How does acupuncture support men during IVF(In Vitro Fertilization) by Ruth Lee

Experts estimate that 40% of couples with infertility issues are due to women while 30 % of the issues are related to men and 30% of couples suffer from unexplained infertility. However, fertility related support such as IVF acupuncture is always focused on supporting women female and very few men seek for help.

So what does male factor infertility mean?

The issues can range from a mild reduction in sperm count, abnormal sperm function, blockages to prevent the delivery of sperm, complete absence of sperm, to the inability to ejaculate. All these can prevent conception from happening.

How can acupuncture help?

For men, acupuncture can help balance the energy flow through the system. It can improve blood flow to the testes where sperm are produced, restore balance of the body’s natural hormonal level, and facilitate a more relaxed nervous system which often result in improved semen analyses, especially for men with low sperm count, poor sperm motility or poor sperm morphology. Combined with herbal formulas, acupuncture can even help with sex dysfunction such as reduced libido or erectile difficulty which can as a result lead to natural conception. Our fertility acupuncturist and registered Chinese medicine practitioner Master Ruth Lee has worked with many couples where conception could not take place until the male partner received treatment so Ruth always encourage her clients to come with their partners.

How to evaluate the effectiveness of acupuncture on male’s fertility?

Ruth often encourages patients to bring their past health reports especially any fertility test results for a holistic understanding of the couple’s health conditions. It can also be serve as an evaluation tool to review the effectiveness of the treatment. For example, patients can repeat the semen analysis three months after the treatment to see if the quality of the sperm is improved.
According to the 5th edition of the WHO laboratory manual for the examination and processing of human semen, a normal semen sample should be:
Semen volume: >1.5ml
Total count: >39 million/ejaculate
density: >15million/ml
Progressive motility:>32%
Morphology: >4%
White blood cell: <1million/ml

Is it painful?

Sometimes what hinders men to come for acupuncture is the phobia on needling. Ruth ensures that the disposable needles she uses for acupuncture are hair-fine and often painless. What you can feel is the electrical charge which is the Qi arrival and that is crucial for an effective acupuncture treatment. The sensation comes from the point of insertion along the meridians to unblock the qi and blood flow inside your body. Due to the rebalanced and harmony of body and mind, most people find it very relaxing and will doze off during the treatment.

How often should you have acupuncture?

During the IVF, the man’s main contribution is to provide sperm during the testing stages and on the day of egg collection. It takes around 10 weeks for the sperms to get mature in the system and the result is actually a reflection of your health conditions two months ago. Ideally, Ruth will suggest couples to get started 3 months before the process and usually have one or two acupuncture treatments a week before the testing and egg collection day.

If you or a loved one is suffering from infertility, Ruth can provide assistance
Please contact us at +852-25303315 or appt@balancehealth.com.hk for a personalized consultation.

IUI is often the first recommendation to patients experiencing difficulty with conception in a fertility clinic as is more affordable and less invasive compared to IVF (In Vitro Fertilisation). It is a method which combines hormone treatment for the woman and a painless insemination procedure where washed sperm is placed directly into the uterus, followed by the natural fertilisation in the womb.

Who should consider IUI?

If you or your partner experience the below conditions, you may consider IUI as your fertility treatment:

• Failure to ovulate caused by stress, Polycystic Ovarian Syndrome(PCOS) or over-weight
• Hostile cervical mucus that prevents the sperm from penetrating
• Mild male factor infertility such as poor motility, low count, or abnormal morphology
• Sexual dysfunction including premature or inhibited ejaculation or erectile dysfunction
• Unexplained fertility
• Donor sperm

How does acupuncture work to support IUI?

Research shows that for women, acupuncture improves blood flow to the ovaries and uterus, which can lead to improving the egg quality and ovulation, as well as nurturing an uterine lining that is more receptive to implantation.

Here are the seven benefits of acupuncture support to IUI:

1. Regulate the hypothalamus-pituitary-ovarian-axis for a balanced system.
2. Enhance the production of healthy follicles and eggs.
3. Stimulate the ovulation.
4. Decrease the side effects of hormone medications.
5. Calm down the stress response.
6. Facilitate healthy endometrium and the internal environment of the uterus.
7. Support implantation by preventing uterine contractions.

How often should you do acupuncture for IUI support?

Acupuncture works before, during and after the IUI process. I recommend that treatments begin 3 months prior to the procedure. If this is not possible you should begin treatments as soon as possible. One should consider booking an acupuncture treatment and consumption of herbal formulas once a week before fertilization and schedule an acupuncture treatment one day before and after the procedure for best results.

How does Chinese herbal help for IUI and fertility?

Traditional Chinese medicine is one of the most sophisticated herbal systems that exists and has been used for more than two thousand years to treat gynaecological disorders including infertility. In the last decades, experimental and clinical studies have shown that the appropriate use of Chinese herbs increases fertility two-fold within a four month period[1].

A case study showed that by optimizing the uterine and ovarian health, Chinese herbal formulas works well to improve follicle count and quality[2]. The report reviewed a 43-year-old woman with diminished ovarian reserve and multiple uterus fibrosis treated with Chinese herbal medicine for 6 months and achieved a natural conception and a live birth of a healthy baby.

What are the ingredients in the herbal formulas and are they safe?

Herbal treatments rarely use single herbs, but are rather prescribed as balanced, targeted formulas to provide holistic cure and lead to a higher conception and successful pregnancy rate. After a proper diagnosis, I will select around 10-20 different ingredients among thousands of herbs in the Chinese pharmacy that best fit your condition. Some commonly use herbals include angelica root, rehmannia root, Chinese dodder seed, glossy privet fruit, and sometimes minerals like fluorite or ingredients from animal-derived ingredients like Antler Pilose Antler and Colla Corrii Asini. The formula is customized based on one’s dietary restrictions and preference.

Working with a qualified professional who will help ensure that herbal ingredients are pure, without any additives, or chemicals like pesticides or heavy metals is the key to a successful pregnancy. I only select herbal manufacturing companies which are of excellent quality adopting systematic standard operating procedures that are strictly in compliance with the GMP standards of the PRC and Australia and the USP.

If you or your loved one is suffering from infertility, please contact Balance Health at +852-25303315 or appt@balancehealth.com.hk for a personalized consultation.

[1] Karin Ried. Chinese herbal medicine for female infertility: an updated meta-analysis.
Ried K. Complement Ther Med. 2015 Feb;23(1):116-28. doi: 10.1016/j.ctim.2014.12.004. Epub 2015 Jan 3.PMID: 25637159

[2]Benqi Teng, Jie Peng, Madeleine Ong and Xianqin Qu. (2017) Successful Pregnancy after Treatment with Chinese Herbal Medicine in a 43-Year-Old Woman with Diminished Ovarian Reserve and Multiple Uterus Fibrosis: A Case Report. Medicines (Basel) 2017 Mar; 4(1): 7.
Published online 2017 Feb 9. doi: 10.3390/medicines4010007

Registered Chinese Medicine Practitioner
PHD, Li Ka Shing Faculty of Medicine (HKU)
MChinMed Acupuncture (HKU)
BChinMed (HKU)

According to the World Health Organization, clinical depression (Major Depressive Disorder) is a common mental disorder affecting more than 264 million people worldwide.[1] It is also the leading cause of disability and a major contributor to the global burden of disease. The most common symptoms of depression include continuous low mood or sadness and loss of interest and pleasure in activities once enjoyed. It can lead to a variety of emotional, physical and social problems like feeling hopeless/helpless, change of appetite and sleeping pattern, avoiding social contact and activities, etc which will eventually decrease a person’s ability to function effectively in life.

We use the term depression a lot in our daily life, however, most of the time it is used to denote various depressive symptoms, low mood or situational depression instead of clinical depression. Situational depression is also known as “adjustment disorder with depressed mood.” It often resolves in time. This short-term form of depression is normally triggered by a traumatic event or major change in a person’s life, like divorce, loss of job, or death of a close relative. If the person can come to terms with these major life changes, he may eventually come out of the depressive mood and recover. Conversely, if the depressive mood lingers for a prolong period of time, it may also advance to clinical depression.

Apart from stressful life events, genetic pre-disposition, imbalance of chemical in the brain, early childhood trauma, medical conditions, drug use and environmental stress, all play a role in the development of clinical depression. Although most of these factors are not controllable, researches indicated that properly managed stress, especially chronic stress, could help to prevent the advancement of situational depression, and reduce the recurrence of depression episode. Chronic stress elevate stress hormones such as cortisol, and reduced serotonin and other neurotransmitters in the brain, which links to depression. When these chemical systems not working normally, the biological processes like sleep, appetite, energy, and sex drive, and normal regulation of mood will also be disrupted.

Conventional depression treatments normally include psychological treatments (e.g. counselling, cognitive behavioural therapy, interpersonal psychotherapy) and the use of antidepressants (e.g. selective serotonin reuptake inhibitors -SSRIs, tricyclic antidepressants -TCAs). Depression, especially clinical depression is considered to be difficult to treat, with high relapse rate. Non-compliance, intolerance of side-effect of the prescribed drugs, and high cost of the therapies, all contribute to the relapse. As various genetic, physical and emotional factors might be involved in the etiology of depression, there is no universal cure. In recent years, more patients suffered from depression turn to complimentary and alternative medicine to seek for treatment options that suit their personal needs. Chinese herbal medicine and acupuncture are among the popular choices.

Traditional Chinese Medicine(TCM) views human being as an holistic entity, stressing that the physical, emotional, psychological and even spiritual components of a person are interconnected and interdependent. The health of a person is achieved by maintaining the dynamic homeostasis of all these components, which is also known as a state of “Yin-Yang balance”. The energy raised from different emotions will affect their specific corresponding organ systems. Repressed or over-expressed emotions can disrupt the function of the organ systems, causing psychosomatic ailments (e.g. insomnia, gastrointestinal problems) and actual physical damages overtime.

Depression as we mentioned in modern days is very similar to the “Stagnation syndrome –鬱症” , a condition which TCM has been treating for centuries. Symptoms of stagnation syndrome, such as sleeping disorder, fatigue, headache, gastrointestinal problems, and emotional restlessness, are also classic symptoms of major depression. Habitual suppression of emotional experiences and ruminating over problems predict the onset and the severity of major depression. Likewise, the onset of stagnation syndrome is induced by the inhibition of emotions, leading to “qi” (vital energy) stagnation or blockage that can elicit clinical symptoms. Besides, modern epidemiological studies also indicated that there is significant positive correlation between the 2 diseases

Based on the wealth of knowledge TCM accumulated in treating stagnation syndrome, both acupuncture and herbal medicine are commonly used to treat patient with depression. The treatments target to 1) regulate the specific depressive symptoms, 2) promote the proper qi flow in the body so as to restore the internal balance, and 3) strengthen the organ systems related to the depressive symptoms and raise the energy level of the patient so that one can better manage the stress induced by the environment.

Regulate the depressive symptoms

From the TCM point of view, the cause of an ailment can be repressed or over-expressed emotions, but the ailment itself can also lead to a further development of the emotion imbalance. In actual clinical practices, we frequently come across depressed patients with insomnia symptoms. The root cause of the insomnia could be the depressive mood, however, if the symptom is not properly treated, the energy of the patient will be further depleted and lead to an advancement of the depressive mood. Prompt treatment of the symptoms caused by depression could prevent the down-spiraling effects. Small success in treating the specific depressive symptom could also boost the patient’s confidence and help him to regain control of his current condition. The most common depressive symptoms like sleeping disorder, fatigue, headache and gastrointestinal problems can all be properly treated by herbal medicine and/or acupuncture.

Restore proper qi flow and internal balance

As mentioned above, the onset of depression is often related to the habitual suppression of emotional experiences. Suppressed emotions disrupt normal qi flow in the body. Disrupted flow leads to blockage or stagnation of the vital energy, blood and body fluid in the body which could further lead to other physical symptoms (e.g. blood stagnation could lead to chronic headache). Restoring the normal qi flow could solve of the root cause of emotional imbalances. The restoration is normally achieved by using acupuncture to regulate the qi flow of the meridian of specific organ system corresponding to depression and its related symptoms. Other manual therapies, like cupping and acupressure may also be employed to promote the overall yin-yang balance of the patient.

Strengthen the related organ systems

Sadness is the pre-dominating emotion in both functional and clinical depression. According to TCM’s Five Element framework, sadness or grief corresponds to the lung system. Excessive sadness is normally rooted in the deficiency of lung qi, and continual unresolved sadness will further deplete the vital energy in the lung system, form a vicious cycle. Common symptoms of depression like shortness of breath, shallow breathing, sweating and fatigue are the manifestation of lung qi deficiency. This condition can be improved by tonifying the vital energy in the lung system and strengthening the spleen (digestive) system to support the lung functions.

Dysfunction of the liver system also contribute to the development of depression. Liver is responsible to a large degree for the movement of qi through the body. Liver qi can become blocked due to stress or other reasons, resulting in qi stagnation which is the major cause of depression from the TCM perspective. Regulating the energy of the liver system by strengthening and detoxifying the organ play a key role in treating depression and its related symptoms.

Chinese herbal medicine assumes a key role in tonifying and regulating these organ systems. When the herbal medicine is prescribed to treat depression, empirical TCM formula with proven efficacy will be used but also supplemented with other herbs which could restore the patient’s balance according to their current conditions. This multi-drug, multi-target approach of TCM fits perfectly within the multifactorial pathophysiology of depression.
Personalized formula and dosage do not only improve efficacy but also minimize unnecessary side effects.

In summary, depression, from a TCM perspective is caused by an imbalance of organ systems that eventually results in dysregulation of the brain function. It is a multifactorial illness with a variety of pathological mechanisms in different patients. A TCM practitioner typically identifies the principal cause of depression that is unique to each patient and applied acupuncture or medicinal herbal treatment. Apart from treating the symptoms , the therapeutic objectives also include proper releasing of the stagnated vital energy and restoring the balance of the related organ systems of the patient.

Reference:

1. https://www.who.int/news-room/fact-sheets/detail/depression
2. https://www.webmd.com/depression/features/stress-depression#1
3. Ng SM, Leng LL. Major depression in chinese medicine outpatients with stagnation syndrome: prevalence and the impairments in well-being. Evidence-Based Complementary and Alternative Medicine. 2018 Sep 13;2018.