Yes.

Acupuncture is well known for its potent effect on relieving stress. Many couples turn to acupuncture before and during their IVF cycles to help reduce stress and alleviate anxiety. During these stressful times, finding coping mechanisms that work for you is important to optimize your chances of conception.

When one is inflicted with high levels of stress the body reacts by flooding the blood with 'stress' chemicals that direct blood flow away from the reproductive organs. Blood is the messenger of nutrients, oxygen, and gonadotropic IVF medications to the developing eggs and uterine lining. This simple correlation emphasizes the need to manage stress and anxiety when trying to conceive and carry to term.

Generally, 1-2 treatments per week in the weeks leading up to embryo transfer help reduce stress and optimize the ovaries response to IVF.

For more research on the effects of acupuncture on patients undergoing IVF visit our research section.

See what women have to say about receiving acupuncture on the day of IVF embryo transfer

I was thankful for the treatment before and after the transfer. Because it was onsite, it was only a few feet a way, which meant more time to let the embryo "snuggle in". It greatly helped to relieve all the tension that I felt leading upto the transfer. Dr. Pentland was of course (and still is) a good sounding board and offered some great advice for the day of the transfer.

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I found it to be relaxing and calmed me down a little. I was super nervous as not knowing what the outcome is going to be in a few weeks time especially since I have had treatment done many times and have been unsuccessful so thought I would give accupuncture a try as it is supposed to help with blood flow and all. Having the clinic onsite is great, helps decrease some of the stress of having to drive around to places and make it for the transfer on time. Thank you so much to Dr Pentland he was great!

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Loved it ! Just having you there was calming for me because you've been there right from the beginning with us and it would have been weird if you hadn't been there. I went into the transfer very relaxed and I'm certain it contributed to our success.

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Amazing service. Relaxing, great to be on site, all questions were answered. And successful, can't be better than that!

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The acupuncture was helpful in that it was relaxing --- taking your mind off the transfer. The heated bed and blanket was quite nice as the room is somewhat cool. Overall... enjoyable experience.

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I found the whole acupuncture experience to be very relaxing. I would highly recommend listening to the IVF meditation mp3 that Dr. Pentland suggested, before embryo transfer. It made what could have been a stressful day a very positive experience. I was also very appreciative that Dr. Pentland is on site at the PCRM clinic and that there was such a smooth transition to the embryo transfer procedure.

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After 6 rounds of Clomid and a failed IVF cycle, I explored the option of IVF acupuncture for my second IVF cycle. Having acupuncture on my embryo transfer day gave me the confidence that my body and mind were at their epitome of relaxation. Also, having it done on site gave me the calming, positive and warm thoughts I was seeking for the moments leading up to my embryo transfer - and the relaxation right after. I am currently 22 weeks pregnant with twins. I truly believe Dr. Pentland's help has contributed to my success!

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I enjoyed the service, it was quite relaxing to be in such nice surroundings, I particularly enjoyed the heating pad

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It was relaxing during a stressful time. Great to have it next door. Nice to try and relax pre-transfer. You feel rushed with the procedure it's great to have the "down" time to relax and focus on the embryo transfer afterward.

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When I first heard about a new acupuncture service on site at PCRM, I was so glad because of a convenience. I had a really great relaxing experience on the day of embryo transfer. In my opinion, it is very important to be comfortable on this day of treatment. I was surprised of the calm environment: warm bed and blanket, pleasant scent of essential oils and relaxing meditation. Many thanks to Dr. Spence Pentland.

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Reduced egg supply, and or difficulty in egg development or recruitment, generally a sign of advanced maternal age. This condition is synonymous with premature ovarian failure, although this patient population is most often of younger maternal age.

Generally determined by high follicle stimulating hormone (FSH) levels, a low antral follicle count (AFC), and changes in a woman's menstrual cycle.

Both Chinese and naturopathic medicine treat diminished ovarian reserve, generally with acupuncture, herbal therapy, supplements and vitamins, lifestyle counsel, current accepted fertility diet recommendations, and self massage techniques. When committed to fully, 3-12 months (depending on presentation of condition) of an individualized treatment plan deeply nourishes a woman's reproductive essence and optimizes her chances of conceiving with her own eggs either naturally of via IVF.

With this diagnosis, coupled with advanced maternal age, many women pause at the thought of waiting 3-12 months to attempt another IVF cycle. This is understandable. But, if these months are spent wisely, a 'turning back of the biological clock' effect takes place and moves the woman into a better circumstance as far as her reproductive potential is concerned.

That said, whatever a woman's choice may be as far as treatment options and protocols, the IVF Acupuncture Group doctors fully support that choice and will treat to the best of their abilities to optimize the given scenario.

From a scientific perspective, the answer to this question is unknown. BUT, what is known, is that hot foot baths in the evening help increase ovarian blood flow and decrease blood pressure, if done at a certain temperature.

Research shows that hot water foot baths (49 degrees celsius) is potentially very beneficial to a woman's fertility. So every night before bed, especially during the follicular phase of the menstrual cycle, women should give the feet some warm love! Run your hot water tap for 1 minute, most water furnaces are set to 49 degrees celsius (if it feels WAY too hot, check the temp on your hot water heater), and fill a container large enough to fit both feet, then kick back and relax for 15-20 minutes. This is a great time to do your castor/moxa packs as well.

It should be said, as an alternative answer to the original question, that if you ask a doctor of Chinese medicine the same question, the answer you will most likely hear is, 'yes, quite possibly'. Coldness from a Chinese medical perspective is evidence that a 'cold' state of the uterus and ovaries may be present. A cold uterus does not carry pregnancies well.

Dr. Pentland carries professional grade supplements. To each woman facing fertility challenges he recommends; Basic Prenatal, Q-Best 100 (coq10) , Vitamin D (all from Thorne Research, a company known for its research, quality, pure ingredients, & superior absorption), and Pro EPA omega fish oils (Nordic Naturals). Dr. Pentland also strongly recommends the Thorne Mediclear dietary cleanse to help reduce internal inflammation that may be impeding fertility potential, as well as a product called Phytoprophen, another Thorne Research product designed to modulate the bodies inflammatory processes, help heal tissue, and encourage circulation vital to ovarian, uterine, and testicular health. Below are the products available and information as to why these companies have been carefully chosen. ***To purchase visit Qi Integrated Health at 2618 w. broadway Vancouver (map & details), or contact Dr. Pentland directly to place an order and arrange pick up.

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	Mediclear Dietary Cleanse *rice protein, pea protein, and accessory nutrients to support liver detoxification. >>full info click here $57 per bottle (requires 1.5 per cleanse)
	Prenatal Multivitamin *a complete dietary supplement for pregnant and lactating women. >>full info click here $20 per bottle (30 day supply)
	CoQ10 Q-Best 100 *New Crystal free form for superior absorption. Improve both sperm and egg quality. >>full info click here $65 per bottle (1-2 month supply)
	Pro EPA Omega Fish Oils *Important for regulation of inflammation surrounding reproductive tissues. Third party lab tested for safety. >>full info click here $40 per bottle (1 month supply)
	Vitamin D liquid *Hands down the best quality, best priced, best absorbed Vitamin D on the market. >>full info click here $25 per bottle (at 1000 i.u. per day supplies over 1 year dosage)
	Phytoprofen *botanical extracts to support the body's normal inflammatory response. >>full info click here $22 per bottle (10-15 day supply)

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Why Thorne? Reason #1: Pure Ingredients

Thorne uses the purest ingredients available. A lot of companies make the same statement, but compare the two labels on this page. They appear to be identical. But what you don't see are the potentially allergenic ingredients used by other companies. Companies are not required to list these ingredients if they aren't added at the time the product is manufactured.

Why Thorne? Reason #2: No Impure Additives

Compare the labels on this page. Here you see the IMPURE ingredients used by other companies. Companies are required to list these additives because they are added at the time the product is manufactured. Thorne is the ONLY company to use pure, hypoallergenic ingredients – from raw materials to the finished product. For 25 years, we have NEVER used the common, inexpensive, potentially harmful additives often used by other companies. We never have, and we never will. That's why your health-care practitioner trusts Thorne.

Why Thorne? Reason #3: Absorption

Thorne products contain no lubricants made of ingredients that can prevent you from absorbing the active nutrients. Lubricants enable tableting and capsuling machines to run more efficiently, but these large fat molecules can prevent the product from dissolving in your digestive tract. Good for the machine – not necessarily good for you. You may not absorb the product or receive its benefits. Large fatty acid additives in this category include stearic acid and its cousins, magnesium stearate and calcium stearate. These lubricants have similar negative properties – reduced dissolution and inhibited absorption.

One of the major causes of infertility and IVF failure is a thin uterine lining, inadequate blood flow to the uterus, i.e. poor uterine artery pulsatility index. Treatment to increase blood flow is essential to improving fertility and reducing chances of miscarriage. It should be noted that stress, lack of exercise, not enough rest, lack of joy, and certain foods all can inhibit blood flow to the uterus and ovaries. The following are recommended to do at home to help increase blood flow to reproductive organs and optimize your fertility;

Castor Oil / Moxa Pack Treatment
Administer for 10 days in the follicular phase of your menstrual cycle (i.e. day 3 to 12). A castor oil / moxa pack is placed on the skin to increase circulation and to promote elimination and healing of the tissues and organs underneath the skin (i.e. ovaries and uterus). Recommended to do in the evening at the same time as hot water foot soak (below). Moxa packs can be purchased at Qi Integrated Health.
METHOD: Castor oil / moxa packs are made by soaking (not dripping wet) a small piece of flannel/cotton (i.e. facecloth size folded) in castor oil and placing it on the skin immediately above the pubic hair line. The cloth then is covered with a sheet of plastic (plastic bag cut out), and then a moxa pack is placed over the plastic to heat the oil for 30-60 minutes each night (while you are doing a warm foot bath is optimal). Be sure and rest while the pack is in place. After removing the pack, cleanse the area with a dilute solution of water and baking soda. Store the cloth in a covered container in the refrigerator. Castor oil should not be taken internally. It should not be applied to broken skin, or used during pregnancy and breastfeeding. *NOTE: if using moxa packs to wear throughout the day (they stay warm for almost 24 hrs) with the included belt, please be sure to have at least 1 layer of clothing between the pack and your skin.

Hot Water Foot Soak
Research shows that hot water foot baths (49 degrees celsius) is potentially very beneficial to a woman's fertility. So every night before bed, especially during the follicular phase of the menstrual cycle, women should give the feet some warm love! Run your hot water tap for 1 minute, most water furnaces are set to 49 degrees celsius (if it feels WAY too hot, check the temp on your hot water heater), and fill a container large enough to fit both feet, then kick back and relax for 15-20 minutes. This is a great time to do your castor/moxa packs as well (above).

Femoral massage
Perform from end of menses to ovulation or retrieval date if undergoing IVF. Do 2-3 times each leg (separately), 1-2 times per day. This massage increases the blood flow to the pelvic organs, providing more nourishment to the uterus and ovaries, testes and penis. Compress the femoral artery with your fingers, fairly heavy pressure will be required. When you feel the flow has ceased, hold for 30 seconds. The femoral artery can be located level with your pubic bone, just beneath the crease in your groin between your thigh and lower abdomen. The blood will then back up and increase the pressure gradient in the iliac arteries which forces more blood into the pelvic arteries. This floods the pelvic organs and genitals with more blood. When the hold is released, you should feel a sensation of warmth rushing down your legs as the blood supply returns to the lower extremities. Do not perform this exercise if you: are pregnant, are post-transfer during an IVF cycle, have high blood pressure, have heart disease or circulatory problems (aneurisms, varicose veins, phlebitis, thrombosis), have a history of strokes, or detached retinas.

A research study recently published from the University of Adelaide, Australia suggests that management of female infertility with Chinese Medicine can improve pregnancy rates 2-fold within a 4 month period compared with Western Medical fertility drug therapy or IVF. (link to study absract)

Cost comparison of In Vitro Fertilization (IVF) and Traditional Chinese herbal/acupuncture therapy;

1 IVF cycle costs between $8,000 - $12,000 (Canada)

1 year of weekly acupuncture treatments and daily herbal medicine costs between $6,000 - $10,000.

Safe, effective, and natural. It should be emphasized that with Traditional Chinese medicine and acupuncture treatment for one year, aside from increased fertility, the inevitable health benefits will positively impact a patients whole life drastically. These changes will manifest for many months to years post cessation of treatment.

This meta-analysis review concluded that "the assessment of the quality of the menstrual cycle, integral to Traditional Chinese medicine diagnosis, appears to be fundamental to successful treatment of female infertility." More accurately, Traditional Chinese medicine takes the whole person into account, not just their menstrual cycle. In holistic medicine (as opposed to reductionist science based medicine) each system is intimately integrated with every other. Taking the whole picture into account, not just what we see under a microscope, is paramount in holistic medicine, and the future of all medicine, including allopathic evidence based western bio-medicine.

To learn more about how Traditional Chinese medicine and acupuncture can help your fertility, call 604.742.8383 to set up a free 15 minute phone consult with Dr. Spence Pentland.

Medical evaluation and treatment of the infertile male; below is an exhaustive list of diagnostics that can and often should be run, particularly in difficult cases. First of all, men should get their sperm checked, examined for a varicocele, get blood work done to see levels of blood sugar and thyroid hormones. ***If sperm tests show very low count, then hormones should be checked (testosterone, prolactin, FSH, LH), ultrasound should be done to look for absent vas deferens, and genetic testing should be considered (y-chromosome microdeletions, karyotyping, cystic fibrosis). Men should always be counseled to avoid hot tubs, alcohol, paint, prolonged activities that warm the genitals, tight underwear, too much paper handling, and canned foods. ***Treatments include; varicocele repair, medications for hormonal issues, antioxidant therapy, acupuncture, and herbal medicine.

History:

recent fevers or illness

cancer

infections or STI's

surgeries

trauma

Family: cryptorchidism, hypogonadism

DES exposure

Medications

childhood infections: mumps

diabetes

thyroid issues

Social History:

tobacco, alcohol, drugs, steroids

Proper timing of intercourse

lubricant use

Heat exposure

Toxin exposure

Occupational history

Partner history (gynecological & obstetrical)

Physical:

BP

BMI (with waist circumference)

Secondary sex characteristics

Penis: hypospadias, chordee, plaques or venereal lesions

Spermatic cord: varicocele or lipomas

Rectal: prostate, cysts, irregularities with seminal vesicles

Testis: size, shape, irregulairties

Epididymes & Vas deferens: absence, tenderness (infection/inflammation), obstruction

Transrectal ultrasound: obstructions

Labs:

Semen analysis (ASA & round cell staining to determine leukocyte content - CD45 monoclonal antibody)

Post-ejaculate urinalysis: check for retrograde ejaculation & seminal fructose (if absent or PH is low, seminal vesicles may be absent or obstructed)

TSH (Free T3 & T4, anti TPO): especially if motility or morphology or erectile health is an issue.

Testosterone

FSH

LH

prolactin

estrogen

Coritsol

Fasting glucose

Post-coital testing

CBC

Cholesterol

STI swab

p34

acrosin

sperm penetration

dynein testing (if see respiratory issues)

Genetic:

karyotyping

Y-microdeletions

kleinfelters

Treatment:

Surgery (varicocele)

Medications (thyroid, metformin, beta blockers)

Clomid or HCG (diabetes, prolactinoma, low testosterone, low FSH)

Antioxidants (zinc 60mg, folate 5mg - wong et al fert steril 77:491, 2002)

Acupuncture

Herbal medicine

Yes.

Evidence and experience shows that acupuncture and/or Chinese herbal medicine can improve sperm parameters (natural fertility or IVF support), decrease stress, increase libido, aid with erectile dysfunction, and treat issues associated with prostatitis and chronic pelvic pain syndrome (CPPS).

Yes.

The importance of overall health and well-being three to six months before conception cannot be over-stated. Nurturing your ‘whole’ self can help you conceive naturally, or ensure that your body is optimized for IVF success.

Dr. Spence Pentland provides traditional Chinese medicine and acupuncture, combined with dietary advice, lifestyle guidance, and mind-body techniques, to offer a very powerful way to enhance your fertility and chances of conception.

Call to book an initial appointment to evaluate both male and female reproductive health. From there, an individualized treatment plan is created. Free 15 minute phone consults are also offered to answer any questions before booking.

Using acupuncture and Chinese medicine to increase your fertility and chances of getting pregnant can look quite different for different people. Individual treatment plans are created for each person that walks in to the clinic. The amount of acupuncture treatments and Chinese herbal medicine varies depending on the cause of the infertility, as well as the persons overall health and need for re-balancing. The following are generalized treatment protocols to give you some idea of what to expect.

WOMEN. A protocol of acupuncture 1/week for at least 3 cycles/months is generally the minimum length of treatment protocol recommended to almost any woman wanting to use acupuncture to optimize her fertility, no matter what the underlying condition. A deeper understanding of the female menstrual cycle and various observation techniques will ensure fertile times are pinpointed. This also helps with treatment targeting regulation of the different phases of the cycle. Emotional support with each turn of events is paramount. Time to dialogue is a part of each and every appointment. Chinese herbal medicine may be prescribed depending on need. This is in the form of a tea that is taken 2x/day for 1-6 months or more. If western medical intervention is thought to be necessary and has not been undertaken, referrals to family doctors or fertility specialists to begin routine fertility testing is likely (ABORM certified acupuncturists most often work closely with local reproductive health specialists). Supplements, lifestyle changes, exercise (yoga), time with girlfriends, singing, meditation, more nourishing work-life balance, and dietary modifications will also be discussed and re-visited as necessary. A treatment plan combining some or all of the above is developed and followed to optimize your fertility and overall health and well-being (as your fertility is most often simply a manifestation of your overall health). After your initial recommended course of treatment is complete, a progress evaluation is made. It is at this time that an additional course of treatment may be recommended.

IVF, ICSI, FET, IUI, Superovulation, Clomid. For complete information regarding the integration of acupuncture and IVF please click here.

PCOS (POLYCYSTIC OVARY SYNDROME). This syndrome can have many faces. The most common aspect of PCOS is irregular or absent ovulation (annovulation). Other common manifestations include excess body and facial hair, oily skin and acne, and obesity or weight gain.

RECURRENT MISCARRIAGE. For a more complete overview of how traditional Chinese medicine and acupuncture views and treats women that have experienced recurrent pregnancy loss click here.

AGE RELATED (DIMINISHED OVARIAN RESERVE).

MALE FACTOR INFERTILITY (poor sperm parameters). 2 acupuncture treatments per week for 6-8 weeks, or 1 acupuncture treatment per week for 12 weeks consecutively. This is based on clinical study literature produced in China. Chinese herbal medicine may be prescribed depending on need, if the 1 acupuncture treatment per week option is chosen, or if acupuncture treatments are not an option. These come in the form of either concentrated powder that is re-constituted with hot water and taken 2x/day, or raw herbals (roots, berries, leaves, etc) are cooked as soup and taken 2x/day. Supplements, lifestyle changes, exercise, and dietary modifications will also be discussed.

THIN ENDOMETRIAL LINING. Click here for a full article on various ways to treat a think uterine lining.

If you do eat meat then there are a few considerations to help minimize the negative effects that accompany this dietary choice. *Note: this article does not refer to fish consumption.

First of all I want to encourage everyone to listen to their bodies needs, first and foremost. Have compassion for yourself with the cravings that may come with times of increased protein needs such as pregnancy, heavy physical labour, or healing traumatic injuries. If you do choose to be a vegetarian or vegan consider that after hundreds of years of animal foods being regularly eaten in a family lineage it can take some time to adjust to this nutritional path.

It should also be noted that traditional Chinese medicine believes that certain people may benefit from moderate consumption of particular meats when trying to conceive. Talk to your acupuncturist to determine your needs as different people require different meats to properly thrive.

Always eat local organic free range meats. These animals generally had a happier life and this energy transmits through the food into your body and cells, remember you are what you eat. The raising of non-organic 'meat' is a travesty as we learn the conditions of these poor animals lives before slaying. Remember we are the consumers and what we buy dictate their conditions, you can make a difference. Also be sure to give thanks to the animal for helping sustain your life. Pesticides, hormones, and antibiotics used in the raising of non-organic animals have been shown to have many ill effects on our bodies health and fertility.

When you do eat meat, small amounts 2-3 times per week is enough. To improve the digestion of meats slice thinly and soak in vinegar, lemon juice, wine, beer, or tomato juice for 30 minutes or more to help break down the fat and protein chains. Ginger and marjoram also help rid the body of the unwanted toxins associated with meat consumption. Leafy greens, garlic, onions, cabbage and cauliflower are great foods to include with your meat meals for improving digestion of the proteins and fats. Also, grilling red meat over a high heat open flame creates carcinogens. To help offset these negative effects use rosemary in both the marinade and post cooking seasonings.

Lastly, I have said this before and I will say it again; in an ideal world we would all be vegetarian, for individual health reasons, ethical reasons, and the health of the planet. Because of the large amount of land that is required to raise animals for human consumption, we have cut down much of the great forests on earth. These forests are the lungs of the earth. Because the earth’s lungs are being compromised, global warming is resulting. So if you choose to eat either none, or less meat, you are doing a huge part for the health of the earth. Maybe you choose to be a vegetarian instead of driving a Prius? Maybe being a vegan will offset the carbon footprint your trips to Hawaii produce!

Read more articles & FAQ's on diet and infertility.

At one time or another, women trying to conceive will understand the importance of optimal blood flow to the uterus and ovaries. Blood brings food and oxygen to your eggs, uterine lining, and developing embryo.

Stress, lack of exercise, not enough rest, lack of joy, and certain foods all can inhibit blood flow to the uterus and ovaries. This will ultimately lead to periods with clotted blood. Clotted menstrual blood is nothing more than uterine lining that is necrotic, or dead, due to lack of food and oxygen supply. If a new embryo tries to implant into uterine lining that is not living, the chances of its survival are drastically reduced. So treatment to reduce and eliminate clots in menstrual blood is a very common approach to improving fertility and reducing chances of miscarriage.

Here are a few Dietary principles you can implement when you are bleeding to help eliminate menstrual blood clots, increase your fertility, and reduce the chances of miscarriage;

1. avoid sour food when bleeding (yogurt, vinegar, pickles, grapefruit, currants, and green apples.
2. eat more blood nourishing foods when bleeding such as eggs, carrots, spinach, dates, & goji berries.
3. consume more blood invigorating foods when bleeding such as fish, ginger, cinnamon, and turmeric.

Click here for a full article on how to treat a thin uterine lining.

Read more articles & FAQ's on diet and infertility.

To most women I recommend eating at least some meat when trying to conceive, especially if you are of advanced maternal age or have been diagnosed with a low ovarian reserve. In support of whole foods / Paleolithic (caveman) diet I recommend to my patients, Matthias and his research team from Germany found evidence that glycine, a non-essential amino acid found in most meats helps protect the ovarian tissue from cellular apoptosis (death). doi:10.1016/j.fertnstert.2007.08.047.

The issue of whether meat is good or bad for our overall health is yet to be determined. If you listen to mainstream media and its portrayal of massive studies such as the 'China Study' or the 'Harvard nurses Study' you would put your tail between your legs and run away from any type of cooked flesh. BUT, the truth is, even studies with the exposure and magnitude of these are fallible and may contain 'skewing' of certain conclusions to better massage the original hypothesis of the doctors involved. Please read this critique of the recent movie 'forks over knives' which heavily advocates vegetarianism. I am definitely not sold, especially when it comes to the fertility advanced maternal age infertility or diminished ovarian reserve...http://rawfoodsos.com/2011/09/22/forks-over-knives-is-the-science-legit-a-review-and-critique/#more-1487

Read more articles & FAQ's on diet and infertility.

The soft resin lining of the tin cans that tomatoes are stored in contains bisphenol-A (BPA). The acidity of the tomato causes the BPA to leech into your food. BPA is a synthetic estrogen that has been directly linked to reproductive problems such as poor sperm production and chromosomal damage in the eggs.

The solution is to buy tomatoes in glass bottles or tetra packs. Or better yet, eat fresh!

Read more articles & FAQ's on diet and infertility.

Yes.

According to research, it is important to avoid green tea when trying to conceive. It contains EGCG which has negative effects to reproductive health.

The function of Vascular endothelial growth factor (VEGF) is to create new blood vessels during embryonic development. It also restores the oxygen supply to tissues when blood circulation is inadequate. Green tea (ECGC) reduces VEGF production.

Granulosa cells produce sex steroids (i.e. fsh which converts androgens to estrogens, and progesterone in the luteal phase) which are essential aspects of optimal fertility in each phase of the menstrual cycle. Granulosa cells also contribute to many growth factors for the developing egg. Green Tea (EGCG) inhibits granulosa cell proliferation.

See relevant study abstract: click here

Read more articles & FAQ's on diet and infertility.

Conclusion: electroacupuncture could decrease serum FSH and LH levels, and increase estrogen levels in women with ovarian deficiency with little to no side-effects.

To investigate the effects of electroacupuncture (EA) on serum FSH, E2, and LH levels, women with primary ovarian insufficiency (POI) were treated with EA once a day, five times a week for the first four weeks and once every other day, three times a week, for the following two months, and then were followed up for three months. Serum E2, FSH, and LH levels were measured at baseline, at the end of treatment, and during followup. A total of 11 women with POI were included in this prospective consecutive case series study. Compared with baseline, patients' serum E2 increased, FSH decreased, and LH decreased (P = 0.002, 0.001, and 0.002, resp.) after EA treatment, and these effects persisted during followup. With treatment, 10 patients resumed menstruation (10/11, 90.91%), whereas one patient remained amenorrhea. During followup, two patients, including the one with amenorrhea during treatment, reported absence of menstruation. Temporary pain occurred occasionally, and no other adverse events were found during treatment. The results suggest that EA could decrease serum FSH and LH levels and increase serum E2 level in women with POI with little or no side effects; however, further randomized control trials are needed.

Evid Based Complement Alternat Med. 2013;2013:657234. doi: 10.1155/2013/657234. Epub 2013 Feb 28., Zhou K, Jiang J, Wu J, Liu Z. - Department of Acupuncture, Guang An Men Hospital, China Academy of Chinese Medical Sciences, No. 5 Bei Xian Ge Street, Xuan Wu District, Beijing 100053, China ; Department of Physical Therapy, Daemen College, 4380 Main Street, Amherst, NY 14226, USA. http://www.ncbi.nlm.nih.gov/pubmed/23533511

A research study recently published from the University of Adelaide, Australia suggests that management of female infertility with Chinese Medicine can improve pregnancy rates 2-fold within a 4 month period compared with Western Medical fertility drug therapy or IVF. (link to study absract)

Cost comparison of In Vitro Fertilization (IVF) and Traditional Chinese herbal/acupuncture therapy;

1 IVF cycle costs between $8,000 - $12,000 (Canada)

1 year of weekly acupuncture treatments and daily herbal medicine costs between $6,000 - $10,000.

Safe, effective, and natural. It should be emphasized that with Traditional Chinese medicine and acupuncture treatment for one year, aside from increased fertility, the inevitable health benefits will positively impact a patients whole life drastically. These changes will manifest for many months to years post cessation of treatment.

This meta-analysis review concluded that "the assessment of the quality of the menstrual cycle, integral to Traditional Chinese medicine diagnosis, appears to be fundamental to successful treatment of female infertility." More accurately, Traditional Chinese medicine takes the whole person into account, not just their menstrual cycle. In holistic medicine (as opposed to reductionist science based medicine) each system is intimately integrated with every other. Taking the whole picture into account, not just what we see under a microscope, is paramount in holistic medicine, and the future of all medicine, including allopathic evidence based western bio-medicine.

To learn more about how Traditional Chinese medicine and acupuncture can help your fertility, call 604.742.8383 to set up a free 15 minute phone consult with Dr. Spence Pentland.

CONCLUSION: Acupuncture seems to have beneficial effects on live birth rate when performed on the day of ET, and to be useful also in PCOS as well as in male idiopathic infertility, with very low incidence of side effects.

Acupuncture has been used as treatment for infertility for hundreds of years, and recently it has been studied in male and female infertility and in assisted reproductive technologies, although its role in reproductive medicine is still debated.

AIM: To review studies on acupuncture in reproductive medicine, in experimental and clinical settings.

METHODS: Papers were retrieved on PubMed and Google Scholar and were included in the review if at least the abstract was in English.

RESULTS: There is evidence of benefit mainly when acupuncture is performed on the day of embryo transfer (ET) in the live birth rate. Benefit is also evident when acupuncture is performed for female infertility due to polycystic ovary syndrome (PCOS). There is some evidence of sperm quality improvement when acupuncture is performed on males affected by idiopathic infertility. Experimental studies suggest that acupuncture effects are mediated by changes in activity of the autonomic nervous system and stimulation of neuropeptides/neurotransmitters which may be involved in the pathogenesis of infertility.

Conclusion: patients exhibiting a low fertility potential due to reduced sperm activity may benefit from acupuncture treatment.

A group of infertile men with abnormal semen analysis were randomly divided into 2 groups; one group was given 10 acupuncture treatments over 5 weeks, and the other group, no treatment. Significant improvements (p < 0.05) were demonstrated in the acupuncture group compared to the control group, in particular improved motility and morphology.

The aim of this prospective controlled study was to assess the effect of acupuncture on the sperm quality of males suffering from subfertility related to sperm impairment.

Semen samples of 16 acupuncture-treated subfertile patients were analyzed before and 1 month after treatment (twice a week for 5 weeks). In parallel, semen samples of 16 control untreated subfertile males were examined. Two specimens were taken from the control group at an interval of 2-8 months. The expanded semen analysis included routine and ultramorphological observations.

The fertility index increased significantly (p < or = .05) following improvement in total functional sperm fraction, percentage of viability, total motile spermatozoa per ejaculate, and integrity of the axonema (p < or = .05), which occurred upon treatment. The intactness of axonema and sperm motility were highly correlated (corr. = .50, p < or = .05).

Conclusions: It is concluded that acupuncture may be a useful, nontraumatic treatment for males with very poor sperm density, especially those with a history of genital tract inflammation.

This pilot study once again showed a positive effect of acupuncture on sperm count - but this time on men with such low sperm counts (or no sperm) that they would usually require a testicular biopsy to extract sperm for use in an IVF cycle. Seven of the 15 men with no sperm at all produced sperm detectable by the light microscope after a course of 10 acupuncture treatments (p < 0.01) ie enough sperm could be produced for ICSI to be performed without recourse to testicular biopsy. The control group with similar semen analysis had no treatment and showed no change after 3 months.

Classic therapies are usually ineffective in the treatment of patients with very poor sperm density. The aim of this study was to determine the effect of acupuncture on these males. Semen samples of 20 patients with a history of azoospermia were examined by light microscope (LM) and scanning electron microscope (SEM), with which a microsearch for spermatozoa was carried out.

These examinations were performed before and 1 month after acupuncture treatment and revealed that the study group originally contained three severely oligoteratoasthenozoospermic (OTA), two pseudoazoospermic and 15 azoospermic patients.

The control group was comprised of 20 untreated males who underwent two semen examinations within a period of 2–4 months and had initial andrological profiles similar to those of the experimental group.

No changes in any of the parameters examined were observed in the control group. There was a marked but not significant improvement in the sperm counts of severely OTA males following acupuncture treatment (average=0.7±1.1×106 spermatozoa per ejaculate before treatment vs. 4.3±3.2×106 spermatozoa per ejaculate after treatment). A

definite increase in sperm count was detected in the ejaculates of 10 (67%) of the 15 azoospermic patients. Seven of these males exhibited post-treatment spermatozoa that were detected even by LM. The sperm production of these seven males increased significantly, from 0 to an average of 1.5±2.4×106 spermatozoa per ejaculate (Z=−2.8, P≤0.01). Males with genital tract inflammation exhibited the most remarkable improvement in sperm density (on average from 0.3±0.6×106 spermatozoa per ejaculate to 3.3±3.2×106 spermatozoa per ejaculate; Z=−2.4, P≤0.02).

Two pregnancies were achieved by the IVF-ICSI procedure.

Conclusion(s): For the first time point- and frequency-specific effects of abdominal EA on TBF are shown in humans.

Just as electrocaupuncture can increase blood flow to the ovaries and uterus (see reports above) so it can to the testicles. These authors demonstrate that particular frequencies applied for just 5 minutes are effective in increasing blood flow in the testes, and suggest that such a stimulus may address the damaged microcirculation associated with varicoceles, and with aging. They note that decreased testicular arterial blood flow may result in impaired spermatogenesis from defective metabolism in the microcirculatory bed and suggest that further research is needed to discover if electroacupuncture can improve sperm manufacture in this instance.

Objective: To clarify the role of the abdominal acupuncture points and the frequency of short-term electroacupuncture (EA) stimulation on testicular blood flow (TBF) in humans.

Design: A prospective, randomized study.

Setting: University hospital, Department of Radiology, ultrasound unit.

Patient(s): Eighty healthy male volunteers were randomly allocated to three groups in stage one and to a single group in stage two. In the first stage of the study, the abdominal acupuncture points ST-29 (guilai) were stimulated using simple needle insertion, 2 Hz burst EA or 10 Hz EA, in three different groups. In the second stage of the study, abdominal acupuncture points ST-25 (tianshu) were stimulated with the frequency found to be more effective in stage one. Stimulation was for 5 minutes in each group.

Intervention(s): Electroacupuncture and Doppler flowmeter.

Main Outcome Measure(s): Four groups were compared for volume flow and other related parameters of TBF.

Result(s): The 10-Hz EA stimulation of ST-29 (guilai) increased TBF, but simple needle insertion and 2-Hz burst stimulation did not. The 10-Hz EA stimulation of ST-25 (tianshu) did not result in significant changes in TBF.

Further investigation is required to ascertain whether these findings may be helpful in the clinical treatment of infertile men.

Conclusions: After receiving acupuncture twice weekly for 6 weeks motility of sperm (but not overall count) was found to increase significantly.

This recent small clinical trial randomised 57 patients who had extremely low sperm counts, to acupuncture and placebo acupuncture groups. The authors conclude that the results of the present study support the significance of acupuncture in male patients with severe oligoasthenozoospermia. More evidence with larger trials needs to be accumulated before the efficacy and effectiveness of acupuncture in male infertility can be evaluated.

In this first prospective, randomized, single-blind, placebo-controlled study, 28 infertile patients with severe oligoasthenozoospermia received acupuncture according to the principles of traditional Chinese medicine (TCM) and 29 infertile patients received placebo acupuncture. A significantly higher percentage of motile sperm (World Health Organization categories A–C), but no effect on sperm concentration, was found after acupuncture compared with placebo acupuncture.

Conclusions: Acupuncture can improve sperm quality and fertilization rates in assisted reproductive technology. The fertilization rates after acupuncture (66.2%) were significantly higher than that before treatment (40.2%) (P < 0.01).

This trial looks at sperm behaviour in an IVF setting. It was a “before and after” study involving 82 infertile men with pathological semen abnormalities and who’s sperm achieved a poor fertilization rate in at least 2 IVF/ICSI cycles. They were given acupuncture twice a week over 8 weeks and the IVF/ICSI cycles were repeated.

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).

Conclusion: men going through IVF with poor sperm morphology has been correlated to poor embryo cleavage rates, lower IVF embryo transfer rates, decreased pregnancy rates, lower ongoing pregnancy rates, and increased miscarriage. Poor sperm morphology is a good indicator of IVF outcome.

One-hundred-and-twenty-three in-vitro fertilization (IVF) cycles were analysed in order to clarify the influence of strictly normal morphology (SNM) of spermatozoa on IVF outcome. SNM was defined using strict criteria according to Kruger with our modifications. The IVF cycles studied were divided into three groups: %SNM <12% (13 cycles), 12 <40% (68 cycles), ≥40% (42 cycles). The cleavage rates per oocyte were higher in the groups with 12–40% and ≥40% of %SNM than in the group with %SNM <12%. The embryo transfer rate per cycle increased with increasing %SNM. The overall pregnancy rate per cycle increased with increasing %SNM (7.7% in %SNM < 12%, 22.1% in 12–40% of %SNM, and 40.5% in %SNM ≥40%). The ongoing pregnancy rate per cycle also increased with increasing %SNM (7.7% in %SNM <12%, 14.7% in 12–40% of %SNM, and 31.0% in %SNM ≥40%). The miscarriage rate was lower in %SNM ≥40% (23.5%) than in 12–40% of %SNM (33.3%). It was suggested that %SNM is a good predictor of IVF outcome.

Conclusion: The Chinese Traditional Medicine acupuncture and moxa techniques significantly increase the percentage of normal-form sperm in infertile patients with oligoastenoteratozoospermia without apparent cause.

In a prospective, controlled and blind study, a group of infertile men (married for 3 - 11 years without children) were randomized into two groups, the treatment group receiving 10 acupuncture treatments and the control group receiving sham acupuncture treatments. The patients in the acupuncture group demonstrated a significant increase in the percentage of normal forms compared to the control group

Aim: To evaluate the effect of Chinese Traditional Medicine, acupuncture and moxa treatment, on the semen quality in patients with semen abnormalities.

Methods: In a prospective, controlled and blind study, nineteen patients, aged 24 years ~ 42 years and married for 3 years ~ 11 years without children with semen abnormalities in concentration, morphology and/or progressive motility without apparent cause, were randomized into two groups and submitted to acupuncture and moxa treatment at the therapeutic (Study Group) and the indifferent points (Control Group), respectively, for 10 weeks. Semen analyses were performed before and after the treatment course.

Results: The patients of the Study Group presented a significant increase in the percentage of normal-form sperm compared to the Control Group (calculated U=16.0, critical U=17.0).

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.

A group of infertile men who had pathological semen analyses according to WHO criteria, were treated with acupuncture twice a week for 5 weeks. A statistically significant increase after acupuncture in the percentage and number of sperm with no structural defects was demonstrated compared to the control group of patients who received no treatment. They concluded that male infertility patients could benefit from having acupuncture. A general improvement of sperm quality, specifically in the ultrastructural integrity of spermatozoa, was seen after acupuncture.

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. I

NTERVENTION(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: daily ejaculation improves sperm DNA health.

Objective
To evaluate the relationship between duration of sexual abstinence and sperm selection on sperm DNA fragmentation (SDF).

Design
Prospective study based on normozoospermic individuals.

Setting
Fertility and IVF unit and university unit for research.

Patient(s)
Two cohorts of normozoospermic individuals: 21 men (aged 25–35 years) attending a clinic and with clearly adverse female factors; and a group of 12 selected donors (aged 20–25 years).

Intervention(s)
SDF assessment using the sperm chromatin the dispersión test (Halosperm) in two cohorts of normozoospermic men.

Main Outcome Measure(s)
SDF assessment after 24 hours of abstinence with recurrent ejaculation (one every 24 hours) using neat sperm samples; and SDF assessment before and after sperm selection with abstinence of 3 hours.

Result(s)
Lower baseline levels of SDF were observed after shorter periods of abstinence between ejaculations (24 hours and 3 hours) than those recommended. This effect is much more marked after quick repetitive ejaculation (3 hours of abstinence) and sperm selection.

Infertility is a condition diagnosed after a couple has had one year of unprotected, well-timed intercourse, or if the woman has suffered from multiple miscarriages. If the woman is over 35 years old, it is diagnosed after 6 months of unprotected, well-timed intercourse.

As per the ASRM (American Society of Reproductive Medicine), infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children. Conception is a complicated process that depends upon many factors: on the production of healthy sperm by the man and healthy eggs by the woman; unblocked fallopian tubes that allow the sperm to reach the egg; the sperm's ability to fertilize the egg when they meet; the ability of the fertilized egg (embryo) to become implanted in the woman's uterus; and sufficient embryo quality. Finally, for the pregnancy to continue to full term, the embryo must be healthy and the woman's hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result.

Accurately determining the time a woman ovulates is paramount when trying to conceive. The only other parameters that are equal in importance is being certain there is sperm present and that the fallopian tubes are open.

The following are ways to better pin-point when and if you have ovulated so that proper timing of sex can occur;

BBT (basal body temperature charting). Learning to properly take and chart your basal body temperature each morning for at least 3 menstrual cycles is a great thing to do if you have been trying to conceive without luck. In a perfect world there will be a slight dip in your temperature at the end of your follicular phase (bleed and maturing of the egg). This dip, if followed by a rise in temperature of at least 0.2 degrees celcius in the following couple days is an indicator of ovulation. The temperature should remain at higher temperatures for at least 10 days to support and maintain an early pregnancy.

‘Fertile’ pre-ovulation cervical fluid. This essential body fluid is something that a woman trying to conceive must understand. ‘Slippery, clear, raw egg-white, stretchy’. These are the common descriptions given to the vagnial secretions that must be present just before the release of the egg from the ovary (ovulation). There are 3 main characteristics to look for when identifying ‘fertile’ pre-ovulatory cervical fluid; 1. It is slippery so as to provide lubrication for sex. Some women report a ‘wet’ sensation. 2. It becomes more transparent (like raw egg-white) due to higher water content so as to aid in sperm motility (swimming). 3. It stretches when examined between the fingers. Does not appear ‘tacky’ like lotion. Click here to learn more about the importance of cervical fluid and fertility.

Ovulation Urine Strips (luteinizing hormone detection strips). Depending on the length of your menstrual cycle, starting to use these pee strips should occur when approx 1/3 of your cycle is complete (i.e. 30 day cycle, start using strips on day 10). Be sure to use the same urine each day to be sure to obtain accurate relative results (i.e. always use 1st or 2nd pee of the day). There are very expensive strips at your local drugstore and they often come with a fancy monitor. You don't need these. All you need is simple strips that show you a line when your ovulating hormones are at their peak (go to early pregnancy tests website to order). When the tests show the luteinizing hormone at its peak, this communicates to the woman that in the next 12-36 hours ovulation will occur.

'Twinges' or slight pain. This is often reported around ovulation. Theories of it being the follicle (aspect of the ovary which contains the egg) rupturing and releasing the egg are quite likely true.

Libido or sex drive. Yes, women are ready to make babies like no other time of their cycle during ovulation. If a woman is healthy and trying to conceive has not completely snuffed out all romance, this is a great indicator of when a woman is fertile.

Cervical position. When a woman is fertile her cervix (muscular opening between the vagina and the uterus), which when open allows the passage of sperm into the uterus and ultimately the fallopian tubes. it also retracts upwards away from the vaginal opening and softens to allow for deeper penetration during intercourse. Simply put, when a woman is fertile, sex is better for both partners.

Day 21 Progesterone blood work. A lab test that can tell to some certainty whether a woman ovulated. A woman gives blood approx 7 days after she thinks she has ovulated. Numbers within a certain range are tell tale.

Ultrasound. Sometimes a woman will get ultrasounds to determine if a follicle is in atrophy (shrinking). This is also a good indicator as to whether an egg has been released.

OK, now lets put some of this together very simply. Libido, cervical position, twinges, fertile cervical fluid, and ovulation pee strips should all be present at approximately the same time. This is when a woman is fertile. This is when intercourse should occur. If sperm is healthy, every day is great. If sperm is not optimal, allow a day between ejaculations. Once the BBT has risen, it is now too late. See 'When should we have sex?' for a more detailed description of punctual coitus.

How a Harvard-trained doctor began to appreciate traditional Chinese medicine - by Leana Wen, M.D.

As a child growing up in China, I was always aware of Traditional Chinese Medicine (TCM). TCM is what we refer to as Eastern medicine, in contrast to the Western medicine we know from U.S. hospitals. I never understood much about TCM, only that it somehow involves herbs and that many Chinese people used it. The more I progressed in my medical training in major U.S. academic centers, the more distanced I felt from TCM. Why should I learn about something that lacks evidence, when there’s so much to know about for which there is good research?

Last fall, I went to China on a research trip. While my study is primarily on its Western medical system, I was so fascinated by what I learned of Eastern medicine that I spent many free evenings observing TCM practitioners. There is so much I didn’t know. As a discipline, TCM is far too complex for me to understand in my short observation, but there are some very important “lessons from the East” that are applicable to our Western medical practice:

#1. Listen—really listen. The first TCM practitioner I shadowed explained to me that to practice TCM is to “listen with your whole body”. Pay attention and use every sense you have, he said. I watched this doctor as he diagnosed a woman with new-onset cervical cancer and severe anemia the moment she walked into his exam room, and within two minutes, without blood tests or CTs, sent her to be admitted to a (Western) medical service. I’ve seen expert clinicians make remarkable diagnoses, but this was something else!

“How could you know what you had and that she needed to be admitted?” I asked.

“I smelled the cervical cancer,” he said. “I looked and saw the anemia. I heard her speak and I knew she could not care for herself at home.” (I followed her records in the hospital; he was right on all accounts.)

#2. Focus on the diagnosis. I watched another TCM doctor patiently explain to a young woman with long-standing abdominal pain why painkillers were not the answer.

“Why should we treat you for something if we don’t know what it is?” he said. “Let’s find out the diagnosis first.” What an important lesson for us—to always begin the diagnosis.

#3. Treat the whole person. “A big difference between our two practices,” said one TCM doctor, “Is that Western medicine treats people as organs. Eastern medicine treats people as a whole.” Indeed, I watched her inquire about family, diet, and life stressors. She counseled on issues of family planning, food safety, and managing debt. She even helped patients who needed advice on caring for the their elderly parents and choosing schools for their child. This is truly “whole person” care!

#4. Health is not just about disease, but also about wellness. There is a term in Chinese that does not have its exact equivalent in English. The closest translation is probably “tune-up to remain in balance”, but it doesn’t do the term justice, because it refers to maintaining and promoting wellness. Many choose to see a TCM doctor not because they are ill, but because they want to be well. They believe TCM helps them keep in balance. It’s an important lesson for doctors and patients alike to address wellness and prevention.

#5. Medicine is a life-long practice. Western medicine revers the newest as the best; in contrast, patients revere old TCM doctors for their knowledge and experience. Practicing doctors do not rest on their laurels.

“This is a practice that has taken thousands of years to develop,” I was told. “That’s why you must keep learning throughout your life, and even then you will only learn just a small fraction.” Western medicine should be no different: not only are there new medical advances all the time, doctors need to continually improve their skills in the art of medicine.

#6. Evidence is in the eyes of the beholder. Evidence-based medicine was my mantra in Western medical training, so I was highly skeptical of the anecdotes I heard. But then I met so many patients who said that they were able to get relief from Eastern remedies while Western treatments failed them. Could there be a placebo effect? Sure. Is research important? Of course. But research is done on populations, and our treatment is of individuals. It has taken me a while to accept that I may not always be able to explain why—but that the care should be for the individual patient, not a population of patients.

“In a way, there is more evidence for our type of medicine than for yours,” a TCM teacher told me. “We have four thousand years of experience—that must count for something!”

There is so much I have not covered about TCM. Its practices vary regionally, and no doubt, there are more and less capable practitioners (as there are in Western medicine). More research into TCM methods will be important. However, regardless of whether we Western doctors want to prescribe TCM treatments, we should recognize there is much to learn from Eastern medicine, including what it means to be a physician to really care for our patients. Upon my return from China, I, for one, have a newfound appreciation for Eastern medical practice a renewed understanding of holistic medical care.

Original article: http://www.psychologytoday.com/blog/the-doctor-is-listening/201301/6-les...

Yes. As a matter of fact, at the time of this writing I have a 45 year old woman in Vancouver that after 3 consecutive miscarriages, is pregnant naturally and about to give birth. For me, this has only happened a handful of times but it does happen, there is hope. Although, I have to say, the women that I have seen achieve advanced maternal age babies are women that took great care of themselves, followed recommendations for acupuncture and Chinese medicine treatment, exercised regularly, got enough sleep, and ate a diet conducive to optimized fertility. They also seem to maintain a young spirit and walk through their days with a deep faith that they are being taken care of and things will happen as it should.

I have also worked with women of ages up to 51 that have conceived with the aid of a donor egg. Strong commitment to prolonged treatment protocols and lifestyle choices seem to be key in these cases.

Bottom line to me is that conception with women of advanced maternal age boils down to overall health and well-being. A woman's state of fertility potential is not a separate entity from the rest of her body mind and spirit. In Chinese medicine, all 3 of these treasures must be nourished in order to optimize chances of long life and conception after age 40.

A great resource for these numbers:http://www.fertilityplus.org/faq/hormonelevels.html

*note: in Canada, the estrogen/estradiol values for cycle day 3 are <200.

A great resource for this: http://fertilityplus.org/faq/infertility.html#sect7

Yes. Most of the following apply to both men and women.

Age is a primary cause and risk factor of infertility. Statistically, once over the age of 35, chances of conception each month when trying to conceive drop quite drastically, as well, the chances of miscarriage increases.

Weight is a risk factor of infertility and a cause of increased incidence of miscarriage. Obesity is an epidemic that can be avoided or reversed with proper support, sensible diet and nutrition, sustainable healthier lifestyle choices, deep commitments to change, and shining lights on the aspects of yourself that will sabotage your success.

Smoking and alcohol use have been definitively linked to infertility. The bottle and the butts must go, it is that simple. When we see clearly that our health is directly correlated to our fertility, we will vow to live in a way that optimizes and preserves our health and well-being.

Drug and toxin exposure have major impacts on many aspects of our health and fertility. Be sure your doctor clearly defines the risks toward your fertility of medications you are taking. As well, a multitude of environmental toxins that have hormonal disrupting effects surround us daily. Educating yourself on chemicals such as phthalates is extremely important.

Sexually Transmitted Diseases (STDs) most notably chlamydia and herpes, either make it impossible to produce offspring on your own (blocked tubes from infection) or produce disease mechanisms not yet fully understood that make conception difficult.

Tubal blockage can either be complete obstruction of one or both tubes, partial blockage, or a fluid filled tube called a hydrosalpinx. The full and partial blockages often are caused by a past chlamydial infection or endometriosis that has damaged the tube physically. In this scenario, when it is both tubes affected, IVF is necessary in order to get pregnant. If it is a fluid filled scenario (hydrosalpinx), a woman may notice watery discharge or very watery periods. HSG tests, abdominal massage, acupuncture, and Chinese herbals often help this condition. The tubal fluid creates a toxic uterine environment for the implanting embryo. One other condition commonly seen is that of a fallopian tube that is in spasm and therefore appears as blocked when in essence it is not. Acupuncture and meditation can often help this condition as well.

Endometriosis is a condition where uterine tissue is present outside of the uterus. This can cause inflammation, damage, and obstruction of the regular function of the uterus, ovaries, and tubes. See the Endometriosis section for more information.