Acupuncture & Infertility Flashcards
TCM Pattern for absence or irregularity of ovulation?
Kidney Xu
TCM pattern for blockage of Fallopian tubes
With possible Fire poison and stasis of Blood?
Damp Heat
TCM pattern for uterine myxomas?
Blood stasis, phlegm.
TCM pattern for pelvic adhesions?
Damp heat, Blood Stasis.
True or False:
The Du Mai is responsible for follicular development, ovulation and corpus luteum development.
True: along with the Ren and Chong Mai
True or False: The Du Mai is responsible for the expulsion of the ovum?
True
True or False:
Du, Ren, Chong are all Yin?
False
Du = Yang
The easiest TCM pattern to treat for infertility?
Blood Deficiency
“Cold in the Uterus” typically occurs in which phase of menstruation?
Luteal or Progesterone Phase
(not enough Yang to warm the uterus)
Tx: Warm the uterus (can also be Phase 3)
True or False:
Nourish Qi in the follicular development stage (2)?
False: Tonify Kidneys and Nourish blood
Which phase is the follicular development phase?
Phase 2
Describe what happens during Phase 3 - Ovulation?
- Decline of Estrogen
- LH hormone surges
- Yin turns to Yang (temp. increase)
- Ovulation (egg is released)
- Egg implanted in uterine wall
- LH triggers progesterone
Acupuncture TX principle for Phase 3 - Ovulation?
Nourish and Invigorate Blood
Which stage is most YANG?
Luteal Phase (4) (Qi or Yang stage. One week post ovulation yang reaches it's peak)
How many days does the corpus luteum last?
14 days
If spotting occurs just prior to when period is due..what is the TX principle?
Strengthen Qi.
Spotting due to lack of Qi. This spotting is not considered Phase 1 b/c period has not really started.
What is progesterone responsible for in terms of a woman’s menstrual cycle?
- Builds lining of uterus in Luteal Phase (4)
- Tells pituitary to stop producing FSH
- Levels remain high for one week and drop off if pregnancy is not achieved
What hormone triggers progesterone?
LH (triggers Corpus Luteum to secrete progesterone Phase 3)
In which phase does LH surge?
Phase 3 - Follicular Maturity and Ovulation
Which is the shortest phase of menstruation?
Phase 3 - Follicular Maturity and Ovulation
Which phase it the most Yin?
Phase 2 - Follicular Proliferation or Development Phase
Which Phase is the Blood Phase?
Phase 1 (menstruation)
What is acupuncture TX principle in Phase One?
Invigorate Blood, and regulate menstruation. Move blood if too little. Stop blood if too much.
Acupuncture TX principle in Phase Two - Follicular Development?
Tonify Kidneys (and Liver), Nourish Blood (and Yin)
What happens in days 1-4?
Menstruation
What Phase is the Follicular Development Phase?
Phase 2
In which phase does the pituitary begin making FSH and LH hormones to stimulate growth of new follicle?
Begins at Phase 1 (menstruation) and continues in Phase 2 (follicular)
How long does Phase 2 continue?
Until ovulation (around day 14)
What 3 Excess patterns can cause fallopian tube abnormalities?
- Blood stasis
- Blood Heat
- Dampness
What 2 Deficiency patterns can cause hormonal disturbances of ovulation?
- Kidney Def.
2. Blood Def.
What TCM organ controls the wax and wane of yin & yang?
Kidneys
What EV(s) are the basis for follicles, ovum and corpus luteum?
Ren and Chong
What Ev(s) are the basis for follicular & corpus luteum development and ovulation?
Du, Ren, Chong
What TCM pattern is a uterine myoma?
Blood stasis or Phlegm
(myomas do not respond well to acupuncture if large) Affects Uterus and hormones
True or False: These conditions respond to acupuncture.. 1. Adhesions 2. Malformations 3. Hypoplasia 4. TB of uterus
False
Secondary infertility in western medicine is considered…?
Prior pregnancy
True or False: These three organs are responsible for fertility? 1. Hypothalamus 2. Pituitary 3. Ovary
True: they all release vital hormones
True or False: These three organs are responsible for ovulation? 1. Hypothalamus 2. Pituitary 3. Ovary
True: they all release vital hormones
Stress can primarily affects which gland?
- Hypothalamus
- Pituitary
- Ovary
- Hypothalamus
Tumors can affect the function of which gland?
- Hypothalamus
- Pituitary
- Ovary
- Pituitary
Absence of FSH receptors can affect the function of which gland?
- Hypothalamus
- Pituitary
- Ovary
- Ovary
True or False:
cervical mucus can be unreceptive to sperm?
True (considered a hormonal factor in infertility)
True or False:
Hyperthyroidism can cause infertility?
True: it creates Blood heat affecting LV & HT
True or False:
Adhesion to the endometrial can cause infertility?
True
TCM definition of infertility?
2 years
True or False:
During pregnancy Blood, Yin, Yang and Jing are all consumed?
False:
Only Blood, Yin and Jing
Prolonged scanty periods?
Kidney Yang Def.
Scanty pale delayed periods?
Blood Deficiency
Periods that are early, short, heavy (2x per month) are due to which TCM pattern?
Blood Heat
Periods that are early, scanty and with light blood are due to which TCM pattern?
Kidney Yin Deficiency
Irregular periods with dark blood and clots?
Blood stasis
Irregular periods with emotional issues?
Liver Qi Stagnation
Which TCM pattern?
Absence or irregularity of ovulation?
Kidney Deficiency
Which TCM pattern?
Blockage of fallopian tubes?
Damp Heat
Uterine Myomas?
Blood stasis or Phlegm
Pelvic Adhesions?
Damp Heat, stasis of blood
Which phase involves the atrophy of the corpus luteum?
Menstruation. Phase One
TX principle for Luteal Phase?
Tonify Kidneys, Consolidate the Ren and Chong Mai
Which phase? Pre-menstrual phase, corpus luteum develops and secretes progesterone.
Luteal Phase
Cold in Uterus: Primary or Secondary infertility?
Primary
TCM pattern for Delayed cycle, scanty period, small clots, painful.
Cold in Uterus
Irregular periods, delayed, mid cycle pain, discharge.
Dampness on Lower Jiao
Most difficult infertility pattern to treat?
Dampness (polycystic ovarian disease)
What are the four phases of menstruation?
- Menstruation
- Follicular Development
- Ovulation
- Luteal
What are the four TCM phases of menstruation?
- Blood Phase
- Most Yin Phase - Blood and Yin Empty
- Yin to Yang Phase - Blood and Yin fill Ren and Chong
- Most Yang Phase - Yang Qi and Live Qi Rises
What hormone correlates to each phase?
- Estrogen / LH, FSH begin
- Estrogen / LH, FSH
- LH and FSH Peak / Estrogen declines / Progesterone begins
- Progesterone
What are current WHO standards for male infertility?
- Volume more than 1ml
- Count: more than 20 mill per ml
- Motility: more than 50%
- Morphology: more than14%
Prolonged illness and taxation causes what TCM pattern?
Qi and Blood Def.
Improper Diet causes what TCM pattern?
Damp Heat pouring Downward
Phlegm Turbidity causes what TCM pattern?
Blood stasis obstructing semen
Congenital Deficiency causes what TCM pattern?
Deficiency of Essential Qi.
Debilitation of Life Gate Fire causes what TCM pattern?
Essential Qi deficiency
What organ stores essence and governs reproduction?
Kidney
Tian Gui refers to what in men?
Seminal fluid
menstruation in women
What needs to be abundant in order for Tian Gui to arrive?
Kidney Qi
Tian Gui enters what?
Ren and Chong
Excessive sexual activity can lead to what TCM pattern?
Essential Qi Deficiency Cold due to Debilitation of Life Gate Fire
Excessive consumption of alcohol, greasy food damages the SP & ST, especially in overweight and obese
can lead to what TCM pattern?
Phlegm Turbidity and Blood Stasis Obstructing Semen
Prolonged illness or physical injury can lead to what TCM pattern?
Phlegm Turbidity and Blood Stasis Obstructing Semen
Excessive consumption of alcohol or greasy and spicy foods damages SP and ST causing damp-heat and phlegm that pours downward affecting the quality of seminal fluid
Damp-Heat Pouring Downward due to Improper Diet
Essence is derived from?
Blood
Qi and Blood may become deficient due to insufficient Spleen Qi, SP & ST damage, constitutional deficiency or poor recovery from illness
- what TCM pattern?
Qi and Blood Deficiency due to Prolonged Illness of Taxation
Essentially, infertility results from what?
Essentially: infertility results from Kidney Qi deficiency with a failure of Yin essence transformation
The key to male infertility lies at what organ’s deficiency?
Kidney
Deficiency at the Root, Excess at the Branch
Root
Root Tx: Kidney and Spleen
Branch Tx: Invigorate Blood, transform stasis, clear heat, disinhibit dampness, transform phlegm
For male immune infertility ASA (anti-ssperm antibodies what two organs do yo treat?
Kidney and liver
(invigorate blood, free the collaterals)
BL 18, BL 23, LV 3
TX principle for Abnormal Semen?
Tonify KD and essence, regulate Yin and Yang CV 4, KD 12, SP 6
Low Sperm Count?
Fortify SP, tonify KD, invigorate blood, dispel dampness BL 23, CV 4, BL 20, ST 36
Is male infertility one issue or many?
Many. 16