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Preparing to Conceive

Regulating the Menstrual Cycle

Acupuncture is able to influence and regulate hormonal functions, returning your hormones to their normal state of balance. There are many hormones involved in the menstrual cycle, primarily oestrogen, progesterone, follicle stimulating hormone (FSH), and luteinizing hormone (LH), all of which can have profound effects, if even just a little imbalanced.

Through the use of Chinese medicine, you generally see significant changes in the quality of a client's menstrual cycle within three months. Such changes are evidenced by improvements in the color, amount and consistency (clotting) of the menstrual blood along with regularity of the cycle. Pre-menstrual symptoms such as tender/distended breasts, bloating, cramping and changes in the patient's emotional state may also be reduced with consistent treatment. All of these changes are positive indicators that a patient's hormonal balance is improving.

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Acupuncture

Cochrane S, Smith CA, Possamai-Inesedy A, Bensoussan A. Acupuncture and women's health: An overview of the role of acupuncture and its clinical management in women's reproductive health. Int J Women's Health. 2014;6: 313-25.

Zhou K,Wu J, Liu Z. Electroacupuncture modulates reproductive hormone levels in patients with primary ovarian insufficiency: Results from a prospective observational study.Evid Based Complement Altern Med. 2013;2013:657234.

Ernst E, Lee MS, Choi TY. Acupuncture in obstetrics and gynecology: An overview of systematic reviews. Am J Chin Med. 2011;39(3): 423-31.

Herbs

Tan L, Tong Y, Sze SC, Xu M, Shi Y, Song XY, Zhang TT. Chinese herbal medicine for infertility with anovulation: A systematic review. J Altern Complement Med. 2012;18(12): 1087-1100.

Ried K, Stuart K. Efficacy of traditional Chinese herbal medicine in the management of female infertility: A systematic review. Complement Ther Med. 2011;19(6): 319-31.

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Optimising Male Fertility

Male factor infertility accounts for 40% of all infertility cases, and yet when it comes to treatment, the emphasis is typically placed on the female. Some men may not realise that there are a number of things that can be done to improve overall health and fertility. Men suffering with low sperm count, poor motility, morphology and liquefaction can all benefit from what Chinese medicine has to offer. There is little that conventional medicine can do with sperm disorders however, the advent of intra-cytoplasmic sperm injection (ICSI) has greatly assisted IVF success rates, and many men believe ICSI to be the sole solution to their fertility problems.

Chinese medicine has a different perspective on male fertility. It seeks to pin-point areas of imbalance in the body that may be leading to poor health and as a result, poor fertility. Factors such as high stress, disrupted sleep, low energy, elevated blood sugar, poor diet and digestive inflammation can all negatively impact health and sperm development. Acupuncture and Chinese herbs help to regulate areas of distress in the body so as to promote optimal health and vitality.

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Focusing on the Egg & Sperm Quality

Acupuncture helps to improve blood flow to the uterus and ovaries thereby providing an increase in oxygenation, nutrition, anti-oxidants and proper hormonal cues to the tissues, overall increasing ovarian response. All of which leads to better egg quality. Follicles developing in the ovaries develop over a period of 9-12 months. During this growth phase, follicles go through many changes. When the follicle is about 90 days from ovulation, it is exposed to the internal blood supply within the ovary. It is at this point where we believe that Chinese medicine can have a strong impact on follicle quality. Improving blood flow will also help thicken the uterine lining to ensure a more effective implantation. This is an important time prior to the process of falling pregnant (3 - 4 months) for those who wish to optimise their chances of success whether trying naturally or alternatively, plan on using IVF or assisted reproductive technologies.

Similarly for men, research has shown acupuncture and Chinese herbs can help improve quantity, quality and movement of sperm. It takes about 100 days for sperm to mature, therefore at least 3 months of treatment is needed before an improvement would be seen on sperm analysis.

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Females / Egg (Please also refer to articles under IVF and Assisted Reproductive Technologies)

Stener-Victorin E, Kobayashi R, Kurosawa M. Ovarian blood flow responses to electro-acupuncture stimulation at different frequencies and intensities in anaesthetized rats. Autonom Neurosc. 2003;108: 50-55.

Males / Sperm

Dieterle S, Chunfang L, Greb R, Bartzsch F, Hatzmann W, Huang D. A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia. Fertil Steril. 2009;92(4): 1340-43.

Pei J, Strehler E, Noss U, Abt M, Piomboni P, Baccetti B, Sterzik K. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertil Steril. 2005;84(1): 141-47.

Siterman S, Eltes F, Wolfson V, Lederman H, Bartoov B. Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study. Androlog. 2000;32(1): 31-39.

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Addressing Lifestyle Factors such as Stress, Sleep & Diet

One of the most significant ways acupuncture can increase fertility is by reducing stress, which is often a key factor in the fertility of both men and women. When people are under stress, the hormone cortisol is released, altering the brain's neurochemical balance. Erratic cortisol levels affect the hormone conversion pathway that is used to synthesise reproductive hormones, favouring the production of stress hormones instead. The body views stress hormones as more important as they are necessary for our survival instincts and thus our ability to stay alive. Further, it has been suggested that stress may have an effect on uterine receptivity and number of implantation sites, thereby negatively impacting on IVF and assisted reproductive technologies. Acupuncture works to calm the stress hormones by influencing the levels of dopamine, serotonin and beta endorphins which help the body to feel relaxed and calm.

Currently lots of research is being undertaken in the area of sleep deprivation, immune factors and fertility. It has been demonstrated that people with chronic insomnia have higher levels of some cytokines, mainly interleukin 6 (IL-6) and tumour necrosis factor (TNF). These immune factors have been shown to influence embryo implantation and the development of the placenta. Acupuncture appears to exert a modulatory effect on the immune system reducing these inflammatory markers.

In addition, lack of sleep has a profound effect on energy levels and weight loss as blood sugar levels and insulin resistance increases. Further, the odds of having Metabolic Syndrome (a cluster of conditions including high blood pressure, high blood sugar levels and obesity, that can lead to heart disease, stroke and diabetes) are nearly doubled in people who sleep less than 6 hours per night. Further compounding this, research shows that a person's weight can seriously impact on their fertility. Being significantly overweight or underweight has big repercussions on the reproductive cycle. In this case, the combination of Chinese herbs and acupuncture provide the best results along with a nutritionally sound eating plan.

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Stress

Eshkevari L, Permaul E. Acupuncture blocks cold stress-induced increases in the hypothalamus-pituitary-adrenal axis in the rat. J Endocrinol. 2013;217: 95-104.

Kim H, Park HJ, Han SM, Hahm DH, Lee HJ, Kim KS, Shim I. The effects of acupuncture stimulation at PC6 (Neiguan) on chronic mild stress-induced biochemical and behavioral responses. Neurosc Letters. 2009;460(1): 56-60.

Depression

Zhang ZJ, Chen HY, Yip K, Ng R, Taam Wong V. The effectiveness and safety of acupuncture therapy in depressive disorders: Systematic review and meta-analysis. J Affect Disord. 2010;124(1-2): 9-21.

Wang H, Qi H, Wang BS, Cui YY, Zhu L, Rong ZX, Chen HZ. Is acupuncture beneficial in depression: A meta-analysis of 8 randomized controlled trials? J Affect Dis. 2008;111(2-3): 125-34.

Weight Control

Güçel F, Bahar B, Demirtas C, Mit S, Çevik C. Influence of acupuncture on leptin, ghrelin, insulin and cholecystokinin in obese women: a randomised, sham-controlled preliminary trial. Acupunct Med. 2012;30: 203-07.

Li MY, Wei DY, Wu JM. Analysis on the interrelation between acupuncture-induced weight reduction and menstruation. Zhen Ci Yan Jiu. 2007;32(2): 142-44.

Sleep

Cao H, Pan X, Li H, Liu J. Acupuncture for treatment of insomnia: A systematic review of randomized controlled trials. J Altern Complemen Med. 2009;15(11): 1171-86.

Chen HY, Shi Y, Ng CS, Chan SM, Yung KK, Zhang QL. Auricular acupuncture treatment for insomnia: A systematic review. J Altern Complement Med. 2007;13(6): 669-76.

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IVF & Assisted Reproductive Technologies (ART)

Assisting the Success Rate of IVF & Assisted Reproduction

Villahermosa DI, Santos LG, Nogueira MB, Vilarino FL, Barbosa CP. Influence of acupuncture on the outcomes of in vitro fertilisation when embryo implantation has failed: A prospective randomised controlled clinical trial. Acupunct Med. 2013;31(2): 157-61.

Zheng CH, Huang GY, Zhang MM, Wang W. Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: A systematic review and meta-analysis. Fert Steril. 2012;97(3): 599-611.

Huang DM, Huang GY, Lu FE, Stefan D, Andreas N, Robert G. Acupuncture for infertility: Is it an effective therapy? Chin J Integr Med. 2011;17(5): 386-95.

Stener-Victorin E, Humaidan P. Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer. Acupunct Med. 2006;24(4): 157-63.

Magarelli P, Cridennda D. Acupuncture & IVF poor responders: A cure? Fert Steril. 2004;81(3): S20.

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Medication Phase

Many IVF programs, at the beginning of a cycle, use strong medications to stimulate the ovaries to produce numerous follicles. There are a few variations to this process and different drug combinations can be used. Acupuncture can assist these medications and moderate some of the side effects, whilst at the same time working to improve the lining of the uterus. Traditionally, acupuncture is used rather than Chinese herbs due to the possibility of interactions with the medications. This is an important time as your body is preparing for oocyte pickup (egg collection).

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Magarelli PC, Cridennda D, Cohen M. Changes in serum cortisol and prolactin associated with acupuncture during controlled ovarian hyperstimulation in women undergoing in vitro fertilization-embryo transfer treatment. Fertil Steril. 2009;92(6): 1870-79.

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Egg Collection (Oocyte Pick Up)

The IVF side effects are often more pronounced after this procedure. Hormone levels are still very high so you may experience cramping, headaches, breast soreness and mood swings. The empty follicles often fill up with fluid, so a feeling of bloating may persist. These side effects tend to subside more quickly with acupuncture treatment.

Acupuncture also reduces inflammation and tissue trauma to the area, and therefore helps to prepare a more conducive environment for the arrival of an embryo in the following days.

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Zhang J, Wang X, Lü R. Analgesic effect of acupuncture at Hegu (LI 4) on transvaginal oocyte retrieval with ultrasonography. J Trad Chin Med. 2013;33a (3): 294-97.

Ng EH, So WS, Gao J, Wong YY, Ho PC. The role of acupuncture in the management of subfertility. Fertil Steril. 2008;90(1): 1-13.

Sator-Katzenschlager SM, Wölfler MM, Kozek-Langenecker SA, Sator K, Sator PG, Li B, Heinze G, Sator MO. Auricular electro-acupuncture as an additional perioperative analgesic method during oocyte aspiration in IVF treatment. Hum Reprod. 2006;21(8): 2114-20.

Humaidan P, Stener-Victorin E. Pain relief during oocyte retrieval with a new short duration electro-acupuncture technique - an alternative to conventional analgesic method. Hum Reprod. 2004;19(6): 1367-72.

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On the day of Embryo Transfer or Intra Uterine Insemination (IUI)

An acupuncture treatment before the embryo transfer or insemination can help dilate the cervix to make the transfer process smoother. It has also been shown to decrease the spasms and cramping that often occur during the transfer procedure. Further, a treatment before transfer helps clients feel calm, prepared, and grounded prior to the experience.

Numerous research articles have detailed the benefits of also having an acupuncture appointment after the transfer, on the same day. This treatment is aimed at regulating blood flow to the uterus, preparing your uterine lining to support implantation and to also relax the uterus to prevent contractions.

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Fu H, He Y, Gao Y, Man Y, Liu W, Hao H. Acupuncture on the endometrial morphology, the serum estradiol and progesterone levels, and the expression of endometrial leukaemia-inhibitor factor and osteopontin in rats. Evid Based Complement Alternat Med. 2011;2011: 606514.

Manheimer E, Zhang G, Udoff L, Haramati L, Langenberg P, Berman BM, Boulter LM. Effects of acupuncture on rates of pregnancy and live births among women undergoing in vitro fertilization: Systematic review and meta-analysis. BMJ. 2008;336(7643): 545-49.

Westergaard LG, Mao Q, Krogslund M, Sandrini S, Lenz S, Grinsted J. Acupuncture on the day of embryo transfer significantly improves reproductive outcome in infertile women: A prospective randomized trial. Fert Steril. 2006;85: 1341-46.

Dieterle S, Ying G, Hatzmann W, Neuer A. Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: A randomized, prospective, controlled clinical study. Fert Steril. 2006;85: 1347-51.

Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K. Influence of acupuncture on pregnancy rate in patients who undergo assisted reproduction therapy. Fert Steril. 2002;77(4): 721-24.

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During the Cycle to Decrease the Effects of the Process

Acupuncture can help to reduce emotional swings, headaches, fatigue and generalised discomfit during this time. Further the stress and apprehension experienced by many women after the transfer but before the pregnancy test can be extreme. Acupuncture is recommended during this time to calm the autonomic nervous system down and reduce the anxiety.

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Mental / Emotional

Grant LE, Cochrane S. Acupuncture for the mental and emotional health of women undergoing IVF treatment: A comprehensive review. Aust J Acupunct Chin Med. 2014;9(1): 5-12.

Isoyama D, Cordts EB, de Souza van Niewegen AM, de Almeida Pereira de Carvalho W, Matsumura ST, Barbosa CP. Effect of acupuncture on symptoms of anxiety in women undergoing in vitro fertilisation: A prospective randomised controlled study. Acupunct Med. 2012;30(2): 85-88.

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During Pregnancy

To Reduce the Risk of Miscarriage

Once implantation is achieved, TCM can still be beneficial and many clients like to continue with it throughout their pregnancy. The first trimester is crucial and can be fraught with anxiety as rates of miscarriage are at their highest. This is particularly important in IVF induced pregnancies, which have a higher risk of miscarriage than natural conceptions. In the case of recurrent miscarriage, it is routine to treat until the pregnant client is in their 13th week or until a point beyond which their last miscarriage occurred. Both Chinese herbs and acupuncture are used at this time.

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Liu F, Luo SP. Effect of Chinese herbal treatment on Th1- and Th2-type cytokines, progesterone and beta-human chorionic gonadotropin in early pregnant women of threatened abortion. Chin J Integr Med. 2009;15(5): 353-58.

Liu Y, Wu JZ. Effect of Gutai decoction on the abortion rate of in vitro fertilization and embryo transfer. Chin J Integr Med. 2006;12(3): 189-93.

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Ensuring Optimum Health & Wellbeing

Acupuncture can help to treat many of the common complaints during pregnancy. In the first trimester, morning sickness, heartburn, reflux, fatigue, poor sleep, increased urination, hemorrhoids, constipation and emotional 'ups and downs' are all very common. Often things quieten down in the second trimester, but then more musculoskeletal issues like lower back pain, hip/pelvic pain and sciatica along with oedema and insomnia can appear in the third trimester. Chinese medicine provides a natural way to treat these conditions as most medications are contra-indicated during pregnancy.

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Morning Sickness

Smith C, Crowther C, Beilby J. Acupuncture to treat nausea and vomiting in early pregnancy: A randomized controlled trial. Birth. 2002;29(1): 1-9.

Carlsson CP, Axemo P, Bodin A, Carstensen H, Ehrenroth B, Madegård-Lind I, Navander C. Manual acupuncture reduces hyperemesis gravidarum: A placebo-controlled, randomized, single-blind, crossover study. J Pain Symptom Manage. 2000;20(4): 273-79.

Mental/Emotional

Sniezek DP Siddiqui IJ. Acupuncture for treating anxiety and depression in women: a clinical systematic review. Med Acupunct. 2013;25(3): 164-72.

Manber R, Schnyer RN, Lyell D, Chambers AS, Caughey AB, Druzin MC, Celio C, Gress JL, Huang MI, Kalista T, Martin-Okada R, Allen J. Acupuncture for depression during pregnancy: A randomized controlled trial. Obstet & Gynecol. 2010;115(3): 511-20.

Guerreiro da Silva JB. Acupuncture for mild to moderate emotional complaints in pregnancy- a prospective, quasi-randomised, controlled study. Acupunct Med. 2007;25(3): 65-71.

Manber R, Schnyer RN, Allen J, Rush AJ, Blasey CM. Acupuncture: A promising treatment for depression during pregnancy. J Affect Disord. 2004;83(1): 89-95.

Pain/Discomfit

Smith CA, Cochrane S. Does acupuncture have a place as an adjunct treatment during pregnancy? A review of randomized controlled trials and systematic reviews. Birth. 2009;36(3): 246-53.

Ee C, Manheimer E Pirotta M White A. Acupuncture for pelvic and back pain in pregnancy: A systematic review. Am J Obstet Gynecol. 2008;198(3): 254-59.

Kvorning N, Holmberg C, Grennert L, Aberg A, Akeson J. Acupuncture relieves pelvic and low-back pain in late pregnancy. Acta Obstet Gynecol Scand. 2004;83(3): 246-50.

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Turn Breech Presentation

A highly effective treatment in Chinese medicine is that of breech presentation. The dried herb moxa (Artemisia Vulgaris) is lit and held above a point on the outside of the little toe. The sensation is warm to hot, but not painful as the smoldering herb doesn't touch the skin. Best results are obtained around 34 weeks, whilst the baby still has room to turn around. Instructions are given for the woman to continue this treatment over the next 10 days at home.

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Vas J, Aranda-Regules JM, Modesto M, Ramos-Monserrat M, Baron M, Aguilar I, Benitez-Parejo N, Ramirez-Carmona C, Rivas-Ruiz F. Using moxibustion in primary healthcare to correct non-vertex presentation: A multicentre randomised controlled trial. Acupunct Med. 2013;31(1): 31-38.

Vas J, Aranda JM, Nishishinya B, Mendez C, Martin MA, Pons J, Liu JP, Wang CY, Perea-Milla E. Correction of nonvertex presentation with moxibustion: A systematic review and meta analysis. Am J Obstet Gynecol. 2009;201: 241-59.

Van den Berg I, Bosch JL, Jacobs B, Bouman I, Duvekot JJ, Hunink MG. Effectiveness of acupuncture-type interventions versus expectant management to correct breech presentation: A systematic review. Complement Ther Med. 2008;16(2): 92-100.

Neri I, De Pace, VivianaDe Pace V, Venturini, PaoloVenturini P, Facchinetti, Fabio Facchinetti F. Effects of three different stimulations (acupuncture, moxibustion, acupuncture plus moxibustion) of BL.67 acupoint at small toe on fetal behavior of breech presentation. Amer J Chin Med. 2007;35(1): 27-33.

Habek D, Cerkez Habek J, Jagust M. Acupuncture conversion of fetal breech presentation. Fetal Diagn Ther. 2003;18(6): 418-21.

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Pre-birth & Inducing Labour

Three to four weeks prior to the due date treatments to prepare the pelvis and cervix can be commenced. Research indicates a reduction in women requiring medical intervention, including medical induction and caesarean section along with a more efficient active stage of labour when acupuncture is used regularly in the last month of pregnancy.

In addition, acupuncture can be used for birth induction by utilising the acupuncture points that are otherwise forbidden during pregnancy. The points need to be stimulated quite strongly in order to increase uterine activity and assist with cervical ripening. Acupuncture is a safe, viable alternative to Western medical induction for post-term babies. It is very effective, especially if the expectant mother is prepared to commit to daily sessions and allow adequate time before medical induction is scheduled. Women will often progress into labour after their first treatment, but more commonly after 2-3 treatments.

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Pre-birth

Betts D, Lennox S. Acupuncture for prebirth treatment: an observational study of its use in midwifery practice. Med Acup. 2006;17(3): 16-19.

Inducing Labour

Gribel G, Coca-Velarde LG, Moreira Sa RA. Electroacupuncture for cervical ripening prior to labor induction: A randomized clinical trial. Arch Gynecol Obstet 2011;283: 1233-38.

Rabl M, Ahner R, Bitschnau M, Zeisler H, Husslein P. Acupuncture for cervical ripening and induction of labor at term: A randomized controlled trial. Wien Klin Wochenschr. 2001;113(23-24): 942-46.

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Post Natal Recovery

Caesarean Section & Natural Birth Post Natal Support

The post-partum period, especially the first month after birth, is an important time for the mother to gather strength and rest after her labour and delivery. Many problems that arise in the post-partum period stem from the loss of blood and energy that can occur during birth (whether vaginal birth or caesarian section). From a Chinese medicine viewpoint it is very important that the mother receives enough rest and looks after her diet to ensure she is recovering well and rebuilding her reserves after the birth. This applies to all women, not just those who have had a difficult birth or pregnancy. Most new mothers manage to cope, but often end up absolutely exhausted a few months later, especially if they don't look after themselves well. It's no wonder then that some mothers go on to suffer postnatal depression.

Herbal tonics in the first few weeks after birth are recommended in order to support energy and blood building, promoting stamina and recovery.

'Mother warming' is a one off treatment given to new mums ideally in the first 10 days after birth. The dried herb moxa (Artemisia Vulgaris) is lit and held above the lower abdomen. The sensation is warm to hot, but not painful as the smoldering herb doesn't touch the skin. The treatment is designed to heal and strengthen the womb and surrounding muscles, and thus will energise and aid recovery. For women who have had a caesarean scar, care is taken to avoid moxa over this area if it is overly red. Following the 'mother warming', some gentle acupuncture is given to further calm, relax and tonify which will be tailored according to how the mother is feeling.

Acupuncture over the next few weeks is also beneficial to balance emotions (particularly anxiety and depression), minimise any local pain or bleeding difficulties, aid perineal healing, and help with certain breastfeeding problems (i.e. insufficient lactation, blocked ducts or mastitis).

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Postnatal Depression (Please also refer to articles under Mental/Emotional Aspects of Pregnancy)

Chung KF, Yeung WF, Zhang ZJ, Yung KP, Man SC, Lee CP, Lam SK, Leung TW, Leung KY, Ziea ET, Taam Wong V. Randomized non-invasive sham-controlled pilot trial of electroacupuncture for postpartum depression. J Affect Disord. 2012;142(1-3): 115-21.

Breastfeeding/Insufficient Lactation

Neri I, Allais G, Vaccaro V, Minniti S, Airola G, Schiapparelli P, Benedetto C, Facchinetti F. Acupuncture treatment as breastfeeding support: Preliminary data. J Altern Complement Med. 2011;17(2): 133-37.

Wei L, Wang H, Han Y, Li C. Clinical observation on the effects of electroacupuncture at Shaoze (SI 1) in 46 cases of postpartum insufficient lactation. J Tradit Chin Med. 2008;28(3): 168-72.

Post Caesarean Section Pain

Xu J, MacKenzie IZ. The current use of acupuncture during pregnancy and childbirth. Curren Opin Obstet Gynecol. 2012;24(2): 65-71.

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Gynaecological Conditions

Polycystic Ovarian Syndrome (PCOS)

The classic presentation of PCOS features an array of signs and symptoms, including irregular menstrual cycle, weight gain, acne, excess hair growth (hirsutism), and low energy levels. Hormone imbalances, such as excess androgens (i.e. testosterone) and insulin resistance, are at the core of this condition. Further imbalances in neuroendocrine and ovarian functions result in elevated LH levels. A high LH to FSH ratio leads to anovulation - the cause of the infertility.

Research has repeatedly demonstrated that acupuncture (in particular low frequency electro-acupuncture) and Chinese herbs are very effective at stimulating ovulation and regulating the menstrual cycle in PCOS sufferers, profoundly affecting the reproductive organs through mechanisms in the sympathetic nervous system, endocrine and neuroendocrine systems.

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Zheng YH, Wang XH, Lai MH, Yao H, Liu H, Ma HX. Effectiveness of abdominal acupuncture for patients with obesity-type polycystic ovary syndrome: A randomized controlled trial. J Altern Complem Med. 2013;19(9): 740-45.

Johansson J, Redman L, Veldhuis PP, Sazonova A, Labrie F, Holm G, Johannsson G, Stener-Victorin E. Acupuncture for ovulation induction in polycystic ovary syndrome: A randomized controlled trial. Am J Physiol Endocrinol Metab. 2013;304(9): 934-43.

Jedel E, Labrie F, Odén A, Holm G, Nilsson L, Janson PO, Lind AK, Ohlsson C, Stener-Victorin E. Impact of electro-acupuncture and physical exercise on hyperandrogenism and oligo/amenorrhea in women with polycystic ovary syndrome: A randomized controlled trial. Am J Physiol Endocrinol Metab. 2011;300(1): 37-45.

Lim C, Wong WU. Current evidence of acupuncture on polycystic ovarian syndrome. Gynecol Endocr. 2010;26(6): 473-78.

Stener-Victorin E, Jedel E, Mannerås L. Acupuncture in polycystic ovary syndrome: Current experimental and clinical evidence. J Neuroendocrinol. 2008:20(3); 290-98.

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Endometriosis

Abnormal tissue growth, as occurs in endometriosis, often results in symptoms of pain and menstrual irregularity and can lead to serious problems with fertility. The cause of endometriosis remains unclear. What we do know is that a variety of pathological causes may contribute, such as hormonal imbalance, immune reaction to retrograde menstrual flow, chronic inflammation and the inherited tendencies of some cells to express as endometrial cells.

Endometriosis can cause infertility due to damage to the fallopian tubes which can prevent egg fertilisation. In addition, inflammatory proteins in the uterine cavity may prevent implantation, creating a hostile environment for the embryo.

One of the important goals of using acupuncture for treating endometriosis is to achieve and to maintain the maximum uterine blood flow and to reduce the overactive immune response, thus providing a favourable environment to achieve pregnancy and prevent miscarriages. Research shows that Chinese medicine promotes uterine blood circulation, regulates the endocrine system and suggests that acupuncture could act as an analgesic by elevating levels of endorphins in the blood. Acupuncture and specific herbal medicines can reduce or eliminate cramps while maintaining regular menstrual cycles to improve chances of getting pregnant either naturally or with assisted reproductive technologies.

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Smith CA, Zhu X, He L, Song J. Acupuncture for dysmenorrhoea. Cochrane Data Syst Rev. 2011.

Cho SH, Hwang EW. Acupuncture for primary dysmenorrhoea: A systematic review. Brit J Gynecol. 2010;117(5): 509-21.

Rubi-Klein K , Kucera-Sliutz E, Nissel H, Bijak M, Stockenhuber D, Fink M, Wolkenstein E. Is acupuncture in addition to conventional medicine effective as pain treatment for endometriosis?: A randomised controlled cross-over trial. Euro J Obstet Gynecol Reprod Biol. 2010;153(1): 90-93.

Yu YP, Ma LX, Ma YX, Ma YX, Liu YQ, Liu CZ, Xie JP, Gao SZ, Zhu J. Immediate effect of acupuncture at Sanyinjiao (SP6) and Xuanzhong (GB39) on uterine arterial blood flow in primary dysmenorrhea. J Altern Complement Med. 2010;16(10): 1073-78.

Witt CM, Reinhold T, Brinkhaus B, Roll S, Jena S, Willich SN. Acupuncture in patients with dysmenorrhea: A randomized study on clinical effectiveness and cost-effectiveness in usual care. Am J Obstet Gynecol. 2008;198: 166e1-8.

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