Philip A.M. Rogers MRCVS

AP and the Urogenital / Adrenal System


Alieva_EA; Fanchenko ND; Parshutin NP; Gasparov AS; Pshenichnikova TIa (1993) The effect of a decrease in body weight in patients with the polycystic ovary Syndrome. Akush Ginekol Mosk (3):33-36. 80 patients with polycystic ovary Syndrome and excessive weight were examined. In 60 patients weight reduction resulted from diets and in 20 it occurred over the course of AP. Such treatment led to pregnancy in 21 (34%) patients. Diets and AP for weight reduction are recommended as the first stage of treatment for patients with polycystic ovaries combined with obesity.

Anon_New Scientist (1995) Electric blankets and birth defects. New Scientist 2 Aug, p11. This is a report of the first study showing a link between exposure to EMFs (electromagnetic fields) and birth defects. The study looked at 486 women who had been trying to conceive for more than 12 months. They found that those who slept with their electric blanket switched on were 7 times more likely to have babies with urinary tract defects than those who turned their blankets off.

Bahr_FR (1994) [AP in gynaecology and obstetrics]. Gynakologe Dec 27(6):369-374. In German.

Chen_BY; Yu J (1991) Relationship between blood radioimmunoreactive beta-End and hand skin temperature during the EAP induction of ovulation. AETRIJ 16(1-2):1-5. Inst of AP Research, Shanghai Med Univ, PRC. 13 cycles of anovulation menstruation in 11 cases were treated with EAP to induce ovulation. In 6 of these cycles which showed ovulation, the hand skin temperature (HST) of these patients was increased after EAP. In the other 7 cycles ovulation was not induced. There were no regular changes in HST of 5 normal subjects. The level of radioimmunoreactive beta-End (r beta-E) fluctuated, and returned to the pre-AP level by 30 min after withdrawal of needles in normal subjects. After EAP, the level of blood r beta-E in cycles with ovulation declined or maintained the range of normal subjects. But the level of blood r beta-E in cycles in which the induction failed to cause ovulation was kept higher than normal (p <.05). There was a negative correlation in the decrease of blood r beta-E and increase of HST after EA (r=.677, p <.01). EA can regulate the function of the hypothalamic-pituitary-ovarian axis. Since a good response is usually accompanied with the increase of HST, monitoring HST may provide a rough but simple method to predict the curative effect of EA. The role of r beta-E in the mechanism of EA ovulation induction was discussed.

Chien_CH; Li SH; Shen CL (1991) The ovarian innervation in the dog: a preliminary study for the base for EAP. J Auton Nerv Syst Sep 35(3):185-92. Dept of Anatomy, Coll Med, Nat Cheng-Kung Univ, Tainan, Taiwan, ROC. The origin of the canine ovarian sensory and sympathetic nerves was studied by applying horseradish peroxidase (HRP) or wheat germ agglutinin conjugated to HRP (WGA-HRP) to the ovarian stroma and into the ovarian bursa. HRP/WGA-HRP positive neurons were found bilaterally in the dorsal root ganglia of segments T10-L4, with most located in T13-L2. In sympathetic paravertebral ganglia, labelled neurons were distributed bilaterally in ganglia from T11-L4 with the majorities located in segments T13-L2. Both distributions show ipsilateral predominance. Labelled prevertebral neurons were mainly located in the aorticorenal ganglion, ovarian ganglia and caudal mesenteric ganglion. No labelled neurons were found in the dorsal motor nucleus of vagus, nodose ganglia or sacral segment from S1-S3. This study provides the possible morphological basis of EAP concerning the somatovisceral reflex of the ovary.

Gerhard_I et al (1993) Ear-AP in the treatment of female infertility. Gynaecol Endocrinol 6(3):171. In a German study of 90 infertile women, half were treated with auricular AP (in the ear and half with hormone treatment. There was a fractionally higher birth rate in the group treated with AP (22/45) than in the group treated with hormones (20/45). The researchers noted that the AP group experienced additional health benefits and no adverse side effects. They concluded that "auricular AP seems to offer a valuable alternative therapy for female infertility due to hormone disorders", being more effective and with no side effects. [Alan: I also know that nutrition can help a lot with infertility].

Gerhard_I; Postneek F (1992) Ear-AP to treat female infertility. Gynecol Endocrinol Sep 6(3):171-181. Dept for Gynecological Endocrinology and Reproduction, Women's Hospital, Univ of Heidelberg, Germany. 45 infertile women suffering from oligoamenorrhoea (n=27) or luteal insufficiency (n=18) were treated with Ear-AP after a full gynaecologic-endocrinologic workup. Results were compared to those of 45 women who received hormone treatment. Both groups were matched for age, duration of infertility, body mass index, previous pregnancies, menstrual cycle and tubal patency. Women treated with AP had 22 pregnancies, 11 after AP, 4 spontaneously, and 7 after appropriate medication. Women treated with hormones had 20 pregnancies, 5 spontaneously, and 15 in response to therapy. 4 women of each group had abortions. 35-38% of women of each group who failed to become pregnant after therapy developed endometriosis, with normal menstrual cycles. Only 4% of the women who responded to AP or hormone treatment with a pregnancy had endometriosis, and 7% had normal cycles. Also, women who remained infertile after hormone therapy had higher body mass indices and testosterone values than responders from this group. Women who became pregnant after AP suffered more often from menstrual abnormalities and luteal insufficiency with lower estragon, thyrotropin (TSH) and dehydro-epiandrosterone sulphate (DHEAS) levels than the women who achieved pregnancy after hormone treatment. Although the pregnancy rate was similar for both groups, eumenorrhoeic women treated with AP had adnexitis, endometriosis, out-of-phase endometria and reduced postcoital tests more often than those receiving hormones. 12/27 women (44%) with menstrual irregularities remained infertile after therapy with AP compared to 15/27 controls (56%) treated with hormones, even though hormone disorders were more pronounced in the AP group. Side-effects were observed only during hormone treatment. Various disorders of the ANS normalized during AP. Ear-AP offers a valuable alternative therapy for female infertility due to hormone disorders.

Gong_D; Liang C; Lai X; Lai X (1993) [Effects of different AP manipulation on plasma estradiol, testosterone and cortisol in patients with KI Xu]. Chen Tzu Yen Chiu 18(4):253-256. Dept of AP and Moxibustion, Guangzhou Coll of TCM. Observation was made on the effect of different AP manipulation on plasma estradiol (E2), testosterone (T), E2/T and cortisol (C) in 78 patients with KI Xu (Deficiency). The level of E2 and T in women was lowered by both reinforcing manipulation (RFM) and reducing manipulation (RDM). E2/T index was lowered by RDM but not by RFM, and there was significance (p <.05) between the RDM group and RDM group in E2/T, but no significance between the men's groups. The level of C was decreased by RDM but not by RFM. The different manipulation effects are different on the level of sex hormones in women and the C level in patients with KI Xu.

Hao_LC (1987) EAP therapy trial for treating infertility in mares. Theriogenology Sept 28(3):301-305.

Hasenpusch_E (1988) Treatment of non_cyclic young postpartum cows with EAP or Abbovestrol-spiral. Inaugural-Dissertation, Tierarztliche Hochschule Hannover (No 41), 99pp. Summary in: English.

Hirsh_RC1 (1996) Chin Med and Assisted Reproductive Technology for the Modern Couple: Part 1. Adapted from WWW. [Roger C Hirsh, OMD LAc BAc (UK), Dipl NCCA (email: has been working for the last 7 yr to specialize in reproductive health care within the TCM model and to integrate the diverse traditions of TCM and WM in his work with fertility. An Honours graduate of the International Coll of Oriental Med (London, 1976) he received his Doctorate in Oriental Med (1984) with a specialty in Constitutional Med. After a 3000 h Postgrad internship with Master Sehan Kim OMD and Ms Kyo Ok Kim MD PhD, he joined the Centre for Orthomolecular Med in Palo Alto, where he practised AP and Herbal Med for several years as a member of a 6 physician team. Dr Hirsh has served as an adjunct faculty member of the Am Coll of TCM, the California AP Coll and Emperor's Coll of TCM and is one of the founders and is currently chairman of the board of directors of China International Med Univ. He is currently in private practice in Beverly Hills, California, specializing in work with couples who have simple to complex fertility concerns or are preparing to have a family: WebMaster].

AP and Herbal Therapy are ancient methods used to treat and prevent disease in TCM. These systems are as ancient and effective as any other Med techniques used in the world today. They have been practised consistently for the past 5000 yr in the Orient. Circa 17.5% of the world's population uses AP and herbs as their main form of health care. Although AP has been used in England, France, and Germany for several centuries, only in the past 2 decades have AP and TCM been recognized in the USA. The benefits of AP and TCM in treatment for the infertile couple can be found in early TCM literature. Not only do these techniques assist in regulating the menstrual cycle and invigorating the sperm, but they also serve to enhance the function of the whole body. This "whole body" health approach, in turn, provides a key to unlock unlimited potential in healing. This is especially appropriate for the over 40 couple as it stimulates overall health to effect reproductive health and a reduction of biological age.

PMS, amenorrhoea, endometriosis, blocked fallopian tubes, immune system incongruities, and infertility related hormonal problems yield to many of these old world (traditional) procedures. Also, herbal formulas that tonify KI-Qi (KI- and adrenal- function), and KI-Jing-Essence are especially useful in raising sperm count and motility. The highly technical and expensive methods used in WM are supported by complimentary TCM procedures and Herbal Med. Complete treatment programs also include a series of Qigong healing energy exercises to enhance Qi-flow in specific Channels, as well as the use of AP, TCM and Herbal Med. These exercises, developed by Chinese Taoists (metaphysicians) >3000 yr ago, stimulate the flow of intrinsic Qi in the body which, in turn, enhance health and benefit organ function. The meditative dance-like movements coordinate with specific visualizations and exercise; they oxygenate the blood and simultaneously enhance one's artistic nature. Oriental sexological literature lists specific sexual positions that enhance a man's sperm count and motility as well as regulating a woman's cycle. Currently, studies focused on understanding the effects of these techniques are under way in the USA and Europe. Longevity and regaining a persons youthfulness are key topics. As a way to heighten a couple's fertility, TCM has several advantages.

Advantages of using TCM:
1. TCM sees the person as an integral Mind/body organism, thereby does not treat just symptoms/diseases. TCM ventures to stimulate the bodies natural healing potential by treating root causes rather than just symptoms.
2. TCM, used to treat infertility, minimizes undesired side effects and accumulated toxicity from invasive procedures and drug therapies, known and unknown.
3. TCM may be used to strengthen and balance one's general health so that IVF, GIFT, ZIFT, ICSI, AHT and TET procedures are more effective. Patients of TCM derive general health benefits and endocrine system balancing from specific AP and Herbal Med. Pregnancy becomes easier to achieve and postpartum recuperation happens faster. Med studies have been done in China to verify this type of whole body health enhancement.
4. Widespread use of TCM suggests that it is a complete health care system and can be used with or without integration with WM. The integration of WM, as we know it in America, began in the Orient <100 yr ago. It is called integral TCM (ITCM). TCM techniques (AP and herbs) seem to work best when combined with WM.

Unexplained infertility / LV-Qi Stasis: Irritability, depression, frustration are keywords to LV-Qi-Stasis. Whenever an organ is mentioned in TCM, it implies the related Channel and its TCM functions. A Channel is a conduit along which Qi (vital energy) flows. The psychological aspect of LV is said to assist in planning easily and wisely. The person who suffers from LV-Qi-Stasis may be found in a job that they don't enjoy, working late hours, and with a history of taking birth control pills. There often exists an inner psychological frustration about having and raising children. Dysfunctional family factors play a major role in LV-upset, as the condition may have existed for years.

Physical symptoms of irregular periods, PMS, dark coloured blood with small clots, breast pain with distention, worry and frequent sighing and headaches often accompany the psychological symptoms. Pulse diagnostic palpation at the radial artery usually reveals a wiry and small quality pulse in the person with a LV imbalance. Pulse Diagnosis at the radial artery is an extremely sensitive and skilled art that takes years to perfect. It is like a Lab blood test. Each wrist has >12 different pulse positions and 28 pulse qualities can related to each one of these positions. The readings yield a multitude of relationships when integrated and compared with the patients' signs, symptoms and tongue characteristics. The different pulses can confirm a diagnosis and be used to monitor a patient's progress. Both pregnancy and the sex of a child can be diagnosed from the pulses by a skilled practitioner.

Infertility due to LV-Qi-Stasis manifests mostly in women and is a common cause of unexplained infertility. This is because this type of LV-Stasis effects the blood flow in the pelvic cavity. AP at the right time in the menstrual cycle, in conjunction with an herbal formula and some counselling, very likely can clear the Stasis in several mo. The resulting pregnancy is more than welcome along with the emotional clarity that arrives when LV is less toxic (less LV-Stasis). Couples must realize, however, that the prevalence of LV-Qi-Stasis in modern society is not something simple that can be relieved overnight. It may take 9 mo or more to release the stress, trauma, and toxin in the system, if it is at all possible. Some cases resolved in <1 mo.

Miscarriage in TCM: Since the Western Han Dynasty (206BC-24AD), Chinese people have been using TCM to effectively treat both male and female infertility.

Hirsh_RC2 (1996) Chin Med and Assisted Reproductive Technology for the Modern Couple: Part 2. Many texts have been published in the Med literature focusing on these problems that have so recently come to the forefront in western society. TCM for threatened miscarriage includes AP, herbs, diet and an a different approach to exercise. Treating infertility and miscarriage by any method is complicated and involved. The Med that helps the patient attain a healthy vital energy (Qi, Tian kuei) can greatly aid the woman who has had miscarriages due to hormonal imbalance. For women >40 there are herbs to nourish the deeper vitality necessary to ovulate healthy ova. Currently, both in China and America, TCM is used with WM techniques and testing to design an effective course of treatment for the couple wishing to achieve not only pregnancy, but a healthy baby delivered at full term. 60% of all spontaneous abortions occur in the first half of the first trimester of pregnancy. Genetics play a key role in habitual miscarriages. To presume that TCM alters genetic structure without triple blind studies etc., would be a stretch of the imagination for most people. However, TCM is very effective in strengthening a persons' constitution. If a woman has miscarried, it is important to build and conserve her Qi and build her Xue. This usually means building and conserving KI-Qi, as within KI both Yin (Xue) and Yang (Qi) are generated. In TCM, KI means the whole psychophysical interrelated matrix and visceral relationship of KI function and its Channel conduits, not just the ear-shaped organs guarded by the ribs just above the lower back.

In TCM, all chronic imbalances effect KI; if a person has a weak constitution (e.g. is pale, feels cold is undernourished, etc), then this is a result of either prenatal (genetic) influences (Yuanqi-Xu) and/or life-habits and illnesses which weaken or obstruct KI-Qi. The way to change these conditions, if possible, is to change them through treating KI with tools of AP, herbs, diet, and exercise. KI means bone and bone marrow, and Xue is made from the marrow. Xue nourishes Qi and the cycle regenerates and builds. In TCM, the Xue nourishes, the Qi protects, and KI-Qi holds the fetus. KI is injured by Cold, therefore dietary considerations are generally applicable for this patient. Recent studies have also shown that good dental hygiene and dental work of high quality can increase fertility.

A very famous formula, that builds Qi-Xue, is used to strengthen the body and prepare a woman for conception. This is especially useful if she has a history of miscarriage. The formula should be given for 3-6 mo before conception is attempted. It is called "The Rock on Tai Mountain Decoction." This somewhat poetic name refers to a great mountain that many Chinese religiously pilgrimage to, hoping to get their prayers answered. It is an extremely demanding climb of 1000, just as pregnancy is demanding of the modern mother. Just giving this herbal decoction does not guarantee that conception will take place and the next baby delivered to full term. Seeing the patient as a whole person and thereby considering their total health picture helps the TCM physician decide how to choose and change a formula to be specific to the patient.

Sex during pregnancy: Oriental culture has a very direct and honest attitude toward sexuality. As sex is seen as a natural function, as natural as "clouds and rain", nothing sexual is considered to be "dirty". In training, a TCM practitioner is taught that it is not the job of the physician to be judgemental about an individual's sexual practices; it is more important to discuss the consequences of these practices. Therefore it is easy for the doctor to indicate that intercourse during the first trimester is contraindicated, especially for the woman that has a history of miscarriage, as the placenta is not yet fully formed. Many men have a problem with this recommendation (but the "problem" can be solved without risk to the female). Usually, TCM practitioners go one step further and indicate that it is probably best for all couples to abstain from intercourse for the whole 9 mo of pregnancy. Modern couples usually have no problem with this idea especially when they consider the investment they have made. For the couple, where the woman is over 40, intercourse is not recommended for the entire pregnancy even by western physicians.

Raising fertility quotient with TCM
1.        Timing and consistency of treatment, whether having AP or just taking herbs, is of primary importance. Consistency of treatment is most important for men, as to raise sperm count and motility with herbs starts to take effect in mo 4 of treatment. It takes 70 d to generate new sperm. Timing and consistency is also important for women, as specific hormonal adjustments can be made at each week of the cycle. Missing 1 wk of treatment may lose an important chance to heal a particular segment of the 4 phase menstrual cycle. It takes a minimum of 3 consecutive cycles (12 treatments) to do the foundation work of regulation regardless of biological age. Most women can benefit from this type of concentrated foundational treatment every 2 yr, even if they aren't trying to conceive. This should be started before a woman reaches 28 yr old or earlier if birth control pills have been taken.

2.        Course of 6-9 mo: If a woman is nearing 40-yr old and has had either many fertility drugs (over 3 cycles), birth control pills, PMS, ART procedures, elevated FSH, polycystic ovaries, endometriosis, sperm antibodies, or a history of drug, alcohol, or smoking abuse, then it usually takes longer to balance her reproductive system. Likewise, if a man has a history of STDs, history of drug, alcohol, smoking, or sexual abuse, urinary tract infections, burning urination, chronic lower back pain, prostatitis, difficulty passing urine, or other urological health issues it takes longer to rejuvenate the reproductive function. The extent of rejuvenation is relative to the effort and inherent constitution of the individual. Daily training sessions with the right exercises usually provide tangible results when combined with weekly treatment, meditation and a reasonable diet. The couple must expect to focus 6-9 mo before expecting to evaluate results. There is no quick path to conception, full term pregnancy and recovery after delivery.

3.        Re-evaluation: In TCM, it is appropriate to evaluate between the 6th-9th mo of consistent treatment if a woman is in a high state of wellness (warm hands and feet and no PMS are good indicators), and has a "normal" active and a relatively low-stress, energy-abundant lifestyle.

4.        Biological v chronological age: The 2000-yr old TCM classic (Neijing Suwen Lingshu) states precepts of health and aging that remain very important today. Accordingly, the normal life span for humans is over 100 yr. Some monks have lived in good health to >150 yr old. In the Neijing dialogue between the Yellow Emperor and his old Taoist teacher (Qi-po), Huangdi asks: "Why does medicine exist?". Qi-Po answers: "because people have severed themselves from their roots (Tao)".

Hirsh_RC3 (1996) Chin Med and Assisted Reproductive Technology for the Modern Couple: Part 3. The reconnection between the individual and their "roots" (spirituality) is a very important aspect in the maintaining of youthfulness and is thereby inherent in the basic foundation of TCM. Modern science supports this in the focus on the emerging stem cell technologies and the possible cures for major life threatening diseases. The umbilical cord is abundant in stem cells, which suggests a deep-rooted connection between Jingqi (Source-Essential-Ancestral Qi) and the umbilicus. The umbilicus contains CV08 (Shenque, Spirit Palace, also called Qishe (Qi Residence), and is also the essential physical connection to the mother's uterus and the route of the mothers Qi to the foetus). Understanding the root cause and quality of one's own longevity can slow the aging process and rejuvenate the body as thoughts can create reality. Knowing with certainty that we are an ageless body is the basis for creating high level wellness in the modern world. Longevity however is more than just belief.

5.        Correct dietary and exercise habits are just as important for the preconceptive mother as for the father. Eating salads (Cold nature food) for a year is not the best diet for a person who has generally a low basal body temperature (BBT). Sometimes eating meat such as lamb (warming food) can help tonify a "Cold" barren uterus. In cases of unexplained infertility, or male factors, couples can do specific physical and mental exercises to generate the right environment necessary for creativity and conception.

6.        Combining WM reproductive technologies with TCM (AP and Herbal Med) demands good communication between team members which includes the patient as captain. Communication between the patient, the acupuncturist and the reproductive specialist is a delicate process. It is important for the physician to know the procedures of the acupuncturist or herbalist and vice-versa. Lack of knowledge of a patient's herbal program can affect the results of an ART procedure. It even can be detrimental, as alternative therapies effectively change a person's body. Also, it is important that the patient tell the acupuncturist about any herbs or vitamins (other than standard prenatal vitamins) that are being taken while undergoing treatment. Over-the-counter herbal remedies may sometimes be effective, but may not be indicated for a particular cycle. It could be like having carpet delivered for the baby's room before the concrete foundation was poured for the house.

TCMs and AP work quite differently than WMs. They are gentle and deep acting rather than flashy and bright. Expect to feel a growing subtle influence that permeates your life like the smell of star jasmine on a summers night.

7.        Previous AP treatment? When selecting an acupuncturist or any healer it is important to know that they are suitably qualified to do fertility work. Communication, experience and skill are important. Having a state AP license means that acupuncturists have passed a course of study that qualifies them as entry level practitioners. Usually this training lasts circa 3000 h. Though some programs for physicians are only 300 h, more and more doctors who integrate the reproductive techniques of TCM with WM have more than entry level experience of treating couples. These physicians are to be sought out, as treating infertile couples demands not just general practice but also a specialty skill. General practice skills help remove pre-existing conditions. If these conditions are the cause of infertility then the couples fecundity quotient will increase. However, if either reproductive function or biological age of the endocrine system is the primary contributory factor then specialty skills and experience is necessary.

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5.Endometriosis & Infertility and TCM, Flaws, Bob, CO, Blue Poppy Press, 1989.
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7.A Woman's guide to Endometriosis, Older, Julia, Charles Scribner's Sons, NY,1984.
8.Handbook of Chin Herbs and Formulas, Vol 1 & 2, Him-che Yeung, Los Angeles, 1985.
9.Chin Herbal Patent Formulas, A Practical Guide, Jake Fratkin, Shya Publications, 1986.
10.Chin Tonic Herbs, Ron Teeguarden, Japan Publications, Inc. 1985.
11.Wise Woman Herbal For the Childbearing Year, Weed, Susun, New York, Ash Tree Publishing, PO Box 64, Woodstock, NY 12498, 1986.
12.Consumer Protection Issues Involving IVF Clinics (stock number 552-070-06387-1 US Govt Printing Office, $31) 202-2753030.