1 Hallam Institution of TCM in Sheffield UK, Sheffield, United Kingdom. Email: [email protected].
2 The Princess Alexandra Hospital NHS Trust, Harlow, United Kingdom.
3 St Mary’s Hospital Paddington, London, United Kingdom.
4 Institute of Pharmaceutical Science, King’s College, London, United Kingdom.
Int Rev Neurobiol. 2017;135:297-311. doi: 10.1016/bs.irn.2017.02.014. Epub 2017 Apr 12.
Abstract
Male infertility normally refers a male’s inability to cause pregnancy in a fertile female partner after 1 year of unprotected intercourse. Male infertility in recent years has been attracting increasing interest from public due to the evidence in decline in semen quality. There are many factors contributing to the male infertility including abnormal spermatogenesis; reproductive tract anomalies or obstruction; inadequate sexual and ejaculatory functions; and impaired sperm motility, imbalance in hormone levels, and immune system dysfunction. Although conventional treatments such as medication, surgical operation, and advanced techniques have helped many male with infertility cause pregnancy in their female partners, effectiveness is not satisfactory and associated with adverse effects. Chinese herbal medicine (CHM) has been used to improve male infertility in China for a very long time and has now been increasingly popular in Western countries for treating infertility. In this chapter we summarized recent development in basic research and clinical studies of CHM in treating male infertility.
It has showed that CHM improved sperm motility and quality, increased sperm count and rebalanced inadequate hormone levels, and adjusted immune functions leading to the increased number of fertility.
Further, CHM in combination with conventional therapies improved efficacy of conventional treatments. More studies are needed to indentify the new drugs from CHM and ensure safety, efficacy, and consistency of CHM.
1 Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
2 Rehabilitation Medicine University Clinic Stockholm, Danderyds Hospital AB, Stockholm, Sweden.
Abstract
Introduction
Endometriosis is a multifactorial, estrogen-dependent, inflammatory gynecological condition – often with long-lasting visceral pelvic pain of different origin, and infertility among women. Current management options for patients’ are often inadequate, with side effects for many for whom acupuncture techniques could be an alternative. Earlier studies have discussed the efficacy of acupuncture, but not its methodological aspects.
Objectives
To summarize the documented clinical effects of acupuncture on rated visceral pelvic endometriosis-related pain, and associated variables among individuals, within and between studied groups, and to discuss the methodological treatment aspects.
Methods
Published full text clinical studies, case reports, and observational studies with abstracts written in English were searched by using the keywords “Acupuncture and Endometriosis” in databases such as PubMed, Web of Science, and CINAHL. The reporting guidelines, Standards for Reporting Interventions in Clinical Trials of Acupuncture was used for the methodological report.
Results
Three studies were found including 99 women, 13-40 years old, with diagnosed endometriosis. The studies were different in research design, needle stimulation techniques, and evaluation instruments. Methodological similarities were seven to12 needle insertions per subject/session, and 15-25 minutes of needle retention time. The needles were placed in lower back/pelvic-abdominal area, in the shank, feet, and hands. Treatment numbers varied from nine to 16 and patients received one to two treatments per week. Similarity in reported treatment effects in the quoted studies, irrespective of research design or treatment technique, was reported decrease of rated pain intensity.
Discussion
Meta-analysis is the standard procedure for the evaluation of evidence of treatment effects, ie, on a group level, usually without analysis of the individual responses even with obvious spread in the results leading to lack of guidance for treatment of the individual patient. By conceptualizing pain as subjective, the individual aspect should serve as the basis for the analysis to allow clinical recommendations. From a physiological and a western medical perspective, acupuncture can be regarded as a type of sensory stimulation that induces changes in the function of the central nervous system that partly can explain the decrease of perceived pain in response to acupuncture treatment irrespective of the technique.
Conclusion
Endometriosis is often painful, although with various origin, where standard treatments may be insufficient or involve side effects. Based on the reported studies, acupuncture could be tried as a complement as it is an overall safe treatment. In the future, studies designed for evaluating effectiveness between treatment strategies rather than efficacy design would be preferred as the analyses of treatment effects in the individual patients.
Check your ovulation is very important if you want to conceive naturally. by checking your ovulation, you know whether you ovulate, and when you ovulate.
When women ovulate, subtle changes may occur in the body both physically and psychologically. By observing the signs and symptoms, you may know whether you ovulate and when you ovulate.
As we know the best and most accurate way to check ovulation is blood testing and ultrasound. Your doctor may give you a blood testing for raising progesterone after ovulation. Transvaginal Ultrasound is the most accurate way to check whether you ovulate or not. However it’s not always convenient to have blood test and ultrasound every cycle. It will be much easier to check ovulation at home.
So, how to test ovulation naturally at home?
Listed 6 ways to check or test you ovulation naturally at home
1. Check your ovulation by counting menstrual cycle:
check ovulation
Ovulation usually happens two weeks before your period starts. If you have a regular 28 days’ cycle, you may ovulate on day 14. If you only have a 21 days cycle, you may ovulate on day 7 – right just after you finish bleeding!
2. Check your Basal Body Temperature (BBT)
Basal Body Temperature (BBT) is the temperature when you are in fully rest. BBT is sensitive to hormone change, especially after ovulation the progesterone increase your BBT 0.3 ~0.5 degrees.
Although BBT doesn’t predict your ovulation, it is a great tool to check whether you ovulate or not. And it is a great tool to check whether you have good quality ovulation or not. Here is how to check your BBT.
3. Check cervical mucus
Before and during ovulation, you may have more clear and stretching mucus – the egg white like fertile mucus. Fertile mucus change the environment of vagina and cervix. It provide an optimal environment for sperm to swim and survive. Therefore make it ready for fertilisation. Fertile mucus usually present from 2 to 5 days.
4. Saliva Ferning Test:
Saliva-based kits analyse dried saliva under a microscope. During ovulation, eastrogen levels rise, causing a fern-like pattern in dried saliva.
5. Ovulation Predictor Kits (OPKs):
These kits detect the surge in luteinising hormone (LH) in your urine, indicating that ovulation is likely to occur within the next 24-36 hours.
Ovulation kit
6. Chart record other changes or symptoms during ovulation:
Feels have more energy, more feminine, and more confident in yourself; You may notice increased libido before and during ovulation period.
Ovulation pain
Some people may have slightly discomfort or pain at either side of lower abdomen. The pain is a dull or stitching, sharp pain.
Ovulation bleeding or spotting
Ovulation bleeding or spotting happens due to the sudden withdrawal of oestrogen at the time of ovulation.
If you know that you are ovulating, having sexual intercourse before and during the time gives you the chance to conceive naturally.
This study did not use acupuncture or herbs, but it is interested to include it here as a way of managing early pregnancy in women who have had previous miscarriages. There is currently no known prevention therapy for unexplained recurrent miscarriage, but this study showed that emotional support and close supervision helped improve outcomes in subsequent pregnancies.
Abstract
One hundred and thirty three couples were investigated at a recurrent miscarriage clinic. In their next pregnancy 42 women (Group 1) with unexplained recurrent miscarriage were managed with a programme of formal emotional support and close supervision at an early pregnancy clinic. Two women were seen in 2 pregnancies (44 supervised pregnancies); 86% (38 of 44) of these pregnancies were successful. Four of the 6 miscarriages had an identifiable causal factor. Nine women (Group 2), also with unexplained recurrent miscarriage, acted as a control group. After initial investigation they were reassured and returned to the care of their family practitioner and did not receive formal supportive care in their subsequent pregnancy; 33% (3 of 9) of these pregnancies were successful (p = 0.005; Fishers Exact Test). Whilst acknowledging that there is a significant spontaneous cure rate in this condition, emotional support seems to be important in the prevention of unexplained recurrent miscarriage, giving results as good as any currently accepted therapy.
Lian Fang et al, Zhong Xi Yi He Xue Bao 2009 Feb;15(1):42-46 Chinese Journal of Integrated Medicine
A chinese herb formula for endometriosis was given to women with long term infertility and endometriosis before and during an IVF cycle and various ovarian parameters were compared with a group of women with endometriosis who embarked on IVF directly without taking the herbs. The group who took the herbs produced more eggs and had a higher fertilisation rate (although a difference in pregnancy rate was not reported). Additionally the follicles of the women who took the herbs showed a reduced level of inflammatory cytokines compared to the women in the control group.
Abstract
Objective
To observe the effect of Quyu Jiedu Granules (QJG) on the microenvironment of ova in patients with endometriosis (EM).
Methods
Twenty EM patients who received in vitro fertilization and embryo transfer (IVF-ET) were randomized equally into a treated group and a control group.Further, 20 patients who received IVF-ET due to oviduct factors were enrolled into a non-endometriosis group.The dosage of gonadotrophic hormone used, the number of ova attained, fertilization rate and clinical pregnancy rate were all observed, and the levels of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) in follicular fluid as well as their mRNA expressions in ovarian granular cells were detected by RT-PCR on the very day of ovum attainment.
Results
The ova attainment (13.80±6.87) and fertilization rate (0.69±0.31) in the treated group were all higher than the corresponding values in the control group (9.80±5.32 and 0.47±0.22); the follicular fluid contents of TNF-α and IL-6 in the treated group were 1.38±0.21 ng/mL and 130.56±12.81 pg/mL, respectively, which were lower than those in the control group (1.98±0.34 ng/mL and 146.83±17.65 pg/mL, respectively). Further, the treated group showed much lower mRNA expressions of TNF-α and IL-6 in ovarian granular cells.
Conclusions
The elevation of TNF-α and IL-6 contents in follicular fluid and their mRNA expressions in ovarian granular cells are possibly related to the low quality of ova in EM; QJG might raise the ova quality by reducing TNF-α and IL-6 levels to improve the living micro-environment for the ova.
Liddell HS et al,