Related Articles

Infertility, Subfertility, and Fertility Enhancement

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

Sections

Information Resources / Additional Information

  1. A 2004 report on the prevalence of subfertility and infertility by the European Society of Human Reproduction and Embryology, published in the esteemed Oxford Journals, Human Reproduction, shows that subfertility may be defined as failure to conceive in 6 cycles for half these couples, or after 12 unsuccessful cycles for many, although even for these couples, pregnancy will be achieved in 55 percent of cases in the next 36 months (without treatment), overturning prior assumptions that clinical infertility occurs in most couples when pregnancy does not occur in 12 months. Timing of intercourse was the most important factor for couples having difficulty with achieving pregnancy. These researchers caution against over-treatment for infertility, and found that "in cases with a good prognosis (especially unexplained infertility) the couples should be encouraged to wait (with artificial reproductive technology) because they have a similar probability of achieving pregnancy with and without treatment." Accumulative evidence of health risks and high costs have led to increased advice once again, as in the past, to not rush into standard fertility treatment. Of course, correcting the standard array of potential health factors that contribute to subfertility, with Complementary Medicine, seems like a sensible and logical protocol in the waiting approach: http:/humrep.oxfordjournals.org/content/20/5/1144.full
  2. A 1998 article in the Oxford Journals reveals the success rates for standard fertility treatment, which has changed very little over the last decade. On overall success rate for intrauterine insemination with clomiphene and HCG ovarian stimulation was about 13%, with a miscarriage rate of 23.5%, and a multiple pregnancy rate of about 14%. The rates of success declined in women over age 40, and with those experiencing fertility problems for over 6 years: http://humrep.oxfordjournals.org/content/14/3/698.full
  3. By 2015, experts such as these, at the Baskent University School of Medicine, in Turkey, noted that even with much advance in technology, and screening, ART (artificial reproductive technology) still only provides success in about 40 percent of cases, and is expensive, and time consuming. These experts noted that acupuncture and Chinese herbal medicine should be included in future ART to improve results. The difference between these and other new medical treatments is the lack of adverse health effects and low-cost. These experts also noted that in 2015, actual testing of the many adjuvant treatments used, with randomized controlled human clinical trials, was still rarely seen: http://www.ncbi.nlm.nih.gov/pubmed/24919029
  4. A 2015 randomized controlled human clinical trial of 120 women with PCOS receiving fertility treatment, in China, showed that a combination of lowered dosage of clomiphene with a short course of acupuncture and the use of Chinese Herbal Formula improved the pregnancy rate and reduced the early abortion or miscarriage rate significantly over the use of Clomiphene and HCG. The measurable benefits included improved HCG cervical mucus, endometrial thickening and morphological type quality of the endometrium. The points used on the 5th day of menstruation included Ren 3, Ren 4, ST29, and was supported by a traditional herbal formula used in the first half of the menstrual cycle, before ovulation, which tonifies the kidney system and improves circulation. Such study provides proof and guidelines that can help TCM physicians provide integrated treatment with minimal cost, saving the patient much money, reducing adverse health effects, and improving success with ART. No adverse effects from the use of acupuncture and herbal medicine have been noted in any published trial of combined therapy to date: http://www.ncbi.nlm.nih.gov/pubmed/25854013
  5. A 2015 randomized controlled human clinical trial of 114 women seeking fertility treatment with IVF-ET (in vitro fertilization with embryo transfer) showed that adding a simple course of acupuncture and moxibustion at the beginning of ovuatory induction, with just 3 treatment sessions, improved the high-quality embryo rate and positively affected hormonal levels of estradiol, progesterone and HCG in a homoestatic manner, as well as improving the health of the endometrial lining, endometrial blood flow and morphology. The points used at the beginning of ovulatory induction with clomiphene included Ren 3, REn 4, REn 6, Zigong, and SP10, with moxibustion applied at Ren 8: http://www.ncbi.nlm.nih.gov/pubmed/26054135
  6. A 2010 article in Time magazine describes that evidence that links fertility drugs and in vitro fertilization to a doubling of autism risk: http://www.time.com/time/health/article/0,8599,1990567,00.html
  7. A 2013 study of the risk of acquiring an autism spectrum disorder associated with use of hormonal fertility interventions, by the Birla Institute of Technology and Science, Hyderabad, India, found a statistically significant relationship in this family health survey, involving 942 families across India. These statistics are still unclear, and a smaller study at the Harvard School of Public Health found that a combination of an ovulation-inducing drug (OID) and artificial insemination was significantly associated with Asperger Syndrome and other spectrum disorders, but not Autistic Disorder itself, especially among older mothers seeking this reproductive technology (PMID: 22686388): http://www.ncbi.nlm.nih.gov/pubmed/24296891
  8. A 2012 article by National Public Radio's Shots health blog, reports that the U.S. Centers for Disease Control and Prevention (CDC) reports a 23 percent rise in autism disorder rates between 2006 and 2008, and a 78 percent rise from 2002 to 2008, coinciding with explosive growth in the use of drug-induced ovulation and pregnancy: http://www.npr.org/blogs/health/2012/03/29/149612138/autism-rates-jump-again-as-diagnosis-improves
  9. A article in the Archives of Gynecology and Obstetrics 2012 Mar 6, from Mansoura University Hospitals in Egypt, points out that recent CDC information suggest a higher than expected risk of birth defects with the use of Clomid (clomiphen citrate), the most common fertility drug used to induce ovulation. Alternatives are now being considered to resolve Polycsytic Ovarian Syndrome (PCOS), to allow pregnancy, rather than utilization of Clomid with birth defect and autism risks. Of course, standard medicine is loathe to recommend Complementary Medicine, acupuncture with herbal and nutrient medicines, to achieve this goal, despite success in recent studies: http://www.ncbi.nlm.nih.gov/pubmed/22392485
  10. A 2006 study at McGill University, Montreal, Quebec, Canada, confirmed that there was a sightly higher incidence of congenital fetal abnormalities and chromosomal anomalies with the use of ART, Clomiphene citrate, and Letrozole: http://www.sciencedirect.com/science/article/pii/S0015028206008430
  11. A 2013 study at the University of Oxford, United Kingdom, showed that use of ART and subfertility were associated with a significantly higher rate of asthma and allergic pathologies in the first 5 years of life. Similar results for eczema have been noted, as well as ADHD, and the practice of C-sections, and multiparity, also have been associated with these early childhood diseases. Parents who utilize ART drugs, often have twins or triplets, and deliver via C-section should be aware of these risks: http://www.ncbi.nlm.nih.gov/pubmed/23223378
  12. A 2013 study at the University of Barcelona found that Assisted Reproductive Technologies have been associated with general vascular dysfunction in late childhood, and found in a controlled study of 200 children that use of common fertility treatments resulted in cardiac and vascular remodeling in the fetus that persisted in postnatal life: http://www.ncbi.nlm.nih.gov/pubmed/23985787
  13. A 2010 study at Temple University School of Medicine, in Philadelphia, Pennsylvania, U.S.A., of the effects of Assisted Reproductive Technology, published in the esteemed Scientific American, found that these technologies altered DNA methylation and the epigenetic code, with genetic code altered in 5-10 percent of the babies born with fertility therapies: http://www.scientificamerican.com/article/assisted-reproduction-genetics/
  14. A 2013 study at the University of Tennessee Graduate School of Medicine, in Knoxville, Tennessee, noted that a number of studies now confirm that male aging may negatively affect sperm DNA, with poorer repair of DNA and may result in the child acquired an allele, or single strand of the double-stranded DNA, with potential to cause neurocognitive disorders such as autism and schizophrenia. In these males, drug strategies utilizing selective estrogen modulators (SERMS), such as clomiphene and serophene, have been increasingly prescribed off-label to maintain fertility potential in aging, but this would not solve the problem of poor sperm DNA repair in aging, and come with relatively common adverse effects such as vasomotor hot flush, heart arrythmias, tachycardia, gastrointesinal symptoms, headaches, visual problems, and male sterility with high dosage causing hyalinization of tubal membranes: http://www.ncbi.nlm.nih.gov/pubmed/?term=clomiphene+autism
  15. A 2000 review of common medications and their affects on fertility and pregnancy, published in the Journal of the American Medical Association (JAMA) Internal Medicine, shows that a variety of drugs that treat pain, inflammation, and rheumatic diseases are proven to adversely affect fertility, conception, fetal health, and breastfed babies. For instance, aspirin at higher doses may affect uterine contractility, bleeding, and fetal health, NSAIDS have similar risks, and common drugs used to treat autoimmune and rheumatic disease come with stern warnings of fetal effects, as well as impaired fertility: http://archinte.jamanetwork.com/article.aspx?articleid=1729684
  16. A 2013 report from experts at the University of Alberta and the A.L.S. Laboratory Group, in Edmonton, Canada, shows that organofluorines such as perfluorinated compounds (PFCs) used extensively for stain resistance, nonstick cookware surfaces, and many other applications cause reproductive and developmental toxicity and cancer, as well as liver and metabolic damage, and are bioaccumulative and do not break down in the environment, with toxic accumulation affecting a high percentage of humans and animals now across the globe: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776372/
  17. Stress has been linked positively to problems with fertility and conception, as this New York Times Health article shows in August 17, 2010. Simple stretegies such as acupuncture and herbal medicine can help resolve stress and increase your chances: http://www.nytimes.com/2010/08/17/health/research/17stress.html
  18. The study that linked stress biomarkers with problems conceiving were conducted at Oxford University Medical College: http:/www.nih.gov/news/health/aug2010/nichd-11.htm
  19. A 2012 study at the Harvard University School of Medicine shows how adrenal stress and adrenal glucocorticoids regulate the neurohormone kisspeptin-1 expressing neurons in the hypothalamus and contribute to infertility and obesity, especially with leptin deficency, and leptin resistance: http://dash.harvard.edu/bitstream/handle/1/9453704/Wang_gsas.harvard_0084L_10169.pdf?sequence=1
  20. Many sound scientific studies now exist confirming the efficacy of acupuncture therapy in fertility protocol. The discouraging advice is now mostly anecdotal and obvious in its prejudice. Fertility clinics utilizing acupuncture, such as this one in Toronto, Ontario, provide links to an array of scientific studies: http://totalwellnesscentre.net/infertility_studies.html
  21. A 2013 review of all published studies in the West on the use of Complementary Medicine to aid fertility treatments, by the University of Illinois Hospital and Health Sciences System, in Chicago, Illinois, U.S.A. found that Complementary Medicine may be a viable option for infertility care, not only for patients with insurance coverage of funds to pay for expensive IVF therapy, but for those patients not able to afford this expensive standard therapy. Such studies show that experts in standard medicine are slowly and reluctantly admitting that Complementary Medicine is proven to aid treatment of infertility and subfertility: http://www.ncbi.nlm.nih.gov/pubmed/23943040
  22. A 2013 review of all published studies in the West on the use of Complementary Medicine to aid fertility treatments, by the University of Michigan School of Medicine, showed that while the number and size of these studies published is still relatively small, 37 randomized controlled human clinical trials were found that met guidelines, and offered proof that these Complementary Medicine therapies do work. The treatments most supported so far included acupuncture, selenium (methylselenocysteine for male subfertility), weight loss where applicable, and psychotherapy (or stress reduction): http://www.ncbi.nlm.nih.gov/pubmed/23796256
  23. A 2009 study at the Reproductive and Fertility Centers in Colorado Springs, Colorado, and published in Fertility and Sterility 2009 Dec;92(6):1870-9, found that there exists a beneficial regulation of cortisol and prolactin from acupuncture performed when receiving IVF, and that these benefits may explain the higher rates of success with concurrent IVF and acupuncture stimulation: http://www.ncbi.nlm.nih.gov/pubmed?term=acupuncture cortisol prolactin fertility
  24. A 2014 study in China demonstrated that electroacupuncture at a single point, SP6, can increase a number of key fertility hormones, including FSH and LH, as well as GnRH, which is integral to a pulsatile release of gonadotrophin hormone in the early stage of the cycle leading to release of eggs in the ovaries: http://www.ncbi.nlm.nih.gov/pubmed/25069195
  25. A 2005 study at the Shanghai Medical Center of Fudan University, in China, showed that electroacupuncture restores the hypothalamus-pituitary-ovary axis in laboratory animals that have had an ovary removed, both by increasing mRNA expression in the hypothalamus to influence gonadotropin-releasing hormone (GnRH), but also with measurable increase in the aromatase activity that regulates hormone activity: http://www.ncbi.nlm.nih.gov/pubmed/15777765
  26. Further study at the Shanghai Medical Center of Fudan College, in China, in 2012, showed that electroacupuncture also restrained elevated expression of alpha and beta estradiol receptors in the hypothalamus of laboratory animals, which is associated with excess kisspeptide-1 expression and subsequent suppression of fertility. This effect would also restore the response of GnRH neurons to a relative lowered estrogen level, contributing to fertility potential. Such studies show how acupuncture stimulation works by modulation of the neurohormonal system to achieve homeostasis: http://www.ncbi.nlm.nih.gov/pubmed/21376784
  27. A 2011 study at the China Academy of Chinese Medical Sciences, in Beijing, China, found in a randomized controlled study that electroacupuncture stimulation at the point Ren 4 is able to potentiate the effects of low-dose estrogen in down-regulating hypothalamic expression of GnRH, kisspeptin-1 (K1) and GPR (gastrin-releasing peptide), and up-regulate hypothalamic CRH expression, indicating that this simple part of the acupuncture protocol in fertility could play an important role in regulation of reproductive potential. Overexpression of these neurohormones, such as K1, have been found to be integral to inexplicable subfertility, and linked to metabolic concerns in PCOS and obesity, as well as stress-induced subfertility. Fertility clinics now us pharmaceutical GnRH antagonists in ovarian hyperstimulation to induce viable eggs. Such study is revealing just how effective an evidence-based protocol could be with TCM care in subfertility, and with the use of a low-dose bioidentical estriol cream in the first half of the menstrual cycle, could be effective in helping women overcome subfertility without expensive drug therapies with risks and adverse health effects: http://www.ncbi.nlm.nih.gov/pubmed/?term=kisspeptin+acupuncture
  28. A 2007 controlled study at Tongji Medical College, at Huazhong University of Science and Technology, in Wuhan, China, showed that acupuncture improved embryo implantation success in laboratory animals by modulating progesterone (P4) and prolactin (PRL), as well as the expression of prolactin receptors and protein mediators: http://www.ncbi.nlm.nih.gov/pubmed/17717926
  29. A 2010 study at the University of Pittsburgh found that women who received acupuncture achieved pregnancy with IVF at a rate fo 64.7%, compared to the group not receiving acupuncture, who achieve pregnancy at a rate of 42.5%. Examining the stress scores, the researchers stated: "The acupuncture regimen was associated with less stress before and after embryo transfer, and it possibly improved pregnancy rates": http://www.ncbi.nlm.nih.gov/pubmed/20621276
  30. A 2015 retrospective study of the integration of massage therapy in IVF clinics in Austria found that massage therapy was significantly associated with greater success rates in IVF, especially prior to embryo transfer, and that the effect is likely due to stress reduction, reduction on uterine contractions, and enhanced blood circulation: http://www.ncbi.nlm.nih.gov/pubmed/25830275
  31. A 2013 study at the Clinic for Human Reproduction, in Sao Paolo, Brazil, found that acupuncture and moxibustion increased pregnancy rates when used as an adjunct treatment in women undergoing IVF, when prior embryo implantations had failed. The variety of results of such randomized controlled human clinical trials across the world may be attributed to study design rather than actual efficacy. If the acupuncture treatments are administered without the proper protocol, the success of this therapy is of course limited. To insure that a proper course of therapy is administered, patients would be smart to choose an independent qualified Licensed Acupuncturist with clinical expertise, rather than rely on acupuncture protocol delivered in standard medicine, which has shown a consistent bias against the success of Traditional Chinese Medicine over decades: http://www.ncbi.nlm.nih.gov/pubmed/23512550
  32. A 2015 study of 1231 women undergoing IVF, by the Oregon Health and Science University and the Oregon College of Oriental Medicine, in Portland, Oregon, as well as the Poma Fertility Northwest Center for Reproductive Sciences, in Kirkland, Washington, U.S.A. found that the whole protocol of integrative care in TCM, acupuncture plus herbal and nutrient medicine, was associated with greater odds of live birth in IVF, with no adverse effects noted: http://www.ncbi.nlm.nih.gov/pubmed/25911598
  33. A 2015 meta-review of all published studies of Chinese Herbal Medicine used in fertility treatment, conducted by the National Institute of Integrative Medicine, in Hawthorn, Melbourne, Victoria, Australia, found after reviewing 40 randomized controlled human clinical trials in recent years, involving 4247 women diagnosed with infertility, that Chinese herbal medicine can improve pregnancy rates 2-fold within a 3-6 month period of care, compared to standard ART fertility treatment, and may also improve ovulation rates, cervical mucus score, and thickness of the endometrial lining. No adverse effects were noted in these studies, and this analysis should finally provide confidence that TCM therapy is safe and very effective, as well as inexpensive:http://www.ncbi.nlm.nih.gov/pubmed/25637159
  34. A 2013 study at Tongji Medical College and Huazhong University of Science and Technology found that acupuncture stimulation is shown to modulate the endometrial immune environment, reversing attenuated CCL2 and CXCL8 expression and increasing the subset of uterine NK cells, to decrease uterine implantation failure in laboratory animals undergoing IVF implantation: http://www.ncbi.nlm.nih.gov/pubmed/24396391
  35. A 2011 randomized controlled human clinical trial at Shandong University, in Jinan, China, found that electroacupuncture at 4 common points significantly improved a number of measurable outcomes for women with polycystic ovarian syndrome (PCOS) and infertility, including fertility rate, ova cleavage rate, quality of embryos, pregnancy rates, and signs of healthy kidney function. The treatment involved a short course of electracupuncture to Ren 4, Ren 3, zigong, Sp6 and K3: http://www.ncbi.nlm.nih.gov/pubmed/21894688
  36. A 2012 study at Tongji Medical College and Huazhong University of Science and Technology found that acupuncture stimulation is shown to improve the receptive state of the endometrial lining to IVF implants by promoting T helper cell type 2 (Th2) secretion and inhibiting Th1, to decrease uterine implantation failure in laboratory animals undergoing IVF implantation. Various studies have demonstrated a variety of beneficial physiological effects from a sufficient course of acupuncture, properly administered, prior to IVF fertilization: http://www.ncbi.nlm.nih.gov/pubmed/22315633
  37. A 2013 study at Tehran University of Medical Sciences, in Tehran, Iran, found that women undergoing IVF fertility treatment receiving just 5 acupuncture treatments during the course of chemical induction of ovulation, retrieval of viable oocytes (eggs), and implantation in the uterine lining after fertilization, achieved a higher average of good quality oocytes and embryos with just this minimal and simplified treatment. The researchers noted that a number of human clinical trials had found that acupuncture increased fertility rates with IVF, but some of these studies reproduced with women with polycystic ovarian syndrome (PCOS) and anovulation showed no benefit, so this study only included women with PCOS. While again, the benefits were downplayed, women considering this protocol should consider that a course of 5 acupuncture sessions during the fertility process costs very little and comes with no adverse side effects, only the improvement of overall health and decrease of physiological stress. Utilization of acupuncture and the whole protocol in Traditional Chinese Medicine also present that women with the choice to use just this minimal approach, or a more extensive course of therapy to enhance fertility and benefit the health overall, both for the mother and the fetus. The extremely low rates for malpractice insurance and the absolute absence of cases of harm show that such integrative medicine is extremely safe: http://www.ncbi.nlm.nih.gov/pubmed/23376852
  38. A 2012 study at the University of Western Sydney, in Australia, found that the threat of miscarriage is a common problem, and that there is almost no treatment in standard medicine to prevent miscarriage, whereas numerous studies have shown that acupuncture "demonstrates beneficial hormonal responses with decreased miscarriage rates", and should become a standard option for women with a threat of miscarriage in their history, along with Complementary and Integrative Medicine (CIM or CAM), such as Chinese Herbal Medicine: http://www.ncbi.nlm.nih.gov/pubmed/22439880
  39. A 2013 review of studies of Chinese Herbal Medicine for the prevention of miscarriage, by the Beijing University of Chinese Medicine, in Beijing, China, found that there were only 14 small randomized controlled human clinical trials published, with a majority of these perhaps having a high or unclear risk of bias in study design, but that they showed clearly that Chinese Herbal Medicine added to progesterone and human chorionic gonadotropin treatment was superior to this treatment without herbal medicine, and that no adverse effects were noted from the use of Chinese Herbal Medicine in these studies, which included 3660 patients. The wide variance in presentation and thus the variance in herbal treatment with formulas, or heterogeneity, made assessment difficult. Such study does show that professional herbal treatment in TCM is safe and effective, though, and that a combination of herbal formula, acupuncture and even small dosage of bioidentical progesterone stimulating cream, may be very successful in decreasing risk of miscarriage, and very safe: http://www.ncbi.nlm.nih.gov/pubmed/24245671
  40. A 2013 study at the Zhejiang Academy of Medical Sciences, in Hangzhou, China, found that the herbal formula Da Bu Yin Wan (Great Nourishment of Yin), composed of Shu di huang (treated rhemannia), Huang bai (phellodendron), Zhi mu (anemarrhena), and Gui ban (Testudis plastrum, deep fried), significantly increased the thickness of the uterine wall and the number of corpus luteum (potential ova, or eggs), and down-regulated GnRH, GPR54 and Kisspeptin-1 in the hypothalamus of laboratory animals, showing the potential as part of the fertility protocol in TCM: http://www.ncbi.nlm.nih.gov/pubmed/23668015
  41. A 2010 study of published randomized controlled human trials utilizing Chinese herbal medicine (CHM) in the treatment of infertility in women with polycystic ovary syndrome found that evidence supported the addition of CHM to clomiphene treatment to improve outcomes of a successful pregnancy. No evidence of ill effects or contraindication were noted: http://www.ncbi.nlm.nih.gov/pubmed/20824862
  42. A 2015 survey in Australia of 412 women who had visited the Brisbane obstetric hospital for the first checkup in pregnancy, or who had visited a private clinic for this purpose, showed that 8.3 percent of them had used Complementary and Integrative Medicine as part of their fertility protocol, with about half of these women discontinuing the herbal formulas once they became pregnant. No adverse effects were noted, and this survey shows that confidence in herbal formulas along with nutrient medicine and acupuncture is increasing, without any fear of adverse effects, despite years of consistent warning against this practice: http://www.ncbi.nlm.nih.gov/pubmed/26053057
  43. This website from the University of Maryland gives a succinct description of the workup for male infertility that is standard: http://www.umm.edu/patiented/articles/what_causes_of_male_infertility_000067_4.htm
  44. This website from the University of Iowa gives another view of male subfertility, with varicoceles, ductal obstruction, hypogonadism, ejaculatory dysfunction, and gonadotoxins found with objective testing of subfertile men, and a suggestion that treatment of these problems will result in much increased chance of success with fertility. Complementary Medicine and TCM may play an important role in such treatment protocol: http://www.uihealthcare.com/topics/medicaldepartments/urology/evaltreatsubfertmale/index.html
  45. A 2003 study of environmental chemicals that possess androgenic or antiandrogenic activities via effects at androgen receptors found that 202 chemicals have been identified in industrial use and environmental pollution. http://www.ncbi.nlm.nih.gov/pubmed/14565775
  46. A 2011 meta-analysis of studies of couples undergoing assisted reproduction techniques (ART) found that evidence suggests that antioxidant supplementation for subfertile males may significantly improve the rates of success for pregnancy: http://www.ncbi.nlm.nih.gov/pubmed/21249690
  47. A 2012 meta-analysis of studies of couples undergoing evaluation for subfertility by the esteemed Cochrane Database found that numerous studies confirm that use of antioxidants by men in treatment of subfertility increases the chance for pregnancy: http://summaries.cochrane.org/CD007411/antioxidants-for-male-subfertility
  48. A 2010 study at the University of Kelaniya, Sri Lanka, found that sperm count, motility, and viability, and pH and viscosity of seminal fluid, was affected greatly by variations in seminal zinc: http://www.ncbi.nlm.nih.gov/pubmed/21234172
  49. A 2002 study at the University Medical Centre Nijmegen, the Netherlands, found that a combination of zinc sulfate and folic acid, taken for 26 weeks, significantly increased total normal sperm counts in both normal and subfertile men: http://www.ncbi.nlm.nih.gov/pubmed/11872201
  50. A 2014 study at National Chiao Tung University and Kaohsiung Medical University, in Taipei, Taiwan, found that the balance of bacteria in the spermatic fluid, or biome, was highly correlated with healthy sperm and male fertility. Predominance of Lactobacilli and Gardnerella was found in over 80 percent of samples of healthy sperm, and a predominance of Prevotella was common in unhealthy sperm samples. The hope is that probiotic balancing may improve male subfertility: http://www.ncbi.nlm.nih.gov/pubmed/25340531
  51. A 2008 study at King George's Medical University in Lucknow, India, found that treatment with the herb Mucuna pruriens increases sperm concentration and motility in various infertile and subfertile groups of men, and subsequent study found that the herb acted on the hypothalamic pituitary gonadal axis to improve steroid hormone profile as well to correct male infertility. This herb is dopaminergic, which accounts for its reputation as a aid to poor libido: http://www.ncbi.nlm.nih.gov/pubmed/18001713
  52. A 2012 study at Kongkuk University in South Korea found that the Chinese herb Cordyceps (Dong chong xia cao) significantly increased sperm motility and function in laboratory studies: http://www.ncbi.nlm.nih.gov/pubmed/22872590
  53. A 1997 study at Taipei Medical College, Taiwan, found that the Chinese herb Cornus officianalis (Shan zhu yu) contains as chemical that may significantly enhance sperm motility: http://www.ncbi.nlm.nih.gov/pubmed/9358903
  54. A number of studies in 2012 at Air Force General Hospital of PLA, Beijing, China, Department of Andrology, showed that the standard Chinese herbal formula to enhance male fertility, Bu Shen Yi Jing Tang, worked by increasing the intracellular calcium ion concentration in sperm tails, and by enhancing a key genetic expression (CatSper1), and countered induced sperm subfertility in laboratory animals, significantly improving sperm motility and activity: http://www.ncbi.nlm.nih.gov/pubmed/23042256
  55. A 2002 study by the American Society for Reproductive Medicine published in Fertility and Sterility Vol 78(6);1187-1194, Dec 2002, found with randomized controlled studies that environmental xenoestrogens, such as biphenyls (e.g. PCBs) and phthalates, were highly associated with sperm and ejaculate quality. An unfortunate conclusion suggests that this problem in the environment is limited to fish eaters and vegetarians, showing the continued obstinate attitude toward this ubiquitous problem and misdirecting patients and doctors who may have concerns. http://www.fertstert.org/article/S0015-0282(02)04389-3/abstract
  56. Studies citing the potential of fluoride to reduce sperm count and viability, as well as cause other hormonal problems, especially as a halogen competor with iodine, are seen here: http://www.fluoridealert.org/2007research/06.html /// or go to the main website to navigate: http://www.fluoridealert.org/
  57. A 2005 study from Charite Medical University in Berlin, Germany, outlines the ways that normal accumulative amounts of PCBEs affect male fertility. This is another group of halogens, namely bromines, that like flouride, both reduces sperm counts and affects the health and development of the male reproductive system while also competing with iodine and contributing to iodine deficiency, subclinical hypothyroidism, poor neurohormonal health, and decreased antioxidant protections: http:/www.ncbi.nlm.nih.gov/pmc/articles/PMC1277857/
  58. A number of studies on animals and humans has found that a variety of hormones are involved in the reproductive cycle. A 2000 study by the University of Michigan Reproductive Sciences Program found that the hormone leptin, previously thought to exert effects only on appetite and metabolism in conjunction with insulin hormone, is actually a key regulator of the pulsatile release of luteinizing and growth hormones that are integral to the success of the reproductive mechanism: http://endo.endojournals.org/cgi/content/abstract/141/11/3965
  59. The syndrome called polycystic ovary syndrome (PCOS) now affects more than 10% of women of reproductive age, and some recent studies have noted this problem in ver 20% of some populations in industrialized countries. PCOS seems simple, an abnormal growth of cysts in the ovaries, but is a very complex hormonal imbalance with much variation, as this article explains. The cysts are actually egg follicles that have not matured due to hormonal imbalance: http://www.infertilityphysician.com/androgen/pcos.html
  60. A meta-analysis of standard therapies for clearing of ovarian cyst tissue in uterine endometria, or endometriomas, in 2010, at the University of Amsterdam, Netherlands, found that no standard treatment protocol is proven effective to clear this common problem and improve reproductive outcomes. Acupuncture and TCM are effective in this regard, though, and underutilized: http://www.ncbi.nlm.nih.gov/pubmed/21069706
  61. Scientific study in China in 1997 has proven that acupuncture exerts significant beneficial effects on the hypothalamus: http://www.wellspringintegrative.com/acup_pit.htm
  62. Scientific study in 2007 at the Martinos Center for Biomedical Imaging at Massachusetts General Hospital proved with functional MRI imaging that acupuncture stimulation significantly affects the hypothalamus using human subjects: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1997288/
  63. Studies in 2010 at the Chongqing Medical University in China found that electroacupuncture could significantly lower total cholesterol and triglyceride levels, acting in a similar fashion to the hypothalamic leptin stimulating effects noted with electroacupuncture. These effects were measure using just 2 points, ST40 and ST36: http://www.ncbi.nlm.nih.gov/pubmed/21090330
  64. Studies in 2008 at the University of Gothenberg, Sweden, found that low frequency electroacupuncture on laboratory animals could resolve polycystic ovarian syndrome by its effects on insulin metabolism and adipose cells. Both electroacupuncture and mild exercise was shown to benefit leptin metabolism and reduce insulin resistance: http://www.ncbi.nlm.nih.gov/pubmed/18388196
  65. Followup studies at the University of Gothenberg, Sweden, confirmed that 2Hz intense electroacupuncture could resolve polycystic ovarian syndrome by decreasing insulin resistance and improving adipose cell metabolism, creating improved balance between insulin and leptin, which drives a hypothalamic generated hyperprolactinemia responsible for polycystic ovarian syndrome: http://www.ncbi.nlm.nih.gov/pubmed/20663984