The Difference between IVF and TCM

The Benefits of Acupuncture Treatments

The Truth about Herbal Medicine

The Benefits of Nutritional Counseling

The Benefits of Fertility Massage

Pre and Post Embryo Acupuncture Treatments

Traditional Chinese Medicine and Infertility

 

 

“I have known Mike for over three years, both personally and professionally. Mike represents the epitome of the dedicated clinical practitioner. His empathetic manner puts his patients at ease even under situations of great stress. His knowledge base is extensive and he delivers compassionate care with great empathy and sensitivity to his patient’s needs.”

 

“Over the last three years, Mike and I have worked very closely together, both in the office setting and in educational seminars and other programs. This interaction has taught me a great deal, and has helped me to understand the importance of acupuncture and other complementary treatments in helping individuals and couples that suffer from infertility. I would also say that it has made me a better practitioner as a result. Mike is a true role model and teacher, and I truly appreciate the experiences we have shared and all that he has taught me.”


Daniel Levine, MD, FACOG
Medical Director, Hudson Valley Fertility

 

 

THE DIFFERENCE BETWEEN IVF and TCM


Western reproductive medicine can do the following things: promote follicular development with certain medications, promote ovulation with other medications, perform intra-uterine-insemination, and in-vitro-fertilization. Western reproductive surgeons can also perform often necessary surgeries to create a fertile environment where polyps, fibroids, uterine anomalies and cervical anomalies are present. Without these types of interventions many infertile women would never have children.

Traditional Chinese medicine can often regulate systemic dysfunction naturally. That means that TCM can contribute to helping the PCOS patient ovulate without Clomid or perhaps with a lesser amount of Clomid. In the morbidly obese PCOS patient, weight loss is of paramount importance in increasing the ability to conceive because excess fat stores androgens and converts androgens to estrogen thereby creating a hormonal imbalance that is unlikely to enable conception. Acupuncture and herbal medicine along with exercise and life-style changes can make weight loss and its attendant health benefits possible.


Endometriois


In the endometriosis patient, acupuncture and herbal medicine cannot eradicate endometriosis but it can reduce the inflammatory environment associated with this disease. An interesting example of this is the patient with stage 1 endometriosis who does not present with pelvic distortion but cannot get pregnant. Why not? Her husband's sperm is fine and other than the endometriosis there are no contributing factors that are contributing to the state of infertility. Even other autoimmune disorders have been ruled out as possible contributing factors. The infertility stems from an inflammatory intrauterine environment that either destroys the embryos or makes the uterine lining inhospitable to an embryo which is trying to implant. Acupuncture and herbal medicine can often regulate this environment by reducing this inflammatory process.


Male factor


Many men have low sperm count as a result of a minor vericocele. Surgeons do not operate on minor vericoceles because the benefit does not exceed this risk. The cause of a vericocele is pooling and stagnating and over-heating of blood in the pampiniform plexus. The pampiniform plexus is the veins in the testicles. The sperm- killing-heat is caused by the pooling and stagnating of blood. Acupuncture and herbs can strongly move qi (energy, metabolism, circulation) and blood in the testicles. As a result of this, the blood is less congealed, the blood flow is more functional and the heat is diminished, contributing to increased sperm count. Even in the face of a major vericocele, the surgical outcomes are successful 50% of the time. This means that even with surgery there is a 50% possibility that the count will remain low. One of the reasons for this is that long term blood stagnation and heat in the testicles causes tissue necrosis (death) and sperm cannot be adequately produced. The determination of success can only be made after the surgery. The recovery time after the surgery is six months. The reason that this is the case is because the inflammation which is caused by the surgery takes that much time to be reduced. Utilizing acupuncture and herbal medicine after a vericocelectomy shortens recovery time by two months making the total recovery time four months instead of six. Men with any sperm anomaly should refrain from taking hot baths, saunas or riding a bicycle for long periods of time as all of these activities facilitate increased testicular temperature.

What about the patient who wants to do an IVF with her own eggs but her FSH is 18 and her doctor states that donor-egg is the only option? The doctor, essentially, is correct. He or she views this patient as one who either will not respond to gonadal stimulation and therefore produce either no eggs or produce too few to justify the continuation of the IVF cycle. So the reproductive endocrinologist offers the donor egg option with full integrity and with the patient's best interest in mind. But, here is what I have witnessed on more than a few occasions: I will treat the patient with acupuncture and herbal medicine and her numbers will regulate. Not necessarily to a 'perfect' level, but to levels which will facilitate having the reproductive endocrinologist have a 'second-look'. Subsequently many IVF cycles have been completed with a great many successful outcomes and many failures too. But I choose not to focus too much importance on the failures. It is the successes that would have never occurred had acupuncture and herbal medicine not been utilized on the patient who was told that donor-egg was the only option. In other words, inclusion of TCM has only an upside potential.


Implantation failure


Accounts for a substantial amount of infertility. Almost every patient that I have reports that her lining is "beautiful" according to her reproductive endocrinologist. The scientific truth however is that the morphology of the lining is not analogous to intraendometrial vascularization. This means that even though your lining may be thick it does not mean that there is enough blood flow getting to the lining. This is why sometimes even in the absence of any observable or diagnosable pathology, infertility manifests. Acupuncture and herbal medicine have been shown to increase endometrial vascularization and thereby increasing implantation potential.


The idiopathic patient


Idiopathy means 'no known cause'. What 'no known cause' means is that the limited Western medical diagnostic capabilities available today are only able to diagnose what they can, not what they cannot. In other words, there are many subclinical causes of infertility that have yet to be discovered and which, to date, have no remedies. Over time, this will change. This is by no means meant to be a derisive comment of Western reproductive medicine. IVF has brought thousands of children into the world and created thousands of happy families. These successes would not have been possible in the 'infertile population' prior to the advent of this incredible technological breakthrough.

Traditional Chinese medicine, based upon its method of diagnosis does not, as part of its medical vocabulary have a word that is analogous to 'idiopathic.' In other words, all cases of infertility can be diagnosed and treated. There are no mysteries or impossible cases. Each and every case can be, analyzed, differentiated, diagnosed and treated.

TCM can often establish a treatment protocol where Western medicine has none to offer other than donor-egg. TCM uses specific herbal formulas prescribed for a particular patient for a particular disorder, taking into consideration the whole patient as well as their pathology. The whole person is treated, not just their disease. What really does the "whole person" mean? It means that if the patient has a bad marriage, has low libido, chronic headaches, arthritis, depression, anxiety, frustration, a history of surgeries, a history of psycho-emotional trauma, a job she hates, a dying mother, low self-esteem, a smoker, a drinker, a stress eater, etc., etc., these things can contribute to her infertility.

How? Because the mind, spirit and body are inextricably connected. Not convinced? Ok, the why when you are very stressed do you get a headache or a stomach-ache. Why is it that when you are very depressed you have no energy? Why is it that when you pray you feel more empowered? Why is it that when you look better, you feel better and when you feel better you have more energy and when you have more energy you are less likely to get sick and when you are not frequently sick you are not chronically depressed?

Because the mind, spirit and body are inextricably connected. This is why TCM doctors treat the whole person; only treating the disease is like treating a cancer patient with aspirin for their pain.

This is why the best case scenario in the treatment of reproductive disorders (as well as all disorders) is to integrate both methods of medical expertise. The TCM application will help the Western reproductive medical protocol succeed in a shorter period of time. Or TCM may be the difference between success and failure in the Western medical setting; remember, IVF has a 30% success rate which means conversely that it has a 70% failure rate.


Herbs


Many doctors tell their patients not to take herbs. Can you imagine why? Go ahead, let your mind swirl around and try and latch on to one word that sticks. How about 'dangerous'? DID YOU KNOW: there are more than one million hospitalizations per years as a result of dangerous side-effects caused by pharmaceutical products. But pharma is big business and it has the money and power to squelch the media. When is the last time you heard about someone dying or even being hospitalized as a result of taking herbs? I'll tell when: NEVER. When is the last time you heard about someone getting sick, or being hospitalized or dying from herbal medicine? I'll leave that answer to you.

My view is that most Western medicine when prescribed by an expert in his or her field is safe and effective and usually there are no harmful side-effects. Why is it so difficult for Western physicians to say the same thing about herbal medicine? Is it perhaps because if a patient conceives as a result of herbs that a $10,000.00 to $15,000.00 IVF cycle would be cancelled? Again, I'll let you answer that question.

Herbal medicine, when prescribed by a Board Certified herbalist is not only safe, but safer than Western drugs. Can herbs "interfere" with Western medicine in an IVF cycle? No. I have been giving herbs to patients while they have been taking Western medicine for ten years. All that's happened is the production of babies. Can the Western medical establishment be threatened by herbs or acupuncture? I'll leave that for you to answer.

Here is a medical quiz. If you had a choice of doing something that could improve your chances of conception, would it be:

  1. Meditating
  2. Praying
  3. Yoga
  4. Acupuncture
  5. Herbal medicine
  6. Changing your diet
  7. Reducing stress

You're correct; all of these will help. But can you identify the two things above that have a three-thousand-year-old history of successfully treating infertility? There are only two in the list and only two in the world.

What I find amazing is that every infertile couple is not including acupuncture and herbal medicine as part of their protocol to conceive. Some individuals say they "don't believe in it." How can you not believe in something that has been scientifically proven to be effective in countless Western scientific studies?



Non-Believers


I've had my share of non believers; they were believers nine months later when they sent me tear-stained letters of gratitude for helping them become parents. Come to my office and see the photos on the walls, the photos of families, the photos of joyous moms and dads, the photos of their smiling cherubs; all sent from non-believers. I can assure that they are all converts now. In fact, a large referral source for me is from former 'non-believer' patients.

I am a staunch supporter and firm believer in Western reproductive medicine. But, TCM has been successfully treating infertility for 2930 years longer than Western medicine. And I want parity. Not for my ego or for the validation of the medicine that I so proudly practice but because parity will enable real patient care; better patient care than we presently have; more successful outcomes, more families granted to those who should but cannot have them.

Based upon the information I have provided herewith, it is my conclusion that to not use Traditional Chinese Medicine as part of an assisted-reproductive-medical-protocol is very short-sighted indeed.


Your world is a garden from which you can remove weeds of doubt and replace them with seeds of hope.


Mike Berkley, L.Ac., FABORM
Founder and Director, The The Berkley Center for Acupuncture & Herbal Medicine


 

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THE BENEFITS OF ACUPUNCTURE TREATMENTS


For eleven years, the acupuncture protocols and techniques and natural fertility medicine along with nutritional guidance and fertility massage provided at The The Berkley Center for Acupuncture & Herbal Medicine have been effective in accomplishing the following goals:

 

  1. Improve the function of the ovaries to produce higher quality eggs
  2. Increase blood flow to the uterus and increase the health of the uterine lining
  3. Relax and de-stress
  4. Prevent uterine contraction post IVF embryo transfer (this helps the embryo to successfully implant)
  5. Reduce the side-effects of IVF medications
  6. Strengthen the immune system and increase energy levels
  7. Improve sperm count, motility, morphology and reduce sperm DNA fragmentation
  8. Increase chance of conceiving
  9. Decrease chance of miscarriage
  10. Prevent morning sickness
  11. Help speed up physical recovery after giving birth
  12. Treat post-partum blues
  13. Reduce recovery time after a vericocelectomy 
  14. Naturally ‘turn’ breeched presentation

 

We have helped hundreds of infertile couples succeed where success was thought to be impossible.  We invite you to come to our Center and view our ‘Wall of Miracles’!

 

We use:

    1. Proprietary acupuncture protocols developed by Mike and used by Licensed and Board Certified Acupuncturists trained in the Berkley Method. If, however, your intake is with Mike, he will be the only one treating you.
    2. Customized herbal medicine prescriptions individually created for each and every patient by Board Certified Herbalists trained in the Berkley Method

 

And, if you live outside of the New York Metropolitan area, we offer:

 

    1. Telephone Consultations which will allow us to provide you with a proprietary, customized herbal medicine prescription created specifically for you. We will be in touch with you on a monthly basis to follow-up and monitor you. We are also available to you by phone or email every day should you have questions.
    2. We can also, at the end of the telephone consultation, provide you with a customized acupuncture-points-protocol designed to specifically enhance your fertile wellness for your acupuncturist to follow.

 

Call 877.965.BABY or 212.685.0985 to schedule your in-person visit or your telephone consultation. 

We invite you to join The Berkley Center Family so we can help you to start yours!

 

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The Truth about Herbal Medicine

 

Chinese herbal medicine has been used for more than 3000 years to treat various types of pathological presentations including infertility. The main difference between acupuncture and herbal medicine is that acupuncture helps to move energy and improve blood flow throughout the body in general and to specific areas in particular. If for example, one is trying to improve ovarian health and improve egg-quality, acupuncture can be used to drive blood to the ovaries, generally improving their function and making them more responsive to gonadotropins.

Herbal medicine however actually changes organ function. Herbs help to stimulate and nourish what is deficient (low platelet count) and to eradicate what is in excess (elevated androgen levels). Many reproductive endocrinologists do not want their patients to take herbs. The following two reasons are usually given:

1. "Herbs lower fsh falsely because they contain phytoestrogens." This misinformation would only be accurate if the herbs lowered fsh, and the patient's estrogen levels rose above 65pg/ml. The fact remains that many of our patients have their fsh levels regulated with herbal medicine in the context of an estradiol level which remains between 25pg/ml to 65pg/ml.

2. "Herbs can interfere with reproductive medicine." This is absolutely not the case. Herbs actually work synergistically with reproductive medicine. For example, many patients are poor responders to gonadotropins but, when gonadotropins are used in conjunction with herbs the response is frequently improved.

The main reason that your doctor does not want you to take herbal medicine is because she or he is trying to protect you against what they perceive to be a health hazards which may occur as a result of the herbs. Of course these herbs when prescribed by a Board Certified herbalist are completely safe. Health hazards do not occur as a result of taking herbs anymore than health hazards occur as a result of taking Lupron or Gonal-F.

Your doctor should be commended for his or her responsible behavior towards their patient, but, unfortunately their information comes from not having the information; in other words, ignorance.

This attitude may also be manifested by practitioners of Complementary medicine. Many Complementary medicine doctors frequently advise their patients to stay away from IVF or IUI procedures because the "drugs will be harmful." Of course this is utterly untrue. Once again, it comes from a position of ignorance. Western reproductive medical intervention is efficacious and safe. Think about this: when was the last time that you heard of someone being hospitalized or dying from herbal medicine which was prescribed by a Board Certified herbalist? I have never heard of such a case.

 

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PREGNANCY OUTCOMES THROUGH NUTRITIONAL COUNSELING IMPROVING

It is the balance of the “synergistic whole” of everything we eat over a period of time, not just at one meal or for one week that affects our long-term health, hormone balance and fertility quotient.
 
Our unique genetic make-up and responses to the environment means our bodies react differently to what we consume and to how we live.

The right food and fluids which nourish your body can make a huge difference in preparing your body for conception, increasing your fertility quotient and carrying through a successful pregnancy.

Nutrition is not simple. There is a vast choice of foods, and different preparation methods. Different foods contain hormones, trans-fats, soluble and insoluble fiber, sugar, and phyto- estrogens. Do you know which foods contain too much of one and not enough of another? Which foods can actually reduce your chances of having a successful pregnancy and which ones can help?  Because of the huge choice of nutrition based books, deceptive food labels, and so much conflicting food based data, it is almost impossible to know what diet is right for YOU, especially when you are trying to conceive.

Managing your nutrition and addressing lifestyle factors can:

³ Help women with a short lueal phase
a Improve egg quality
a Improve sperm quality
š Optimize success with IVF
[ Be beneficial in hormone balance
t Impact the baby’s neural development in the first 3 months
t Positively impact pregnancy in women with PCOS and Diabetes
Ý Help lower visceral fat (belly fat), which is linked to lower pregnancy rates
Ý Fertility is affected by Gluten sensitivity (often sub-clinical)
b Affect your estrogen levels
{ Affect absorption of essential nutrients
z Decrease insulin resistance and weight gain
¤ Correct body weight in “pre-diabetes” and thus carry pregnancy to term 
Ø Assist in regulating your menstrual cycle ª Increase the flow of blood to the uterus, helping to provide a more fertile environment for the embryo to grow and develop

 


Conceiving and carrying through a successful pregnancy is linked to body weight
:
³It is more difficult with a high body weight
³It is more difficult with a low body weight
³It is harder with bulimia nervosa type food habits

The Berkley Center’s Nutritional Counselor, Pratibha (Tibha) Patel uses nutritional therapies that take into account established data, new research, Eastern approaches to nutrition together with years of clinical experience as a registered dietitian. Tibha will be your nutrition guru utilizing customized nutrition programs to help create the most possible fertile environment possible.

Partners are strongly encouraged to join us in order to offer their support and learn about the benefits of nutritional changes!


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the Benefits of Fertility Massage

 

Fertility massage encourages relaxation, particularly for tense muscles and tight connective tissues that can constrict uterine blood flow. Fertility massage will improve circulation especially to the uterus and ovaries. Our techniques also help reduce emotional strain and stress so that you can experience a beautiful successful pregnancy from conception to the postnatal stages.

 

The massages are customized to specifically fit the needs of each individual. The type of massage you will receive depends upon your condition and what is best for your overall care.

 

These different massage types include Swedish, to stimulate blood flow and circulation, Amma Therapy, which, like acupuncture works within the channels and meridians of the body, Myofascial release, an effective therapeutic approach in the relief of constrictions and adhesions that may be contributory factors in infertility and the letting go of emotional trauma, and Reflexology.

 

Reflexology is used to facilitate relaxation and stimulate the circulation of blood and lymphatic fluids. It is especially useful in stress-related disorders.  We can discuss these options if they are deemed appropriate after your evaluation.

 

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PRE AND POST EMBRYO ACUPUNCTURE TREATMENTS

 

Acupuncture on Embryo Transfer Day
A practitioner from our office can be available to provide onsite acupuncture services at your home, hotel or the reproductive endocrinologist’s office on the day of embryo transfer. Contact our office on the day of your egg retrieval or when you have a tentative transfer date and time so we can schedule this. Be sure that your reproductive endocrinologist and his or her staff are aware that you will be receiving acupuncture so that a room and an adequate amount of time are made available for you. The treatments last approximately twenty-five minutes each and are performed immediately before and after the transfer.

 

Acupuncture After Embryo Transfer
Women who continue treatment after embryo transfer throughout the first trimester have higher ongoing pregnancy rates. Why is this? It is the implanted blastocyst (your tiny growing baby) that sends a hormone called human-chorionic-gonadotropin to the corpus-luteum. It is the corpus-luteum that is responsible for the secretion of progesterone, an important chemical for keeping you pregnant.

 

By continuing to stimulate blood flow to the blastocyst, acupuncture helps to maintain the health and strength of the blastocyst-corpus-luteum relationship, thereby maintaining the proper level of progesterone.  Then, after six weeks, your placenta takes over the role of secreting progesterone. Acupuncture stimulates blood flow to the placenta helping it to do its job of protecting and nourishing your growing baby. One major reason for miscarriage is inappropriated blood flow to the placenta.

 

READ THIS STUDY!
‘Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial’ by Lars G. Westergaard, M.D., Ph.D., Qunhui Mao, M.D., Marianne Krogslund, Steen Sandrini, Suzan Lenz, M.D., and Jergen Grinsted, M.D., Ph.D

 

  1. See, e.g., Harefuah. 2003 Apr;142(4):297-300, 316; Obstet Gynecol. 1992 Nov;80(5):852-4
    2.  See, e.g., Wien Klin Wochenschr. 2001 Dec 17;113(23-24):942-6; Minerva Ginecol. 2003 Dec;55(6):503-  
  2. 10; Obstet Gynecol. 1989 Feb;73(2):286-90.

 

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TRADITIONAL CHINESE MEDICINE AND INFERTILITY

 

Written by Mike Berkley, L.Ac., DA(RI)

 

Although health and healing are the common goals of Traditional Chinese Medicine (TCM) and western medicine, their ideas on the cause of disease, the disease itself and the process used to regain health are different. The western physician learns that disease must be cured by prescribing medicine which kills bacteria or renders a virus ineffective and, at times, surgical intervention is a necessity.

 

There is nothing inherently wrong with this approach. It often works. The question worth exploring is why TCM succeeds where western medicine fails? What is the mechanism of action of acupuncture and herbal medicine which results in palliation or cure that is not manifest in biomedicine?

 

Though the goal of TCM is to cure a patient, the doctor of TCM attempts to do this not by treating the disease but rather by treating the whole person, taking into account the various attributes of an individual which, when combined, account for an individual being sick or healthy. A person, according to the tenets of TCM is more than their pathology. While treating the pathology may yield impressive results, they are commonly temporary.

 

A person is not, according to TCM, represented solely by his or her illness, but by the accumulation of every human interaction engaged in from the moment of birth, including the values of and the culture from which the individual develops. The emotional experiences, eating habits, work habits, work and living environment, personal habits and the social milieu are factors that contribute to disease and are factors which, when modified appropriately may lead to regained health.

 

Though the Western scientific community has not, to date, arrived at a methodology to use in research of Chinese medicine, the veracity and efficaciousness of this medical modality is nonetheless proved by its long history of continued success. More than a quarter of the world's population regularly uses TCM as part of their health care regimen. Chinese medicine is the only form of classical medicine, which is regularly and continuously used outside of its country of origin.

 

The Four Examinations
The 'Four Examinations' is a method of diagnosis which dates back over three thousand years. Observing, Listening and Smelling (Listening and Smelling are counted as one of the Four Examinations), Questioning and Palpating make up the 'Four Examinations'. This method of diagnosis is far from simplistic, allowing the practitioner to arrive at a differential diagnosis.

Each of the "Four Examinations" can take years to master, and while these diagnostic tools are not replacements for that which Western medicine can provide in analyzing and treating disease, they have the ability to offer information which, when understood in the context of TCM, provides additional opportunities in mapping out patterns of disease and arriving at greater treatment success.

 

The doctor of TCM must approach a patient with a clear and calm mind, without a preconceived diagnosis and etiology. This mind-set will enable the practitioner to yield clinical gems which are clues about the individual who sits before us! This is the stuff of TCM.

 

The subjective, interpretive and objective evidence of an individual obtained via the 'Four Examinations' leads to the discovery of the etiology of disease while concomitantly opening a window to the 'Whole Person", thus revealing where in the individual's life the pathogenesis started and what initiated it. The practitioner of TCM must utilize his own interpretive skills, which takes into consideration what is verbalized by the patient and what is observed, while considering what the patient does not verbalize as well. Often, that which is not said can be as clinically enlightening as the information which is freely provided. The tone of the voice, the complexion, the condition of the eyes (in TCM, the Shen or spirt of an individual is said to be revealed through their eyes. Who can deny the clinical efficacy of this? Is there a different expression revealed through the eyes of a clinically depressed individual than from those of a happy, well adjusted one?), the facial expression, the overall demeanor, how one walks, sits, and stands are all observed and utilized by the doctor of Chinese medicine as part of the information required to arrive at a differential diagnosis. The doctor must be able to note and sense inconsistencies in an individual that are expressed by the patient even without the patient being cognizant of the chasms which exist between what they verbally express and what their spiritual presentation divulges. The sensitivity to and awareness of these human idiosyncrasies enables the TCM doctor to develop an understanding of who the patient is even before the 'main complaint' is discussed.

 

Proper treatment in TCM is more than the elimination of pathological processes. In addition to attacking a pathological factor(s), it is the responsibility of the TCM doctor to support the individual in his or her goal of achieving overall health which includes aspects of physical-psycho-emotional and spiritual health. This paradigmatic approach is an inexorable part of the process of healing. Without it, we are merely chasing the sickness and forgetting about the patient. With this approach, the patient is seen as a whole person, representing the sum of a lifetime of experiences if you will, not just an embodiment of pathology.

 

Pathologies are guests (and we hope temporary ones!) in a home which serves as a gracious host - our physical, emotional and spiritual selves. TCM first is concerned with strengthening the immune function which includes homeostasis of the physical, emotional and spiritual attributes of the patient, so as to be able to assist the patient in his or her endeavor to do battle and destroy the enemy at the gates (or inside them). When people are chronically exhausted from lack of sleep resulting from anxiety or depression, they can become chronically sick as a result of a lowered immune system.

 

In TCM the point of departure from Western medicine is not to view the acute presentation (called "the branch" in TCM) as primary, but to treat the etiology (called "the root" in TCM) which is the anxiety and depression which causes the insomnia then facilitating exhaustion and lowering the immune function which can lead to chronic illness.

 

So, rather than prescribing antibiotics repeatedly, we might address the patient's anxiety/depression syndrome or refer them out to a psychotherapist for appropriate intervention while simultaneously providing treatment.

 

Infertility and TCM - Mechanisms of Action
It was shown in a study done at Harvard that stress reduces the hypothalamic-anterior pituitary-ovarian axis function, thus being a factor to be considered in the infertility work-up. Acupuncture releases endorphins which mitigate ones response to stressful stimuli thus enhancing the possibility for conception.

 

"Historically, infertility, particularly "functional" infertility, was attributed to abnormal psychological functioning on the part of one or both members of the couple. Preliminary works in the 1940s and 1950s considered "psychogenic infertility" as the major cause of failure to conceive in as many as 50% of cases. As recently as the late 1960s, it was commonly believed that reproductive failure was the result of psychological and emotional factors. Psychogenic infertility was supposed to occur because of unconscious anxiety about sexual feelings, ambivalence toward motherhood, unresolved oedipal conflict, or conflicts of gender identity. Fortunately, advances in reproductive endocrinology and medical technology as well as in psychological research have de-emphasized the significance of psychopathology as the basis of infertility, and modern research shows that there is little evidence to support a role for personality factors or conflicts as a cause of infertility. This perspective unburdens the couple by relieving them of the additional guilt of thinking that it is their mental stress that may be responsible for their infertility.

 

Biologically, since the hypothalamus regulates both stress responses as well as the sex hormones, it's easy to see how stress could cause infertility in some women. Excessive stress may even lead to complete suppression of the menstrual cycle, and this is often seen in female marathon runners, who develop "runner's amenorrhea". In less severe cases, it could cause anovulation or irregular menstrual cycles. When activated by stress, the pituitary gland also produces increased amounts of prolactin, and elevated levels of prolactin could cause irregular ovulation. Since the female reproductive tract contains catecholamine receptors catecholamines produced in response to stress may potentially affect fertility, for example, by interfering with the transport of gametes through the Fallopian tube or by altering uterine blood flow. However, more complex mechanisms may be at play, and researchers still don't completely understand how stress interacts with the reproductive system. This is a story, which is still unfolding, and during the last 20 years, the new field of psychoneuroimmunology has emerged, which focuses on how your mind can affect your body.

 

Research has shown that the brain produces special molecules called neuropeptides, in response to emotions, and these peptides can interact with every cell of the body, including those of the immune system. In this view, the mind and the body are not only connected, but also inseparable, so that it is hardly surprising that stress can have a negative influence on fertility.

 

Stress can reduce sperm counts as well. Thus, testicular biopsies obtained from prisoners awaiting execution, who were obviously under extreme stress, revealed complete spermatogenetic arrest in all cases. Researchers have also showed significantly lower semen volume and sperm concentration in a group of chronically stressed marmoset monkey, and these changes were attributed to lower concentrations of LH and testosterone (which were reduced in the stressed group). However, how relevant these research findings are in clinical practice is still to be determined."

 

The stress factors that acupuncture addresses stems from both psycho-emotional factors as well as physical etiologies. For example, extremely painful pre-menstruum or mid cycle pain can be debilitating. This type of physical stress, no doubt produces emotional stress as a result of missed work, manifest pain and other life-style factors resulting from such extreme pain; all can mitigate the function of the reproductive system.

 

The insertion of acupuncture needles has been shown to effectively increase blood circulation. Acupuncture is very effective in treating, for example, Reynaud's Syndrome. Enhanced microcirculatory patency to the uterine lining does, undoubtedly contribute to a healthier and more growth oriented endometrium, especially when utilizing electrical stimulation on inserted acupuncture needles on points known as zigongxue which reside superior to the ovaries. The points zigongxue are located 3 inches inferior to the umbilicus and three inches bilateral to the anterior midline.

 

"They reviewed existing evidence regarding the role of acupuncture in the treatment of infertility, and identified a number of studies indicating that acupuncture can be beneficial as an adjunct to other infertility treatments, including IVF. Only one randomized controlled study examined the independent effect of acupuncture on IVF outcomes, but this indicated a positive effect.

 

The reviewed authors also highlight evidence that shows the effects of acupuncture may be mediated through neuropeptides that influence gonadotropin secretion, which could in turn affect the menstrual cycle. The technique can also reduce stress, which is known to adversely affect fertility, and has been implicated in the regulation of uterine blood flow."

 

"Using acupuncture during assisted reproduction may improve pregnancy rates, say researchers. However, they acknowledge that the mechanism behind this effect is unclear, and the team plans to carry out further studies to confirm, and further investigate, their findings.

 

Noting that acupuncture has been shown to affect the autonomic nervous system, Dr. Wolfgang Paulus (Christian-Lauritzen-Institut, Ulm, Germany) and colleagues postulated that the therapy could increase endometrial receptivity via control of related muscles and glands.

 

The researchers randomly assigned 160 women receiving assisted reproductive therapy to undergo IVF with or without acupuncture, before and after embryo transfer. In acupuncture subjects, the needles were placed at points believed to influence reproductive factors, for example by improving blood flow to the uterus.

Paulus et al report that the acupuncture group had a higher rate of pregnancy compared with those not given acupuncture (43 percent versus 26 percent). They conclude, therefore, that acupuncture could be "a useful tool" for improving pregnancy rates during certain infertility treatments."

 

A Diagnostic Window - East Meets West
One TCM diagnosis which exists and which may be etiologic for male or female infertility is called Liver qi stagnation. One of the key identifiers of an individual with the pattern differentiation of Liver qi stagnation is anger, rage, frustration, depression and anxiety.

 

"Symptoms of depression, anxiety, and anger may help in determining the nature of infertility experienced by some couples, and identify those who would benefit most from psychological counseling, suggest researchers.

 

Dr. Secondo Fassino (University School of Medicine, Turin, Italy) and colleagues recorded the personal characteristics of 156 infertile and 80 fertile couples, and measured their degree of psychopathology. When the researchers divided the couples according to the nature of the infertility-organic, functional, or undetermined-they found that the triad of anxiety, depression, and a tendency toward anger suppression successfully predicted the diagnosis of organic or functional infertility in women, with 97 percent accuracy.
For infertile men, anxiety was also an important independent predictor of functional infertility, increasing the likelihood of having this form of infertility five-fold, while depression was more predictive of organic infertility. However, with men - unlike women - anger did not appear to influence infertility in men.

 

The results suggest the possibility of identifying a subgroup of infertile subjects where, beyond the distress that is consequent to the failure of repeated attempts to conceive a baby, there is also a poorly adaptive psychological functioning, which is likely to play an important role in the onset and course of functional infertility," the team concludes."(iv)

 

It is becoming more and more prevalent that research conducted by Western scientists and physicians are highlighting the veracity and effectiveness of Traditional Chinese Medicine.

 

Natural Fertility Medicine
The efficacy of herbal medicine in treating infertility is indisputable to the patient community although the mechanism of action is not completely understood at this time. Similarly the mechanism of action of tricyclic antidepressants is not fully understood in its effect on chronic pain (i.e., in the case of fibromyalgia), but its efficacy has been maintained.

 

Practitioners of Chinese herbal medicine rarely use a single herb in treatment. Chinese herbs are formula based; many herbs are mixed together to create the perfect 'decoction' specifically designed for the individual patient.
Some formulae contain two herbs and some thirty or more herbs. Each herb has many functions. Each herb has its own flavor, nature, temperature and trophism. Prescribing the correct herbal medicinals requires extensive training and clinical experience.

 

Self-medicating with herbal medicine presents a dual dilemma. At best the herbs will be useless, as the key to correct formula prescription is an accurate differential diagnosis which can only be rendered by a licensed, board certified, experienced practitioner. At the worst case, self-prescribing of herbal medicine may prove harmful or fatal.

 

A good example of this is Ma Huang/Ephedra. Ma Huang is an herb prescribed on a daily basis by hundreds of TCM practitioners to thousands of patients safely.

 

That several people have died as a result of taking Ma Huang has nothing to do with the dangerous properties of the herb, rather with the fact that in all cases of fatalities the individuals were self-medicating, without directions from a doctor required for appropriate applications and contraindications. Aspirin can also prove fatal if taken by a hemophiliac. This is not an indication that aspirin should be banned or that it is a dangerous drug, but that it is unsafe if used inappropriately and safe if used appropriately.

 

Not only is herbal medicine safe, it is highly effective in treating much pathology without the concomitant adverse effects which often accompany pharmaceutical drugs. There are many hospitalizations and fatalities which occur yearly as a result of adverse reactions to biomedicine. The occurrence of adverse reactions to herbal medicine is far less.

 

I have used herbal formulas repeatedly to lower elevated FSH levels, to regulate irregular menstrual cycles, to mitigate pain in the endometriosis patient; to mitigate pain in the patient who presents with ovulation and/or menstruation related migraines; to thicken an unresponsive endometrium; to treat the amenorrheic and the oligoamenorrheic patient; to treat patients with partial tubal occlusion; and the patient who presents with idiopathic infertility. Additionally, I have successfully treated male factor infertility, which includes presentations such as low sperm count and poor motility, poor morphology and sperm dna fragmentation.

 

Clearly, further research is needed to fully understand the mechanisms of action of acupuncture and herbal medicine in treating the infertile patient. Nevertheless, it is my opinion that the best-case scenario for most patients is to offer them every reasonable option which may serve to successfully address their presentation. Based upon the empirical evidence of my practice in which I specialize in the treatment of the infertility, the integration of acupuncture and herbal medicine into the treatment protocol from a clinical perspective makes sense.

 

i Domar, Alice

ii Fertility and Sterility 2002: 78: 1149-53

iii Fertility and Sterility 2002: 77: 721-724

iv Human Reproduction 2002; 17: 2986-94

v Adverse reactions to drugs are very common in everyday medical practice. A French study of 2067 adults aged 20-67 years attending a health centre for a check up reported that 14.7% gave reliable histories of systemic adverse reactions to one or more drugs. In a Swiss study of 5568 hospital inpatients, 17% had adverse reactions to drugs. Fatal drug reactions occur in 0.1% medical inpatients and 0.01% of surgical inpatients. The main drugs implicated are antibiotics and non-steroidal anti-inflammatory drugs. Adverse reactions to drugs occurring during anesthesia (muscle relaxants, general anesthetics, and opiates), although less common (1 in 6000 patients receiving anesthesia), are life threatening, with a mortality of about 6%.

BMJ 1998;316:1511-1514 ( 16 May )

 

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