Reproductive Wellness, San Diego - Fertility & Reproductive Health

Women with Breast Cancer Turn to Complementary Medicine

Marc Sklar — Tue, 09 Mar 2010 18:46:00 GMT

Women with Breast Cancer Turn to Complementary Medicine

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Your Thyroid and Infertility

Marc Sklar — Tue, 09 Mar 2010 18:08:00 GMT

This came across my email today and I thought I would post this as this is something we see commonly in our office and treatment is very effective using chinese medicine and functional medicine.

Marc

High Antithyroid Antibodies:

Associated with Adverse Pregnancy Outcomes

Even for Euthyroid Women

Women often contact us to express a common concern. Their doctors have told them that their high anti-thyroid antibody levels are of no importance to their health. The women also tell us how their doctors justify this belief to them: "You're 'euthyroid,' the doctors explain. "That means your TSH is 'in range.' And when your TSH is in range, your thyroid function is just fine. So don't worry about the antibodies."

But two groups of women do remain concerned: those who have tried but can't get pregnant, and others who have had troubled or failed pregnancies. Both of these groups of women have science on their side: studies show that women who have in-range TSH and thyroid hormone levels but high anti-thyroid antibody levels are more likely to be infertile and to have complications of or failed pregnancies.

Increased need for thyroid hormone during pregnancy

Dr. R. Gärtner wrote that pregnancy increases the demand for thyroid hormone by 30%-to-50%. The thyroid gland, he added, has to cope with the increased demand for thyroid hormone. Because of the increased demand on the gland, he wrote, it's important that the pregnant woman get enough iodine, both during her pregnancy and when she's breast feeding.
They also have read enough to know that an in-range TSH level is no assurance whatever that a person has enough thyroid hormone regulation to be healthy.

One group of the women is concerned about their high anti-thyroid antibody levels because they aren’t able to get pregnant. They fear that their autoimmune thyroiditis is responsible for their infertility.

The second group of women remain concerned about their high anti-thyroid antibodies because they’ve had troubled or failed pregnancies. They, too, suspect that autoimmune thyroid disease is responsible.

I’ll be forthright and say here that both groups of women do indeed have good reason for concern over their anti-thyroid antibody levels. Below I support this proposition by briefly reviewing some of the relevant evidence. That evidence, to give a more specific proposition, shows this—even in women with in-range TSH and thyroid hormone levels, high anti-thyroid antibodies are associated with both infertility and complicated and failed pregnancies.

Ovarian stimulation and in vitro fertilization. In 2009, Italian researchers wrote, “Anti-thyroid antibodies, even if not associated with thyroid dysfunction, are suspected to cause a poorer outcome of in vitro fertilization.” (Italics mine.) They analyzed patients’ records for the prevalence of autoimmune thyroiditis among infertile women who had reference range TSH and thyroid hormone levels. The prevalence of high antibodies in euthyroid women was 10.5%.

Some of the women with autoimmune thyroiditis didn’t undergo thyroid hormone therapy. Compared to control women, these untreated women didn’t respond as well to ovarian stimulation and in vitro fertilization.

The researchers noted that women who used T4 responded better to ovarian stimulation. However, they responded no better to in vitro fertilization than did women with autoimmune thyroiditis who didn’t undergo thyroid hormone therapy. But women who were treated with combined thyroid hormone, aspirin, and prednisolone responded as well to in vitro fertilization. In fact, they responded as well as women who didn’t have autoimmune thyroiditis.

The findings from this Italian study support the 2008 findings of Spanish researchers.[6] These researchers found that women with implantation failure had a higher incidence of both thyroid peroxidase (TPO) and anti-thyroglobulin antibodies—despite the patients’ TSH and free T4 levels being in-range.

The Spanish researchers also found that both types of anti-thyroid antibodies were higher in women with “unexplained infertility” than in women with recurrent spontaneous abortion. (This is an important finding in that women with recurrent spontaneous abortion also have a high incidence of anti-thyroid antibodies.[3,4,5]) And once more, the women with unexplained infertility had in-range TSH and free T4 levels. The Spanish researchers wrote that thyroid autoimmunity in euthyroid women is “strongly” related to both unexplained infertility and implantation failure.[6]

Euthyroid autoimmune thyroiditis. In a review 2009 paper,[1] Dr. R. Gärtner pointed out that women who are euthyroid but have high thyroid peroxidase antibodies more often have miscarriages, preterm deliveries, and postpartum thyroiditis. (He believes that if these euthyroid women begin taking T4 early in their pregnancies, they’re less likely to have pregnancy complications.)

Indeed, whether the women are euthyroid or hypothyroid, if they have high anti-thyroid antibodies, they are more susceptible to reproductive problems. In 2000, researchers in Greece found that compared to control women, women with recurrent spontaneous miscarriage had a higher incidence of high anti-thyroid antibodies.[3] In 2004, Israeli researchers found a statistically significant association between thyroid peroxidase antibodies recurrent miscarriages[4] And in 2008, Iranian researchers reported that compared to controls, women with recurrent spontaneous abortions had a significantly higher incidence of both thyroid peroxidase and anti-thyroglobulin antibodies. They concluded, “. . . thyroid autoimmunity was independently associated with a higher risk of recurrent abortion.”[5]

Subclinical hypothyroidism. Dr. Gärtner noted[1] that if a pregnant mother isn’t euthyroid but has subclinical hypothyroidism, this may impair normal development of the fetus. The mother, he wrote, should undergo thyroid hormone therapy even when her TSH is within the upper end of the reference range. And again, for emphasis perhaps, he wrote, “Special care is necessary in women with elevated TPO antibodies, because these [women] more often develop postpartum thyroiditis.”

Conclusion. The research literature contains sufficient evidence that high anti-thyroid antibodies are associated with infertility and troubled pregnancies. Because of this, in my opinion, if you’re a euthyroid woman with high anti-thyroid antibodies, and you’re concerned that these may be associated with your infertility or problematic pregnancies, your concern is warranted.

Let your concern motivate you. If you want to continue working with your current clinician who has been mistaken about the issue, then share the research I’ve cited in this article with him or her. Hopefully he or she will cooperate with you so as to relieve your concerns. If not, however, let your concern motivate you to find another clinician who will cooperate with you. In either case, work with the clinician you choose to relieve any health problems you have related to your autoimmune thyroiditis—and especially, of course, any reproductive problems you have.

Acupuncture is effective for Period Pain

Marc Sklar — Fri, 26 Feb 2010 02:22:00 GMT

Acupuncture may be an effective way of easing severe period pain, a South Korean review of 27 studies suggests.

Researchers said there was "promising evidence" for acupuncture in treating cramps, but that more work was needed.

In the British Journal of Obstetrics and Gynaecology, they noted two studies found little difference between real and sham acupuncture in treating pain.

Acupuncture is a less contentious form of complementary medicine than some, but its value is still disputed.

Period pain can be severe in some women and may be accompanied by nausea, diarrhoea, migraine and backache. Common treatments include pain killers, applying heat and exercise - although a recent study questioned the efficacy of the latter.

This latest review involved 27 studies - which included nearly 3,000 women. They addressed a variety of forms of acupuncture - from classical to acupoint injection.

Traditional acupuncturists insert needles in acupuncture points located along what they describe as "energy meridians" - a concept for which many scientists say there is no evidence. Sham acupuncture places needles away from these points.

It is not clear whether either form alleviates pain as a result of the placebo effect - the very ritual of undergoing acupuncture - or cause subtle changes in the nervous system and brain activity which can be beneficial.

Nice backs needles

The analysis by the team from Kyung Hee Medical Centre found that patients with severe period pain reported a greater reduction in their symptoms when using acupuncture compared with pharmacological treatments.

But they stressed there were methodological flaws in some studies, and that the findings did need to be interpreted with caution. Nevertheless, there was "promising evidence", they wrote.

In the UK, the National Institute for Health and Clinical Excellence (Nice) has backed the use of acupuncture in the treatment of low back pain - a move welcomed by some but criticised by those who say there is little evidence for its efficacy.

The editor-in-chief of the BJOG, Professor Philip Steer, noted that some women had period pain, also known as primary dysmenorrhoea, so badly they were "unable to function normally".

"Women with primary dysmenorrhoea should consult their GPs or gynaecologists on the best treatment available to them. Complementary therapies should not be used exclusively, at the expense of conventional treatment, unless significant improvements have been made and your doctor tells you otherwise."

Celiac Disease and Infertility....What is the link?

Marc Sklar — Thu, 04 Feb 2010 18:03:00 GMT

Reposted from the New York Times.

Can Foods Contribute to Infertility?

By THE NEW YORK TIMES

Robert Stolarik for The New York Times People sensitive to the gluten in bread, pasta and other foods may face fertility problems.

Dr. Sheila Crowe, a professor in the division of gastroenterology and hepatology in the department of medicine at the University of Virginia, recently joined the Consults blog to answer reader questions about celiac disease, an often overlooked digestive disorder that causes damage to the small intestine when gluten, a protein found in wheat, barley and rye, is eaten. Millions of people have celiac disease, but most don’t know they have it, in part because symptoms can be so varied. Here, Dr. Crowe responds to a reader concerned about the links between celiac disease and infertility.

Celiac Disease, Infertility and Miscarriages

Can you explain the link between celiac and infertility? Are you more likely to be infertile if you have celiac?
Melanie

Dr. Crowe responds: Yes, infertility, or the inability get pregnant, seems to be more common in women with untreated celiac disease, based on a variety of studies in different countries. Other gynecological and obstetrical problems may also be more common, including miscarriages and preterm births. Men with untreated disease may also face fertility issues. Although these problems were not always recognized as being related to celiac disease by doctors and other health professionals, this situation is starting to change.

Women with celiac disease are reported to start having periods later and stop menstruating earlier than average. They also suffer more often from secondary amenorrhea, a condition in which menses start but then stop. Together, these menstrual disorders lead to fewer ovulations, which results in less of a chance to get pregnant. Hormonal factors and poor nutrition are thought to play a role in causing these problems.

For men, problems can include abnormal sperm – such as lower sperm numbers, altered shape, and reduced function. Men with untreated celiac disease may also have lower testosterone levels.

Of course, for both men and women, how often a couple has intercourse affects fertility. If someone feels lousy from untreated celiac disease, infrequent sexual activity may be contributing to the problem. One study from Italy suggests that sexual relations occurred less often when one partner had active celiac disease compared with couples in which the partner’s celiac disease was being treated.

Once a woman with active celiac disease does conceive, other problems that can arise during the pregnancy include miscarriages and smaller babies because of preterm delivery or delayed growth in the uterus. These conditions are reported to be more common in women with untreated celiac disease, though miscarriages have many causes and occur in up to one-fourth of all pregnancies. Nonetheless, I would recommend that if a woman has repeated miscarriages or is unable to conceive, consideration should be given to screening her for celiac disease by antibody testing (see my earlier posting, “Confirming a Diagnosis of Celiac Disease”).

Indeed, there are many causes of infertility, miscarriages and small babies besides unrecognized celiac disease, and some studies have failed to show that the risks of these problems are actually increased by untreated celiac disease. Larger and better-devised studies are needed.

Still, my own clinical experience suggests that infertility and smaller or preterm babies are more common in women with untreated celiac disease than those without. I am sure some of our readers can share their own experiences in this regard. And the good news is that with proper treatment with a gluten-free diet and correction of nutritional deficiencies, the prognosis for future pregnancies is much improved.

To learn more about celiac disease, visit The Times Health Guide: Celiac Disease, and see Dr. Crowe’s additonal responses:

SIDS Linked to Low Levels of Serotonin

Marc Sklar — Wed, 03 Feb 2010 16:24:00 GMT

SIDS Linked to Low Levels of Serotonin
NIH-Funded Study Finds Abnormalities in Brain Region That Regulates Breathing, Sleep

The brains of infants who die of sudden infant death syndrome (SIDS) produce low levels of serotonin, a brain chemical that conveys messages between cells and plays a vital role in regulating breathing, heart rate, and sleep, reported researchers funded by the National Institutes of Health.

SIDS is the death of an infant before his or her first birthday that cannot be explained after a complete autopsy, an investigation of the scene and circumstances of the death, and a review of the medical history of the infant and of his or her family. According to the National Center for Health Statistics, SIDS is the third leading cause of infant death (PDF - 1.71 MB), claiming more than 2,300 lives in 2006.

The researchers theorize that this newly discovered serotonin abnormality may reduce infants’ capacity to respond to breathing challenges, such as low oxygen levels or high levels of carbon dioxide. These high levels may result from re-breathing exhaled carbon dioxide that accumulates in bedding while sleeping face down. The findings appear in the Feb. 3 issue of The Journal of the American Medical Association.

“We have known for many years that placing infants to sleep on their backs is the single most effective way to reduce the risk of SIDS,” said Alan E. Guttmacher, M.D., acting director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute that funded the research. “The current findings provide important clues to the biological basis of SIDS and may ultimately lead to ways to identify infants most at risk as well as additional strategies for reducing the risk of SIDS for all infants.”

NICHD’s Back to Sleep campaign urges parents and caregivers to place infants to sleep on their backs. Following the campaign’s launch in 1994, the rate of SIDS dropped by more than 50 percent. Widespread adoption of back sleeping appears to have reduced the occurrence of SIDS, but has not eliminated it.

For this study, senior author Hannah C. Kinney, M.D., of Harvard Medical School and Children’s Hospital Boston, and her colleagues examined small samples of tissue from the medulla, a region at the base of the brain that regulates basic functions such as body temperature, breathing, blood pressure, and heart rate. The researchers analyzed brain tissue from infants who died from SIDS and controls who died of other causes. Included in the analysis were 35 infants who died of SIDS, 5 infants who died unexpectedly of other causes, and 5 infants who were hospitalized and died for reasons associated with a lack of oxygen.

The researchers found that serotonin levels were 26 percent lower in tissue from infants who died of SIDS than in tissue from the group of infants who had otherwise died unexpectedly. Measurements of tryptophan hydroxylase, an enzyme needed to make serotonin, also were 22 percent lower.

In earlier work comparing SIDS cases with other infant deaths, Kinney and her coauthors showed that the brains of infants who died of SIDS had higher concentrations of cells that use serotonin in the medulla oblongata, a region of the brain stem. For the current study, the researchers set out to see if this meant the SIDS infants’ brains in fact had altered levels of the brain chemical.

This abnormality appears to fit into the triple-risk model of SIDS, which holds that SIDS occurs only when three elements come together: an infant with an underlying vulnerability, a critical period of development, and an external stressor. The researchers speculate in this case that the low serotonin level would cause the underlying vulnerability. The first year of life is the critical period of development for stabilizing vital functions such as breathing. The final element of the model, sleeping face down, might provide the external stressor.

“Our research suggests that sleep unmasks the brain defect,” Dr. Kinney said. “When the infant is breathing in the face-down position, he or she may not get enough oxygen. An infant with a normal brainstem would turn his or her head and wake up in response. But a baby with an intrinsic abnormality is unable to respond to the stressor.”

“It’s no one single factor but a culmination of abnormalities that result in the death,” Dr. Kinney said. In fact, in 88 percent of the SIDS cases they examined, the researchers found two or more risk factors, such as the infant’s sleep position, an illness, or exposure to cigarette smoke.

Kinney hopes these findings will one day lead to a test that measures infants’ serotonin levels in the blood or other tissues that reflect brain serotonin levels. Such a test might make it possible to identify those at the highest risk for SIDS so that additional steps could be taken to protect them. In the near term, the findings will provide the basis for the development of animal models with serotonin deficiencies, to mimic what occurs in SIDS in human beings.

Uterine Cancer Risk May be Raised by Fertility Drugs January 26

Marc Sklar — Tue, 02 Feb 2010 17:29:00 GMT

According to a Danish study small increases in cancer risk from certain fertility drugs used for longer duration. The research group identified higher uterine cancer risk among women who had used follicle-stimulating hormone and human menopausal gonadotropin (hMG) for duration longer than 10 years. Similar risk was seen among women who at any point took six or more cycles of clomiphene(treatment for women not ovulating normally) or when clomiphene didn’t work when women were injected with six or more cycles of human chorionic gonadotropin (hCG). Uterine cancer risk seemed about two times the usual risk in each of these scenarios though the absolute risk of developing uterine cancer is still not very high.

The study was based on 16 years of research on a group of 54,362 women who underwent fertility treatment between 1965 and 1998. The team compared the use of fertility drugs among 83 who developed uterine cancer and 1,241 of similar age who did not develop cancer of the uterus. 51 and 50 percent of the women who did and did not develop uterine cancer, respectively, used fertility drugs. Differences in risk became clear in investigations of specific fertility drugs used and the length of use. These risks weren’t ruled out when the investigators further allowed for use of a single or multiple fertility drugs, number of births, causes of infertility, and any history of oral contraceptives.

Research Shows that Acupuncture increases Sperm Motility Rates

Marc Sklar — Thu, 17 Dec 2009 18:43:00 GMT

Acupuncture may have significant positive effects on the percentage of motile sperm in infertile men who have severe oligoasthenozoospermia, reports research from Germany. According to two prospective randomized clinical studies (Dieterle et al., 2006; Westergaard et al., 2006) and a systematic
review with meta-analysis (Manheimer et al., 2008), acupuncture has a significant effect on clinical pregnancy and live birth rates when it is conducted at the time of embryo transfer in patients undergoing in vitro fertilization (IVF). The effect of acupuncture on semen parameters has only been evaluated in a small sample of patients, however (Yu Ng et al., 2009). Therefore, the purpose of this study by S. Dieterle and colleagues was to determine the effects of acupuncture on the semen parameters of infertile men with severe oligoasthenozoospermia. "A significantly higher percentage of motile sperm (WHO categories A - C), but no effect on sperm concentration, was found after acupuncture compared with placebo acupuncture," wrote Dieterle et al. ("A Prospective Randomized Placebo-Controlled Study of the Effect of Acupuncture in Infertile Patients with Severe Oligoasthenozoospermia," Fer & Ster, 2009;92(4):1340-1343). The study included 47 infertile men with severe
oligoasthenozoospermia who were randomized to receive either acupuncture (n = 28) or placebo acupuncture (n = 29) twice a week for six weeks. Acupoints were chosen for both groups based on an earlier acupuncture study on sperm morphology in male infertility (Pei et al., 2005). The acupuncture needles,
which were 0.30 x 30 mm, were inserted to a depth of 15 - 30 mm. They were rotated manually to evoke the Deqi sensation; 10 minutes later, they were manipulated again for the same sensation. Non-penetrating needles of the same dimensions were used for placebo acupuncture. Semen samples were
evaluated according to WHO (1999) standards at the following times: ≤ five months prior to intervention, < 3 months prior to intervention, < 2 months after intervention, and ≤ 3 months after intervention. Statistical analysis included Dixon and Mood sign test,

Mann-Whitney U-test, and Wilcoxon matched pairs test. Data are given as mean ± SD. In the group of patients that underwent acupuncture, a significant (P = 0.035) increase occurred in motility A - C after intervention (24.2% ± 17.0 before intervention vs. 33.8% ± 18.2 after intervention). No significant difference was seen in motility A - C after use of non-penetrating needles in the control group. Sperm concentration improved after intervention in the acupuncture group, but not to a significant extent; however, sperm concentration did improve significantly (P = 0.0180) in the control group from 0.016 ± 0.085 million/mL before use of non-penetrating needles to 0.468 ± 1.712 million/mL after placebo acupuncture. Semen volume decreased significantly (P = 0.041) after intervention in the acupuncture group, but no significant difference was noted after placebo acupuncture in the control group. "The decrease in semen volume after acupuncture has to be investigated. There was a significant increase in sperm concentration after placebo acupuncture, but not after acupuncture. These results might be due to the number of patients included in this study," concluded Dieterle et al. "The results of the present study support the significance of acupuncture in male patients with severe oligoasthenozoospermia." Address correspondence to Priv.-Doz Dr. Med. Stefan Dieterle, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Witten/Herdecke, Olpe 19, D-44135 Dortmund, Germany; e-mail: dieterle@ivf-dortmund.de.

Leading the way in Integrative Fertility Treatments

Marc Sklar — Thu, 17 Dec 2009 18:36:00 GMT

Paul Magarelli, Ph.D., M.D. and Diane Cridennda, L. Ac. (FABORM) - recently Acupuncture/IVF Study published in this month's Fertility and Sterility. We at Reproductive Wellness are proud of them, and the word is getting out. So for those who are interested, feel free to click on the link below to listen to the recorded radio interview about their research and how Acupuncture and IVF are being used to make changes and increase IVF success rates!!!

Creating Families

Who is a specialist in Fertility Acupuncture

Marc Sklar — Tue, 15 Dec 2009 18:14:00 GMT

The single best resource for integrating Acupuncture and/or Chinese Herbal Medicine into your fertility treatments is the American Board of Oriental Reproductive Medicine (www.aborm.org). The ABORM Board Certifies Acupuncturists who specialize in the treatment of male and female infertility via a rigorous certification examination that measures their knowledge base in western REI, and Traditional Chinese Medicine as it relates to Infertility. ABORM Fellows are experienced, highly trained, certified, and up-to-date on the very latest in evidence-based CAM treatments for Infertility. They can be an invaluable resource as you go through fertility treatments.

If you are under the care of an Acupuncturist who is not ABORM Certified, it can be a toss-up as to their competency in terms of their experience and training related to Infertility. It’s always best to contact the practitioner and ask a few questions. The fact that they have performed a few pre-transfer and post-transfer acupuncture treatments for IVF patients, does not equal a thorough understanding of western REI, nor a thorough grasp of TCM as it relates to Infertility. Many newly licensed practitioners say they are specialists in fertility because they like the area but in reality they have no real hands on experience.
Remember: you are looking for someone to work with who can refer you out if needed! You dont want some who will keep you as a patient indefinitely.

Stork Talk in San Diego

Marc Sklar — Tue, 15 Dec 2009 18:10:00 GMT

Reproductive Wellness will be hosting its Fertility talk called "The Stork Talk". This will take place on December 15th, 2009 at 6:30pm in Mission Valley at the Courtyard Marriott. Anyone who is interested in learning more about Natural Treatments for fertility is welcome to attend. For more information please contact the clinic at 619-265-0291.

How do we diagnose and determine a treatment plan using Chinese Medicine?

Marc Sklar — Tue, 15 Dec 2009 18:09:00 GMT

How do we diagnose and determine a treatment plan using Chinese Medicine?

Chinese Medicine uses an intricate system of pattern differentiation to determine the correct diagnosis. Each group of signs and symptoms begins to move us through a web of options finally allowing us to determine a pattern of disease. Simply, each group of symptoms is pulled together to show an underlying cause of disease. Through a series of questions and answers the pathomechanism (mechanism that caused the disease) is determined. This allows us to reverse the disease process in the quickest time with the most appropriate treatment. Once the pattern and mechanism are determined a correct treatment plan can be established. Each treatment (set of acupuncture points, herbal medicine, nutrition, supplements, etc …) is carefully picked to coincide with the diagnosis that has been established.

Treatment frequency is determined by a patient’s rate of response. The establishment of a patient’s ability to heal allows our case manager to determine how frequently and for what length of time a patient needs to come in. A patient’s rate of response is reevaluated by their case manager regularly to measure progress and adjust treatment plans as needed.

Marc

Acupuncture, Stress and Ferftility

Marc Sklar — Tue, 15 Dec 2009 18:03:00 GMT

Many patients have recently asked about stress and acupuncture and its affects on the ovaries, so I wrote this out.

Acupuncture originated centuries ago and is the means by which practitioners of Oriental Medicine tap into the vascular systems that enlivens and runs through each person. There are classical entry points (acu-points) along these lines called meridians. The stimulation of a combination of exact points using ultra fine filaments will cause the body to correct the flow of blood and oxygen, sometimes called Qi. Classic texts describe 365 points located on meridians that are mapped onto the surface of the body.

Simply, acupuncture functions by affecting neural pathways along the body. When a needle is inserted into the skin a signal is sent from the area of insertion (the peripheral aspect of the body) to the spinal cord. From the spinal cord a signal is sent to different areas of the brain. Once these areas of the brain are contacted the body will respond by producing more or less of a certain chemical or hormone. It may also then send a signal back to the spinal cord or organs that it is trying to influence. Studies have shown that when needling the point Pericardium 6 (traditionally used for relieving nausea and vomiting) a signal is sent to the brain area that affects vomiting, to inhibit the nausea and vomiting. Similarly, research has shown that pain is reduced through acupuncture. Once the signal of the acupuncture needle has reached the spinal cord it sends a signal to the brain to release opiates. Opiates are our body’s natural painkillers and are released from the pituitary gland. (Pomeranz and Stux: 1988) It has also been seen, in functional MRI’s that acupuncture stimulates the central nervous system. (Cho et al.: 1998; Fang and Hayes: 1999)

These studies are excellent example of how acupuncture works when needling acu-points. These studies however do not explain what Meridians are. Most people who have some understanding of Eastern medicine have heard the word Meridian. The Chinese would describe a meridian as a pathway where qi travels along to bring health to the body. This abstract explanation makes sense to very few in the west. Luckily there is research to show that meridians actually do exist. A research study has demonstrated the map of a meridian pathway. This study involved the injection of Technitium99, a radioactive tracer, into both true and sham acupoints. “The scan of the injection sites showed random diffusion of the tracer around the sham point but rapid progression of the tracer along the meridian at a rate that was inconsistent with either lymphatic/vascular flow or nerve conduction.” (Victor S. Sierpina, MD; Moshe A. Frenkel, MD South Med J. 2005; 98)

Acupuncture has several effects on the body. Some of these effects are:

Restoring blood, nutrients and air flow
Restoring visceral (organ) and immune function
Promoting physiological and autonomic balance – Homeostasis
Relieving pain
Promoting the healing of tissue

It should be known that unlike the needles used to give standard pharmaceutical injections, the filaments used in acupuncture treatments are extremely fine, only twice the width of a single hair. These filaments are designed to enter the skin with the least resistance and with barely any perceived discomfort. Most clients are surprised to discover that treatments involve little or no pain, and are usually quite relaxing.

In short Acupuncture works in 2 fundamental ways; regulating the nervous system and increasing blood circulation. Research has shown that when a needle is inserted into the muscle it causes the blood vessels to dilate. This begins the increased circulation of blood, but then we need to direct the blood to the area of the body that has lost function or is in pain (which are the 2 main effects of a reduced amount of blood circulation). We do this by sending a signal to the brain via the nervous system. This signal tells the body which area to shunt blood to. This is like a computer program; you plug in the code by selecting points, and this tells the body what to do.

The adrenal glands are the stress glands of the body. When the environment is hostile to the body, its reaction is to fight or run. Both of these reactions cause the secretion of adrenal gland hormones. These glands are designed to prepare the body for a temporary emergency; they can become exhausted and over reactive with prolonged environmental stresses.

The adrenal glands are 2 almond shaped glands that sit right above the kidneys. Most noted for secreting adrenaline, they also secret numerous other hormones including cortisol, DHEA and norepinephrine.

Adrenalin- This hormone causes an immediate burst of energy, makes the heart beat harder, raises up the blood pressure and over time leads to heart disease and vascular problems.

Norepinephrine (Noradrenalin) - This hormone takes blood out of the digestive tract and puts it into the muscles. This can lead to digestive problems.

Cortisol- This hormone breaks down fat into sugar keeping your energy constant all day. It also controls sleep, acts as an anti-inflammatory and suppresses the immune system. Allergies, arthritis, fatigue, sleep and weight issues can be related to problems with this hormone.

DHEA- This hormone is considered to be the master sex hormone of the body, controlling estrogen, testosterone, and progesterone. Imbalances with this hormone can affect menopause, PMS, infertility, loss of libido, etc… through its connection with the hypothalamus, pituitary, ovaries/gonads.

These hormones cause the following reactions to prepare you to fight or run:

First, the blood flows toward your muscles, heart and brain, away from the skin, digestive track and reproductive organs; your heart beats rapidly and forcefully, your eyes dilate and glycogen in your liver is converted into glucose for quick energy. All to help you fight or run.

The connection between stress and heart disease is that prolonged stress causes rapid and forceful heart actions which over a prolonged period of time can lead to heart disease. Also the extra blood sent to the heart over time has also been found to be destructive.

Second, as the blood begins to be moved toward your muscles, heart and brain, the first place it gets pulled away from are your ovaries, uterus, testes and your other reproductive organs. The understanding is that the last thing your body needs to do when it is in a stress response is to reproduce. The result of long term stress on the reproductive organs can be menstrual pain, pelvic pain, infertility, high FSH, irregular menstrual cycles, anovulation or a decrease in sperm count.

Third, through the secretion of hormones, the digestive track shuts down. You don’t need to digest when you are being attacked, so your body causes either immediate elimination or stops digestion altogether. The result of long term stress could be constipation, diarrhea or any digestive problems.

Further, more than 50% of your body’s protein, B vitamins and vitamin C are not absorbed when you are under stress. Because the body under stress directs its efforts to run or fight; the immune system stops functioning when you are under stress. Research done by the National Institute of Health (NIH) found that persons under stress are more susceptible to bacteria and viruses.

Your hormonal rhythm that leads to sleep is based on the secretion of adrenal hormone cortisol. With stress, cortisol levels alter which can cause abnormal sleep behavior.

Finally, because these glands secrete DHEA, which has proven to create the estrogen reserves in the body, problems with these glands can be related to PMS, menopausal symptoms and infertility.

As our nervous system is continually hyperfunctioning our body begins to deplete its adrenal glands. As more cortisol is released patients develop adrenal fatigue. Because of the adrenal glands connection to the hypothalamus and pituitary glands (and in turn their connection with the ovaries), adrenal fatigue can, and usually does, lead to poor ovarian reserve. As our skilled practitioners treat our patients they work to boost the adrenal glands and their functioning to minimize the aging process on the ovaries.

Marc

Sponsors for the 2009 San Deigo Fertility Expo

Marc Sklar — Thu, 01 Oct 2009 17:17:00 GMT

This years sponosrs for the 2009 San Diego Fertility Expo are

Reproductive Wellness
Acacio Fertility Center
Project Baby

Lectures and topics for the upcoming San Diego Fertility Expo

Marc Sklar — Thu, 01 Oct 2009 17:15:00 GMT

12:00pm: Coreen Reinhart, Clinical Nutritionist

Topic: Is your body baby ready - what you eat does matter

1:30pm: Marc Sklar, LAc (CA), DA (RI), MSTOM, FABORM Clinical Director, Founder of Reproductive Wellness

Topic: Current research regarding acupuncture and fertility

3:00pm: Dr. Lori Arnold, Board Certified in Reproductive Endocrinology

Scientific Director, La Jolla IVF

Topic: The modern Facts on Fertility

Marc Sklar's Interview on Better Living in San Diego

Marc Sklar — Sun, 27 Sep 2009 00:22:00 GMT

While there are textbook medical approaches for dealing with fertility issues, the last 20 years has seen a rise in wellness approaches to health and well-being, utilizing different types of ancient, tried-and-true practices.

Acupuncture is one of those treatments, along with diet and exercise, herbal medicine, massage, yoga, and reproductive psychology. Holistic in nature, these practices offer an alternative to western medicines, and nowadays often work in conjunction with western medical practices.

With that in mind, the 2009 San Diego Fertility Expo is happening Saturday October 10th at the International House at the Great Hall at UCSD, supported by Reproductive Wellness, a local fertility acupuncture and integrative medicine fertility clinic. While the event is completely free, it's also a fundraiser for the non-profit organization RESOLVE, so donations are encouraged and welcomed.

The San Diego Fertility Expo features leading fertility specialists with plenty of information about fertility and reproductive health, as well as lectures on fertility yoga, acupunture, and reproductive endocrinology, and features speaker Marc Sklar, the Clinic Director and Co-Founder of Reproductive Wellness, and this week's guest on Living Better In San Diego.

A Doctor of Acupuncture, a Licensed Acupuncturist, and a fellow with the American Board of Oriental Reproductive Medicine, Marc Sklar discusses the identification and holistic, tried-and-true treatments of fertility-related issues. You can get more information on Reproductive Wellness and the San Diego Fertility Expo by calling Reproductive Wellness at (619) 4-HEALTH, or (619) 443-2584.

To listen to Marc's interview promoting the San Diego Fertility Expo by following the link below.
Living Better in San Diego - Listen Live

This Years sponosrs for the San Diego Fertilty Expo are The Acacio Fertility Center, Project Baby and Reproductive Wellness.

Fertility Expo, October 10th

Marc Sklar — Wed, 08 Jul 2009 22:27:00 GMT

This years 4th Annual San Diego Fertility Expo is taking place on October 10th. For more information you can visit San Diego Fertility Expo. There will be vendors, local fertility experts, Reproductive Endocrinologists, Acupuncture, nutrition, adoption and Donor agencies and more. Currently our first speaker for the day is Coreen Reinhart who will be discussing Nutrition for Fertility, Why is it important?

Free Fertility Support Group

Marc Sklar — Wed, 01 Jul 2009 22:39:00 GMT

Beginning on Tuesday July 28, 2009 Reproductive Wellness will be sponsoring a monthly Fertility support group. This support group is free to the public and will be professionally lead. Each month there will be short educational section of about 15 minutes before the open discussion begins.

The group will be the fourth Tuesday of each month and will run from 6-7pm. We will meet at our Mission Valley Office located at 2425 Camino Del Rio South, Suite 180, San Diego, Ca. 92108 if you have any questions please contact the Reproductive Wellness office at 619-265-0291. Feel free to bring loved ones and friends.

Fertility Acupuncture and Insurance coverage

Marc Sklar — Wed, 01 Jul 2009 22:30:00 GMT

Reproductive Wellness is now in-network with both Blue Shield and American Specialty Health. We also bill out of network for all other insurance plans if your plan covers acupuncture. So if you have acupuncture benefits through your insurance you have coverage at our office! Don't forget we do all the billing.

Introducing our new acupuncturist, Maring Higa

Marc Sklar — Wed, 01 Jul 2009 22:26:00 GMT

We here at Reproductive Wellness are proud to introduce our newest member, Maring Higa. Maring has been practicing acupuncture in her own practice for years and recently joined our team in June. We hope everyone has a chance to meet her personally. Below is her bio:

Maring Higa, LAc, MSTOM
Acupuncture Associate

"From a young age I was interested in how to achieve optimal health and disease prevention. I studied a variety of different alternative healing remedies including ayurvedic medicine, Tibetan medicine, psychology, nutritional supplementation and Jin Shin Tara. As an athlete I also found that I performed best and recovered faster from injuries when I incorporated natural health, proper nutrition, and visualization techniques. I became an avid believer in the mind, body, and spirit connection.

My personal journey to find optimal health eventually brought me to Chinese Medicine and Acupuncture. I was first introduced to acupuncture when my father tried it as a last resort to fight off the final stages of cancer. Though he was not cured, I believe it made a marked impact in his quality of life. This loss for me was a pivotal moment in my life and I then developed a compelling urge to help others on their personal journey towards health."

Maring brings enthusiasm, passion and dedication to each individual patient. Drawing upon her psychology degree from Naropa Univeristy, she takes an integrative approach to healing. She received a Masters of Science degree from the highly respected Pacific College of Oriental Medicine in San Diego, California. Additionally, Maring traveled to China where she received a certification in International Traditional Chinese Medicine (TCM) from Chengdu University.

From a very young age, holistic medicine has been an integral part of Maring’s personal journey. She hopes to share her knowledge and experiences with every patient.

New research shows that acupuncture is benficial for treating PCOS

Marc Sklar — Wed, 01 Jul 2009 21:54:00 GMT

For women with PCOS, acupuncture and exercise may bring relief, reduce risks
EUREKALERT
Contact: Christine Guilfoy
cguilfoy@the-aps.org
301-634-7253
American Physiological Society
Study finds acupuncture and exercise decrease a key marker for disease
BETHESDA, Md. (June 29, 2009) Exercise and electro-acupuncture treatments can reduce sympathetic nerve activity in women with polycystic ovarian syndrome (PCOS), according to a new study. The finding is important because women with PCOS often have elevated sympathetic nerve activity, which plays a role in hyperinsulinemia, insulin resistance, obesity and cardiovascular disease
The study also found that the electro-acupuncture treatments led to more regular menstrual cycles, reduced testosterone levels and reduced waist circumference.
Exercise had no effect on the irregular or non-existent menstrual cycles that are common among women with PCOS, nor did it reduce waist circumference. However, exercise did lead to reductions in weight and body mass index.
"The findings that low-frequency electro-acupuncture and exercise decrease sympathetic nerve activity in women with PCOS indicates a possible alternative non-pharmacologic approach to reduce cardiovascular risk in these patients," said one of the researchers, Dr. Elisabet Stener-Victorin of the University of Gothenburg, Sweden. The findings regarding menstrual cycles and decrease in testosterone levels in the low-frequency electro-acupuncture are also of interest, according to the researcher.
The study, "Low-frequency electro-acupuncture and physical exercise decrease high muscle sympathetic nerve activity in polycystic ovary syndrome" was conducted by Elisabet Stener-Victorin, Elizabeth Jedel, Per Olof Janson and Vrsa Bergmann Sverrisdottir, all of the Sahlgrenska Academy, University of Gothenburg, Sweden and the Karolinska Institute, Stockholm, Sweden. The study is in the online edition of the American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, published by The American Physiological Society.
Common endocrine disorder
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders, affecting an estimated 10% of women of reproductive age. Among the problems associated with the condition are elevated levels of androgens (such as testosterone, the 'male' hormone found in both sexes), ovarian cysts, irregular menstrual cycles and infertility.
PCOS is associated with increased sympathetic nerve activity in the blood vessels, part of the 'fight or flight' response that results in blood vessel constriction. Chronic activation of the sympathetic nervous system increases the risk of diabetes, high blood pressure, heart attack and stroke.
The Swedish researchers had previously found that PCOS is associated with increased sympathetic nerve activity and said it may arise from the elevated testosterone level that is characteristic of PCOS.
Three groups
The researchers wanted to find a long-lasting treatment for PCOS that would have no adverse side effects, and so they looked at whether acupuncture or exercise could decrease the sympathetic nerve activity in women with PCOS. The study included 20 women, average age of 30 years, divided into the following groups:

low-frequency electro-acupuncture (9)

exercise (5)

untreated controls, (6)

The acupuncture group underwent 14 treatments during the 16-week study. Acupuncture points were located in abdominal muscles and back of the knee, points thought to be associated with the ovaries. The needles in the abdomen and leg were stimulated with a low-frequency electrical charge, enough to produce muscle contraction but not enough to produce pain or discomfort.
The exercise group received pulse watches and were told to take up regular exercise: brisk walking, cycling or any other aerobic exercise that was faster than walking but that they could sustain for at least 30 minutes. They exercised at least three days per week for 30-45 minutes, maintaining a pulse frequency above 120 beats per minute.
The researchers instructed the control group in the importance of exercise and a healthy diet, the same instructions the experimental groups received, but were not specifically assigned to do anything differently.
Key Findings
The researchers measured the muscle sympathetic nerve activity before and after the 16-week study. Following treatment, the study found the following:

Both the acupuncture and exercise groups significantly decreased muscle sympathetic nerve activity compared to the control group.

The acupuncture group experienced a drop in waist size, but not a drop in body mass index or weight.

The exercise group experienced a drop in weight and body mass index but not in waist size.

The acupuncture group experienced fewer menstrual irregularities but the exercise group's irregularities did not change.

In the acupuncture group, there was a significant drop in testosterone. This is an important indicator because the strongest independent predictor of high sympathetic nerve activity in women is the level of testosterone.

"This is the first study to demonstrate that repeated low-frequency electro-acupuncture and physical exercise can reduce high sympathetic nerve activity seen in women with PCOS," according to the authors. "Furthermore, both therapies decreased measures of obesity while only low-frequency electro-acupuncture improved menstrual bleeding pattern."

The study has some limitations, including a small sample size, so further research is necessary, the authors wrote. To find the full study, click here or go to http://rs6.net/tn.jsp?et=1102624936180&s=12053&e=001a5Q6exec6GHckH3mmmELKJoxoJkaWaFb7ZEFfMmV-fLNLpKuEV0EMO1mLbMnlSJgrIQuIp2cySkIeduV1ZD1da6g5aXEcFSHO_I0h1j2CPF25zwrT4dAJkCdEOPOXwJ1poyQmZvRKf1v_h1UqJOc231fPGFLgMVNFiuH79szy52zuqr9ZV26s5p2shK_vXlwtbZObDgI2SUcDzxG046pXr3aMjGgpxi06xJctgeHzDNk9lo4rTK3OLbeOhieek6-jbEHVbSw8zrs1E-7wYmsOcPN0hf1neJXmlKsq1NXBYur822huilyANvkTtHPgFohMPbqulEj7o1HM1bpkJ8hKIXHJC7Y1Bsj7jizwDLoZCYP3aW520N4FBlb-Oe_l9GliaTn7x9UHRE=.

We have been successfuly treating PCOS cases for many years with acupuncture and our proprietary herbal formulas.