 weeks’ gestation.

After adjustment for confounders, the researchers found that the risk of fetal death was increased by 3 percent for women who drank one-half to three cups of coffee daily, compared with abstainers, by 33 percent for those who drank four to seven cups a day, and by 59 percent for women who drank eight or more cups daily.

No link was found between fetal death and tea or cola intake, however, indicating that some compound in coffee other than caffeine may underlie the observed effect.

Acupuncture and good prognosis IVF patients

Acupuncture and good prognosis IVF patients: Synergy.

P. C. Magarelli, D. K. Cridennda, M. Cohen. Reproductive Medicine & Fertility Center, Colorado Springs, CO; East Winds Acupuncture, Inc., Colorado Springs, CO.

OBJECTIVE: To determine the role of electro stimulation acupuncture and traditional combined with auricular acupuncture on IVF outcomes in good prognosis patients.
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Acupuncture & IVF Poor Responders: A Cure?

P.C. Magarelli, D.K. Cridennda. Reproductive Medicine & Fertility Center, Colorado Springs, CO.

Background and Significance: The utility of acupuncture in the treatment of infertility has been demonstrated in two controlled studies. The first study determined the effect of reducing the Pulsatility Index (PI) of the uterine artery on reproductive outcomes; the second study described a Pre/Post embryo transfer protocol that enhanced overall pregnancy rates (PR). There are no studies that have utilized both techniques.

Objective: The purpose of the study was to determine the influence of these two acupuncture protocols on IVF outcomes and secondly to identify the appropriate patient groups that would most benefit from this adjunctive therapy.
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A preliminary immunopharmacological study of an antiendometriotic herbal medicine, Keishi-bukuryo-gan

Tanaka T; Mizuno K; Umesaki N; Ogita S Department of Obstetrics & Gynecology, Osaka City University Medical School, Japan.Osaka City Med J, 44(1):117-24 1998 Jun (ISSN: 0030-6096)

Changes in the specific antiendometrial IgM antibodies in an endometriotic patient, who were treated with leuproride acetate and in turn with Keishi-bukuyogan, were investigated by the flowcytometric analysis which was developed in our laboratory. The oriental therapy decreased the specific IgM antibody titer gradually and kept the patient symptom-free for more than 7 months without any suppression of serum CA125 and estradiol levels. On the other hand, leuproride acetate therapy suppressed both serum CA125 and serum estradiol levels but not the IgM antibody titer. The results suggest that the specific antiendometrial IgM autoantibody could be a pathogenic molecule in endometriosis and it could also serve as a clinical marker for the oriental therapy of endometriosis.

Acupuncture prior to and at IVF embryo transfer

Acupunct Med. 2006 Mar;24(1):23-8.

Acupuncture prior to and at embryo transfer in an assisted conception unit–a case series.
Johnson D.

Chobham Acupuncture Clinic, Chobham, Surrey. info@acupuncture-chobham.co.uk

Over a period of three years, acupuncture was offered to patients entering assisted reproduction therapy. Acupuncture sessions were given at varying, but usually weekly, intervals during the in vitro fertilisation (IVF) cycle, and immediately before and after embryo transfer. Twenty two patients (average age 36.2 years) were treated over a total of 26 IVF cycles and 15 pregnancies were achieved, as determined by presence of foetal heartbeat on ultrasound at four weeks post embryo transfer. This was a success rate of 57.7% compared with 45.3% for patients in the IVF unit not treated with acupuncture (P > 0.05). Relaxing effects were noted following acupuncture and it is speculated that this may have contributed to the increase in pregnancy rate for the acupuncture group.

Auricular acupuncture in the treatment of female infertility

Auricular acupuncture in the treatment of female infertility

Gerhard I; Postneek F Department of Gynecological Endocrinology and Reproduction, Women’s Hospital, University of Heidelberg, Germany.

Gynecol Endocrinol 1992 Sep;6(3):171-81 (ISSN: 0951-3590)

Following a complete gynecologic–endocrinologic workup, 45 infertile women suffering from oligoamenorrhea (n = 27) or luteal insufficiency (n = 18) were treated with auricular acupuncture. Results were compared to those of 45 women who received hormone treatment. Both groups were matched for age, duration of infertility, body mass index, previous pregnancies, menstrual cycle and tubal patency. Women treated with acupuncture had 22 pregnancies, 11 after acupuncture, four spontaneously, and seven after appropriate medication. Women treated with hormones had 20 pregnancies, five spontaneously, and 15 in response to therapy. Four women of each group had abortions. endometriosis (normal menstrual cycles) was seen in 35% (38%) of the women of each group who failed to respond to therapy with pregnancy. Only 4% of the women who responded to acupuncture or hormone treatment with a pregnancy had endometriosis, and 7% had normal cycles. In addition, women who continued to be infertile after hormone therapy had higher body mass indices and testosterone values than the therapy responders from this group. Women who became pregnant after acupuncture suffered more often from menstrual abnormalities and luteal insufficiency with lower estrogen, thyrotropin (TSH) and dehydroepiandrosterone sulfate (DHEAS) concentrations than the women who achieved pregnancy after hormone treatment. Although the pregnancy rate was similar for both groups, eumenorrheic women treated with acupuncture had adnexitis, endometriosis, out-of-phase endometria and reduced postcoital tests more often than those receiving hormones. Twelve of the 27 women (44%) with menstrual irregularities remained infertile after therapy with acupuncture compared to 15 of the 27 (56%) controls treated with hormones, even though hormone disorders were more pronounced in the acupuncture group. Side-effects were observed only during hormone treatment. Various disorders of the autonomic nervous system normalized during acupuncture. Based on our data, auricular acupuncture seems to offer a valuable alternative therapy for female infertility due to hormone disorders.

Acupuncture and ART

Controlled trial of acupuncture effects in assisted reproduction therapy
Paulus W.E.1, Zhang M.2, Strehler E.1, Seybold B.1 and Sterzik K.Christian-Lauritzen-Institut, Reproductive Medicine, Ulm, Germany and 2Tongji Medical University, Department of Traditional Chinese Medicine, Wuhan, China

Introduction: In a former published prospective randomized study we demonstrated the benefitt of acupuncture on the pregnancy rate in assisted reproduction therapy by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer, with a control group receiving no acupuncture. To rule out the possibility that acupuncture produces only psychological or psychosomatic effects, we used a placebo needle set as a control in the present study.

Materials and Methods:Two hundred patients undergoing ICSI or IVF in our fertility centre were included in this prospective, randomized, placebo controlled trial. Only patients with good embryo quality were admitted. They were divided into two groups by random selection: embryo transfer with verum acupuncture (n = 100) and embryo transfer with placebo needling (n = 100). Verum acupuncture was performed in 100 patients 25 min before and after embryo transfer. In the control group (n = 100) a placebo needle set was used without penetrating the skin, but at the same acupoints and after the same scheme. Before embryo transfer we used the following locations: Cx6 (Neiguan), Sp8 (Diji), Liv3 (Taichong), Gv20 (Baihui) and S29 ( Guilai). After embryo transfer, the sterile disposable stainless steel needles (0.25 3 25 mm) were inserted at the following points: S36 (Zusanli), Sp6 (Sanyinjiao), Sp10 (Xuehai) and Li4 (Hegu). After 10 min the needles were rotated. The main outcome measure was clinical pregnancy defined by the presence of a fetal sac at ultrasound examination 6 weeks after embryo transfer. The Chi-squared test was used for comparison of both groups.

Results: Clinical pregnancies were documented in 43 of 100 patients (43.0%) in the acupuncture group, whereas pregnancy rate reached 37.0% (37 out of 100 patients) in the control group. A significant difference between verum acupuncture and placebo needling could not be demonstrated (P = 0.39).

Conclusion:The missing advantage of verum acupuncture versus placebo needling may be due to the methodical problem that real placebo models for acupuncture are lacking. Our placebo needle set induces an acupressure effect thus leading to a higher pregnancy rate than in our population without any complementary treatment.

Effects of Electro-Acupuncture on Nerve Growth Factor and Ovarian Morphology in Rats with Experimentally Induced Polycystic Ovaries

human-reproduction-infertility-acupuncture

Effects of Electro-Acupuncture on Nerve Growth Factor and Ovarian Morphology in Rats with Experimentally Induced Polycystic Ovaries

1

Elisabet Stener-Victorin

2,a, Thomas Lundebergb, Urban Waldenströma, Luigi Mannic, Luigi Aloec, Stefan Gunnarssond, and Per Olof Jansona

a Department of Obstetrics and Gynecology, Göteborg University, SE-413 45 Göteborg, Sweden b Department of Physiology and Pharmacology, Karolinska Institutet, SE-164 01 Stockholm, Sweden c Institute of Neurobiology (CNR), Rome, Italy d Department of Evolutionary Biology, SE-752 36 Uppsala, Sweden

ABSTRACT

Despite extensive research on the pathogenesis of polycystic ovary syndrome (PCOS), there is still disagreement on the underlying mechanisms. The rat model for experimentally induced polycystic ovaries (PCO)—produced by a single injection of estradiol valerate—has similarities with human PCOS, and both are associated with hyperactivity in the sympathetic nervous system. Nerve growth factor (NGF) is known to serve as a neurotrophin for both the sympathetic and the sensory nervous systems and to enhance the activity of catecholaminergic and possibly other neuron types. Electro-acupuncture (EA) is known to reduce hyperactivity in the sympathetic nervous system. For these reasons, the model was used in the present study to investigate the effects of EA (12 treatments, approximately 25 min each, over 30 days) by analyzing NGF in the central nervous system and the endocrine organs, including the ovaries. The main findings in the present study were first, that significantly higher concentrations of NGF were found in the ovaries and the adrenal glands in the rats in the PCO model than in the control rats that were only injected with the vehicle (oil or NaCl). Second, that repeated EA treatments in PCO rats resulted in concentrations of NGF in the ovaries that were significantly lower than those in non-EA-treated PCO rats but were within a normal range that did not differ from those in the untreated oil and NaCl control groups. The results in the present study provide support for the theory that EA inhibits hyperactivity in the sympathetic nervous system.

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