Welcome to my blog

Acupuncture specialist for Fertility, Facial rejuvenation, Pain relief, Fatigue.
Based at Harley Street and Kensington Central London.Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Over 25 year research and clinical experiences

Doctor who is passionate about acupuncture

I love what I do, I am good at it and I am always there for my patients. If you come and see me, you will know why I am standing out.
This blog is to introduce latest development and research of acupuncture and offer a chance of awareness of more treatment options for your condition. The blog is for information purpose only.

About Me

My photo

My specialised areas include fertility, facial rejuvenation, acne, vulvodynia, various pain conditions, chronic fatigue, neurological conditions, digestive problems

Practice contact for appointments and addresses 

Kensington: for appointments at Anamaya center Kensington (Mondays, Tuesdays, Thursdays, Fridays, Saturdays) please call at 02030110355 or email at info@anamaya.co.uk
Address: 1 Adam and Eve Mews, Kensington, London W8 6UG
2 min walk from High Street Kensington underground station

Harley Street: for appointments  at Harley Street (Wednesdays) please call ALO clinic at 02076368845 or email at info@aloclinic.com
Address
Suite 3 Harmont House
20 Harley Street, London W1G 9PH
5 min walk from Oxford Circus underground station

My background: I became a qualified medical doctor 25 years ago in Western medicine  in China and was well trained in Western medicine together with Chinese medicine in the best Medical University in Beijing, China. Particularly I was trained with Dr Zheren Xuan--famous orthopedics expert and founder of soft tissue surgery in China. Furthermore I had training in dermatology and oral and maxilofacial surgery in China. Also I had training in fertility and had research experiences in uterine smooth muscles and blood vessels in China and the UK. I am dedicated to treat patients with acupuncture and am recognised as one of the world leading acupuncture specialists.

I obtained a PhD degree in the University of Leeds in the UK.
I had post doctoral training and worked as a senior researcher in St George's hospital, London, UK.
I had frequently presented my research findings in the top international conferences in the field.
I have many publications including ebooks and articles.

I have many year clinical experiences. Over the years of practising, I have developed unique treatment approaches for infertility, skin aging, acne, vulvodynia, bladder pain, neck pain, headache, migraine, shoulder pain, back pain, fatigue, hot flushes, nerve pain, chronic prostatitis, Parkison's disease, MS, acid reflex, IBS etc to achieve best treatment results. 

My devotion and skills are highly praised by my patients. 

My eBooks

Know your ovary to get pregnant
Know fertility and acupuncture to get pregnant
Vulvodynia, is vulval pain in your mind
Energy fatigue and acupuncture
Headaches, Neck pain and shoulder pain

Sunday, 28 July 2013

Acupuncture helps women with low AMH to get pregnant

When woman is told that her AMH is too low, her fertility is compromised and she can never have children, this is terrifying and her world must be collapsed.

What is AMH? AMH is short for anti-mullerian hormone. It is a substance made by small follicles called antral follicles in women’s ovaries. These follicles are in early stage of follicle development. Once the follicles grow bigger than 8 mm, they no longer produce AMH. The more small follicles are developing, the higher AMH levels are. Vice versa, the higher AMH means there are more small follicles in the ovaries. Since AMH is produced only in smaller follicles and its blood levels are constant, AMH has been used to measure the size of the pool of growing follicles in women. AMH blood levels reflect the size of the remaining egg supply.

If your AMH is low, there are less small follicles developing in the ovaries which means your egg supply is poor. With increasing women’s age, the size of their pool of remaining small follicles decreases. Low AMH reflects poor egg supply and less chance to get pregnant naturally. Low AMH value means poor response to ovarian stimulation and low IVF success rate. Some women may have problems of recruitment and development of follicles; in this case they have fewer follicles developed and their AMH tends to be low. Women with low AMH would have less chance to have good quality eggs. So they may have difficulty to conceive naturally. Women with low AMH level are likely to have poor response to ovarian stimulation for IVF and have fewer eggs retrieved. This reduces their chance to conceive via IVF.

Low AMH is caused by recruitment problem in follicles development. All eggs in women’s ovaries are at rest, they must be recruited for developing and maturing. If the follicles do not recruit enough there are less follicles developing. For example, in the case of premature ovary failure (POF) the ovary function is damaged and there are less follicles developing, AMH value is low in women with POF. What is important factor in follicle recruitment and development? Ovary microcirculation is the key factor in follicle recruitment and development. Good circulation helps bring nutrients to the follicles and take away the wastes produced in the follicles.

AMH is associated with menopause

Anti-mullerian hormone (AMH) is produced in small antral follicles. AMH concentration reflects ovarian aging. Can it be used to predict age at menopause (AMP)? If AMH falls below a critical threshold which corresponds to follicle depletion, will this leads to menopause? There was a large population study to investigate the relationship between AMH and AMP. In this study, there were 27563 women participated. AMH was measured in these women who attended fertility clinics. They found that the critical AMH threshold vary among women; AMH became undetectable about 5 years before the occurrence of menopause. This indicates that declining population average of AMH is associated with menopause.

Does low AMH means that you cannot have children? It is certainly not. Some women with immeasurable AMH still can get pregnant.

Do you need help if your AMH is low? Yes, though low AMH does not mean that you cannot conceive at all, you chance to conceive naturally and via IVF is indeed very low. Some women are trying for years without success.

Women with higher AMH values will tend to have better response to ovarian stimulation for IVF and have more eggs retrieved. Generally, having more eggs with IVF has a higher success rate via IVF.

If AMH is higher than normal, is this a good thing? No, if AMH is higher than normal, it may not be good either. For example, women with polycystic ovary syndrome, often have high AMH. There are problems in later stage of follicle development in this case. There are problems to select dominant follicles to develop and ovulate eventually. So the follicles stay in the small size and produce more AMH. In both cases, the quality of follicles is likely to be poor and this may cause problem of conceiving.

Contraception pills decrease AMH levels

Women are trying not to get pregnant by different approaches. Contraception pills are one of the popular options. When taking the pills, does anyone ever think how the pills work? Are there any side effects of the pills? Recently Kallio S et al from Oulu University Finland studied the effect of combined contraception on antimulleria hormone (AMH) levels. There were 54 healthy women completed the study. They received combined contraception treatment for 9 weeks. The drugs were given by oral, transdermal and vaginal methods. Blood samples were taken before, at 5 weeks and 9 weeks of the treatments. They found that AMH, FSH, inhibin B, LH and E2 levels had decreased significantly in all study groups after 9 weeks of treatment. Significant reductions were already detected after 5 weeks use of combined contraceptives. This study suggests that the decrease of AMH during the use of all combined contraceptives indicates that follicle development is arrested independently of administration route of the contraceptives.

There was another study by Bentzen JG et al from Copenhagen University Hospital who compared ovarian reserve parameters between users and non-users of hormonal contraception. They compared the AMH value, the antral follicle count (AFC) and the ovarian volume in 228 users versus 504 non-users of hormonal contraception. Users of hormonal contraception had 29.8% lower AMH concentration, 30.4% lower AFC and 42.2% lower ovarian volume than non-users. AFC in all follicle size was lower in user than non-user of hormonal contraception. These findings were more pronounced with increasing duration of hormonal contraception. No dose-response relation was found.

Does acupuncture help follicles recruitment and development? During the follicle recruitment and development process, ovarian blood supply is the key. Good blood supply to follicles helps the process, because this helps provide enough nutrition to follicles and take away waste produced in the follicles. As we have already known that acupuncture improves ovarian blood flow to produce high quality of follicles and increased numbers of follicles and egg quality. This will improve the chance of conceivingnaturally or via IVF.

Case report: Low AMH, conceived naturally with the help of acupuncture

When you heard that your AMH is low and it is not possible to conceive with your own eggs. Is this really that bad? Actually a low AMH value does not necessarily mean that you cannot get pregnant naturally. You need to make more efforts than anyone else. Here is a story that a woman got pregnant naturally with low AMH. This is a simple story, but you can see the efforts that she made under the pressure of uncertainty and the lack of time.

There was a 39 year old woman who had been trying to conceive for a year without success. A fertility test found out that her AMH was very low (below 1) which was nearly immeasurable. She was determined to get pregnant naturally. She had paid attention to her diet and made sure her diet was healthy. She also had moderate exercise to keep healthy. By chance she found out that acupuncture could help and she kept going to acupuncture treatments on weekly basis. She made great effort and really believed herself. By the end of six months of acupuncture treatments, she got pregnant naturally.

References
Kallio S et al Fertil Steril (2013) 99:1305-10
Bentzen JG et al Reprod Biomed Online (2012) 25: 612-9
Dolleman M et al J Clin Endocrinol Metab (2013) 98:1946-53

Thursday, 4 July 2013

Acupuncture provides hope of conceiving for women with premature ovarian failure

When women reach age 45, their ovaries may stop functioning. There is no egg supply and no ovulation. Hormone levels are changing. This is so called menopause. The signal for arrived menopause is stopped period which indicates the end of fertile life in a woman. This is a stage that every woman has to go through. For some women, their ovaries stop working before 40 years old. This is called premature ovarian failure (POF), or primary ovarian insufficiency (POI), or premature menopause or hypergonadotropic hypogonadism. POF is the result of premature exhaustion of the follicle pool or follicular dysfunction, such as due to mutations in the follicle-stimulating hormone (FSH) receptor. This is a common condition, affecting 1-2% women younger than 40 years of age and 0.1% of women younger than 30 years of age. The cause for POF could be genetic, because there is family history found in 10-20% women with POF. It also could be due to poor ovarian blood supply. Autoimmune damage could contribute to the cause of POF. Ovaries could be damaged by cancer therapies.

The main symptoms of POF include no regular periods, low blood oestrogen level and high FSH under the age 40. Anti-Mullerian hormone (AMH) level is low. Oestrogen is produced by follicles and its blood level is low if follicles are short of supply or dysfunctional. FSH is produced in the pituitary gland at the base of the brain and it stimulates follicles growing. If a woman is running out of eggs in ovaries in the case of POF, resulting in low level of oestrogen, the pituitary gland will work hard to produce more FSH in order to stimulate ovaries to make more good eggs. AMH is a substance produced only in small ovarian follicles and its level is quite constant correlating strongly with the number of growing follicles. Since this hormone is not dependent on hypothalamic-pituitary-gonadal axis function and decreased to undetectable level at menopause, it could potentially help assess remaining function of ovaries and egg supply.

Women with POF could experience menopause symptoms, for instance hot flushes, night sweats and vaginal dryness, similar to those going through a natural menopause. POF could result in many health problems, such as osteoporosis, heart diseases etc. Associated with the development of POF is the loss of fertility, which in most cases is due to the absence of follicles, and in other cases the inability of remaining follicles to respond to stimulation. For most women, there are no obvious signs before the stop of periods. Most women have a normal period history, and possibly fertility before the start of POF symptoms. A common presentation is for women to fail to resume period after a pregnancy or after stop of taking oral contraceptive pills. For most of women, it is a deeply upset diagnosis not only with unpleasant symptoms, but also with infertility. It may have a huge psychological impact on those diagnosed this condition. Infertility is a significant issue for most women with POF, though many women may ovulate at some points, this cannot be predicted with any reliability.

There are treatments that can help some of the symptoms; however women with POF are unlikely to get pregnant without treatments because their ovaries do not work properly. There is no proven medicine to improve a woman’s ability to get pregnant, if she is diagnosed with POF. A number of treatment regimens have been evaluated with the aim of restore fertility; however, treatments with clomiphene, gonadotrophins, GNRH agonists or immunosuppressants do not significantly improve the chance of conception and are not used. Use of donor eggs is only a reliable option from Western medicine point of view. Is there really nothing you can do apart from accepting that you will no longer have a chance to have a child naturally with your own eggs? Why not try acupuncture? There is a chance to conceive naturally with acupuncture treatment.
According to traditional Chinese medicine (TCM) theory, POF is mainly caused by kidney qi deficiency. Liver and spleen qi deficiency may also contribute. Qi deficiency causes blood stagnation and blockage of channels resulting in ovaries losing function. Acupuncture unblocks the channels and restores qi flowing and blood supply to ovaries. From western medicine point of view, acupuncture improves function of hypothalamic-pituitary-ovarian axis regulating blood hormone levels; acupuncture increases ovarian blood flow improving ovarian function. Acupuncture also regulates nervous system function.

There was a case report in Chinese acupuncture website about effectiveness of acupuncture treatment for POF. There were 76 patients aged from 26-40 with POF diagnosis for 1-9 years. These cases were treated from 1990-1996. Acupuncture treatment was given for 6 months. 68% patients restored normal period, ovulation or pregnancy. FSH level decreased to normal and oestrogen level increased significantly.

Recently research provided evidence of effectiveness of acupuncture on POF. Kehua Zhou et al investigated the effects of acupuncture on FSH, oestrogen (E2) and LH in women with POF. They also studied the menstruation changes in these women. They recruited 11 women with diagnosed POF for 4 months to 10 years. Ages of these women were from 25-39. These women had no menstrual period for at least four months or longer. They had high FSH over 40 iu/l. Before acupuncture treatment, they stopped all medications that possibly affect hormones. After the treatments, there was three month follow-up. Assessments were done before the treatment, at the end of three month treatment and at the end of three month follow-up. They found that after acupuncture treatment, E2 increased while FSH and LH decreased which last at the end of three month follow-up. 10 out of 11 patients resumed menstruation; 9 of them still had menstruation at the end of follow-up. Other symptoms such as night sweating, hot flashes and mood swings were reduced during acupuncture treatments and at the end of follow-up.
The advantage of acupuncture treatment for women with POF is that it is not only effective for improving symptoms caused by POF, but also increases fertility.

References
http://www.wfas.org.cn/lunwen/wfas10/200709/1055.html
Kehua Zhou et al Evid Based Complement Alternat Med (2013) 2013: 657234 Published on line 2013 Feb 28