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Integrative Fertility Enhancement. Cathryn Hu, Ph.D., O.M.D., L.Ac . . Conflict of Interest and Financial Disclosure. Integrative Fertility Enhancement Cathryn Hu, Ph.D., O.M.D., L.Ac. President of Advanced Acupuncture, Inc. Professor of Advanced Acupuncture Institute

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Integrative fertility enhancement l.jpg

Integrative Fertility Enhancement

Cathryn Hu, Ph.D., O.M.D., L.Ac.

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Conflict of Interest and Financial Disclosure

Integrative Fertility Enhancement

Cathryn Hu, Ph.D., O.M.D., L.Ac.

President of Advanced Acupuncture, Inc.

Professor of Advanced Acupuncture Institute


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Celebrating A New Life

The miracle baby

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Human Reproductive System

Human Sexuality: Conception from

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Hormones involves in

the Menstrual Cycle

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Ovulation Process


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Fertility Enhancement Program-an integrative approach

Two phases of treatment in our integrative program:

  • 1.Preparation phase:

    Treating the causation of infertility, nourishing the reproductive organs and their functions.

  • 2. Trial phase:

    Promoting the ovarian functions of follicle maturation and increasing the lining of the uterus.

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The objectives of Preparation Phase

  • Stress relief

  • Causation of infertility

  • PMS treatment

  • Endometriosis

  • Hormone balancing

  • Increasing mucus secretion

  • Sperm quality & quantity improvement

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The objectives of Trial Phase

  • Stimulating follicles maturation

  • Promoting the ovulation

  • Balancing FSH, Estrogen, LH and Progesterone

  • Integrative with IVF procedures

  • Integrative with IUI procedures

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The Hormonal Imbalanced Conditions

  • High FSH level

  • Polycystic Ovarian Syndromes (PCOS)

  • Luteal phase defect

  • Endometriosis

  • Assistant Reproductive Technology


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Other Causations of Infertility

  • Stress-

    -Flight-or-fight response

    -Glucocorticoids can raise its level and weaken the reproductive system, potentially making infertility condition worse. (Prolactin)

  • Age-

    Conception rate: 30’yrs, 40’yrs, decline 5-10 % each year

    Developing chromosomal abnormalities:

    < 35yrs -the rate of is 1:2000 compare to >35yrs,1: 400

    Miscarriage: <30 yrs = 15 %, >40yrs =40 %

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The Causations of Infertility in Traditional Chinese Medicine

  • Male-

  • Kidney yin deficiency

  • Kidney yang deficiency

  • Liver qi stagnation

  • Spleen qi deficiency

  • Blood stagnation

  • Female-

  • Kidney deficiency

  • Cold uterus

  • Blood deficiency

  • Liver depression

  • Stagnant heat

  • Phlegm dampness

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Kidney Yin deficiency signs & symptoms

  • Scanty, dark discharge at the end of the period or amenorrhea

  • Severe lumbago, dizziness, tinnitus

  • Cold sensation in the lower abdomen, loose stools, copious, clear urine

  • Dark facial complexion

  • Tongue is pale with thin white coating

  • Pulse is deep, thread and weak

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Cold Uterus

  • Prolonged menstrual discharge but scanty in volume and mixed with dark clots

  • Cold lower abdominal pain relieved by warmth

  • The tongue coating is thin and white

  • The pulse is deep and slow

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Blood deficiency signs & symptoms

  • Withered, sallow complexion

  • Scanty menstrual discharge during the last days of the period but light in color, dizziness, blurred vision, dry skin, constipation

  • Insidious pain after menstruation.

  • Tongue is pale

  • Pulse is thready and weak

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Liver depression signs & symptoms

  • Early or late menstruation, scanty in volume and dark in color

  • Abdominal distention

  • Premenstrual breast distention

  • Mental depression, eructation and sighing

  • Tongue is red with a thin coating

  • Pulse is wiry and rapid

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Stagnant Heat signs & symptoms

  • Scanty menstrual volume, red purplish in color and mixed with clots.

  • Distention and pain in the lower abdomen, especially along the sides, which refuses palpation.

  • History of lumbar soreness

  • Distension & pain of the chest and hypochondrias

  • Tongue is red with a thin coating

  • Pulse is wiry and rapid

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Phlegm dampness signs & symptoms

  • An obese constitution

  • History of excessive phlegm

  • Pallor or puffiness

  • Delayed menstruation or amenorrhea and excessive leucorrhea

  • Tongue has a thin, white coating

  • Pulse is wiry and slippery

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Individualized Treatment Plan

  • Individualizedtreatment plan based on etiology

  • Acupuncture:

    EA for follicle phase

    MA for Luteal phase

  • Herbal formula: Individualized

    Raw herbs




    • Moxibustion

    • Cupping

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Frequencies & Lengths of Acupuncture Treatment

  • Cumulative effect of series

  • 10-12 sessions to begin cellular change.

  • Pre-cycle: 1-2/wk X 3-6 cycles

  • Trial phase: 2-3/wk X 6-9 cycles

  • Average: 6-12 cycles

  • Less frequency with herbal prescription

  • Speed of improvement proportional to the length of time of imbalance

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Mechanisms of Acupuncture (1) a clinical observation in Shanghai, China

  • Highly increase of the egg production

  • Regulate the function of hormone levels

  • Influence in the gene expression in the brain, normalizing secretion of GnRH, LH, and E2.

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Researches for acupuncture that benefits the fertility

Sandra Emmons, M.D:

-Oregon Health Science University

  • Acupuncture before the IVF, improve the success rate of pregnant woman.

  • Rate significantly higher in the patients combine the herbal treatment.

Cornel University’s

Weil Medical College:

  • Summed up acupuncture’s positive effect o infertility issues.

  • There is sufficient evidence of acupuncture’s value to expand its use into conventional medicine and treatment of female infertility.

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Mechanisms of acupuncture (2)- a study in Harvard,

  • Endorphins releases

    Mitigate one’s response to stressful stimuli, enhance the possibility of conception

  • Minimize prolactin

    Elevated prolactin could

    cause irregular ovulation

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Treatment Protocols (1)Stress-relieve

  • Objectives:

  • Reduces stress and minimizes prolactin

  • By release certain chemicals and neuron-transmitter, such as endorphin, ekenephilin and serotonin, specially benefits the ART patient go through their procedure smoothly

  • Tx Protocols:

    Acupuncture: Shenmen, P 6, Sp-6

    Herbal formula: Suan Zao Ren Tang

    (Sour jujube decoction)

  • Frequency:

    Combine with other treatment

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Integrative Acupuncture Tx

  • Reduces stress

  • Enhances hormone regulation

  • Regulates the menstrual cycle

  • Promotes the ovarian functions

  • Invigorate the sperm qualities

  • Treats PMS, Amenorrhea, Endometriosis and blocked fallopian tubes

  • Increases the effectiveness of IVF, GIFT, ZIFT, and ET. Procedures

  • Protects the fragile embryo

  • Strengthen the immune system

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Acupuncture & IVF procedures -Research in Christian Lairize Institute in Germany

  • 160 women getting IVF

  • Acupuncture before & after the embryo transfer

  • 50% of the patients increased successful implantation.

  • IVF group= 26.3 %

  • IVF plus acupuncture

    = 42.5 %

  • AAI successful rate is 64.9 %

    of integrative IVF patients at December, 2007.

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Acupuncture on the day of Embryo Transfer

  • Acu1= 95, on the day 36%/34%

  • Acu2 =91, on the day and 2 days after 36%/26%

  • Control=87, no acupuncture. 26%/22%

  • Conclusion:

  • Acupuncture on the day of ET significantly improves the reproductive outcome of IVF/ ICSI. Compare to no acupuncture.

  • 2. Repeating acupuncture on ET day and 2 days after provided no additional benefit

  • Westergaard LG, Mao Q, Krogslund M, Sandrini S, Lenz S, Grinsted J.

  • Fertility Clinic Tranglen, Hellerup, Denmark.

  • Fertil Steril. 2006 May;85(5):1341-6. Epub 2006 Apr 5.

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Pain Relieve During Oocyte Retrieval

  • EA has proven analgesic effect

  • Frequency at 80/20/2 Hz

  • Study of 152 cases

    Conclude that

    No differences in EA


    Humaidan P. Brock KBungum L. Stener-Victorin E.

    The fertility clinic, Vyborg Hospital, Skive, DK7800 Skive, Denmark,

    Reprod Biomed. Online, 2006 Jul; 13, (1):120-S.

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Acupuncture & Protection of Embryo

  • Acupuncture boost blood flow to women’s reproductive organs and providing better nourishment.

  • Improve the lining of the uterus, enhance the embryo becomes embedded after conception.

  • Improve implantation and prevent the risk of miscarriage.

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Herbal Treatment

  • Affects many parts of the reproductive cycle by triggering the bodies own natural processes.

  • Trigger the hypothalamus and pituitary to release hormones that stimulates the production of FSH and LH

  • Individualized herbal formula

    is most effective

  • Follow up monthly objective evaluation of hormone test.

  • Aware of the ART treatment and drug interactions.

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Individualized Herbal Treatment

  • Mainly to nourish the reproductive organs, enhance ovarian function, promote follicles maturation and increase linings of the uterus.

  • Classic Herbal formula

  • Individualized herbal formula modification

  • Length of treatment various from 2 to 6 cycles

  • Safe for early pregnancy and prevent miscarriage.

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Classic Herbal Formulas Benefits Fertility

  • 1. Yu Lin Zhu- kidney deficiency

  • 2. You Gui Wan- kidney deficiency

  • 3. Wu Zi Yan Zong Wan-kidney deficiency

  • 4. Ai Fu Nuan Gong Wan-cold uterus

  • 5. Ren Shen Yang Rong Tang-Blood deficiency

  • 6. Yang Jing Zhong Yu Tang-Blood deficiency

  • 7. Chai Hu Shu Gan San-liver depression

  • 8. Kai Yu Zhong Yu Tang-liver depression

  • 9. Qi Re Xiao Yu Tang- Stagnant heat

  • 10. Xiao Zhi Mo Dao Tan Tang-Phlegm dampness

  • 11. Qi Gong Wan-Stagnant heat

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Herbal Treatment Prevents Miscarriage-a Study from Fudan University of Shanghai, 2001

  • The process of conception and pregnancy involves a suppression of the T-help immune response

  • Herbal medicine could inhibit specific immune injury, reprogram the immune system to not react to self-tissue, allow the normal suppression involved in implantation to occur.

  • Individualized herbs: Du zhong

  • Classical Formulas: Dingxiang shi di tang (Clove and Persimmon Calyx decoction)

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Objective Evaluations

  • Initial evaluation

  • Infertility -causation

  • Consider the etiology in TCM

  • Refer to fertility specialist

  • Evaluates partner’s health conditions

  • Release medical records for the history of illness

  • Follow up evaluation:

  • Monthly hormonal tests:

    • Day 2/3: FSH, Estrogen, prolactin

    • During ovulation: Basal temperature chart, mucus and ovulation kits

    • Day 21 or 7 days post ovulation: Progesterone

  • Ultrasound:

    • Day 2: # of follicles & size

    • Day12/13: sizes of follicles

  • Follow up with fertility physician’s plan closely and report any unexpected reactions.

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Food Flavors Recommendation

  • Sweet-Tonifies and harmonizes and relaxes.

  • Pungent- Dispersing and invigorating, promote circulation, moves Qi, blood, & body fluid.

  • Sour Astringent-Absorbing, consolidating

  • Bitter- Dries damp, disperses, often clears, damp, edema and heat

  • Salty-softens and dissolves hard masses. Moistens and lubricates the intestines

  • Bland- diuretic, promotes urination and relieves edema

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Foods that benefits kidney deficiency

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Prenatal Vitamins-Woman

  • Folic Acid- 400mg/day- development of baby’s brain and spinal cord (fortified cereals, green leafy vegetables, citrus, grapefruit)

  • Calcium- bone develop

  • Iron-prevent anemia ( green leaf vegetable, red meat)

  • Fibers- 30-35g/day (unrefined grains, whole wheat, beans, fruits and vegetables

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Infertility isn’t just the woman’s problem anymore

  • 40-50 % male infertility

  • Inadequate # of sperm

  • Inhibited ejaculation

  • Retrograde ejaculation

  • Failure of descend into the scrotum

  • Antibodies to the sperm

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Male Factors of infertility

  • Spermophlebectasia

  • Sperm dysfunction

  • Sexually transmitted disease

  • Physical damage

  • Genetic disease

  • Auto immune disease

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Male Reproductive Organs

  • Testes (gonads):

    • Sperm (exocrine)

    • Testosterone (endocrine)

  • Ducts

  • Glands

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I. Male Organs-Testes

  • Size: 4 cm X 2.5 cm

  • Connective tissue capsule

  • Tunica albuginea

  • Seminferous tubules

  • Rete testis

  • Duct system

  • Epididymis

  • Interstitial cells-produces androgens & testosterone.

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Testosterone Production

  • Produced by interstitial cells

  • Stimulated by LH

  • Testosterone stimulate the male reproductive organs develop & 2nd male characteristics

  • Lack of the testosterone will result in sexual infantilism & sterility.

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II. Male organs- Duct System

  • Transport sperm from the body:

  • Epididymis

  • Ductus deferens

  • Urethra

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Male Organs- Epididymis

  • Highly coiled tube 6M

  • Caps superior of testes

  • 1st part of male duct

  • Storage site of immature sperm

  • Mature in 20 days

  • Ability to swim

  • Walls of epididymis contract to expel the sperm to ductus deference

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Male organs - Ductus Deferens

  • Enclosed tube along with blood vessels & nerves in sperm cord

  • Propel live sperm into urethra by peristaltic waves rapidly squeeze the sperm forward

  • Scrotal Sac

  • Vasectomy- cauterizing the vas deferens. Sperm is still produced but no longer reach the outside

  • Sterile- testosterone still produced and libido remained.

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Male Organs- Urethra

  • 3 main regions

    • Prostate Urethra

    • Membranous urethra

    • Spongy urethra

  • Carry urine and sperm to exterior

  • Ejaculation

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Male Organs-Scrotum

  • Providing the testes with a temperature that is below body temp.

  • Cold->scrotum wrinkled ->testes closer to the body to maintain viable sperm production

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Male Organs- Penis

  • To deliver sperm into the female reproductive tract

  • Circumcision- surgically removed after birth

  • 3 enlarged eretile tissue

  • Erection-blood flow

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Good Sperm Formation

  • Sperm takes 100 days to develop (70/30)

  • 3 main factors:

  • Sperm count: > 20 million/ml/ejaculate

  • Morphology (shape of the sperm)

  • Motility (How fast and straight the sperm swim)

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Macho Sperm Theory

  • Damage fertilized eggs.

  • Some toxins may alter the sperm’s DNA. Damaged chromosomes still carry genetic information

  • Results in infertility, miscarriage, birth defects, learning disabilities, childhood cancer and kidney cancer.

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Male Infertility Assessment

  • Sperm count < 10 million/ml (200 million)

  • Volume < 5 ml per ejaculate

  • Sperm motility < 60 %

  • Sperm Morphology < 50 % normal

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Getting Tested

  • Urologist evaluation

  • Sperm analysis 2-3 Tx

  • Defect factors:

    • Azoospermia

    • Oligiospermia

    • Sperm motility decreases

    • Sperm morphology abnormalities

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Normal Sperm Analysis

  • Volume= 3 ml (2-6ml)

  • Concentration=20M/ml

  • Motility: 50 %> 2 hrs

  • Morphology: >60 %

  • Viscosity

  • Ejaculate normally liquefies < 1hr

  • pH= 7-8

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Sperm abnormalities

  • Adequate

  • Aspermia

  • Azoospermia

  • Oligospermia

  • Poor motility & forward movement

  • High percent of abnormal sperm morphology

  • Anti-sperm antibodies

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Diagnosis of Male infertility

  • Medical HistoryPhysical Examination-structure

  • Secondary sex characteristics evaluation

  • Endocrine function test

  • Sperm analysis and morphology

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Causes of Male Infertility

  • Radiation

  • Environment toxins

  • Undescended testis

  • Varicocele

  • Traumatic injury

  • Infectious injury

  • Testicular atrophy

  • Drug effects

  • Alcohol, nicotine, marijuana, cocaine Prolonged fever

  • Endocrine disorders

  • Congenital abnormalities

  • Surgery of the lower abdominal region

  • Tight underwear

  • Stress, lack of sleep

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Acupuncture Treatment

  • Acupuncture can stimulate histamine release to dilate the blood vessels, therefore to improve the blood circulation, thus reduces varicose veins in the region

  • Most commonly selected points are located on the back and leg areas.

  • Frequency at 1-2 tx/wk or

    based individualized treatment plan

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Responses of TCM treatment

  • Case report:

    • A 43 male with 3 months of combined


    • Sperm count:

      From < 18 million/ml to 93 million

    • Motility : from < 50 % to 97%

    • Morphology: from normal <20 % to 45 %

      Hu,C. etl. Advanced Acupuncture, Inc. 2006

      Los Angels, U.S.A

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Acupuncture & Sperm Quality Improvement

  • Acupuncture effects on sperm production and quality without causing any changes in behavior and sexual desire.

  • Study of 28 men who ere diagnosed with idiopathic infertility received acupuncture twice a week over 5 weeks, significantly increase the quantities of normal sperm and equally reduces in structural defects.

    Hu,C. etl

    Advanced Acupuncture, Inc. 2006, Los Angeles, U.S.A.

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Effect of Acupuncture on Sperm Parameters

  • 16 subject were coanalyzed before & 1 month after treatment

    (Two times/week for 5 weeks)

  • 16 subject of controlled, untreated for comparison

  • Evaluated by semen analysis and ultramorphyological observations.

  • Conclusion;

  • The fertility index increased significantly in the treatment group (p<or =0.5)

  • Sperm motility and axonema intactness were highly correlated

    (corr:= 0.50, p< or = 0.5)

    Siterman S, Israel, 1997

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Protocols improves sperm count and motility

  • Electro-acupuncture:

    • Points: UB-23, 25, K5, Sp 6

    • Frequencies: 2 tx/wk X 5 weeks.

    • Lengths: 2-3 courses until sperm analysis become normalized

  • Herbal formulas:

    • Jin Gui Shen Qi Wan

  • Evaluation:

    • by repeat Sperm analysis between the acupuncture course.

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Chinese Medicine improves semen morphology, motility, & count

  • Randomized clinical trial in Sydney, Australia, 2004

  • Acupuncture and herbal medicine

  • Improve sperm normal form: p<0.038

  • Improve semen motility: p<0.008

  • Improve count: mean increase 220 million sperm

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Acupuncture in the treatment of Psychogenic Erectile Dysfunction

  • Randomized placebo-controlled pilots study, Austria, 2003

  • 22 patients, satisfactory response =68.4%

  • Acupuncture can be effective option >2/3 of PED

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Artificial Insemination (IUI) Dysfunction

  • The sperms are collected and send to sperm wash

  • More concentrated sperm count without semen.

  • Inject to female, let sperm surround with egg to penetration.

  • Option for male infertility

  • Alternative procedure when IVF did not respond well.

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Intracytoplasmic sperm injection DysfunctionICSI

  • For low sperm count & male infertility

  • Sperm & eggs are retrieved

  • Inject 1 sperm into an egg

  • Fertilized egg is then implanted


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Spermophlebectasia Dysfunction(varicose vein of the spermatic cord)

  • Increases blood in the vein of the spermatic cord increases temp. in testicle decrease live sperm count and activity

  • Prolonged presence of the varicosity can result in poor blood circulation to the area & shrinkage/or dysfunction of the testicle unable to produce healthy sperm

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Symptoms of Spermophlebectasia Dysfunction

  • Male age 20-30

  • Chief complain-pain

  • Heaviness of scrotum

  • Pain at testicles, groin and lower abdomen

  • Standing and walking aggravates.

  • Resting in supine position alleviates

  • Signs: Scrotum enlarged and loose

  • Vein is enlarged and purple

  • Varicose veins are also present in the groin and inner thigh

  • Press vein, it shrinks or disappears

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TCM treatment for Spermophelebectasia Dysfunction

  • Acupuncture

    Acupuncture can stimulate histamine release to dilate the blood vessels to improve the blood circulation, thus reduces varicose veins in the region

  • Herbal Formula

    Individualized formulas based on the etiology to improve blood circulation, resolve blockage, and promote healthy sperm

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TCM Treating Dysfunction Male Immune Infertility

  • Observation of “Yikang Tang” (decoction) to treat 100 pt with immune infertility

  • Compare with 100 cases treated with prednisone

  • Results:

  • AsAb decreased significantly, (p<0.01)

  • The sperm density and motile spermatozoa increased significantly

  • The sperm agglutination rate decreased

  • The improvement rate of the symptoms and stability of the therapeutic effect were more dramatic in the treatment group.

    Has more stable effect for male immune infertility than Prednisone.

    -Sun Z. Bao Y. 2006,Honzhong, China

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Classic Herbal Formulas Dysfunction

Modified Jin Gui Shen Qi Wan

  • Main ingredients: Ginseng, Deer horn, Sea horse, Hokuo, Epimedii, Angelica, Cinnamomi, Poria cocos

  • Used for low sperm count, low motility and morphology

Modified Jin Suo Gu Jin Wan

  • Main ingredients:

    Eucommiae, Epimedii, Achyrabthis,Cistanches,

    Cynomorii, Cuscutae.

  • Used for impotency, low libido and early ejaculation

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Modified Jin Gui Shen Qi Wan Dysfunction (Kidney Qi Pill from Golden Cabinet)

  • 87 male pts. were treated and observed in our clinic

  • Comparison made before and after treatment 3-6 months.

  • Measured by routine semen analysis

  • 3 months enhanced function significantly, spouse pregnant rate =56% (49/87)

  • Sperm analysis improvement after 6 months= 68.40%

  • This formula influences regulatory function in FSH, LH, Testosterone, Coticosterone level

    Hu C. Etl

    Advanced Acupuncture, Inc. 2006, Los Angeles, U.S.A.

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Modified Jin Suo Gu Jin Wan Dysfunction(Mental lock pill to stabilize the essence)

  • 82 male patients were treated and observed

  • The length of treatment is 3-6 months

  • The sperm count improves 67.4 %

  • The activity rate of sperm markedly improved after treatment.

    Hu,C. etl

    Advanced Acupuncture, Inc. 2006, Los Angeles, U.S.A.

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Making Good Sperm Dysfunction

  • Eating Healthily

  • Taking Vitamins

  • Drinking more water

  • Copping Stress

  • Staying active

  • Enjoying regular sex

  • Sleeping enough

  • Liver Detox

  • Weekly acupuncture

  • Stop smoking

  • Cut down alcohol

  • Avoid drug intake

  • Minimize caffeine

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Things to avoid Dysfunction

  • High temperature

    ( best at 32 degrees C)

  • Stress( testes malnourished)

  • Alcohol( interferes of testosterone secretion)

  • Smoking(40 % sperm damage by free radicals)

  • Environmental Estrogen

    (meat, microwave plastics)

  • Drugs ( reduces testosterone & libido)

  • Caffeine (impair sperm production & cause chromosomal abnormalities)

  • Toxins (pesticides, heavy metals)

  • Pollutants

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Nutrients for Sperm DysfunctionAltern Med Rev. 2000 Feb;5(1):28-38. Green Valley Health, Hagerstown, MD 21742, USA

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Pro-vitamin for Men Dysfunction

  • Zinc -15 mg/day, (oyster)

  • Vitamin E 100-400IU (Olive oil, wheat germ)

  • Calcium 1000mg

  • Vitamin D 10 mcg

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Good Sperm Diet Dysfunction

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Our Newest Product Dysfunction

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Questions? Dysfunction

Contact information

Cathryn Hu, Ph.D., O.M.D., L.Ac.

Phone: 310-458-2848

Fax: 310-458-2899

Web: www.

Email: Advanced_Acupuncture @