FERTILITY

 

 

It is reported that approximately one in every six couples have trouble with conception (Evers, 2002). Infertility  is defined as the failure to conceive after a year or more of regular intercourse during the time of ovulation.

There are multiple causes for subfertility/ infertility, including male and female factors which we have been involved in and these common list the following:

Common fertility issues in women:

  • Pelvic Inflammatory Disease (PID)
  • Uterine Fibroids
  • Intrauterine device (IUD) complications.
  • Polycystic Ovary Syndrome (PCOS)
  • Endometriosis
  • Pituitary gland failure
  • Ovarian Failure
  • Long Term effects of using both birth control pill
  • Abnormal womb shape
  • History of pelvic infections
  • Pelvic adhesions
  • Being underweight
  • Recurrent miscarriages
  • Nutritional deficiencies
  • Thyroid malfunction
  • Fallopian tube problems (blockages, scarring, etc.)
  • Congenital abnormalities
  • Ectopic pregnancy
  • Lower Abdominal Surgery
  • Previous surgical closure
  • Sexually transmitted disease

Common fertility issues in men:

  • Low sperm count or motility
  • Varicocele
  • Undescended testis
  • Testosterone deficiency
  • Congenital abnormalities
  • Erectile dysfunction
  • Genetic defects
  • Infections
  • Retrograde ejaculation
  • Cystic Fibrosis
  • Epididymis or ejaculatory ducts blockage
  • Sexually transmitted disease.

The causes for infertility can vary from couple to couple, and in some cases are attributed to the male, while other cases are related to the female. Pinpointing the causes can be complex, from ovulation, fertilization, and the journey from the ovum through the fallopian tube into the uterus, which is intricate and must work perfectly for pregnancy to occur.

Gynaecological speciality had developed in both text and practice from the Song Dynasty (960-279). Although the application of acupuncture was heavily criticised by the orthodox medical society a generation ago, it has gradually been honoured in its rightful place with approaching conditions where conventional medical systems cannot. Acupuncture has been able to assist ovulation and a study delivered by Yu Jin (!997) demonstrated statistical significance of improvement with conditions: 50% chronic anovulation, 87.7% in pubertal dysfunctional uterine bleeding, 60% in pubertal oligomenorrhea and 36.8 % in PCOS. The correlation suggested that patients with sympathetic activity, had been suppressed by acupuncture.

Recognising fertility signals and timing are important parts of a fertility plan. Basal Body Temperature (BBT) charting can be a useful way to detect subclinical or undiagnosed patterns of disharmony related to female infertility. For a successful birth, it is essential that a woman should have normal ovarian function and a healthy uterine environment. Since menstruation is the most easily ovserved indication of ovarian function and uterine environment, blood becomes a key component of fertility. In Chinese Medical theory, it is first important to adjust the menstrauation, menstrual abnormalities such as early or late menstruation, dysmenorrhea, amenorrhea, PMS etc. Qi (energy) and blood, supply the reproductive system with oxygen and other important nutrients to the ovaries and womb. Any compromise to this will find a poor uterine environment, potentially making fertility difficult. Just as important is men’s health and how it effects the production of their sperm and sexual activity. Factor’s could be one or many and commonly include stress, depression, poor diet, excessive alcohol consumption, smoking, substance abuse, prescribed drugs.

References:

Evers J. L. (2002) Female subfertility. Lancet 360 (9327), 151-159.

Margarelli P.C. & Cridennda D. k. (2004) Acupuncture and IVF poor responders: a cure? Fertility and Sterility 81 (Suppl.3), 20.

Strauss J. F., III, & Barbieri R. L. (eds) (2004) Yen and Jaffe’s reproductive Endocrinology: Physiology, Pathophysiology and Clinical Management, 5th edn. W. B. saunders, Philadelphia, PA.

Yu J. Induction of ovulation with acupuncture. Poster presented at: NIH Consensus Development Conference on Acupuncture; November; Bethesda, MD: National Institutes of Health; November 3-5; 1997.

Back to Basics:

Having balanced hormone is essential for fertility success. Hypothalamic-pituitary-gonadal (HPG) axis is critical in the regulation of reproduction, both in women and men.

IN WOMEN:

Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH) act primarily to activate the ovaries to produce estrogen and inhibin and to regulate the menstrual and ovarian cycles. In women, the hypothalamus secretes Gonadotropin Releasing Hormone (GnRH) in a pulsatile manner. The GnRH stimulates the pituitary gland to secrete the hormone FSH that stimulates the development and maturation of follicles in the ovary where an egg develops. While developing, this follicle begins to produce a huge amount of estrogen. The produced estrogen causes the lining of the uterus t grow and thicken in preparation of implantation of a fertilised egg. Once estrogen reaches a threshed, it suppresses the further secretion of FSH to stop the stimulation of another follicle. Estrogen also stimulates the hypothalamus to produce GnRH once again, which now signals the pituitary gland to secrete the surge of the hormone LH. At about mid-cycle/ Ovulation, this LH surge, which is accompanied by a rise in body temperature, causes the ovary to release enzymes that make a hole in the sac of the dominant follicle, causing it to rupture and release the egg into the fallopian tube, where it can be further fertilised. After ovulation, estrogen drops dramatically and the follicle’s walls collapse. The dominant follicle, transformed by LH, becomes the corpus luteum after ovulation and begins secreting large amounts of progesterone, which helps prepare the lining of the uterus for implantation of the fertilised egg.

IN MEN:

The HPG axis acts in a similar fashion and its ability to make and regulate these hormones is vital for maintaining virility and sperm production in men. The hypothalamus secretes Gonadotropin Releasing Hormone (GnRH) in a pulsatile manner, which in turn stimulates the pituitary to release FSH and LH. LH tells testes to secrete the testosterone, which stimulates secual desires and develops and maintains male secondary characteristics. Testosterone and FSH stimulate testes to produce sperm. A feedbacl hormone in testosterone and inhibin keeps a check and balance on GnRH, LH and FSH levels. Once the Leydig cells in testicles produce enough testosterone, hormone-control systems suppress GnRH and LH production. When the Sertoli cells, which respond to FSH stimulation, produce enough inhibin, the pituitary reduces FSH production. Any slight irregularities in the hormone system can affect reproduction.

IN ACUPUNCTURE & CHINESE MEDICINE:

As reported, the approach has been shown to regulate hormone levels by moderating the release of beta-endorphin levels in the brain, which improves the release of GnRH secretion by the hypothalamus and regulates FSH and LH, which in turn affects ovulation and menstrual cycle in women and the ability to produce sperm in men.

The action of acupuncture would then interpret as offering a fluent flow of Qi (energy) and blood to stimulate ovulation. Evidence has continued to support that acupuncture and other modalities of Chinese Medicine can help to improve blood flow to the uterus and ovaries and further more, combined with Western Medicine, can improve the outcome of reproductive techniques in assisted reproductive technology (ART) including: In-Vitro Fertilization (IVF), Intra-Uterine Insemination (IUI), Zygote Intrafallopian Transfer, or Tubal Embryo Transfer (ZIFT), Controlled Ovarian Hyperstimulation (COH), and Intracytoplasmic Sperm Injection (ICSI).

Suggested Treatments and Prices:

ACUPUNCTURE

It is best to understand Acupuncture as electrical organising energy, that utilises two main tools which are Qi and meridians. Qi is simply intelligent metabolism, that is, it is formed of electricity which carries necessary biological information. Meridians are clear pathways for this Qi to be transported. That is, it offers least resistance to travel along, and allows free movement and space…

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