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.

Mechanism of Acupuncture: Blood flow to brain study explains Acupuncture works

By: Marilyn Elias

USA TODAY

Acupuncture on pain-relief points cuts blood flow to key areas of the brain within seconds, providing the clearest explanation to date for how the ancient technique might relieve pain and treat addictions, a Harvard scientist reports today. Read more

Male infertility: acupuncture and herbs regulate antisperm antiboy antisperm antibody (AsAb)

Effects of the combined therapy of acupuncture with herbal drugs on male immune infertility–a clinical report of 50 cases.
Fu B, Lun X, Gong Y.

Department of Acupuncture, Second Guangdong Provincial Worker’s Hospital, Guangzhou 510720, China.

To study the clinical effects of the combined therapy of acupuncture with herbal drugs on male immune infertility and on antisperm antibody (AsAb), 100 male cases of infertility with positive AsAb were divided randomly into two groups, each consisting of 50 cases. The acupuncture-drug group was treated with acupuncture on Ganshu (BL 18), Shenshu (BL 23), Taichong (LR 3), Taixi (KI 3), Xinshu (BL 15), Geshu (BL 17), Shenmen (HT 7), and Xuehai (SP 10), combined with oral medication of Liuwei Dihuang Wan (Bolus of the Six Drugs Including Rehmanniae). The control group was treated with oral prednisone. The clinical therapeutic effects and the impact on AsAb were observed in the two groups. The results showed that the total effective rate in the acupuncture-drug group was 90%; while that of the control group was 64%, the comparison showing a statistically significant difference (P<0.05). The positive rate of blood serum and/or AsAb in both the two groups decreased in varying degrees, but the negative-turning rate of AsAb in the acupuncture-drug group was more obvious, the comparison showing also a significant difference (P<0.05). CONCLUSION: The combined therapy of acupuncture with herbal drugs has definite therapeutic effects on male immune infertility, which can regulate AsAb and raise the immunity of the patients.

J Tradit Chin Med. 2005 Sep;25(3):186-9.

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.

Acupuncture: A Clinical Review

Victor S. Sierpina, MD; Moshe A. Frenkel, MD

Family Medicine Department, University of Texas Medical Branch, Galveston, TX
Abstract

This article summarizes the research base, probable mechanism of actions, and clinical
applications of acupuncture. It offers the clinician a deeper understanding of appropriate
conditions for which acupuncture may be useful, outlines how to integrate acupuncture into a
clinical practice, and describes referral and training issues.
Introduction
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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.

Acupuncture and IVF embryo transfer, ART and PCOS

Acupunct Med. 2006 Dec;24(4):157-63.

Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer.

Stener-Victorin E, Humaidan P.

Institute of Neuroscience and Physiolopgy, Sahlgrenska Academy, Goteborg University, Sweden. elisabet.stener-victorin@neuro.gu.se

During the last five years the use of acupuncture in female infertility as an adjuvant to conventional treatment in assisted reproductive technology (ART) has increased in popularity. The present paper briefly discusses clinical and experimental data on the effect of acupuncture on uterine and ovarian blood flow, as an analgesic method during ART, and on endocrine and metabolic disturbances such as polycystic ovary syndrome (PCOS). Further it gives a summary of recent studies evaluating the effect of acupuncture before and after embryo transfer on pregnancy outcome. Of the four published RCTs, three reveal significantly higher pregnancy rates in the acupuncture groups compared with the control groups. But the use of different study protocols makes it difficult to draw definitive conclusions. It seems, however, that acupuncture has a positive effect and no adverse effects on pregnancy outcome.

Effects of ferulic acid on fertile and asthenozoospermic infertile human sperm motility, viability, lipid peroxidation, and cyclic nucleotides.

Effects of ferulic acid on fertile and asthenozoospermic infertile human sperm motility, viability, lipid peroxidation, and cyclic nucleotides.

Zheng RL, Zhang H.

Department of Biology, Lanzhou University, P.R. China.

The capacity of human sperm fertilization principally depends on sperm motility and membrane integrity. Reactive oxygen species, such as superoxide anion and hydrogen peroxide, are known to impair sperm motility and membrane integrity by inducing membrane lipid peroxidation (LPO). Ferulic acid (FA), an effective constituent in various medicinal herbs, has recently been shown to scavenge oxygen free radicals and increase the intracellular cAMP and cGMP. The aim of this study is to investigate the effects of FA on human sperm motility, viability, lipid peroxidation, and cyclic nucleotides in fertile and asthenozoospermic infertile individuals in vitro. The sperm samples were obtained from 10 fertile volunteers and 10 asthenozoospermic infertile patients. Washed spermatozoa were incubated at 37 degrees C in Ham’s F-10 medium with 0, 0.1, 0.2, 0.4, 0.8, or 1.6 mM of FA. Samples were analyzed for viability, determined by eosin-Y dye exclusion method at 0, 1, 2, 3, 5, and 6 h of incubation; motility, determined by the trans-membrane migration method within 2 h of incubation; LPO, determined by thiobarbituric acid (TBA) method at 3 h of incubation and the intracellular cAMP and cGMP, determined, respectively, by 3H-cAMP and 125I-cGMP radioimmunoassay at 3 h of incubation. The results showed: in both fertile and infertile spermatozoa, the viability, trans-membrane migration ratio (TMMR) and the levels of intracellular cAMP and cGMP in FA-treated spermatozoa were significantly higher than those of spermatozoa in control groups, while TBA-reactive substances contents in treated spermatozoa were significantly lower than those in control spermatozoa. The effects of FA on these processes were concentration dependent. These data suggested that FA is beneficial to sperm viability and motility in both fertile and infertile individuals, and that reduction of lipid peroxidative damage to sperm membranes and increase of intracellular cAMP and cGMP may be involved in these benefits. It is possible that FA may be used for cure of asthenozoospermic infertility.

Free Radic Biol Med. 1997;22(4):581-6.

Improvement of IVF Outcomes by Acupuncture: Are egg and embryo qualities involved?

fertility and sterility acupunctureImprovement of IVF Outcomes by Acupuncture: Are egg and embryo qualities involved?

Paul C. Magarelli, M.D., Ph.D., a Diane Cridennda, L.Ac. b, Mel Cohen, MBA a
a Reproductive Medicine & Fertility Center, Colorado Springs, CO b East Winds Acupuncture, Colorado Springs, CO

FERTILITY AND STERILITY®, May 2005, VOL 83, SUP 2, Proceeding from the 2005 Pacific Coast Reproductive Society annual meeting in Palm Springs

Objective: In this study, we examine the impact of Acupuncture on the embryology characteristics of IVF patients, i.e., are there changes in the numbers of eggs generated, embryos fertilized, embryos transferred or remaining embryos for freezing in those patients receiving acupuncture therapy.

Design: Retrospective clinical study

Setting: Private infertility practice and Traditional Chinese Medicine practice

Patients: Two hundred eight IVF cycles were reviewed, 95 received acupuncture (Ac) and 113 were controls (C).

Interventions: Patients randomly chose Ac to complement their IVF treatments. Two published Ac protocols were used. Standard IVF protocols were used and done in one clinic by one physician. The MD was not aware of who received Ac in addition to their IVF. After three years the data were collected and analyzed.

Main Outcome Measures: Number of eggs retrieved, number of eggs fertilized normally, number of embryos implanted, number of embryos frozen, number of embryos transferred, day of transfer, number of prior IVF cycles, Day 3 FSH, Pulsatility Indices, weight, infertility diagnoses, IVF treatment protocols, pregnancy rates, SAB rates, ectopic rates, and multiple pregnancy rates.

Results: Number of prior IVF cycles, Day 3 FSH, Pulsatility Indices, Weight, Infertility diagnoses, IVF treatment protocols were statistically similar. Pregnancy rates for the Ac group were statistically significantly higher than the C group (P ≤ 0.05), SAB rates were lower and multiple pregnancy rates were lower (P < 0.06, not statistically significant). Ectopic pregnancy rates were statistically lower in the Ac group (P ≤ 0.05). There were no statistically significant differences between the C and Ac treated groups for the following embryology parameters: number of eggs retrieved, number of eggs fertilized normally, number of embryos implanted, number of embryos frozen, number of embryos transferred, and day of transfer. Conclusions: There were no discernable statistical differences between embryology characteristics in patients treated with or without Acupuncture. These data suggests that the mechanism of action of Acupuncture on IVF outcomes may be related to affects in the host (the egg provider and the embryo recipient) rather than in direct changes to the eggs retrieved and the embryos created. Key Words: IVF, acupuncture, adjuvant therapies, electro stimulation acupuncture, embryology, eggs

Acupuncture and In Vitro Fertilization: Does the Number of Treatments Impact Reproductive Outcomes?

Acupuncture and In Vitro Fertilization: Does the Number of Treatments Impact Reproductive Outcomes?

D.K. Cridennda L.Ac.(1), P.C. Magarelli MD, Ph.D. (2) , and M. Cohen, MBA (2).
.(1), East Winds Acupuncture Colorado Springs, CO; (2) Reproductive Medicine & Fertility Center, Colorado Springs, CO

Objective: The purpose of this study was to determine the optimal number of acupuncture treatments that provide the patient with the best IVF outcomes, i.e., pregnancy.

Materials and Methods: Retrospective clinical study in private practice Acupuncture and IVF center. Data were compiled in a group of infertile patients (n = 216) who received acupuncture during their IVF treatment cycle between 2001 and 2005. Data were analyzed to determine the optimal number of Electrical Stimulation (e-Stim) acupuncture treatments (Stener-Victorin protocol) that would result in a clinical pregnancy. Two hundred sixteen patients over a 4 year period were included in this study. Based on our previous studies, we determined a significant improvement in IVF outcomes when patients were treated with Acupuncture (Ac). We utilized two protocols: Stener-Victorin et al 1996 (reported on uterine blood flow) and Paulus et al. 2002 protocol (reported on acupuncture given just before and just after embryo transfer). Patients received a combination of both protocols. This population was stratified into pregnant and non pregnant groups and then evaluated by Student T=test and Chi-Square analysis for age, FSH levels, weight, BMI and E-2 levels. The pregnant and non-pregnant groups were further subdivided into those that received or did not receive acupuncture and were analyzed by Chi-square analysis. Since all patients received acupuncture consisting of e-Stim, their distribution was analyzed utilizing Kaplan- Meier survival analysis for pregnancy and no pregnancy to determine the number of e-stimulation that would provide the greatest chance for pregnancy.

Results: Patients age, day 3 FSH levels, weight, BMI (body mass index) and E2 (estrogen level at embryo transfer) were not statistically significantly different between the Non Acupuncture (No Ac) and the Acupuncture (Ac) groups. There was a statistically significant improvement (p < 0.01) in pregnancy rates in the group that received Ac (49 patients of 106 (37.4%) in the No Ac became pregnant vs. 77 patients of 111 (61.1%) of the Ac group became pregnant). This is over 23% increase in pregnancy rates in the Ac group. When the data were compared between e-Stim treatments in the Ac only group, an average of 6.5 treatments were found in the non-pregnant Ac group and 5.9 treatments in pregnant Ac group (not statistically significantly different). When the data were plotted comparing pregnant vs. non pregnant Ac patients, there was a trend towards numerically more e-Stim treatments in those who achieved a pregnancy. In order to confirm or refute differences in these two groups, Kaplan Meier’s survival analyses were done. Based on these analyses, the average accumulated affect in the non pregnant Ac group was 5.1 e-Stim treatments and 8.4 e-Stim treatments in the pregnant Ac group. This was statistically significantly different at the p < 0.05. Conclusion: In traditional Chinese medicine the basic theory is that only when the body is balanced will it function at its optimal level. Acupuncture helps restore balance which results in a higher chance of achieving pregnancy. In our study, we found that patients who received more than 8 e-Stim treatments appeared to have the maximum benefit for IVF outcomes: pregnancy (p < 0.05). In our study, we also reviewed the independent effects of the Paulus protocol, however due to small numbers; we could not perform the analyses. In the IVF center included in this study, patients receive Valium (diazepam) to reduce smooth muscle contractility. This treatment may provide all that is needed to reduce uterine contractility and therefore the additional impact of Ac at the pre and post transfer (Paulus protocol) may well be masked by the medication. More study of these and other treatments must be done. We are currently investigating the role of Ac in stress hormone circulating levels. Source : No outside source of funding.

Combination of Chinese herbs and hormones could lower the NO (nitric oxide) level in semen and improve the quality of sperm

Clinical observation on effect of combination of zhuanyindan and hormone in treating male infertility with positive antisperm antibody
[Article in Chinese]
Yu AL, Zhang FZ, Zhang FX.

Taishan Medical College, Shandong 271000.

OBJECTIVE: To explore the therapeutic effect of combination of Zhuanyindan (ZYD, a Chinese herbal preparation) and hormone in treating male infertility with positive antisperm antibody and its influence on nitric oxide (NO) level. METHODS: Eighty-two patients were randomly divided (according to the digital list) into the WM group (n = 20, treated with prednisone), the TCM group (n = 28, treated with ZYD) and the ICWM group (n = 34, treated with prednisone plus ZYD). The clinical effect, negative converting rate of antisperm antibody, changes of NO level in semen and various parameters of sperm motion before and after treatment were observed. RESULTS: The total effective rate in the ICWM group was 88.2%, that in the TCM group 75.0% and in the WM group 65.0%. Significant difference was seen in the ICWM and TCM group before and after treatment in NO level, sperm motion parameters, including linear motion speed, linearity, propulsion, whip frequency, sperm vitality and mean moving angle, and quality of semen (P < 0.05 or P < 0.01). In the WM group, significant difference in comparison before and after treatment was seen in NO level, propulsion, whip frequency, mean moving angle and quality of semen, including vitality and survival rate (P < 0.01). CONCLUSION: Combination of Chinese herbs and hormone could lower the NO (nitric oxide) level in semen and improve the quality of sperm. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2004 Mar;24(3):223-6.

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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TCM herbs and miscarriage

herbs-miscarriage-acupunctureThis study confirmed Chinese herbal medicines can reduce the risk of miscarriage in the early weeks of pregnancy. Two days after embryo transfer a group of women was administered a Chinese herbal formula renown to reduce the risk of miscarriage. Control group were not administered any hers. But both groups were on progesterone support treatment.

Researchers found, that there was a significant reduction of miscarriages in the group taking Chinese herbal medicine. 23% of women in the progesterone only group miscarried, while in the Chinese herbs group this number was significantly lower – 13%.

The study was published in the Chinese Journal of Integrative Medicine.

Chin J Integr Med. 2006 Sep;12(3):189-93.
Effect of Gutai Decoction on the abortion [miscarriage] rate of in vitro fertilization and embryo transfer.
Liu Y1, Wu JZ.
Author information
Abstract
OBJECTIVE:
To study the effect of Chinese herbal medicine Gutai Decoction (GTD) on the abortion rate of in vitro fertilization and embryo transfer (IVF-ET).

METHODS:
Observed were two hundred and forty-seven women having received IVF-ET and with beta-human chorionic gonadotropin (beta-HCG) > 25 IU/L on the 14th day after transferring. All were treated conventionally with progesterone 20 – 80 mg per day after transferring and if necessary the treatment was supplemented with Progynova 2 – 4 mg per day, with the medication withdrawn gradually from the 9th week of pregnancy till stopped completely. Among them 131 cases received GTD medication additionally, for 109 cases of whom the medication started from the 2nd day of transferring (taken as Group A) and for the other 22 cases from the 14th day after transferring (taken as Group B), the other 116 cases with no additional GTD treatment given were taken as the control group, with the medication lasting to the 12th week. The abortion rate in them was observed.

RESULTS:
The abortion rate in Group A, Group B and the control group was 12.84%, 13.64% and 23.28%, respectively, the difference between the GTD treated groups and the control group was significant (P < 0.05). CONCLUSION: Chinese medicine GTD could reduce abortion rate in women receiving IVF-ET. PMID: 17005079 [PubMed - indexed for MEDLINE]

Stress hormone Cortisol and early miscarriage

Cortisol levels and very early pregnancy loss (miscarriage) in humans
Pablo A. Nepomnaschy , Kathleen B. Welch , Daniel S. McConnell, Bobbi S. Low, Beverly I. Strassmann , and Barry G. England

Author Affiliations
*Department of Anthropology, 1085 South University Avenue,
Reproductive Sciences Program, Department of Obstetrics and Gynecology, L4000 Women’s Hospital,
School of Natural Resources and Environment, 430 East University Street,
Center for Statistical Consultation and Research, 915 East Washington Street,
Department of Epidemiology, School of Public Health, 109 Observatory Street,
**Research Center for Group Dynamics, Institute for Social Research, 426 Thompson Street, and
††Department of Pathology, Medical Science I, 1301 Catherine Street, University of Michigan, Ann Arbor, MI 48109

Communicated by Richard D. Alexander, University of Michigan, Ann Arbor, MI, December 27, 2005 (received for review December 17, 2004)
Abstract

Maternal stress is commonly cited as an important risk factor for spontaneous abortion. For humans, however, there is little physiological evidence linking miscarriage to stress. This lack of evidence may be attributable to a paucity of research on maternal stress during the earliest gestational stages. Most human studies have focused on “clinical” pregnancy (>6 weeks after the last menstrual period). The majority of miscarriages, however, occur earlier, within the first 3 weeks after conception (?5 weeks after the last menstrual period). Studies focused on clinical pregnancy thus miss the most critical period for pregnancy continuance. We examined the association between miscarriage and levels of maternal urinary cortisol during the first 3 weeks after conception. Pregnancies characterized by increased maternal cortisol during this period (within participant analyses) were more likely to result in spontaneous abortion or miscarriage (P < 0.05). This evidence links increased levels in this stress marker with a higher risk of early pregnancy loss in humans.

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