Therapy options

Acupuncture

Acupuncture, a form of alternative medicine is the stimulation of specific acupuncture points along the skin of the body using thin needles. It is commonly used for pain relief, though it is also used to treat a wide range of conditions. Acupuncture is rarely used alone but rather as an adjunct to other treatment modalities. In Western settings acupuncture is used as a primary intervention for fertility problems. Acupuncture is increasingly used as an adjunct to assisted reproductive technologies and more widely in the complementary health care system.

The Western medical acupuncture approach involves using acupuncture after a medical diagnosis. In traditional acupuncture, the acupuncturist decides which points to treat by observing and questioning the patient to make a diagnosis according to the tradition used. 

This method has always been applied to reproductive treatment in China. Western medicine may exert influence on neuroendocrine system, immunological functions and even signal pathway in consideration when discussing the efficacy of acupuncture and these still continue to be studied. The Chinese medicine evaluates the effect of acupuncture from an overall perspective. In Chinese medicine, reproductive function relates not only to reproductive organs, but also to the kidney, the liver, and the heart. 

Acupuncture can be used as an adjuvant treatment for unexplained infertility. Although acupuncture did not increase the cumulative pregnancy rate, it decreased the number of control ovarian hyperstimulation (COH) cycles and more patients got pregnant in natural cycles after receiving acupuncture  (Tab. 1).

Acupuncture treatment procedures should happen once or twice a week, and will continue for anywhere from a few weeks to a few months. Remember the process may take more time than just twice a week if you are combining it with medical infertility treatments, like IVF. In general, the acupuncture treatment can be completed in 12 appointments. At each appointment, your acupuncturist will most likely take additional time to discuss your current condition and answer any questions that you may have.

Traditional Chinese medicine

Traditional Chinese medicine (TCM) is a style of traditional Asian medicine informed by modern medicine but built on a foundation of more than 2,500 years of Chinese medical practice that includes various forms of herbal medicine, acupuncture, massage (tui na), exercise (qigong), and dietary therapy. It is primarily used as a complementary alternative medicine approach. TCM is widely used in China and is becoming increasingly prevalent in Europe and North America.

One of the basic tenets of TCM "holds that the body's vital energy (chi or qi) circulates through channels, called meridians, that have branches connected to bodily organs and functions." Concepts of the body and of disease used in TCM reflect its ancient origins and its emphasis on dynamic processes over material structure, similar to European humoral theory. Scientific investigation has found nohistological or physiological evidence for traditional Chinese concepts such as qi, meridians, and acupuncture points. The TCM theory and practice are not based upon scientific knowledge, and its own practitioners disagree widely on what diagnosis and treatments should be used for any given patient. The effectiveness of Chinese herbal medicine remains poorly researched and documented. There are concerns over a number of potentially toxic plants, animal parts, and mineral Chinese medicinals. A review of cost-effectiveness research for TCM found that studies had low levels of evidence, but so far have not shown benefit outcomes. Pharmaceutical research has explored the potential for creating new drugs from traditional remedies, with few successful results. A Nature editorial described TCM as "fraught withpseudoscience", and said that the most obvious reason why it hasn't delivered many cures is that the majority of its treatments have no logical mechanism of action. Proponents propose that research has so far missed key features of the art of TCM, such as unknown interactions between various ingredients and complex interactive biological systems. 

TCM's view of the body places little emphasis on anatomical structures, but is mainly concerned with the identification of functional entities (which regulate digestion, breathing, aging etc.). While health is perceived as harmonious interaction of these entities and the outside world, disease is interpreted as a disharmony in interaction. TCM diagnosis aims to trace symptoms to patterns of an underlying disharmony, by measuring the pulse, inspecting the tongue, skin, and eyes, and looking at the eating and sleeping habits of the person as well as many other things.

Theories

The fundamental principles of TCM are based on the Yin-Yang doctrine, the symbolic way of designating opposing forces, and the five element theory that everything in the Universe is dominated and balanced by the five elements, wood, fire, earth, metal and water. The therapeutic mechanism of TCM focuses on enhancing human body's resistance to diseases by improving the inter-connections among self-controlled systems and integrating the human body with the environment. The practice of TCM involves physical therapy such as acupuncture and chemical therapy using materials originating from plants, minerals and animals, while TCM natural products may comprise one or more herbs in the form of decoctions.

In Chinese philosophy, the concept of yin yang sometimes referred to in the west as yin and yang) is used to describe how polar or seemingly contrary forces are interconnected and interdependent in the natural world, and how they give rise to each other in turn. Many natural dualities — e.g. dark and light, female and male, low and high, cold and hot — are thought of as manifestations of yin and yang (respectively).

Yin yang are complementary opposites within a greater whole. Everything has both yin and yang aspects, although yin or yang elements may manifest more strongly in different objects or at different times. Yin yang constantly interacts, never existing in absolute stasis. The concept of yin and yang is often symbolized by various forms of the Taijitu symbol, for which it is probably best known in western cultures. There is a perception (especially in the West) that yin and yang correspond to good and evil. However, Taoist philosophy generally discounts good/bad distinctions as superficial labels, preferring to focus on the idea of balance.

Diagnostics

In TCM, there are five diagnostic methods: inspection, auscultation, olfaction, inquiry, and palpation. 

Inspection focuses on the face and particularly on the tongue, including analysis of the tongue size, shape, tension, color and coating, and the absence or presence of teeth marks around the edge. 

Auscultation refers to listening for particular sounds (such as wheezing). Olfaction refers to attending to body odor. Inquiry focuses on the "seven inquiries", which involve asking the person about the regularity, severity, or other characteristics of: chills, fever, perspiration, appetite, thirst, taste, defecation, urination, pain, sleep, menses, leukorrhea. Palpation which includes feeling the body for tender A-shi points, and the palpation of the wrist pulses as well as various other pulses, and palpation of the abdomen. Examination of the tongue and the pulse are among the principal diagnostic methods in TCM.Certain sectors of the tongue's surface are believed to correspond to the zàng-fŭ. For example, teeth marks on one part of the tongue might indicate aproblem with the Heart, while teeth marks on another part of the tongue might indicate a problem with the Liver. Pulse palpation involves measuring the pulse both at a superficial and at a deep level at three different locations on the radial artery (Cun, Guan, Chi, located two fingerbreadths from the wrist crease, one fingerbreadth from the wrist crease, and right at the wrist crease, respectively, usually palpated with the index, middle and ring finger) of each, for a total of twelve pulses, all of which are thought to correspond with certain zàng-fŭ. The pulse is examined for several characteristics including rhythm, strength and volume, and described with qualities like "floating, slippery, bolstering-like, feeble, thready and quick"; each of these qualities indicate certain disease patterns. Learning TCM pulse diagnosis can take several years.

Chinese medicine therapies

1. Herbology: It is traditionally one of the more important modalities utilized in traditional Chinese medicine (TCM). Each herbal medicine prescription is a cocktail of many herbs tailored to the individual patient. One batch of herbs is typically decocted twice over the course of one hour. The practitioner usually designs a remedy using one or two main ingredients that target the illness. Then the practitioner adds many other ingredients to adjust the formula to the patient's Yin Yang conditions. Sometimes, ingredients are needed to cancel out toxicity or side-effects of the main ingredients. Some herbs require the use of other ingredients as catalyst or else the brew is ineffective. The latter steps require great experience and knowledge, and make the difference between a good Chinese herbal doctor and an amateur. Unlike western medications, the balance and interaction of all the ingredients are considered more important than the effect of individual ingredients. A key to success in TCM is the treatment of each patient as an individual. Chinese herbology often incorporates ingredients from all parts of plants, the leaf, stem, flower, root, and also ingredients from animals and minerals. The use of parts of endangered species has created controversy and resulted in a black market of poachers who hunt restricted animals. Most herbal manufacturers have discontinued the use of any animal parts from endangered animals.
2. Acupuncture: In traditional Chinese acupuncture it is thought Qi- the vital life energy found in the body’s meridians is disturbed, and an imbalance of relationships between Yin and Yang. The insertion of needles at acupoints mainly along the meridians would restore normal body equilibrium. This technique remains controversial as there are no anatomical or scientific evidence to validate the existence of Qi or meridians. A recent review claimed little convincing evidence traditional acupuncture is effective in relieving pain, and adverse events continue to be reported). However these claims are strongly contested and the counter claims that inappropriate methodology, interpretations and conclusions were reached.Acupuncture as a modality needs to be appraised, respected and require adequate proficiency gained before practice. Those who practice acupuncture approach the treatment by looking at pathology in the whole body. According to different body conditions, varied acupoints and manipulations are selected. The selection influences multiple targets and many diseases and stimulates the body to treat diseases, affecting the pathological process and improving physique. This adjustment is accomplished by the integration of the central nervous system, including cortex recombination, neural plasticity, and release of various neurotransmitters and hormones. The basis of acupuncture may be in changes in gene expression. Acupuncture anesthesia is a method used to prevent surgical pain and relieve physiological dysfunction. It is suitable for those who are allergic to narcotic drugs. Since 1958, Shanghai No. 1 People’s Hospital used it instead of narcotic drugs to perform tonsillectomies. Since then, acupuncture anesthesia has been passed from general usage to selected application. According to its clinical effect and scientific evaluation, acupuncture anesthesia is effectively used in thyroid surgery, surgery of posterior cranial fossa, craniocerebral operation, anterior cervical surgery, pulmonary resection, caesarean section, tubal ligation, and tooth extraction. It is also used in some surgeries with uncertain results like hysterectomy, caldwell-luc operation, subtotal gastrectomy, and strabismus surgery. It has not proved to provide effective anesthesia in limb surgery and perineal surgery.
3. Moxibustion: It is a traditional Chinese medicine therapy using moxa made from dried mugwort (Artemisia argyi). Available scientific evidence does not support claims that moxibustion is effective in preventing or treating cancer or any other disease, but it plays an important role in the traditional medical systems of China (including Tibet), Japan, Korea, Vietnam, and Mongolia. Suppliers usually age the mugwort and grind it up to a fluff; practitioners burn the fluff or process it further into a cigar-shaped stick. They can use it indirectly, with acupuncture needles, or burn it on the patient's skin.
4. Chinese massage therapy (referred to as tuina): It is commonly defined as the ancient healing art of fingers and strength. Tuina has been practiced in China for over 5000 years. It is a well-respected treatment modality known to be helpful and safe for a wide range of conditions. For these reasons, it is rapidly gaining international favor. Tuina involves a wide range of technical manipulations conducted by a practitioner’s finger, hand, elbow, knee, or foot applied to muscle or soft tissue at specific body locations. It incorporates many of the principles of acupuncture including the use of acupoints. For instance, tuina often uses manual techniques such as pushing, rubbing, kneading, or high-intensity, high-frequency patting to clear energy blocks along specific meridians associated with particular conditions. At present, Chinese massage therapy is widely accepted as a complementary and alternative medicine modality. Its efficacy has been demonstrated for the management of many medical and psychiatric conditions. These include, but are not limited to, failure to thrive in preterm infants, major depressive disorder, substance abuse and dependence, pain syndromes, and immune and autoimmune conditions. Massage therapy has been shown to be particularly effective for disorders of musculoskeletal origin. However, due to a paucity of high-quality studies, there remains controversy about the efficacy and effectiveness of massage. Many clinical trials suffer from inadequate sample size, low methodological quality, and/or sub-therapeutic massage dosing. 
5. Qigong: It is a holistic system of coordinated body posture and movement, breathing, and meditation used for health, spirituality, and martial arts training. With roots in Chinese medicine, philosophy, and martial arts, qigong is traditionally viewed as a practice to cultivate and balance qi (chi), translated as "life energy". 
6. Chinese food therapy: It is a mode of dieting rooted in Chinese understandings of the effects of food on the human organism, and centred on concepts such as eating in moderation. Its basic precepts are a mix of folk views and concepts drawn from traditional Chinese medicine. It was the prescientific analog of modern medical nutrition therapy; that is, it was a state-of-the-art version of dietary therapy before the sciences of biology and chemistry allowed the discovery of present physiological knowledge. It now qualifies as alternative medicine.