Effects of acupressure at the Sanyinjiao point on primary dysmenorrhoea.
Chen HM, Chen CH.

Assistant Professor, Chung Hwa College of Medical Technology, Tainan, Taiwan.

AIM: This paper presents the findings of a study that assessed the effects of acupressure at the Sanyinjiao point on symptoms of primary dysmenorrhoea among adolescent girls. BACKGROUND: Dysmenorrhoea is the most common gynaecological disorder among adolescents. Traditional Chinese acupressure derived from acupuncture is a non-invasive technique. Despite renewed interest in the use of acupressure, relatively few studies have been undertaken to examine its effects on primary dysmenorrhoea. METHODS: An experimental study was conducted between December 2000 and August 2001. Participants were female students attending a technical college in Taiwan. None of the 69 participants had a prior history of gynaecological disease or secondary dysmenorrhoea, and all were rated higher than five for pain on a visual analogue scale from 0 to 10. The experimental group (n = 35) received acupressure at Sanyinjiao (above the ankle) while the control group (n = 34) rested for 20 min, while the control group underwent rest in the school health centre for 20 min without receiving acupressure. Fifty participants (30 experimental, 20 control) completed the 4-6-week follow-up session. Five instruments were used to collect pretest and post-test data at each session: (1) Visual Analogue Scale for pain; (2) the Short-Form McGill Pain Questionnaire; (3) the Menstrual Distress Questionnaire; (4) the Visual Analogue Scale for anxiety; and, for the experimental group only, (5) the Acupressure Self-Assessment Form. Data were analysed using the chi-square test, two-sample t-test and repeated measures two-way anova. RESULTS: Acupressure at Sanyinjiao during the initial session reduced the pain and anxiety typical of dysmenorrhoea. In the self-treatment follow-up session, acupressure at Sanyinjiao significantly reduced menstrual pain but not anxiety. Thirty-one (87%) of the 35 experimental participants reported that acupressure was helpful, and 33 (94%) were satisfied with acupressure in terms of its providing pain relief and psychological support during dysmenorrhoea.

CONCLUSION: The findings suggest that acupressure at Sanyinjiao can be an effective, cost-free intervention for reducing pain and anxiety during dysmenorrhoea, and we recommend its use for self-care of primary dysmenorrhoea.

J Adv Nurs. 2004 Nov;48(4):380-7.

Pain relief during oocyte retrieval with a new short duration electro-acupuncture technique–an alternative to conventional analgesic methods.
Humaidan P, Stener-Victorin E.

The Fertility Clinic, Skive Sygehus, DK 7800 Skive, Denmark.

BACKGROUND: Acupuncture previously has proved its pain-relieving effect for ovum pick-up (OPU). The analgesic effect of electro-acupuncture (EA) was evaluated when EA was applied for only a few minutes prior to OPU in an attempt to make EA more attractive for clinical use. METHODS: Two hundred patients undergoing OPU were randomized prospectively using sealed, unlabelled envelopes, to receive pain relief with either EA in combination with a paracervical block (PCB) (n = 100) or conventional medical analgesia (CMA) in combination with a PCB (n = 100). A visual analogue scale (VAS) was used to evaluate pain and anxiety before, during and after OPU. The primary outcome measure was pain relief; secondary end-points were costs, time to discharge and clinical outcome parameters. RESULTS: There were no differences in any VAS ratings before the procedure. Directly after OPU, the EA group reported significantly higher mean and maximum pain, and ‘pain now’ than the CMA group. At 30 min after OPU and thereafter, no significant differences were found between the groups regarding abdominal pain. Time to discharge and costs were significantly lower in the EA group compared with the CMA group. No differences in clinical outcome parameters were seen. CONCLUSION: A significant difference was found between the EA and the CMA groups regarding pain during the OPU, probably due to the fact that the CMA group was pre-medicated as part of the study design. Despite a per-operative difference in pain rating, EA, given a few minutes prior to OPU, is a good alternative to CMA. The procedure is well tolerated by the patients, with a shorter hospitalization time and lower costs.

Hum Reprod. 2004 Jun;19(6):1367-72. Epub 2004 Apr 22.

Effect of Chinese medicinal herbs on sperm membrane of infertile male
[Article in Chinese]

Liu XD.

Shandong Institute of Traditional Chinese Medicine and Materia Medica, Jinan.

The authors carried on the quantitative analysis of fluorescence polarization degree and fluorescent intensity on wheat germ agglutinin (WGA) receptor in sperm membrane surface and protein macromolecule 1-Anilinonaph thalene-8-suphonic acid salt (1,8-ANS) of sperm membrane to the patients with infertility and adult male with normal fertility, with the method of ultraviolet microspectrofluorometer (SMP, type: 05, made in West Germany). The results were as follows: the patient’s WGA receptor in sperm membrane surface was decreased (P less than 0.001), and the 1, 8-ANS of fluorescent intensity in hydrophobic area of protein macromolecule of sperm membrane was increased (P less than 0.05). After the treatment of Shenjing Zhongzitang, WGA receptor was increased obviously and 1, 8-ANS of fluorescent intensity was changed to be almost normal. It showed that the Chinese medicinal herbs mentioned above have certain influence upon the constitution of WGA receptor and protein macromolecule of sperm membrane.

Zhong Xi Yi Jie He Za Zhi. 1990 Sep;10(9):519-21, 515.

Effect of acupuncture treatment on the immune function impairment found in anxious women.
Arranz L, Guayerbas N, Siboni L, De la Fuente M.

Department of Physiology (Animal Physiology II), Faculty of Biological Science, Complutense University of Madrid, Spain.

It is presently accepted that emotional disturbances lead to immune system impairment, and that therefore their treatment could restore the immune response. Thus, the aim of the present work was to study the effect of an acupuncture treatment, designed specifically to relieve the emotional symptoms stemming from anxiety, on several functions (adherence, chemotaxis, phagocytosis, basal and stimulated superoxide anion levels, lymphocyte proliferation in response to phytohemagglutinin A (PHA) and natural killer (NK) activity) of leukocytes (neutrophils and lymphocytes) from anxious women. The acupuncture protocol consisted of manual needle stimulation of 19 acupoints, with each session lasting 30 min. It was performed on 34 female 30-60 year old patients, suffering from anxiety, as determined by the Beck Anxiety Inventory (BAI). Before and 72 hours after receiving the first acupuncture session, peripheral blood samples were drawn. In 12 patients, samples were also collected immediately after the first single acupuncture session and one month after the end of the whole acupuncture treatment, which consisted of 10 sessions during a year, until the complete remission of anxiety. Twenty healthy non-anxious women in the same age range were used as controls. The results showed that the most favorable effects of acupuncture on the immune functions appear 72 hours after the single session and persist one month after the end of the complete treatment. Impaired immune functions in anxious women (chemotaxis, phagocytosis, lymphoproliferation and NK activity) were significantly improved by acupuncture, and augmented immune parameters (superoxide anion levels and lymphoproliferation of the patient subgroup whose values had been too high) were significantly diminished. Acupuncture brought the above mentioned parameters to values closer to those of healthy controls, exerting a modulatory effect on the immune system.

Am J Chin Med. 2007;35(1):35-51.

Acupuncture: Impact on Pregnancy Outcomes in IVF Patients

12th World Congress on Human Reproduction, Venice Italy March 2005

Paul C. Magarelli, M.D., Ph.D., Diane Cridennda, L.Ac.  Mel Cohen, MBA

Abstract

Take-Home babies rates (THB) have been the single most important IVF outcome. Pregnancy rates (PR) can overestimate the expected success of a high-technology treatment for patients and many clinics use PR as a means of marketing their practices. This has caused disillusionment in patients and government regulation (especially in the U.S.).

Each IVF program strives to improve reproductive outcomes (low ectopic rates, low miscarriage rates and improved take-home baby rates – live births). Usually the approach to these improvements changes in IVF protocols, media adjustments in the IVF lab, patient selection, and subtle nudges towards egg donors for poor responders.

Another approach has been the inclusion of alternative medical modalities: acupuncture, massage therapy, stress reduction techniques, herbal medicine. We, and others, have chosen to incorporate Acupuncture into our IVF treatment protocols.

Recently we presented two studies that demonstrated improvements in pregnancy rates in Good and Poor IVF Responders with the inclusion of two specific Acupuncture Protocols (Steiner-Victorin and Paulus et. Al).

In the poor responders’ group we demonstrated a positive adjustment to Poor Responders pregnancy rates (PR) with improvements in PR in the Poor Responders group equivalent to good responders.

In the Good Responders study, we demonstrated a trend towards improved PR (5% above controls, not significant at p < 0.05).

With these observations noted we have continued our investigation and are reporting on reproductive outcomes in all IVF patients treated with Acupuncture compared to those untreated.

Materials and Methods:

In this study, 130 IVF cycles were reviewed in a retrospective fashion. Patients demographics, years infertile, age of male partners, sperm parameters, Day 3 FSH, Pulsatility Indices, Weight, BMI, infertility diagnoses, IVF treatment protocols were statistically similar for both the Controls (C) and Acupuncture (Ac) treatment groups.

All patients that completed an IVF cycle (retrieval, transfer) were included. There were 82 in the C group (non-acupuncture) and 48 in the Ac group. For the C vs. Ac groups, a summary of their statistics are as follows: Mean Age was 32.6 vs. 32.7, Day 3 FSH was 5.5 vs. 6.4, Pulsatility Indices for right and left uterine arteries were 1.5 and 1.2 vs. 1.4 and 1.0; Sperm counts were 69 vs. 67 million/ml; Sperm motility (%) were 48 vs. 53%, and Sperm morphologies were 6 % normal vs. 7%.

Results:

Pregnancy rates for the Ac group were statistically similar, although numerically higher, versus C (50% v 45% at P < 0.05). Ac miscarriage rates (SAB) were statistically lower than the C (8 % vs. 11% at p <0.01). There were no ectopic pregnancies in the Ac group ( P < 0.01). Live Births were significantly better in the Ac v C groups (42% v 38%). A surprising observation was that multiples pregnancies were significantly lower in the Ac vs. C groups (17 % vs. 22%). Average eggs retrieved were statistically similar to 15 vs. 15 for Ac and C respectively.

Conclusions:

IVF programs can significantly improve their IVF outcomes ( PR, THB, SAB and Ectopic) by adding acupuncture protocols, specifically Steiner Victorin and Paulus. Further studies of Traditional Chine Medicine modalities of treatment are underway. We are organizing a multicenter prospective study to confirm our observations.

Clinical study on “jin’s three-needling” in treatment of generalized anxiety disorder
[Article in Chinese]
Luo WZ, Liu HJ, Mei SY.

College of Acupuncture and Massage, Guangzhou University of TCM, Guangzhou.

OBJECTIVE: To study the clinical effect of “Jin’s three-needling” in the treatment of generalized anxiety disorder. METHODS: Fifty-eight patients with generalized anxiety were randomly assigned to two groups equally, the medication group treated with anti-anxiety drugs and the acupuncture group with “Jin’s three-needling”. The treatment course was 6 weeks. The clinical effects were evaluated with Hamilton anxiety scale (HAMA), clinical global impression (CGI), and treatment emergent symptom scale (TESS) before treatment and at the end of 2nd, 4th, 6th week of the treatment course. The concentration of 5-hydroxytryptamine (5-HT) in platelet, and plasma levels of corticosterone (CS) and adrenocorticotropic hormone (ACTH) were measured with high performance liquid chromatography-electrochemical detection (HPLC-ED) method before and after treatment. RESULTS: The clinical effects in the two groups were equivalent, while the adverse reaction found in the acupuncture group was less than that in the medication group (P < 0.05). The platelet concentration of 5-HT and plasma ACTH level decreased significantly in both groups after treatment with insignificant difference between the group (P < 0.05). The plasma CS level had no obvious change in the two groups after treatment as compared with that before treatment respectively. CONCLUSION: "Jin's three-needling" shows similar curative effect on generalized anxiety to routine Western medicine but with less adverse reaction, which may be realized through regulating the platelet 5-HT concentration and plasma ACTH level.

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Mar;27(3):201-3.

fertility and sterility acupuncture Fertil Steril. 2002 Apr;77(4):721-4.

Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy.
Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K.

Department of Reproductive Medicine, Christian-Lauritzen-Institut, Ulm, Germany. paulus@reprotox.de

OBJECTIVE: To evaluate the effect of acupuncture on the pregnancy rate in assisted reproduction therapy (ART) by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer with a control group receiving no acupuncture. DESIGN: Prospective randomized study. SETTING: Fertility center. PATIENT(S): After giving informed consent, 160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through random selection: embryo transfer with acupuncture (n = 80) and embryo transfer without acupuncture (n = 80). INTERVENTION(S): Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy. MAIN OUTCOME MEASURE(S): Clinical pregnancy was defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer.

RESULT(S): Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group.

CONCLUSION(S): Acupuncture seems to be a useful tool for improving pregnancy rate after ART.

fertility and sterility acupuncture Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility.
Pei J, Strehler E, Noss U, Abt M, Piomboni P, Baccetti B, Sterzik K.

Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China. jianpei99@yahoo.com

OBJECTIVE: To evaluate the ultramorphologic sperm features of idiopathic infertile men after acupuncture therapy. DESIGN: Prospective controlled study. SETTING: Christian-Lauritzen-Institut, Ulm, IVF center Munich, Germany, and Department of General Biology, University of Siena, Siena, Italy. PATIENT(S): Forty men with idiopathic oligospermia, asthenospermia, or teratozoospermia. INTERVENTION(S): Twenty eight of the patients received acupuncture twice a week over a period of 5 weeks. The samples from the treatment group were randomized with semen samples from the 12 men in the untreated control group. MAIN OUTCOME MEASURE(S): Quantitative analysis by transmission electron microscopy (TEM) was used to evaluate the samples, using the mathematical formula based on submicroscopic characteristics. RESULT(S): Statistical evaluation of the TEM data showed a statistically significant increase after acupuncture in the percentage and number of sperm without ultrastructural defects in the total ejaculates. A statistically significant improvement was detected in acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibers of sperm organelles. However, specific sperm pathologies in the form of apoptosis, immaturity, and necrosis showed no statistically significant changes between the control and treatment groups before and after treatment.

CONCLUSION(S): The treatment of idiopathic male infertility could benefit from employing acupuncture. A general improvement of sperm quality, specifically in the ultrastructural integrity of spermatozoa, was seen after acupuncture, although we did not identify specific sperm pathologies that could be particularly sensitive to this therapy.

Fertil Steril. 2005 Jul;84(1):141-7.

Influence of acupuncture on idiopathic male infertility in assisted reproductive technology.
Zhang M, Huang G, Lu F, Paulus WE, Sterzik K.

Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030.

The clinical effects of acupuncture on idiopathic male infertility in sperm parameter and on therapeutic results in assisted reproductive technology were investigated. 22 patients failed in intracytoplasmic sperm injection (ICSI) with idiopathic male infertility were treated with acupuncture twice weekly for 8 weeks, followed by ICSI treatment again. The sperm concentration, motility, morphology, fertilization rates and embryo quality were observed. Quick sperm motility after acupuncture (18.3% +/- 9.6%) was significantly improved as compared with that before treatment (11.0% +/- 7.5%, P < 0.01). The normal sperm ratio was increased after acupuncture (21.1% +/- 10.4% vs 16.2% +/- 8.2%, P < 0.05). The fertilization rates after acupuncture (66.2%) were obviously higher than that before treatment (40.2%, P < 0.01). There was no significant difference in sperm concentration and general sperm motility between before and after acupuncture. The embryo quality after acupuncture was improved, but the difference between them was not significant (P > 0.05). Acupuncture can improve sperm quality and fertilization rates in assisted reproductive technology.

J Huazhong Univ Sci Technolog Med Sci. 2002;22(3):228-30.

Effect of electro-acupuncture on ovarian expression of alpha (1)- and beta (2)-adrenoceptors, and p75 neurotrophin receptors in rats with steroid-induced polycystic ovaries.
Manni L, Lundeberg T, Holmang A, Aloe L, Stener-Victorin E.

Cardiovascular Institute and Wallenberg Laboratory, Sahlgrenska Academy, Goteborg University, SE-413 45 Goteborg, Sweden. l.manni@in.rm.cnr.it

BACKGROUND: Estradiol valerate (EV)-induced polycystic ovaries (PCO) in rats is associated with an increase in ovarian sympathetic outflow. Low-frequency (2 Hz) electro-acupuncture (EA) has been shown to modulate sympathetic markers as well as ovarian blood flow as a reflex response via the ovarian sympathetic nerves, in rats with EV-induced PCO. METHODS: In the present study, we further tested the hypothesis that repeated 2 Hz EA treatments modulate ovarian sympathetic outflow in rats with PCO, induced by a single i.m. injection of EV, by investigating the mRNA expression, the amount and distribution of proteins of alpha1a-, alpha1b-, alpha1d-, and beta2-adrenoceptors (ARs), as well as the low-affinity neurotrophin receptor (p75NTR). RESULTS: It was found that EV injection results in significantly higher mRNA expression of ovarian alpha1b- and alpha1d-AR in PCO rats compared to control rats. The p75NTR and beta2-ARs mRNA expression were unchanged in the PCO ovary. Low-frequency EA resulted in a significantly lower expression of beta2-ARs mRNA expression in PCO rats. The p75NTR mRNA was unaffected in both PCO and control rats. PCO ovaries displayed significantly higher amount of protein of alpha1a-, alpha1b- and alpha1d-ARs, and of p75NTR, compared to control rats, that were all counteracted by repeated low-frequency EA treatments, except for alpha1b-AR. CONCLUSION: The present study shows that EA normalizes most of the EV-induced changes in ovarian ARs. Furthermore, EA was able to prevent the EV-induced up regulation of p75NTR, probably by normalizing the sympathetic ovarian response to NGF action. Our data indicate a possible role of EA in the regulation of ovarian responsiveness to sympathetic inputs and depict a possible complementary therapeutic approach to overcoming sympathetic-related anovulation in women with PCOS.

Electro-acupuncture reverses nerve growth factor abundance in experimental polycystic ovaries in the rat.

Bai YH, Lim SC, Song CH, Bae CS, Jin CS, Choi BC, Jang CH, Lee SH, Pak SC.

Research Division of Biological Science, Chosun University Medical School, Gwangju, Korea.

Polycystic ovary syndrome (PCOS) remains one of the most common causes of anovulation in women of reproductive age. There is some evidence that nerve growth factor (NGF) is involved in the pathogenesis of PCOS. Therefore, seeking the pathogenesis of PCOS is important for controlling fertility. In traditional Oriental Medicine, acupuncture has been used for the function of ovaries. The present study was designed to determine whether electro-acupuncture (EA) could affect experimentally induced polycystic ovary (PCO) in the rat. The two acupoints Sp-6 and E-128 were stimulated to test for efficacy in the protein expression of NGF. Polycystic ovaries were induced by a single injection of estradiol valerate (4 mg i.m.). During the experimental period of 8 weeks, some of the rats were treated with EA twice weekly; this group was compared with a vehicle-treated control group and an estradiol-injected group not subjected to EA. At day 60, the protein expression of NGF was examined by immunohistochemistry in the ovaries, the adrenal glands and some parts of the brain. The estradiol treatment induced a clear PCO appearance, and was associated with a robust increase in NGF expression in the ovaries, the adrenal glands and the brain. EA treatment partly reversed the NGF abundance, particularly in the ovaries, but not in the brain. Our data show that EA affects the NGF involvement in ovarian dysfunction. Copyright 2004 S. Karger AG, Basel

Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome.
Stener-Victorin E, Waldenstrom U, Tagnfors U, Lundeberg T, Lindstedt G, Janson PO.

Department of Obstetrics and Gynecology, Goteborg University, Sweden.

BACKGROUND: The present study was designed to evaluate if electro-acupuncture (EA) could affect oligo-/anovulation and related endocrine and neuroendocrine parameters in women with polycystic ovary syndrome (PCOS). METHODS: Twenty-four women (between the ages of 24 and 40 years) with PCOS and oligo-/amenorrhea were included in this non-randomized, longitudinal, prospective study. The study period was defined as the period extending from 3 months before the first EA treatment, to 3 months after the last EA treatment (10-14 treatments), in total 8-9 months. The menstrual and ovulation patterns were confirmed by recording of vaginal bleedings and by daily registrations of the basal body temperature (BBT). Blood samples were collected within a week before the first EA, within a week after the last EA and 3 months after EA. RESULTS: Nine women (38%) experienced a good effect. They displayed a mean of 0.66 ovulations/woman and month in the period during and after the EA period compared to a mean of 0.15 before the EA period (p=0.004). Before EA, women with a good effect had a significantly lower body-mass index (BMI) (p<0.001), waist-to-hip circumference ratio (WHR) (p=0.0058), serum testosterone concentration (p=0.0098), serum testosterone/sex hormone binding globulin (SHBG) ratio (p=0.011) and serum basal insulin concentration (p=0.0054), and a significantly higher concentration of serum SHBG (p=0.040) than did those women with no effect. CONCLUSION: Repeated EA treatments induce regular ovulations in more than one third of the women with PCOS. The group of women with good effect had a less androgenic hormonal profile before treatment and a less pronounced metabolic disturbance compared with the group with no effect. For this selected group EA offers an alternative to pharmacological ovulation induction.

Acupuncture normalizes dysfunction of hypothalamic-pituitary-ovarian axis.

Chen BY.

Institute of Acupuncture, Shanghai Medical University, P.R. China.

This article summarizes the studies of the mechanism of electroacupuncture (EA) in the regulation of the abnormal function of hypothalamic-pituitary-ovarian axis (HPOA) in our laboratory. Clinical observation showed that EA with the effective acupoints could cure some anovulatory patients in a highly effective rate and the experimental results suggested that EA might regulate the dysfunction of HPOA in several ways, which means EA could influence some gene expression of brain, thereby, normalizing secretion of some hormones, such as GnRH, LH and E2. The effects of EA might possess a relative specificity on acupoints.

Acupunct Electrother Res. 1997;22(2):97-108.

Measuring the Effectiveness of Chinese Herbal Medicine in Improving Female Fertility

By: Trevor A. Wing & Elke S. Sedlmeier

Aim: To determine the relationship between female fertility indicators and the administration of
Chinese herbal medicine (CHM).

Design: A prospective cohort clinical study to measure accepted bio-medical
factors that affect female fertility and to determine if CHM can improve these factors as well as pregnancy outcome.

Setting: A private practice specialising in treating infertility with traditional Chinese medicine (TCM). The study took place between November 2003 and December 2004. Patient(s): Fifty women with the Western medical diagnosis of unexplained infertility.

Interventions: One monitored menstrual cycle measuring pre-treatment fertility factors, followed by treatment with Chinese herbal medicine and subsequent measurement of the changes in the same fertility factors.

Results: Significant differences were observed between the two time points for the majority of factors measured. Pregnancies in the sample group recorded 6 months after commencement of the last treatment were 28, with 11 live births and 7 miscarriages.

Conclusion: The study outcome demonstrates that using Chinese herbal medicine results in higher success rates of pregnancy, with no patient side-effects and a reduction in the category of patients conventionally classified as having unexplained infertility.

Introduction

The research question this study Read more

FALLOPIAN TUBE DYSFUNCTION AND CHINESE HERBAL MEIDCINE

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

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

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

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

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

SETTING: University IVF center.

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

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

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

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 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
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: 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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