Birkdale Acupuncture & Pain Clinic Simon Rowe MATCM Liverpool and Southport

Fertility #01

INFERTILITY

Acupuncture, Infertility & IVF
PCOS & Diet
Fertility Statistics
Endometriosis
Male Fertility
Unexplained Infertility
Costs & Programmes
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ACUPUNCTURE, INFERTILITY & IVF


A number of studies and clinical trials have been run over the past few years showing how conception rates have fallen in the past 30yrs due to women starting pregnancy later in their lives, poor sperm quality and stressful lifestyles, with poor nutrition and little exercise.

Traditional Chinese Medicine (TCM) can offer a path to follow for a healthier body and lifestyle approach and can aide couples conceive naturally, improve sperm quality and quantity, and also improve the chances of achieving a first time IVF implantation and conception with little side effects. Either Acupuncture, Chinese Herbs and/or Dietary therapies will be utilised for maximum effect.

NATURAL APPROACH

Using a TCM approach a regular treatment approach is needed to correct any imbalances in your bi-phasic Basal chart or menstrual cycle, by mainly balancing the oestrogen and the progesterone levels (otherwise known as Yin & Yang in Oriental medicine). Any PMT, cramping or pain, irregular cycles, lack of ovulation, problems with menstruation and any blockages, such as Endometriosis and PCOS will need to be addressed aswell.

Using Acupuncture to regulate your cycle and herbs to nourish the blood/kidneys and clear any menstrual irregularities with advice on diet, we should see a return to a normal, almost painless menstration and regular ovulation.

If your cycle is already regular and painless and free from complications, then Acupuncture can enhance and boost your system for those ladies trying to conceive naturally.


IVF APPROACH

It is preferable to prepare the body before IVF treatment begins, however, we can still assist, especially if your IVF programme begins shortly. All that happens is that our odds are much better in improving the quality of eggs/follicles, conception is still possible but the chances are higher when your body can receive regular pre-IVF treatment with Acupuncture/Herbal tonics.

Obviously this depends on one's financial situation and we have a number of treatment plans to cover different circumstances.

Generally speaking the highest rates of conception occur when regular weekly treatment is given before and during the IVF cycle. Treatment is also especially recommended the day before egg extraction and on the afternoon of any fertilised egg implantation, these treatments help to relax the uterus for collection and enhance the "holding" function of the implantantion.

See the Fertility Statistics page for further information about the improvements Acupuncture can give to helping your IVF chances of conception.


WOMEN OVER 35

Will also need to improve their monthly cycles and strengthen the body for pregnancy in order to lessen the chances of miscarriage, especially for those in the late 30’s and early 40’s age groups. For these women getting healthy and strong first is more important than conceiving even if they do not see it that way!

Nine months of labour is hard on a body which is normally primed for pregnancy between 21-28, as the Chinese reckon women have life cycles of 7 yrs with 14 begins the start of menarche, 35 and the body has peaked, from 42 a woman starts to move into pre-menopause (though not impossible to conceive) and at 49 a woman is ‘barren’! (ie.menopause).

Of course what is more important is a womans biological age, not her birth certificate age, for those women who have followed a healthy, natural lifestyle with regular exercise and a good balanced diet with little or no vices! (drugs,smoking,alcohol,stress), then the outlook is promising if they decide to have a baby later in life.

REMEMBER it takes the body about 90 days to grow an egg naturally in the follicle


MEN

They are still 50% of the equation and since male sperm fertility has reduced dramatically over the past few decades due to poor diet, work stress and environmental pollutions (eg.mobiles, computers, fertilisers etc). It has been shown that with 40% of all infertile couples , it is the man’s sperm quality at fault.

Thankfully, we can fairly quickly rectify the sperm through our special dietary advice and Acupuncture/Herbal patent treatments. Women’s eggs cannot be altered so quickly but can be protected and nourished accordingly. It is the flow of Qi, blood & hormones through the body that Acupuncture and Herbs aims to focus on. back to top



Fertility #02

PCOS & DIET

Polycystic Ovarian Syndrome (PCOS), is the medical term for cysts around the ovaries affecting the proper funtioning hormonal flow of a woman's cycle.

Diet has a big effect on the functioning of the Ovaries, any excess weight and /or lack of exercise will seriously affect the release and implantation of follicles and eggs! And will also contribute to the increasing gyneological problem of PCOS, which causes irregular menstrual cycles and infertility.

5m women in the US have PCOS which equates to about 5-10% of all women of reproductive age. Most is picked up on ultrasound (about 20-25%). And now we are finding that upto 50% of teenage girls have PCOS which must be due poor diet and lack of exercise or is being passed on by the maternal mother.

This syndrome is resistant to IVF and needs regular TCM treatment & the diet needs to be seriously re-addressed with additional exercise. In a UK study out of 2,000 women the following symptoms will apply if PCOS present (source: J Lyttleton):

  • 66% - hirsutism
  • 50% - irregular periods
  • 40% - high Lutein Hormone
  • 38% - overweight
  • 30% - high testosterone
  • 20% - infertile

    Other studies have found a link between PCOS, the metabolism and Type II Diabetes with insulin resistance, obesity and cardiovascular disease also linked. A diet rich in sweet, oily/greasy and dairy foods could cause or exacerbate PCOS!

    What women find with PCOS is that most of their weight goes around their middle and abdomen causing feelings of bloatedness , digestive issues and tiredness leading to prolapses ( miscarriage rates are also higher in this group). So ladies who are mainly apple shaped are at risk.

    In Chinese Medicine PCOS is classified as being a Damp +/or Phlegm condition and causes an obstruction to the fallopian tubes & Uterus impairing implantation and fertilisation. Acupuncture with herbs and diet can bring this under control.

    The effects of weight loss on a woman’s fertility from a recent study showed that:
    * Over 6 months with 10kgs lost = 90% ovulated, 77% got pregnancy and 67% had Live births.
    * No weight loss program = ? unsure ovulated, 12% pregnancy rate, and 3% Live birth rate (75% miscarried in this group).


    Losing weight though is not easy if you have some sort undiscovered insulin resistance and abnormal Ghrelin hormone levels, therefore, one MUST EXERCISE as well as dieting. The best diet so far for these women is a “LOW GI/High Protein Diet”.

    Exercise consumes calories, builds muscle which promotes more efficient use of insulin, reduces blood insulin levels and makes weight loss easier. The Low GI diet is low in calories, does’nt raise blood sugar levels, does’nt produce so much insulin and manages hunger better.

    Even losing 5-10lbs has a massive effect on the body’s hormone and insulin levels!

    Another small Chinese study showed Herbs and Clomid improves the odds;
    Ovulation - Pregnancy
    Combining Chinese Herbs + Clomid:
    87% - 65.6%
    Using Clomid only:
    66% - 36.6% (!)
    (Chinese researches 2004 Jan, Shao B Y et al)

    Western medicine has no effective drug therapy & if the condition is severe will offer IVF, even though the trials show the odds are not great or maybe laser surgery with all its inherent risks. back to top



  • Fertility #03

    FERTILITY STATISTICS

    The average womans cycle should be somewhere between 26-32 days, the textbook cycle would be 28/29 days but what's more important is that it should be REGULAR. If outside these ranges or irregular then TCM treatment needs to taken up in order to regulate the cycle and improve fertility.

    In IVF this is circumvated and the egg and fertilised sperm are implanted regardless of a womans menstrual irregularities and is one reason why their success rates are about 15-20% for pregnancy, of which upto 50% may miscarry in the first trimester for women 35+. These are worrying statistics and can be gleaned from some of the IVF clinics own published rates.

    Recent studies combining Acupuncture & IVF in Germany have increased these percentages to 40%, and combined with Chinese herbs upto 60%, for conception. (April 2002, Dr. Wolfgang, E Paulus et al, Fertility & Sterility Vol.77).

    However, the standard chances of conception for 100 couples are:
    3 months - 50% pregnant
    6 months – 70% pregnant
    12 months – 85% pregnant
    24 months – 92% pregnant
    36 months – 95% pregnant


    From this you can see that getting pregnant right away may not happen as planned! Remember this covers all ages and healthy couples. The older the couple the less chances of getting pregnant within the above time frames and will take longer on average. TCM can help to shorten these odds with regular treatment.

    AGE - this has a huge effect on normal chances of conception:
    20-30 - 95%
    30-40 – 80% big drop after 39!
    40-44 – 50%
    45-49 – 15%

    If there are any minor abnormalities with the sperm/eggs/tubes/menstrual cycle then the chances are as follows (all sources Jane Lyttleton, TCM in Fertility 2004, Churchill Livingstone):

  • 3 months – 20% pregnancy rate
  • 2 years – 63.6% “
  • 3 years – 75.5% “


    Women are born with 2m follicles , this drops to 500k at 18yrs and gradually drops to 100k at 37yrs and 10k at 41 yrs, 5k at 45yrs. The less there are the less that can be stimulated, TCM cannot make more only preserve what is left!

    IVF These were the results from an IVF clinic published in Fertility & Sterility, May 2006 by Dr. Smith, Vol85:
    * Acupuncture on 110 women, 34 women got pregnant with the first implantation and 28 went to full term. These percentages are higher than just using IVF only*

    Another trial by Westergaard et al, Fertility & Sterility, 2006 Vol 85 shows Acupuncture with Embryo Tfr:

    Not Preg - Conceived - Ongoing Preg

    1. No Acu – 87 women:
    76% - 24% - 22%
    2. Plus Acu – 95 women:
    61% - 39% - 36%
    3. Plus Sham Acu – 91 women:
    64% - 36% - 26%


    This shows that Acupuncture not only helped more women conceive than IVF but more importantly there was less miscarriages. Even sham Acupuncture had some good results!

    ICSI – Another small study found that receiving Acupuncture before ICSI found sperm ferilisation rates increased to 66%, compared to only 40% without Acupuncture back to top



  • Fertility #04

    ENDOMETRIOSIS

    This medical complaint describes the condition were endometrial tissue is growing outside of the uterus, with about 5m women in America and 89m worldwide suffering from this condition, symptoms include the following:

  • pelvic pain
  • painful periods
  • premenstrual spotting
  • painful intercourse
  • infertility
  • others - diarrhoea, constipation, pmt, pain on defaecation

    Some women experience no pain nor any of the above symptoms, except infertility and only find out about the Endometriosis via scans or pelvic operations. Western medical treatment find this difficult to cure and uses pain killers or surgery, however, from a Traditional Chinese Medicine perspective if the women is ovulating and menstruating (albeit painfully) this is actually easier to treat than PCOS!

    Endometriosis produces mucus which can obstruct fallopian tubes, cause low progesterone, abnormalities in the endometrium preventing implantation of the fertilised egg, distorts the tubes/ovaries and damages the sperm. TCM uses a lot of blood moving tonics and Acupuncture to clear and reduce the endometriosis and recent trials have shown its effectiveness:

    83 Women with Endometriosis took Chinese Herbs for 3 months, the results where:
  • Cure - 41
  • Good - 27
  • Effective - 10
  • Ineffective - 5

    Another small Chinese trial in 1998 also found that out of 26 women, 24 women were cured after 10-20 days

    To help decrease Endometriosis a special dietary programme can also help reduce this painful syndrome. Dietary advice will be given to the appropriate patients with Chinese Herbal Patents and recommended supplements to diminish the condition. back to top



  • Fertility #05

    MALE FERTILITY

    This is now becoming more common with approximately 40% of men having some sort of spermal abnormality, however, this is not as complex to fix as a woman's hormones (!), because men make sperm in their testes every few days. Whereas women only have a finite number of follicles that can become eggs.

    One in twenty five men also have sub-fertility, according to a Scottish study covering 7,000 men. From 1989 to 2007 men’s fertility levels dropped by 33%, so in less than 2 decades rates have dramatically fallen. What will happen in the next two?

    The WHO have also had to reduce their Sperm Analysis guidelines because of the falls, to 1ml volume, 48.5m sperm per ml, 63% motility with less than 88% abnormal forms. A man’s sperm volume drops 20%, between 30 and 50, and the count of motility drops nearly 5% per year.

    The cause of low sperm counts have been put down to:

  • 66% is due to unknown cause(probably due to stress/diet?)
  • 20% testicular mal descent
  • 7% trauma/torsion
  • 5% genetic problems
  • 1% mumps
  • 1% chemo

    Other causes are obstructions such as reversed vasectomys, vas deferens missing, chlamydia and varicocele ( dilated veins on the scrotum). Strong medication, close proximity to chemicals, pesticides, paints, glues, mobile phones, radiation, wearing tight jeans(!) and hot baths can also damage sperm.

    Western medicine has no real effective therapy to help a man’s fertility and drugs such as corticosteroids/ cyclosporine, sperm washing, immunomagnetic sperm separation and proteolytic enzyeme treatment are either very invasive, expensive or have side effects.

    Again this is where diet, lifestyle and TCM medicine & Acupuncture can really help to improve a man's sperm quality. Plus stress reducing techniques, anti-oxidants and certain good vitamin/mineral supplements and super food groups can all assist.

    In October 1997 tests were done with 32 subfertile men with sperm impairment , 16 were given just 10 acupuncture treatments and 16 no treatment. In the acupuncture group the motility, intact sperm and viable sperm all increased significantly. When herbs are also added the odds further improved:

    A small Chinese trial by Fu B et al, Trad Chinese Med, 2005 resulted in:
    Effectiveness Rate - Decrease in antibodies
    50 men Acu & herbs -
    90% - significant decrease
    50 men just Oral Predisone -
    64% - slight decrease


    Other studies have found that just 5 weeks of Acupuncture can improve men's sperm quality.

    ICSI trials with Acupuncture also showed promising results in China in 2002: Improving motility (18%), morphology (21%) and fertilsation rates (66%).

    Chinese herbs has also had considerable success with sperm morphology, varicoceles (88% disappearance) & conception rates improved to 21% against IUI techniques of 11%.

    During IVF, Chinese herbs protect sperm from the in vitro effects of added ASAB (this slows sperm and reduces their motility in vitro ( Yamanaka M, Nippon, Japan 1998). back to top



  • Fertility #06

    UNEXPLAINED INFERTILITY - A Natural Balance

    The more men & women live in accordance with Nature and follow as sensible a balanced diet of organic produce as possible, the more their chances increase of falling pregnant naturally. Our lifestyles also have to be addressed, with regular exercise, weight management programs, stress reducing techniques and a determination to focus upon one's own health and happiness.

    The more we move away from that focus the more our bodies become out of balance!

    Unexplained infertility is therefore a frustrating diagnosis by the western professions as it does not tell you anything that you don't already know! This is where maybe a Traditional Chinese Medicine approach can pick up the bits of information from a holistic approach and offer a common sense explanation and treatment protocol. And help people move back into balance.

    About 30% of all cases of infertility in women and 25% in men are labelled as unexplained causes (re: Dr. Randine Lewis, The Infertility Cure).

    Often after a battery of negative tests couples are told to just go home and have more sex! Then the next steps offered are IVF or IUI, with all their inherent problems and side effects. TCM offers a way of addressing the manifestation of the problem and determination of the cause. Generally there is always some sort of sign or symptom that has been overlooked, either issues with the menstrual cycle or feelings of cold, heat, tiredness or stress.

    When these imbalances are addressed the reproductive system can begin to function normally and the chances of natural conception increases.

    At Oriental Acupuncture Ltd as part of the infertility programmes, besides Acupuncture we can offer advice and informational handouts covering personal nutritional programmes, selected advice on best forms of exercising, individual recommendations on supplements and Chinese Herbal tonics to improve one's fertility and heal any outstanding illnesses or imbalances which maybe causing unexplained infertility.

    All details are given upon consultation and enrolement on our Fertility Enhancement Programmes... back to top



    COSTS & PROGRAMMES

    In order to make Fertility Enhancement available to as wider a range of infertility patients as possible, a number of different payment schemes are laid out below:

    CONSULTATION & INITIAL TREATMENT...£40 (1hr)

    A full medical case history is taken with a Traditional Chinese Medicine diagnosis of the main fertility issue (includes Pulse Analysis, Tongue assessment and Abdominal palpation) and then an initial treatment is given.

    A prognosis will be given, with an estimate of how many treatments are required though patients need to realise that it takes at least 90 days for an antral follicle to grow. With mutual consent one of the below options will be offered and agreed upon from the outset, or the patient can consider later his or her options.

    TREATMENT OPTIONS:

    Pay per session...£35 (45 mins)

    Discount packages:

    6 Weekly Treatments...£195

    12 Weekly Treatments...£360

    These packages also cover full dietary and nutritional support for both partners, abdominal/ovarian massage techniques and other ancillary treatments.

    Note: all Packages are paid upfront at the start of treatment.



    HEALTH INSURANCE

    Most major Health Insurance providers also re-imburse for cost of treatment for Acupuncture. Amongst the most popular plans Medicash & Simply Health offer from 50% to 100% reimbursement depending on the scheme signed-up for, but please check with your company first before starting treatment that they recognise one of the main associations "ATCM"(Association of Traditional Chinese Medicine). A receipt at the end of treatment is given, which is sufficient to forward to the respective Insurer for re-imbursement.

    Other Insurers that recognise Traditional Chinese Acupuncture:

    Medisure (requires consultant referral)
    Sovereign Health Care
    HSF Health Plan
    National Friendly
    Healthshield
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