The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: a pilot study.
Balk J, Catov J, Horn B, Gecsi K, Wakim A.
Abstract
The aim of this paper was to determine 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. The study was an observational, prospective, cohort study based at the University IVF center.
PATIENT(S): 57 infertile patients undergoing IVF or IVF/ICSI. INTERVENTIONS(S): Patients were undergoing Embryo Transfer with or without acupuncture as part of their standard clinical care.
MAIN OUTCOME MEASURE(S): Perceive Stress Scale scores, pregnancy rates.
RESULT(S): women who received this acupuncture regimen achieved pregnancy 64.7%, whereas those without acupuncture achieved pregnancy 42.5%. When stratified by donor recipient status, only non-donor recipients potentially had an improvement with acupuncture (35.5% without acupuncture vs. 55.6% with acupuncture). Those who received this acupuncture regimen had lower stress scores both pre-ET and post-ET compared to those who did not. Those with decreased their perceived stress scores compared to baseline had higher pregnancy rates than those who did not demonstrate this decrease, regardless of acupuncture status.
CONCLUSIONS(S): The acupuncture regimen was associated with less stress both before and after embryo transfer, and it possibly improved pregnancy rates. Lower perceived stress at the time of embryo transfer may play a role in an improved pregnancy rate.
In this study acupuncture effectively helped patients suffering from both reduced sperm motility and low sperm count. This kind of condition is called oligoasthenozoospermia. The study showed that acupuncture significantly improved percentage of motile sperm.
Fertil Steril. 2009 Oct;92(4):1340-3. doi: 10.1016/ j.fertnstert. 2009.02.041. Epub 2009 Apr 25.
A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia.
Dieterle S, Li C, Greb R, Bartzsch F, Hatzmann W, Huang D.
Source
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Witten/Herdecke, Dortmund, Germany. dieterle@ivf-dortmund.de
Abstract
In this first prospective, randomized, single-blind, placebo-controlled study, 28 infertile patients with severe oligoasthenozoospermia received acupuncture according to the principles of traditional Chinese medicine (TCM) and 29 infertile patients received placebo acupuncture. A significantly higher percentage of motile sperm (World Health Organization categories A-C), but no effect on sperm concentration, was found after acupuncture compared with placebo acupuncture.
Acupuncture improves sperm quality. The mechanism of this improvement may lay in decreased temperature of the scrotum.
It’s well known that sperm doesn’t like heat. Inflammation is one of the worst sources of heat you can have. In this study acupuncture normalised scrotal temperature in patients who had inflammation. But it didn’t affect the guys who had a healthy temperature at the start of the study. It shows acupuncture’s regulatory effect – it helps for the body to self regulate, but it doesn’t disrupt healthy balance.
But most importantly, 15 out of 17 men who had improved sperm count.
Success of acupuncture treatment in patients with initially low sperm output is associated with a decrease in scrotal skin temperature.
Siterman S, Eltes F, Schechter L, Maimon Y, Lederman H, Bartoov B.
Abstract
Poor spermatogenesis in patients with inflammation of the genital tract is associated with scrotal hyperthermia. These patients can benefit from acupuncture treatment. We conducted a study to verify whether the influence of acupuncture treatment on sperm output in patients with low sperm density is associated with a decrease in scrotal temperature.
The experimental group included 39 men who were referred for acupuncture owing to low sperm output. The control group, which comprised 18 normal fertile men, was used to define a threshold (30.5 degrees C) above which scrotal skin temperature was considered to be high. Accordingly, 34 of the 39 participants in the experimental group initially had high scrotal skin temperature; the other five had normal values. Scrotal skin temperature and sperm concentration were measured before and after acupuncture treatment. The five patients with initially normal scrotal temperatures were not affected by the acupuncture treatment.
Following treatment, 17 of the 34 patients with hyperthermia, all of whom had genital tract inflammation, had normal scrotal skin temperature; in 15 of these 17 patients, sperm count was increased. In the remaining 17 men with scrotal hyperthermia, neither scrotal skin temperature nor sperm concentration was affected by the treatment.
About 90% of the latter patients suffered from high gonadotropins or mixed etiological factors. Low sperm count in patients with inflammation of the genital tract seems to be associated with scrotal hyperthermia, and, consequently, acupuncture treatment is recommended for these men.
Chinese herbal medicine for endometriosis a publication in one of the most prestigious evidence journals. Evidence doesn’t get stronger than this.
Chinse herbal medicine outperformed conventional drugs in endometriosis management. Authors concluded that Chinese medicine has fewer side effects, but similar benefits to gestrinone. Oral Chinese medicine tinctures may have a better effect than danazol in relieving dysmenorrhea, even shrinking adnexal masses when used in combination with a Chinese medicine enema.
Chinese herbs for endometriosis
Flower A, Liu JP, Chen S, Lewith G, Little P
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.
https://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.png00Vitalis Skiauterishttps://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.pngVitalis Skiauteris2009-07-09 15:47:422021-09-24 09:00:18Chinese herbal medicine vs gestrinone for endometriosis
Low-frequency Electro-Acupuncture and Physical Exercise Decrease High Muscle Sympathetic Nerve Activity in Polycystic Ovary Syndrome
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
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.
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.
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.
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.
https://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.png00Vitalis Skiauterishttps://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.pngVitalis Skiauteris2008-09-24 14:31:362021-09-24 08:58:33Acupuncture for male and female infertility – systematic review
Stress and reproductive failure: past notions, present insights and future directions Journal Journal of Assisted Reproduction and Genetics
Publisher Springer Netherlands
ISSN 1058-0468 (Print) 1573-7330 (Online)
Issue Volume 25, Numbers 2-3 / March, 2008
Category REPRODUCTIVE IMMUNOLOGY
DOI 10.1007/s10815-008-9206-5
Pages 47-62
Subject Collection Medicine
SpringerLink Date Friday, February 15, 2008
Katrina Nakamura1 , Sam Sheps2, 3 and Petra Clara Arck4, 5(1) Interdisciplinary Studies Graduate Program, University of British Columbia, 6201 Cecil Green Park Road, Vancouver, BC, V6T 1Z1, Canada
(2) Department of Health Care and Epidemiology, University of British Columbia, Vancouver, Canada
(3) Western Regional Training Center for Health and Policy Research, University of British Columbia, Vancouver, Canada
(4) Charité University Medicine, Berlin, Germany
(5) Brain Body Institute, McMaster University, Hamilton, Canada
Received: 24 January 2008 Accepted: 25 January 2008 Published online: 15 February 2008
Abstract
Problem Maternal stress perception is frequently alleged as a cause of infertility, miscarriages, late pregnancy complications or impaired fetal development. The purpose of the present review is to critically assess the biological and epidemiological evidence that considers the plausibility of a stress link to human reproductive failure.
Methods All epidemiological studies published between 1980 and 2007 that tested the link between stress exposure and impaired reproductive success in humans were identified. Study outcomes were evaluated on the basis of how associations were predicted, tested and integrated with theories of etiology arising from recent scientific developments in the basic sciences. Further, published evidence arising from basic science research has been assessed in order to provide a mechanistic concept and biological evidence for the link between stress perception and reproductive success.
Results Biological evidence points to an immune–endocrine disequilibrium in response to stress and describes a hierarchy of biological mediators involved in a stress trigger to reproductive failure. Epidemiological evidence presents positive correlations between various pregnancy failure outcomes with pre-conception negative life events and elevated daily urinary cortisol. Strikingly, a relatively new conceptual approach integrating the two strands of evidence suggests the programming of stress susceptibility in mother and fetus via a so-called pregnancy stress syndrome.
Conclusions: An increasing specificity of knowledge is available about the types and impact of biological and social pathways involved in maternal stress responses. The present evidence is sufficient to warrant a reconsideration of conventional views on the etiology of reproductive failure. Physicians and patients will benefit from the adaptation of this integrated evidence to daily clinical practice.
Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden. elisabet.stener-victorin@neuro.gu.se
Abstract
This review describes the aetiology and pathogenesis of polycystic ovary syndrome (PCOS) and evaluates the use of acupuncture to prevent and reduce symptoms related with PCOS. PCOS is the most common female endocrine disorder and it is strongly associated with hyperandrogenism, ovulatory dysfunction and obesity. PCOS increases the risk for metabolic disturbances such as hyperinsulinaemia and insulin resistance, which can lead to type 2 diabetes, hypertension and an increased likelihood of developing cardiovascular risk factors and impaired mental health later in life. Despite extensive research, little is known about the aetiology of PCOS. The syndrome is associated with peripheral and central factors that influence sympathetic nerve activity. Thus, the sympathetic nervous system may be an important factor in the development and maintenance of PCOS. Many women with PCOS require prolonged treatment. Current pharmacological approaches are effective but have adverse effects. Therefore, nonpharmacological treatment strategies need to be evaluated. Clearly, acupuncture can affect PCOS via modulation of endogenous regulatory systems, including the sympathetic nervous system, the endocrine and the neuroendocrine system. Experimental observations in rat models of steroid-induced polycystic ovaries and clinical data from studies in women with PCOS suggest that acupuncture exert long-lasting beneficial effects on metabolic and endocrine systems and ovulation.
https://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.png00Vitalis Skiauterishttps://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.pngVitalis Skiauteris2008-03-21 21:45:292021-09-24 08:59:38Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence.
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.
https://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.png00Vitalis Skiauterishttps://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.pngVitalis Skiauteris2008-02-10 10:08:432021-09-24 08:59:16Systematic review: Acupuncture and IVF: Acupuncture improves rates of pregnancy and live birth
Effect of electro-acupuncture stimulation of different frequencies and intensities on ovarian blood flow in anaesthetized rats with steroid-induced polycystic ovaries
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. Read more
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.
https://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.png00Vitalis Skiauterishttps://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.pngVitalis Skiauteris2007-10-31 10:45:122015-02-24 17:44:48Acupuncture and Chinese Medicine for Chronic Pelvic Inflammation
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.
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). Read more
https://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.png00Vitalis Skiauterishttps://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.pngVitalis Skiauteris2007-08-01 16:00:562021-09-29 13:58:51In 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
https://infertility-acupuncture.info/wp-content/uploads/2007/06/ivf-follicle-egg-quality-acupuncture-e1581460501436.jpg342812Vitalis Skiauterishttps://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.pngVitalis Skiauteris2007-06-17 07:17:002021-09-24 08:58:34Acupuncture, IVF/ICSI and follicle development
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.
https://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.png00Vitalis Skiauterishttps://infertility-acupuncture.info/wp-content/uploads/2015/03/Infertility-acupuncture-logo-300x152.pngVitalis Skiauteris2007-06-16 07:36:162015-02-24 17:44:48Chinese herbal medicine – higher success rates of pregnancy, no side-effects
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.
IVF + Acupuncture = lower stress, higher pregnancy rate
acupuncture, IVFThe relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: a pilot study.
Balk J, Catov J, Horn B, Gecsi K, Wakim A.
Abstract
The aim of this paper was to determine 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. The study was an observational, prospective, cohort study based at the University IVF center.
PATIENT(S): 57 infertile patients undergoing IVF or IVF/ICSI. INTERVENTIONS(S): Patients were undergoing Embryo Transfer with or without acupuncture as part of their standard clinical care.
MAIN OUTCOME MEASURE(S): Perceive Stress Scale scores, pregnancy rates.
RESULT(S): women who received this acupuncture regimen achieved pregnancy 64.7%, whereas those without acupuncture achieved pregnancy 42.5%. When stratified by donor recipient status, only non-donor recipients potentially had an improvement with acupuncture (35.5% without acupuncture vs. 55.6% with acupuncture). Those who received this acupuncture regimen had lower stress scores both pre-ET and post-ET compared to those who did not. Those with decreased their perceived stress scores compared to baseline had higher pregnancy rates than those who did not demonstrate this decrease, regardless of acupuncture status.
CONCLUSIONS(S): The acupuncture regimen was associated with less stress both before and after embryo transfer, and it possibly improved pregnancy rates. Lower perceived stress at the time of embryo transfer may play a role in an improved pregnancy rate.
PMID: 20621276 [PubMed – in process]PMCID: PMC2904299 [Available on 2011/8/1]
IVF acupuncture, stress and hormones
acupuncture, IVF, stress/anxietyIVF is stressful. And Acupuncture offsets the effects of stress on some reproductive hormones during the in vitro fertilisation.
Acupuncture improves sperm motilty
acupuncture, male fertilityIn this study acupuncture effectively helped patients suffering from both reduced sperm motility and low sperm count. This kind of condition is called oligoasthenozoospermia. The study showed that acupuncture significantly improved percentage of motile sperm.
Fertil Steril. 2009 Oct;92(4):1340-3. doi: 10.1016/ j.fertnstert. 2009.02.041. Epub 2009 Apr 25.
A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia.
Dieterle S, Li C, Greb R, Bartzsch F, Hatzmann W, Huang D.
Source
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Witten/Herdecke, Dortmund, Germany. dieterle@ivf-dortmund.de
Abstract
In this first prospective, randomized, single-blind, placebo-controlled study, 28 infertile patients with severe oligoasthenozoospermia received acupuncture according to the principles of traditional Chinese medicine (TCM) and 29 infertile patients received placebo acupuncture. A significantly higher percentage of motile sperm (World Health Organization categories A-C), but no effect on sperm concentration, was found after acupuncture compared with placebo acupuncture.
Acupuncture improves sperm quality by reducing inflammation in testis
acupuncture, male fertilityAcupuncture improves sperm quality. The mechanism of this improvement may lay in decreased temperature of the scrotum.
It’s well known that sperm doesn’t like heat. Inflammation is one of the worst sources of heat you can have. In this study acupuncture normalised scrotal temperature in patients who had inflammation. But it didn’t affect the guys who had a healthy temperature at the start of the study. It shows acupuncture’s regulatory effect – it helps for the body to self regulate, but it doesn’t disrupt healthy balance.
But most importantly, 15 out of 17 men who had improved sperm count.
Success of acupuncture treatment in patients with initially low sperm output is associated with a decrease in scrotal skin temperature.
Siterman S, Eltes F, Schechter L, Maimon Y, Lederman H, Bartoov B.
Abstract
Poor spermatogenesis in patients with inflammation of the genital tract is associated with scrotal hyperthermia. These patients can benefit from acupuncture treatment. We conducted a study to verify whether the influence of acupuncture treatment on sperm output in patients with low sperm density is associated with a decrease in scrotal temperature.
The experimental group included 39 men who were referred for acupuncture owing to low sperm output. The control group, which comprised 18 normal fertile men, was used to define a threshold (30.5 degrees C) above which scrotal skin temperature was considered to be high. Accordingly, 34 of the 39 participants in the experimental group initially had high scrotal skin temperature; the other five had normal values. Scrotal skin temperature and sperm concentration were measured before and after acupuncture treatment. The five patients with initially normal scrotal temperatures were not affected by the acupuncture treatment.
Following treatment, 17 of the 34 patients with hyperthermia, all of whom had genital tract inflammation, had normal scrotal skin temperature; in 15 of these 17 patients, sperm count was increased. In the remaining 17 men with scrotal hyperthermia, neither scrotal skin temperature nor sperm concentration was affected by the treatment.
About 90% of the latter patients suffered from high gonadotropins or mixed etiological factors. Low sperm count in patients with inflammation of the genital tract seems to be associated with scrotal hyperthermia, and, consequently, acupuncture treatment is recommended for these men.
http://www.ncbi.nlm.nih.gov/pubmed/19122677
Chinese herbal medicine vs gestrinone for endometriosis
Chinese herbs, Chinese medicine, endometriosis, infertilityChinse herbal medicine outperformed conventional drugs in endometriosis management. Authors concluded that Chinese medicine has fewer side effects, but similar benefits to gestrinone. Oral Chinese medicine tinctures may have a better effect than danazol in relieving dysmenorrhea, even shrinking adnexal masses when used in combination with a Chinese medicine enema.
Chinese herbs for endometriosis
Flower A, Liu JP, Chen S, Lewith G, Little P
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.
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PCOS: Acupuncture and Sympathetic Nerve Activity in Polycystic Ovary Syndrome
acupuncture, female infertility, infertility, polycystic ovariesAcupuncture 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
Acupuncture benefits cortisol and prolactin levels in IVF patients
acupuncture, IVFPaul 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.
Acupuncture improves sperm motility
acupuncture, male fertilityEffect 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.
Acupuncture improves ovarian morphology in PCOS by regulating overactive sympathetic nervous system
acupuncture, polycystic ovariesAcupuncture 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
Acupuncture for male and female infertility – systematic review
acupuncture, ART, female infertility, infertility, IVF, male fertility, polycystic ovariesNg 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.
How Stress affects Fertility
female infertility, infertility, stress/anxietyPublisher Springer Netherlands
ISSN 1058-0468 (Print) 1573-7330 (Online)
Issue Volume 25, Numbers 2-3 / March, 2008
Category REPRODUCTIVE IMMUNOLOGY
DOI 10.1007/s10815-008-9206-5
Pages 47-62
Subject Collection Medicine
SpringerLink Date Friday, February 15, 2008
Katrina Nakamura1 , Sam Sheps2, 3 and Petra Clara Arck4, 5(1) Interdisciplinary Studies Graduate Program, University of British Columbia, 6201 Cecil Green Park Road, Vancouver, BC, V6T 1Z1, Canada
(2) Department of Health Care and Epidemiology, University of British Columbia, Vancouver, Canada
(3) Western Regional Training Center for Health and Policy Research, University of British Columbia, Vancouver, Canada
(4) Charité University Medicine, Berlin, Germany
(5) Brain Body Institute, McMaster University, Hamilton, Canada
Received: 24 January 2008 Accepted: 25 January 2008 Published online: 15 February 2008
Abstract
Problem Maternal stress perception is frequently alleged as a cause of infertility, miscarriages, late pregnancy complications or impaired fetal development. The purpose of the present review is to critically assess the biological and epidemiological evidence that considers the plausibility of a stress link to human reproductive failure.
Methods All epidemiological studies published between 1980 and 2007 that tested the link between stress exposure and impaired reproductive success in humans were identified. Study outcomes were evaluated on the basis of how associations were predicted, tested and integrated with theories of etiology arising from recent scientific developments in the basic sciences. Further, published evidence arising from basic science research has been assessed in order to provide a mechanistic concept and biological evidence for the link between stress perception and reproductive success.
Results Biological evidence points to an immune–endocrine disequilibrium in response to stress and describes a hierarchy of biological mediators involved in a stress trigger to reproductive failure. Epidemiological evidence presents positive correlations between various pregnancy failure outcomes with pre-conception negative life events and elevated daily urinary cortisol. Strikingly, a relatively new conceptual approach integrating the two strands of evidence suggests the programming of stress susceptibility in mother and fetus via a so-called pregnancy stress syndrome.
Conclusions: An increasing specificity of knowledge is available about the types and impact of biological and social pathways involved in maternal stress responses. The present evidence is sufficient to warrant a reconsideration of conventional views on the etiology of reproductive failure. Physicians and patients will benefit from the adaptation of this integrated evidence to daily clinical practice.
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Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence.
acupuncture, polycystic ovariespcos acupuncture
Acupuncture in polycystic ovary syndrome: current experimental and clinical evidence.
Stener-Victorin E, Jedel E, Mannerås L.
Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden. elisabet.stener-victorin@neuro.gu.se
Abstract
This review describes the aetiology and pathogenesis of polycystic ovary syndrome (PCOS) and evaluates the use of acupuncture to prevent and reduce symptoms related with PCOS. PCOS is the most common female endocrine disorder and it is strongly associated with hyperandrogenism, ovulatory dysfunction and obesity. PCOS increases the risk for metabolic disturbances such as hyperinsulinaemia and insulin resistance, which can lead to type 2 diabetes, hypertension and an increased likelihood of developing cardiovascular risk factors and impaired mental health later in life. Despite extensive research, little is known about the aetiology of PCOS. The syndrome is associated with peripheral and central factors that influence sympathetic nerve activity. Thus, the sympathetic nervous system may be an important factor in the development and maintenance of PCOS. Many women with PCOS require prolonged treatment. Current pharmacological approaches are effective but have adverse effects. Therefore, nonpharmacological treatment strategies need to be evaluated. Clearly, acupuncture can affect PCOS via modulation of endogenous regulatory systems, including the sympathetic nervous system, the endocrine and the neuroendocrine system. Experimental observations in rat models of steroid-induced polycystic ovaries and clinical data from studies in women with PCOS suggest that acupuncture exert long-lasting beneficial effects on metabolic and endocrine systems and ovulation.
Systematic review: Acupuncture and IVF: Acupuncture improves rates of pregnancy and live birth
acupuncture, ART, female infertility, infertility, IVF, polycystic ovaries, stress/anxietyEric 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.
Electro acupunture increases ovarian blod flow (PCOS)
acupuncture, female infertility, infertility, polycystic ovariesMaintenance 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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Acupuncture and Chinese Medicine for Chronic Pelvic Inflammation
acupuncture, Chinese herbs, Chinese medicine, chronic pelvic inflammationHospital 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.
How acupuncture stimulates ovulation (the mechanism)
acupuncture, female infertility, infertility, polycystic ovariesClinical 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.
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
acupuncture, female infertility, polycystic ovariesRelationship 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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Acupuncture, IVF/ICSI and follicle development
acupuncture, ART, female infertility, ICSI, IVFSandra 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”
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Chinese herbal medicine – higher success rates of pregnancy, no side-effects
Chinese herbs, Chinese medicine, female infertility, infertilityMeasuring 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.
Acupuncture – natural labour pain relief
acupuncture[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.