Browsing articles tagged with " infertility"

69. Occipital Headache, How Can Acupuncture Treat It?

Mar 7, 2017   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

News Letter, Vol. 8 (2), March, 2017, © Copyright

Jun Xu, M.D., Hong Su, C.M.D., Lic. Acup.

www.drxuacupuncture.co

Rehabilitation Medicine and Acupuncture Center

1171 East Putnam Avenue, Building 1, 2nd Floor

Greenwich, CT 06878

Tel: (203) 637-7720

How Can Acupuncture treat Occipital Neuralgia?

 

Linda, a 45-year-old female dental assistant, came to me complaining of severe headaches that started at the back of her head and continued down a portion of her neck.  The pain also radiated up to her scalp, around her ears and sometimes into the bilateral temporal area.  The pain was off-and-on, but occurred every day.  The pain ranged from dull to sharp, and was sometimes located directly behind the right eye.  As a dental assistant, she constantly turned her head to the right when dealing with patients.  This caused the headache to become more severe, and she was frustrated that it interfered with her daily work.  She had consulted several doctors about her condition, and had been prescribed Naprosyn, Percocet and Neurotin, but none of them alleviated her condition.

These headaches intensified when Linda was under stress, which was often because of her job: if she had many patients waiting for her and felt under pressure, the headaches worsened.

When I examined Linda, I discovered that when I pressed her scalp at the base of the skull and suboccipital area, the pain radiated to the back, front and side of her head, and also to the right side of the eye.  When I pressed hard on the suboccipital area (the base of the skull) the pain was exacerbated and I could feel the bilateral temporal artery palpating.

The patient probably suffers from occipital neuralgia, which is a cycle of pain spasms originating in the suboccipital area, caused by an inflammation of the occipital nerves.  The two pairs of occipital nerves (each nerve contains a greater and lesser occipital nerve) originate in the second and third vertebrae of the neck.  These nerves supply areas of the skin along the base of the skull and behind the ear, but are not always connected directly with the structures inside the skull. However, they do interconnect with other nerves outside the skull and continue into the neuro-network.  Eventually they can affect any given area along the scalp, mainly on the bilateral temporal area behind the ear and sometimes connect to the nerve branch on either side of both eyes.

Occipital neuralgia may occur continuously, often as the result of the nerve impingement, especially from arthritis, muscle spasm, or as the result of a prior injury or surgery.  Sometimes these conditions will impinge the occipital nerve root, leading to severe headaches at the back of the head, leading to muscle spasm.  Linda exhibits the severe form of occipitical neuralgia, most likely because her profession causes her to tilt her head in the same manner for a good part of her day. This stress causes the occipital nerve to be impinged, sending a constant signal to the nerve network in her scalp, leading to headaches and the pain behind her right eye.

The clinical diagnosis of this condition is based on palpation by the doctor of the bilateral occipital nerve root, which will induce or trigger the headache. Doctors currently use various treatments.  One option is to inject 1% lidocaine 5cc into the occipital nerve root, which decreases or relieves the pain, confirming the diagnosis.  A second option is to use surgery to cut or burn the nerve with a radial wave probe.  A third option is to use a small injection of Botox or a similar medication.  Western medicines include anti-inflammatory or narcotics such as Percocet or Darvocet, Naurontin, anti-epilepsy medication, etc.  For the majority, these medications do not work well, though occasionally they can reduce the occurrence and frequency of the occipital neuralgia.

Some patients respond to physical therapy and massages to decrease the spasm of the neck muscle, which might temporarily relieve the occipital neuralgia.  Though doctors may recommend surgery, many patients resist this type of treatment.

According to Traditional Chinese Medicine, occipital neuralgia belongs in the category of the side headache, i.e. the Shao Yang Gallbladder meridian headache.  Gallbladder meridians are distributed around the sides of the head, and excessive heat in the gallbladder can lead to headaches.  The gallbladder meridian originates from the outside of the eye, and continues up the temporal nerve area, around the lateral skull area, down the occipital nerve area, down through the trunk and to the outside of the leg.  If there is excessive heat along this meridian, there will be an imbalance of yin and yang.  For example, if the patient undergoes stress, muscle spasm or arthritis, the nerve and the gallbladder meridian will be impinged.  This, in turn, will cause the gallbladder to heat up, leading to excessive heat, an imbalance of yin and yang and a severe headache.

Another meridian identified in occipital neuralgia by Traditional Chinese Medicine is the urinary bladder meridian, which starts from the inside corner of the eye, continues through the middle and the top of the scalp, and follows down the back of the trunk and into the back of the leg.  Due to the connection between the gallbladder and urinary bladder meridians, heat in one will cause heat in the other to rise, generating pain around the eye, the temporal area and the scalp, and making the ensuing headache severe and highly unbearable.  Therefore, the principal acupuncture treatment is to relieve this excessive heat in the gall bladder and urinary tract.

The main acupuncture points used for treatment are: Du 20 Bai Hui, GB 20 Feng Chi, GB1 Tong Zi Liao, GB 8 Shuai Gu, Extra point Tai Yang, GB 34 Yang Ling Quan, SI 3 Hou Xi, Lu 7 Lie Que, Kid 6  Zhao Hai, Li 3 Tai Chong.

Linda underwent my treatment three times a week for one month, resulting in immediate, short-term relief of her headaches.  However, the headaches continued to plague her because of her strenuous work.  In addition, her irregular menstrual cycle and hormonal changes led to more severe headaches.  Thus, I also treated her for hormonal changes by utilizing a Chinese herb Da Zhi Xiao Yao San.  The combination of acupuncture and herbal therapy seemed to be effective and, after about two months of treatment, Linda reported that her headaches occurred only infrequently and were very mild, and that she was satisfied with her treatments.

Usually, acupuncture, with or without the addition of herbal supplements, can alleviate the problems and pain associated with these headaches.  However, sometimes it is best to combine acupuncture with a nerve block (utilizing 4cc of 1% lidocaine plus 10 mg Kenalog mixed together) injected into both sides of the occipital nerve origin.  One month of this combined treatment should give the patient 95% relief from his/her symptoms.

Tips for acupuncturists:

  1. You should identify the location of the pain and tenderness, and treat the headache accordingly.  For example, the frontal headache belongs to the Yang Ming meridian; the temporal side headache belongs to the Shao Yang meridian; the top scalp headache belongs to the Jue Ying meridian.
  2. Always use Du 20 Bai Hui for all the different types of headaches. This is based on my personal experience over 20 years of practice.

Tips for patients:

  1. You should be very specific when describing the tender points on your head because each tender-point location belongs to a different meridian, and treatment varies based on each location.
  2. Massaging the Tai Yang and UB 20 Feng Chi points for 20 minutes, 2 to 3 times a day, will greatly decrease the headache.

 

67. Dr. Jun Xu’s calling from West Africa

Mar 5, 2017   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

Dr. Jun Xu went to Leprosy village in 2013, 2014 and 2016, soon he will go to the leprosy village on March 31, 2017.

In 2013, there was no a single room being used for treatment in the leprosy village, Dr. Xu and his team had to use a tent. The temperature was around 125 Fahrenheit degrees.

The leprosy patients were waiting for their turn to be attended. Dr. Jun Xu saw about 200 patients a day.

Typical leprosy patient:
Early Stages
Spots of hypopigmented skin- discolored spots which develop on the skin
Anaesthesia(loss of sensation) in hypthese opigmented spots can occur as well as hair loss
“Skin lesions that do not heal within several weeks of and injury are a typical sign of leprosy.” (Sehgal 24)

Progression of disease

“Enlarged peripheral nerves, usually near joints, such as the wrist, elbow and knees.”(Sehgal 24)
Nerves in the body can be affected causing numbess and muscle paralysis
Claw hand- the curling of the fingers and thumb caused by muscle paralysis
Blinking reflex lost due to leprosy’s affect on one’s facial nerves; loss of blinking reflex can eventually lead to dryness, ulceration, and blindness
“Bacilli entering the mucous lining of the nose can lead to internal damage and scarring that, in time, causes the nose to collapse.”(Sehgal 27)
“Muscles get weaker, resulting in signs such as foot drop (the toe drags when the foot is lifted to take a step)”(Sehgal 27)

Long-term Effects
“If left untreated, leprosy can cause deformity, crippling, and blindness. Because the bacteria attack nerve ending, the terminal body parts (hands and feet) lose all sensations and cannot feel heat, touch, or pain, and can be easily injured…. Left unattended, these wounds can then get further infected and cause tissue damage.” (Sehgal 27)
As a result to the tissue damage, “fingers and toes can become shortened, as the cartilage is absorbed into the body…Contrary to popular belief, the disease does not cause body parts to ‘fall off’.” (Sehgal 27)

Every year, Dr. Jun Xu and his team bring around $300,000 worth of medicine donated from his team members and Americares in Stamford, CT to treat the leprosy and other patients in Senegal and Guinea Bissau. http://www.americares.org/, in 2017, his team also received medicine donation from Direct Relief in California, https://www.directrelief.org/.
Dr. Jun Xu and his team finally established a clinic in the leprosy village, one building for the clinic, and another building for the living of doctors and nurses.

Leprosy village people were celebrating the opening of the clinic.

There are 8 wards, which could hospitalize the patients if it is medically necessary.

Dr. Jun Xu’s team usually stay in Senegal for 10 to 14 days, these are the foods his team brought from US in order to keep them health and safe. They do not dare to eat street food.

The above are the coolants contained food Dr. Jun Xu’s team brought from US

Dr. Jun Xu and his team from US in 2006.
If you are interested in joining Dr. Jun Xu’s team or donating to his work in Senegal, please address your check payable to AGWV, and send to
Jun Xu, MD, 1171 E Putnam Avenue, Riverside, CT 06878, USA.
Dr. Xu promises that all your donation 100% will go to Senegal and his team will nerve use a penny from your donation. You will receive the tax deductible receipt. Any amount is a great help for Africa patients.
For more info, please visit our websites at
http://www.drxuacupuncture.co/ and http://www.africacriesout.org/

64. Acupuncture and Infertility Case Discussion

Jan 23, 2016   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

 

News Letter, Vol. 7 (1),  January, 2016 © Copyright

Case Discussion

Acupuncture and  Infertility

Jun Xu, M.D. Lic. Acup., Hong Su, C.M.D., Lic. Acup.
www.drxuacupuncture.co

Rehabilitation Medicine and Acupuncture Center

1171 East Putnam Avenue, Building 1, 2nd Floor

Greenwich, CT 06878

Tel: (203) 637-7720


Baby

Amy S., a 36-year-old woman, is an OB-GYN at a Connecticut hospital, who delivers babies every day. When she finished her residency two years ago, she and her husband wanted to have a baby and tried for a pregnancy for a year to no avail. As a doctor, Amy is well aware of the workings of her body. She consulted the best endocrinologist and infertility specialist in the area, who checked her hormone levels, including the thyroid, pituitary gland, adrenal gland, ovaries, etc., only to find nothing was wrong. She was careful about nutrition, was at her ideal weight of 120 pounds and neither drank nor smoked. She also had an ultrasound study which showed no problem in her tubes, uterus or ovaries. Amy’s husband was also examined and shown to have a normal quantity and quality of sperm with no antisperm antibodies; the delivery of his sperm was also normal. He showed no retrograde ejaculation and no blockage in the ejaculatory duct.
Amy came to me for consultation and evaluation. She is an open-minded physician, devoted to her job, and works between 55 and 60 hours a week. Her husband is an emergency physician who works in the same hospital and he, too, works hard. Amy and her husband are often on call, causing much stress. They both keep irregular hours and often do not see much of each other. From her history, I could tell she was very stressed, unhelpful to her pregnancy situation.
Amy told me she had read an article which indicated that acupuncture plus IVF (in vitro fertilization) could help the patient increase the success rate for pregnancy. She tried it once without success.
Based on the above information, Amy has unexplained infertility. Unexplained infertility is, by definition, when a couple has not conceived after 12 months of contraceptive free intercourse.

 

In order to understand Amy’s condition, let’s discuss some basic physiology of women.

 

BBT

·       Basal Body Temperature (BBT) is women’s body temperature at rest (wake up time).

·       BBT rises after ovulation due to increased progesterone released from the corpus luteum after ovulation.

·       Ovulation can be detected on a fertility chart for the day BEFORE the temperature rises.

·       When ovulation is detected on a fertility chart, the chart shows a biphasic (lower temperatures followed by higher temperatures) pattern.

·       BBT stays in the higher range throughout the luteal (post-ovulation) phase until the next cycle begins.

·       BBT stays high if there is a pregnancy.

 

What is this BBT chart about?

·       Follicular phase

The follicular phase begins on Day 1 of the menstrual cycle. Estrogen and progesterone levels are at their lowest during menstruation. During this phase the uterine lining, or endometrial lining, both sheds through menstruation and begins a period of regrowth and thickening in preparation for an embryo should conception occur.

 

The follicular phase lasts about 10 to 14 days, or until ovulation occurs.

 

Before a woman ovulates, the basal body temperatures range from around 97.0 to 97.5 degrees Fahrenheit (36.1 to 36.3 Celcius). This is due to the presence of estrogen, which keeps temps down. Temperatures will vary from person to person, but should stay below your cover line.

  Luteal phase

The luteal phase begins when ovulation occurs. During ovulation, the ovaries release a single egg from only one of the two ovaries during each menstrual cycle. Ovulation is a process that begins when the level of luteinizing hormone or LH surges, and ends 16 to 32 hours later with the release of an egg from the ovary.

 

Once ovulation has occurred, the temps go up from around 97.6 to 98.9 F (36.4 to 36.6 C). The day after ovulation, the temp generally jumps up by at least 0.2 degrees F (0.11 degrees C), and then continues to rise somewhat. This increase in temperature is caused by the progesterone released from the follicle after ovulation.

The actual temperatures are less important than noting a pattern showing two levels of temperatures. If there is no pregnancy, then this temperature will stay elevated for 10 – 16 days, until the corpus luteum regresses. At this time, progesterone levels drop dramatically and you get your period.

If your Basal Body Temperature remains elevated for 18 days or more after ovulation, you should probably test for pregnancy.

BBT

 

Ovulation

·       After ovulation, the corpus luteum produces the heat-inducing hormone, progesterone to prepare the lining of the uterus for the implantation of a fertilized ovum. Progesterone causes the resting body temperature to rise after ovulation so that it is possible to identify ovulation for the day BEFORE the temperature rises.

 

·       A fertility chart that shows ovulation detected by BBT will have a BIPHASIC pattern. This means that it will show lower temperatures before ovulation, a rise (thermal shift), and then higher temperatures after ovulation. Ovulation usually occurs on the last day of lower temperatures. Then higher temperatures after ovulation.

 

·       To illustrate, see the image below. The blue dots represent daily temperature readings. Ovulation is identified by the vertical red line. The horizontal red line is a “cover line” to help to visualize the biphasic pattern.

BBT2

 

Conception takes time

·       A normal, healthy couple only has a 25 percent chance of conceiving each month, even when they have sex right around the time of ovulation. After a year of trying, 75 to 85 percent of couples will have conceived.

·       If your Basal Body Temperature remains elevated for 18 days or more after ovulation, you should probably test for pregnancy.

6 Pregnancy Tips

1.  Have Intercourse Often: Sperm can survive in a woman’s body for up to 5 days. To increase your odds, you should have sex frequently 3 days before ovulation and continuing for 2 to 3 days after you think you’ve ovulated.

2.  Lie Low after Sex: Sperm has to swim upstream to meet your eggs, stay in bed for at least a few minutes after intercourse.

3.  Create a Sperm-Friendly Environment: Avoid putting any chemicals into your vagina, such as vaginal sprays, scented tampons, artificial lubricants, and douching. They can alter the normal acidity of the vagina.

4.  Know When You Ovulate: Please use the above chart to estimate your ovulation day. You might also use an over-the-counter ovulation predictor kit (OPK) to check for hormonal changes in your urine before ovulation.

5. De-Stress: Try acupuncture, yoga, meditation, or long walks to reduce stress. Research indicates that stress can interfere with getting pregnant.

6.  Maintain a Healthy Weight: Studies show that weighing too little — or weighing too much — can disrupt ovulation and may also affect production of key reproductive hormones. A healthy BMI is between 18.5 and 24.9.

healthy-bmi-chart

Definition of Infertility:

a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.(WHO).

There are many causes of infertility, including the following:

For the male:

1. Impaired production and function of sperm, low sperm concentration. Normal sperm concentration is greater than or equal to 20 million sperm per milliliter of semen. A count of 10 million or fewer sperm per milliliter of semen indicates low sperm concentration, and the chances of conception lessen. A count of 40 million sperm or higher per milliliter of semen indicates increased fertility; also, if a sperm changes its shape and mobility or is slow, the sperm may not be able to reach or penetrate the egg.

2. The malfunction of the Hypothalamic-Pituitary-Gonadal Axis: if the axis is not working properly, the male hormone level will be disturbed and the sperm will be both low in count and slow in activity.

3. The testes system, including transportation and maturation.

For the female:

1. Fallopian tube damage or blockage.

2. Endometriosis.

3. Ovulation disorders.

4. Hormonal causes, such as hypothyroidism,

4. Early menopause.

5. Polycystic ovary syndrome.

6. Fibroid in the uterine.
Even though there are many women who cannot conceive because of the above reasons, there are also 15-20 % of couples who cannot conceive due to unexplained reasons, and Amy falls into this category. Therefore, many couples have to use the following technology for help.

Assistant Reproductive Technology:

1.     Intrauterine Insemination (IUI)

Intrauterine insemination is the placement of a man’s sperm into a woman’s uterus using a long, narrow tube, which usually help the sperm to go upstream to meet eggs. The successful rate sometimes can be 20%.

2.     In Vitro Fertilization (IVF)

Eggs and sperm are taken from the couple and are incubated together in a dish in a laboratory to produce an embryo. The embryo then will be placed into the woman’s uterus, where it may implant and result in a successful pregnancy.

A. IVF stimulation protocols in the US generally involve the use of 3 types of drugs:

1), Medications to suppress the luteinizing hormone (LH) surge and ovulation until the developing eggs are ready.

There are 2 classes of drug used for this:

GnRH-agonist (gonadotropin releasing hormone agonist) such as Lupron,

GnRH-antagonist such as Ganirelix or Cetrotide

Lupron essentially “shuts down” the body’s reproductive hormone system.

While shut down, IVF patients use a follicle stimulating hormone (FSH) drug like Gonal-F or Follistim, to cause the recruitment and development of follicles. Dosages of FSH are adjusted based upon each patient’s response and it is continued until the follicles are mature.

2), FSH product (follicle stimulating hormone) to stimulate development of multiple eggs

Gonal-F, Follistim, Bravelle, Menopur

3), HCG (human chorionic gonadotropin) to cause final maturation of the eggs

The ovaries are stimulated with the injectable FSH medications for about 7-12 days until multiple mature size follicles have developed.

Ovulation cannot occur naturally while on Lupron because LH, which triggers ovulation, is suppressed. This prevents a premature surge of the LH before the retrieval, which could cause loss of the cycle. Once the eggs are mature, an injection of Human chorionic gonadotropin (hCG) or LH is given to stimulate ovulation. Egg retrieval is scheduled 35 hours later.

 B. Egg Retrieval:

this is the process used to remove the eggs from the ovaries   so they can be fertilized.

C. Fertilization:

the sperms are placed in a dish with the egg and left overnight in an incubator. Fertilization usually occurs on its own. However, sometimes, a single sperm is injected into an egg using a needle. This process is called intracytoplasmic  sperm injection (ICSI). About 60% of IVF in the Unites States is performed with ICSI.Embryos that develop from IVF are placed into the uterus from 1 to 6 days after retrieval.

 D. Embryo Transfer:

a long, thin tube will be inserted through the vagina and into the uterus and injects the embryo into the uterus. The embryo should implant into the lining of the uterus 6 to 10 days after retrieval.

Evidence of Acupuncture as an adjunct to IVF

Now, more and more evidence show acupuncture as an excellent adjunct to IVF. In one article published in Evidence Based Complement Alternative Medicine, 2012, Zheng, et al found out that Twenty-three trials ( a total of 5598 participants)  indicate that acupuncture, especially around the time of the controlled ovarian hyperstimulation, improves pregnancy outcomes in women undergoing IVF.

(Evid Based Complement Alternat Med. 2012;2012:543924. doi: 10.1155/2012/543924. Epub 2012 Jul 2.

The role of acupuncture in assisted reproductive technology.

Zheng CH1, Zhang MM, Huang GY, Wang W.)

 

Another study also showed significant improvement of odds with acupuncture treatment.

Reprod Biomed Online. 2015 Jun;30(6):602-12. doi: 10.1016/j.rbmo.2015.02.005. Epub 2015 Feb 24.

Impact of whole systems traditional Chinese medicine on in-vitro fertilization outcomes.

Hullender Rubin LE1, Opsahl MS2, Wiemer KE2, Mist SD3, Caughey AB3.

 

The following acupuncture protocols are used to help IVF patients:

 

A.    Lupron Routine:

to help suppress the luteinizing hormone (LH), and reduce the side effects of Lupron, Ganirelix or Cetrotide

 

1.     Diji (SP8), Zhongji (Ren 3), Xuehai (SP6), Zusanli (St 36), Sanyinjiao (SP6), Hegu (LI4), Taicong (Lv3).

2.     Cerebrum acupoints(HP-Zone)

Yameng(DU15), Fengfu(DU16),Naohu(DU17)

Tianzhu(UB10),Fengchi(GB20),Wangu(GB12)

3.     Huatuojiaji:

 

B.    FSH Routine:

to help stimulation of multiple eggs.

1.     Cerebrum acupoints(HP-Zone)

Yameng(DU15), Fengfu(DU16),Naohu(DU17)

Tianzhu(UB10),Fengchi(GB20),Wangu(GB12)

2.     Intersection-Zone:

Baihui(Du20),Sishencong(EX-HN-1),Touwei(St8)

3.     Abdominal Zone:

Guanyuan (Ren 4),Zigong (EX Points)

4.     Sacrum-Zone:

Mingmen (DU4),Shenshu (UB23), Eight Liao Points (UB31-UB34).

C.    HCG Routine:

to improve the final maturation of the eggs

1.     One day before egg retrieval: Neiguan (PC6) , Zusanli(St36), Pishu (UB20), Shenshu (UB23), Ganshu(UB18) , Diji (SP8), Taixi (Kid3), Taicong (Liv 3), Quchi (LI11).

2.     Three hours before egg retrieval: Zigong (Extra Points), Sanyinjiao (SP6), Hegu(LI 4), Neiguan(PC6), Taicong(Liv 3), Quchi(LI11).

D.    After Egg Retrieval:

Many patients showed the following symptoms, such as abdominal tender, emotional unsteady, headache, weight gain, nausea and sometimes vomiting, etc.

On the same day: Qihai (Ren 6), Shuidao (St 28), Daimai(GB26), Yinlingquan(Sp9), Sanyinjiao(SP6), Zusanli(St36), Xiaguan (St7), Quchi(LI11), Taicong(Liv3).

E.    For the mobility and viability of Sperm:

Zhongji(Ren3), Guanyuan(Ren4), Zusanli(St36), Taixi(Kid3), Shenshu(UB23), Mingmen(Du 4), Dahe(Kid12), Sanyinjiao(SP6).

F.    Before the Embryo Transfer:

For continues three days: Qihai(Ren6), Guanyuan(Ren7), Sanyinjiao(SP6), Zusanli(St36), Taixi(Kid3), Xuehai(Sp10), Pishu(UB20), Shenshu(UB23), and Ganshu(UB18).

G.   After the Embryo Transfer:

Within 24 hours: Quchi(LI11), Neiguan(PC6), Sanyinjiao(SP6), Zusanli(St36), Taicong(Liv3).

Within 36 hours: Quchi(LI11), Zusanli(St36), Xuehai(Sp10), Diji(Sp8), Taixi(Kid3), Taicong(Liv3), Ear Shenmen, Ear Neifenmi, Ear Zigong.

H.    After confirmed pregnancy:

Quchi(LI11), Zusanli(St36), Neiguan(PC6), Yinlingquan(Sp9), Taixi(Kid3), Taicong(Liv3), Ear Shenmen, Ear Neifenmi, Ear Stomach, until six weeks of pregnancy.

Some important acupuncture points:

Back PointsAbdomen

Amy’s treatment:

Amy was scheduled to have hormone regulation (hormone treatment) for a month before trying to become pregnant again, and to have acupuncture treatments with me three times a week during that month.

 

After four weeks of treatment, Amy underwent the IVF procedure and was kept on the acupuncture treatment twice a week. Amy reported to me that she had eight eggs mature, a much improvement compared with  the first IVF treatment which had produced only three mature eggs.
After a 48 to 72 hour culture, six of her eggs were fertilized and Amy’s doctor implanted four into the uterus. The doctor told her she should have bed rest overnight and that she could return to work the next day; however, I told her to have bed rest for two days, because Amy’s job is more stressful than most people’s, and she has to bend forward in her work to deliver babies.
A month after insemination Amy told me she was pregnant. She was very excited about her condition and eight months later delivered twins, a boy and a girl. She was thrilled with the results, as was her husband.

My personal experience:

1. In unexplained infertility, most of the cases are stress related. As an OB-GYN doctor, Amy worked very hard, as did her husband, and they had little time to be together. They are both under constant stress, their bodies always tight, in particular Amy’s uterus muscles. These factors made it very difficult for the fertilized eggs to attach themselves to the uterus. Some patients may be lucky enough to be pregnant; however, they may not retain their baby in the uterus because of the stress and tightness of their uteruses. They may have frequent miscarriages. My treatment is mainly for stress-reduction.

2.  Many unexplained infertility patients have irregular hormone environments in their bodies because of their high stress levels. These will affect the patient’s entire reproductive system, such as Oocyte maturation, delivery, fertilization, implantation, etc. My acupuncture points are selected to adjust the hormone environment and make the different hormones harmony.

3.  Each patient should have about one month of acupuncture treatment before starting the IVF procedure to prepare the patient’s hormonal system and to have her relax psychologically.

4.  It is extremely important for the patient to have 48 hours of bed rest after insemination before taking up normal activities, because at this time the fertilized eggs are very weakly bound to the uterus. Any inappropriate movement during these first 48 hours might cause an early miscarriage.

5.  For the key acupuncture points, you may do the acupressure by yourself as indicated above.

I thank Dr. Ming Jin, a professor from Shanghai University of Traditional Chinese Medicine, who gave me a lot of important input.

63. Dr Jun Xu was featured on Greenwich Time on August 26, 2015

Aug 28, 2015   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

Dear Friends:

I have been featured on Greenwich Time on August 26, 2015. Please click the following link to read the entire article.

http://www.greenwichtime.com/news/article/Acupunture-joins-options-of-couples-hoping-to-6465359.php#photo-8533281

Acupuncture treatment for infertility is a popular adjunct treatment with IVF.  I have been working with Greenwich Fertility Center and helped many patients.

If you have any friends or relatives, who are interested in my service, please forward this news letter to them.

Thank you very much!

Best,

 

Jun Xu, MD

Rehabilitation Medicine and Acupuncture Center

1171 E Putnam Avenue, Riverside, CT 06878

Tel:203-637-7720

1: Acupuncture and Unexplained Infertility

Jan 21, 2009   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

News Letter, Vol. 1 (1)

January, 2009

© Copyright

Jun Xu, M.D. Lic. Acup., Hong Su, C.M.D., Lic. Acup.

www.rmac.yourmd.com
www.drxuacupuncture.co

Rehabilitation Medicine and Acupuncture Center

1171 East Putnam Avenue, Building 1, 2nd Floor

Greenwich, CT 06878

Tel: (203) 637-7720

Case Discussion 1:

Unexplained Infertility

Amy S., a 36-year-old woman, is an OB-GYN at a Connecticut hospital, who delivers babies every day. When she finished her residency two years ago, she and her husband wanted to have a baby and tried for a pregnancy for a year to no avail. As a doctor, Amy is well aware of the workings of her body. She consulted the best endocrinologist and infertility specialist in the area, who checked her hormone levels, including the thyroid, pituitary gland, adrenal gland, ovaries, etc., only to find nothing was wrong. She was careful about nutrition, was at her ideal weight of 120 pounds and neither drank nor smoked. She also had an ultrasound study which showed no problem in her tubes, uterus or ovaries. Amy’s husband was also examined and shown to have a normal quantity and quality of sperm with no antisperm antibodies; the delivery of his sperm was also normal. He showed no retrograde ejaculation and no blockage in the ejaculatory duct.


Amy came to me for consultation and evaluation. She is an open-minded physician, devoted to her job, and works between 55 and 60 hours a week. Her husband is an emergency physician who works in the same hospital and he, too, works hard. Amy and her husband are often on call, causing much stress. They both keep irregular hours and often do not see much of each other. From her history, I could tell she was very stressed, unhelpful to her pregnancy situation.


Amy told me she had read an article which indicated that acupuncture plus IVF (in vitro fertilization) could help the patient increase the success rate for pregnancy. She tried it once without success.


Based on the above information, Amy has unexplained infertility. Unexplained infertility is, by definition, when a couple has not conceived after 12 months of contraceptive free intercourse.


There are many causes of infertility, including the following:

For the male:

1.
Impaired production and function of sperm, low sperm concentration. Normal sperm concentration is greater than or equal to 20 million sperm per milliliter of semen. A count of 10 million or fewer sperm per milliliter of semen indicates low sperm concentration, and the chances of conception lessen. A count of 40 million sperm or higher per milliliter of semen indicates increased fertility; also, if a sperm changes its shape and mobility or is slow, the sperm may not be able to reach or penetrate the egg.

2.
The malfunction of the Hypothalamic-Pituitary-Gonadal Axis: if the axis is not working properly, the male hormone level will be disturbed and the sperm will be both low in count and slow in activity.

3.
The testes system, including transportation and maturation.

For the female:

1.
Fallopian tube damage or blockage.

2.
Endometriosis.

3.
Ovulation disorders.

4.
Early menopause.

5.
Polycystic ovary syndrome.

6.
Fibroid in the uterine.


Even though there are many women who cannot conceive because of the above reasons, there are also 15 % of couples who cannot conceive due to unexplained reasons, and Amy falls into this category.


Amy was encouraged to have IVF treatment and, beforehand, get acupuncture treatments. She was scheduled to have hormone regulation (hormone treatment) for a month before trying to become pregnant again, and to have acupuncture treatments with me three times a week during that month.


Two groups of key acupuncture points were selected for Amy:

Stomach


Zhong Ji (Ren # 3), Guan Yuan (Ren # 4), Gui Lai (Stomach # 29), Chong Men (Spleen # 12), and Fushe (Spleen # 13). This group of acupuncture points adjusts the hormonal level of the entire body. Zhong Ji and Guan Yuan (Ren # 3 and Ren # 4) directly stimulate the uterus, which makes the uterus muscle very relaxed, and will increase the chance of contraception and easy implantation. Stimulation of the point Fushe (Spleen 12), and Chongmen (Spleen 13)—both points bilateral and adjacent to the ovary and uterus—will directly adjust the ovary’s hormonal secretion cycle, in turn increasing the activity of the pituitary, adrenal and ovary axis and increasing the chance of contraception. Gui Lai (Stomach 29) is also adjacent to the ovary and uterus, which assists the first four points in adjusting the entire female hormone system.


The second group is on the back eight-liao points.


Picture
Eight-liao points (eight points on both sides of the sacral area) directly stimulate the pudendal nerve and the pelvic splanchnic nerve. These nerves will stimulate the uterus and ovaries and help increase the chance of contraception, as well as adjust the entire hormonal system of the female reproductive system.


The two groups above of key acupuncture points will be alternatively treated during each day’s visit, in addition to the Hegu Large Intestine # 4, Quchi Large Intestine # 11, San Yin Jiao Spleen # 6, Xue Hai Spleen # 10 and Tai Chong Liver # 3 – all of which will help adjust the hormone environment in the entire body and thus aid contraception.


After four weeks of treatment, Amy underwent the IVF procedure and was kept on the acupuncture treatment twice a week. Amy reported to me that she had eight eggs mature, an improvement from the first IVF treatment which had produced only three mature eggs.


After a 48 to 72 hour culture, six of her eggs were fertilized and Amy’s doctor implanted four into the uterus. The doctor told her she should have bed rest overnight and that she could return to work the next day; however, I told her to have bed rest for two days, because Amy’s job is more stressful than most people’s, and she has to bend forward in her work to deliver babies.


A month after insemination Amy told me she was pregnant. She was very excited about her condition and eight months later delivered twins, a boy and a girl. She was thrilled with the results, as was her husband.


In my personal experience:

1.
In unexplained infertility, most of the cases are stress related. As an OB-GYN doctor, Amy worked very hard, as did her husband, and they had little time to be together. They are both under constant stress, their bodies always tight, in particular Amy’s uterus muscles. These factors made it very difficult for the fertilized eggs to attach themselves to the uterus. Some patients may be lucky enough to be pregnant; however, they may not retain their baby in the uterus because of the stress and tightness of their uteruses. They may have frequent miscarriages. My treatment is mainly for stress-reduction.

2.
Many unexplained infertility patients have irregular hormone environments in their bodies because of their high stress levels. These will affect the patient’s entire reproductive system, such as Oocyte maturation, delivery, fertilization, implantation, etc. My acupuncture points are selected to adjust the hormone environment and make the different hormones harmony.

3.
Each patient should have about one month of acupuncture treatment before starting the IVF procedure to prepare the patient’s hormonal system and to have her relax psychologically.

4.
It is extremely important for the patient to have 48 hours of bed rest after insemination before taking up normal activities, because at this time the fertilized eggs are very weakly bound to the uterus. Any inappropriate movement during these first 48 hours might cause an early miscarriage.

5.
For the key acupuncture points, you may do the acupressure by yourself as indicated above.

According to studies from Germany and Australia, the IVF treatment without acupuncture has a 29% success rate for pregnancy. However, the combination of acupuncture with IVF increases the success rate to 49%–almost a third higher than IVF alone. Therefore, it would seem advisable to combine the two treatments.

For more questions, please visit www.rmac.yourmd.com refer to the icon of fertility.

Case Discussions