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Infertility Treatment

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Infertility Treatment

SIRM and the Poor Responder

By | February 29th, 2008|Infertility Treatment|

SIRM has a local clinic close to my office.  I just finished treating a client who completed a cycle with SIRM, with great success!  She was refused by 2 other fertility clinics due to her long and complicated history.  I think for some women SIRM offers interesting protocols and strategies for couples with usual cases.  SIRM published a journal article about one of their protocols.  I find the theory behind it to be a solid solution for “poor responders”.  My client, the “poor responder”, did not have a poor response with her IVF cycle and had 10 follicles retrieved with [...]

OHSS and Trigger Shots

By | February 25th, 2008|Infertility Treatment|

As usual, the journal Fertility and Sterility has tons of interesting research.  This particular article grabbed my attention, since every year one of my clients will have problems with hyperstimulation.  The article discusses the use of a GnRH agonist (encourages the pituitary to secret higher levels of FSH/LH) as the trigger before retrieval.  Most IVF cycles use HCG (identical to FSH/LH) as the trigger, which has a long half life (it lingers for a long time in the blood stream before the body can eliminate it) and it can encourage the continual growth of follicles.   OHSS is serious consequence [...]

PCOS, Part Three

By | February 25th, 2008|Infertility Treatment|

Coming Soon.

PCOS: What is going wrong? Part 2, continued

By | February 9th, 2008|Infertility Treatment|

Increases FSH Receptors and Estradriol Release   Whether increased granulosa cell sensitivity to FSH arises primarily from the ovary or secondarily as a result of non ovarian factors is unknown. Studies have shown that granulosa cells from PCOS have greater binding of FSH compared with normal ovaries.   1. FSH Receptor Hyper-responsiveness and Hyperstimulation   Despite a lack of ovulation, studies have demonstrated that PCOS granulosa cells are extremely sensitive to follicle-stimulating hormone (FSH) stimulation when compared with normal cells.Studies find women with PCOS have estradiol secretion in response to FSH (during stimulation) that is comparable to normal women. Yet, [...]

PCOS: What is going wrong? Part 2, continued

By | February 9th, 2008|Infertility Treatment|

Increases FSH Receptors and Estradriol Release   Whether increased granulosa cell sensitivity to FSH arises primarily from the ovary or secondarily as a result of non ovarian factors is unknown. Studies have shown that granulosa cells from PCOS have greater binding of FSH compared with normal ovaries.   1.  FSH Receptor Hyper-responsiveness and HyperstimulationDespite a lack of ovulation, studies have demonstrated that PCOS granulosa cells are extremely sensitive to follicle-stimulating hormone (FSH) stimulation when compared with normal cells. Studies find women with PCOS have estradiol secretion in response to FSH (during stimulation) that is comparable to normal women.   Yet, beyond [...]

PCOS: What is going wrong? Part 2

By | February 1st, 2008|Infertility Treatment|

My previous article described the basic theory behind follicular growth.With that basic theory we can look at what is can happen when hormones and receptors don’t work properly. The following information comes from the article “The reproductive phenotype in polycystic ovary syndrome” by R Jeffrey Chang.I have changed some of the wording to simplify concepts, but if you want to read the article the in its’ originality go to:http://www.nature.com/ncpendmet/ journal/v3/n10/full/ncpendmet0637.html    1) Follicles Unable to Fully Mature. Normal follicle development involves pre-antral growth of the primordial follicle (containing an immature oocyte surrounded by a single layer of flat granulosa cells) [...]

PCOS- Part one: Follicular Growth

By | January 26th, 2008|Infertility Treatment|

PCOS Part One:  Follicle growth PCOS is one tough cook to crack.  Women with PCOS have a difficult time conceiving and some cases involve scar tissue from cyst formation.  I have treated several women in my practice with this problem.  Treatment time is long, but acupuncture and herbs are successful in decreasing the amount of cysts and promoting ovulation.  I thought it would be interesting to understand why cysts form and how it correlates with Chinese medicine.  The first part of post will focus on how a follicle grows. To start with here are some definitions: Aromatized - an enzyme [...]

Sweating, flashing and fertility

By | January 9th, 2008|Infertility Treatment|

In the confusing world of fertility, where do hot flashes and night sweats belong?  From a Western medical point of view, these problems have no influence on the success of conception.   From a Chinese medicine view, hot flashing/night sweats indicate an imbalance of a women’s energy.  Balanced energy is important and can be thought as hormones.  An example of balanced hormones would be low estrodiol in the follicular phase, which encourages the pituitary to secrete more FSH to stimulate the ovaries.  An example of an imbalance would be low estrodiol and high FSH on day 20 of the cycle, [...]

Early cleavage does not predict treatment outcome following the use of GnRH antagonists in women older than 35

By | January 3rd, 2008|Infertility Treatment|

January 3, 2008 Interesting - if GnRH antagonist can block cellular division and decrease the secretion of E2 from the ovaries, could this be a part of the mechanism of increasing the follicular phase in the preceding article?  Often we only think drugs have a singular effect, GnRH antagonist should only effect pituitary, yet GnRH receptors exist in the ovaries/follicles and play an important role in embryonic growth.  If GnRH has a role in cellular replacement/growth, then could some problems with embryonic quality be related to drugs blocking important hormonal receptors?    From a Chinese perspective GnRH would be considered [...]

Novel follicular-phase gonadotropin-releasing hormone antagonist stimulation protocol for in vitro fertilization in the poor responder

By | December 18th, 2007|Infertility Treatment|

This article was of interest to me. I work with poor responders and they are not just “older” women. I have treated women in their early 30’s with “poor responder” diagnosis. They have normal FSH, E2 and regular cycles, but respond very poorly to fertility drugs and produce limited follicles. The article rethinks the traditional IVF stimulation cycle for poor responders and raises some interesting thoughts about how hormones can effect more than one part of the cycle.   The authors developed a protocol to lengthen the follicular phase of the IVF cycle. By increasing the number of days during [...]