High FSH, low egg quality and quantity.
By Dr. Daniel Lee
The quality of the eggs depends on two things: the integrity of the DNA and the environment in which they were developed during the follicular phase (the first half of the cycle). The integrity of the DNA is genetically predetermined and is subject to damage by chemicals we are exposed to over the years, as well as the degradation with age. Even though no improvement can be made on the integrity of the DNA, there is a way with acupuncture and herbs to improve the environment in which the follicles develop.
Introducing Acupuncture for Infertility Protocol.
This protocol involves maximizing the blood flow to the ovaries to ensure a constant and steady supply of hormones and nutrients that is needed for the normal growth and to reduce self-immune attacks on the ovaries and uterus. This goal is accomplished by combining accurate diagnosis and effective treatment with acupuncture and herbs.
This protocol is similar to the principle we use daily in running the landscape irrigation system for a house. If our goal is to have greener grass in the backyard, we first need direct more water flow to the backyard. That means increasing the watering time or turning up the flow volume for the backyard. This also means reducing the watering time and decreasing the flow volume to the front yard, if the water supply is limited. When the egg-bearing follicles are bathed with constant, uninterrupted supply of hormones, nutrients free of auto-immune attacks, they will flourish. Among the infertility patients who have high FSH or are advanced in age and have poor egg-production, some unfortunately have DNA issues that can’t be helped. My heart goes out for them. However, some of these patients can see an improvement when the Acupuncture for Infertility Protocol is applied. The best way to find out if an infertility patient can improve the egg quality or quantity is to try this Protocol. If it works, the patient will have a baby naturally or in conjunction with IUI or IVF. If it does not work, the patient will have the comfort of knowing that she has done her best in giving her eggs the best environment to grow and that it may be time to move on to the next step such as donor eggs.
The following are a few examples of applying Dr. Lee’s Acupuncture for Infertility Protocol on his patients in year 2004.
High FSH=33, Age=40, Pregnant with Acupuncture and Herbs Alone.
(More cases of high FSH listed below)
A 40-year old female with a high FSH of 33. She failed 5 IUI and one IVF cycles. She was on day 3 of stimulation for her first IVF when she was first seen in my office. She had no previous acupuncture treatment to normalize her imbalance and was asked not to take herbs by her Reproductive Endocrinologist. Since acupuncture work together to keep the patient balanced, by taking out herbs, patients’ bodies will not receive support the other six days of the week, when not receiving acupuncture. Therefore, her next IVF cycle was not successful. Because of the high FSH and her age, 2 REs advised her that she would have less than 1% chance of pregnancy with IVF using her own eggs. She decided to try acupuncture and herbs alone to reduce her high FSH. After 14 more treatments and taking Chinese herbs from Dr. Lee, she was pregnant within 3 months. She was discharged at week 15. She had a full term pregnancy and gave a birth to a girl weighing 8 lb.
P.S. Weeks before her positive pregnancy test, she had made many inquires about donor eggs.
Follicle Quantity Tripled from 3 to 12.
This is a 41-year old female with FSH of 10.6. She failed 3 IUI cycles. She then tried 3 IVF cycles, but each time it was converted to IUI due to low follicle count of 3. Patient was given choice of using acupuncture with IVF or IVF only with donor eggs. She chose acupuncture with IVF. After 10 acupuncture treatments with Dr. Lee along with Chinese herbs for 5 weeks starting from mid March 04, her balance was restored in later April 2004. She took one month off then restarted 4 more acupuncture treatments during her next IVF stimulation period. To her surprise, she had 12 follicles (3 times more follicles than at in all three previous attempts) over 20 mm, with a uterine lining over 15 mm at the time of retrieval. There were 7 eggs retrieved, of which 6 were mature and 5 fertilized. Three days later, she had 4 embryos with grade A and one grade AB. Two weeks later, she was pregnant. She continued with 8 more acupuncture treatments to prevent miscarriage. She is still happily and securely pregnant at week 12 when she was discharged from acupuncture treatment.
Fertilization Rate Increased from 40%~50% to 78%.
This is a 33-year old female with FSH of 11. She failed 3 IVF cycles. She ended up with only 3 embryos out of 6 mature eggs (50%) in her first and third IVF cycles. She had 2 embryos out of 5 mature eggs (40%) in her second IVF cycle. After 8 acupuncture treatments along with Chinese herbs from Dr. Lee for 2.5 months starting from mid May 2004, her balance was restored at the end of July 2004. At the same time period, her husband also had 6 acupuncture treatments to improve sperm quantity and quality. In her next IVF cycle following Acupuncture for Infertility Protocol, she had 9 eggs retrieved and out of which 7 were fertilized, or 78% fertilization rate. All 7 embryos survived to day 3 with 6 to 10 cells in each and grade A+ to B-. She got pregnant with twins.
Unilateral Ovarian Deficiency:
Acupuncture helps to balance the size of follicles in different ovaries.
To increase the chance of pregnancy, it is better to have 8 to 25 follicles during IVF stimulation. However, the number of eggs that are mature depends on the uniformity of the size of the follicles. If one ovary has fewer and smaller follicles than that in the other ovary during IVF stimulation, then the patient has what Dr. Lee calls UOD or unilateral ovarian deficiency. Over the years in treating infertility, Dr. Lee has developed a unique acupuncture technique and acupuncture point combination called “Selective Ovarian Follicle Acceleration” or SOFA to speed up the development of follicles in the deficient ovary in order to catch up with the rest.
Here is an example. A 33-year old female had 4 acupuncture treatments to correct her imbalance prior to her third IVF. On day 4, the ultrasound showed 3 medium size (7,8,10 mm) follicles in the right ovary and only 1 (6 mm) follicle in the left ovary. Dr. Lee gave the patient an acupuncture treatment with SOFA technique on day 6. The ultrasound done on day 8 showed the left ovary had produced additional 6 follicles (11, 12, 12, 13, 13, 14, 15 mm) while the right side has only increased by 1 additional follicle. She ended up retrieving 11 eggs with 9 mature and 8 fertilized. All 8 embryos turned into blastocysts on day 5.
The bottom line: Among the “sub-responder” patients, those with sub-optimal blood circulation to the ovaries or uterus due to either stress or other internal imbalance, can respond better in future natural cycles or with IUI/IVF cycles with optimized blood flow, ensuring the delivery of the natural or injected hormone to the ovaries and/or uterus after applying the Acupuncture for Infertility Protocol in advance.
More cases of high FSH
High FSH: 23.6, Age: 38
Pregnancies with Acupuncture and herbs only
Pregnancy date: 5/30/08
A 38-yr-old patient from Orange County who has a 2-year-old son came to see Dr. Lee on 1/26/08. She wanted to try acupuncture treatments and Chinese herbs for the 2nd child. Here is her history.
—She had failed 5 cycles of Clomid .
—high FSH of 23.6
—Right tube 100% blocked.
—Left ovary never showed any follicular growth.
Dr. Lee found that there was moderate internal imbalance in her body and right away, started treatments and herbs designed for her particular case. But, her IUI was to start the next month. With limited time to prepare her condition, she failed the IUI cycle. She then wanted to try Dr. Lee’s acupuncture and Chinese herbal treatment. Her RE thought that the patient was “wasting her time and money” because her history of lack of follicle growth in the left ovary and the only functioning right ovary was paired with a blocked fallopian tube. Since Dr. Lee had helped other patients with similar cases (in fact he has seen even a worse case of ovulation occurring in the ovary with tube removed on the same side), the patient decided to continue the treatment with Dr. Lee. Two months later, with only 8 more treatments after failed IUI cycle, she got pregnant.
She gave a birth to a healthy boy 7 lbs 13 oz 20 1/2” on 1/31/09.
High FSH=31, Age=38 with blocked tubes.
A 38-yr-old infertility patient from Hacienda Heights, failed to get pregnant after trying on their own for over 3 years. She previously failed one IVF. She has had 2 laparoscopies to remove large (4~5 cm) chocolate cysts and severe endometriosis in the past 10 years. Her HSG done 6 years ago showed 100% blockage of the right tube and partial blockage of the left tube. Her FSH was 31. She had been to many acupuncturists and herbalists without success. She had been on birth control pills to manage her severe menstrual cramps. This patient started acupuncture and herbal treatments designed for her special case by Dr. Lee at the end of April 2005. After three weeks, her day 3 FSH was, 31 still high, and E2 was 13. To get pregnant, she needed to get off the birth control pills. So she did. She was surprised to find out that she had less menstrual pain without BCP, just 3 days of heavy menstrual bleeding in mid-June 2005. But, her next cycle, that should have started in mind July, never came. She was pregnant. She had only 9 acupuncture and herbal treatments with Dr. Lee in two and a half months.
High FSH= 32, Age= 36 pregnant naturally.
A 36-yr-old infertility patient from Orange County who had one child naturally 2 years ago but could not get pregnant again due to high FSH which had been climbing from 15 in Jan 06 to high FSH of 23 in Feb 06. She had only 3 acupuncture and Chinese herbal treatments before she tested again in March 06 which was 32. She was told to consider donor eggs by her RE. She has faith in Dr. Lee’s treatments and continued the treatments despite of the continued high FSH. One month later with 6 more treatments, her FSH dropped down to 12.7 (E2=20.7) in April 06. With 6 more treatments, she got pregnant naturally on 5/15/06. She is now on weekly acupuncture treatments to prevent miscarriages.
Lesson learned: Don’t panic with high FSH of 23 or 32. One still has chance of getting pregnant given enough time to get body normalized. In her case, it took 9 treatments (which is very fast) to get her FSH down without increasing Estradiol. Additional 6 more treatments to get her pregnant naturally.
high FSH=33, Age=41 with only one ovary
A 41-yr-old patient from Orange County failed 2 IVF cycles prior to seeing Dr. Lee. Both of her tubes and one of her ovaries were removed due to hydrosalpinx and scar tissue formations. So IVF was the only way for her to get pregnant. But, with high FSH of 33, her follicles did not grow with IVF stimulations. She was determined to get her body optimized before she attempts her 3rd IVF. She started her FSH reduction treatments on 9/21/05 with acupuncture and non-estrogenic Chinese herbs. One month later, her day 3 FSH dropped down to 19 then 16, 18, 12, 12.5, 9.2 and finally in March 06 down to 11 (with E2<50) after 19 treatments in 6 months. She had additional 5 treatments of acupuncture with Chinese herbs with her 3rd IVF. She got pregnant on 3/31/06. She is on weekly treatment program with Dr. Lee to prevent miscarriages.
Critics may say that anyone one can reduce FSH just by giving patients estrogen. But, that will suppress growth of follicles and minimize the chances of pregnancy. The reductions of FSH achieved by Dr. Lee’s method maintain the normal follicular growth and ovulation which are essential for fertility, whereas reductions of FSH by giving estrogen can not.
Lesson learned: Get prepared first before starting IVF. When the body has a chance to get optimized, it will do what you want naturally. Do not force yourself to get pregnant. Instead, focus your energy on the preparation between IVF cycles. When your body is ready, pregnancy will be achieved even with previous history of high FSH of 33 and age of 41 with only one ovary.
High FSH=35, Age=38,
Pregnancy date: 12-5-08
—Failed 2 IVFs, 2nd IVF canceled due to lack of follicular growth.
—RE’s solution was donor egg.
She started with Dr. Lee on 9/1/07. Her high FSH dropped down to 11 in Dec 07, then 6.5 in Nov. 08. She wanted to try natural intercourse. But, her husband’s sperm failed to improve. Dr. Lee recommend to try IVF with her own eggs. She had only 2 eggs retrieved from 3 follicles and only 1 fertilized. She was able to get pregnant and stay pregnant. At time of this update on 5/7/09, she was about 25 weeks pregnant.
Bottom Line: High FSH does not always mean that eggs will never be good again.
High FSH=56, Age=40,
1-10-06 update A New Record. Pregnant naturally with a high FSH of 56 A 40-yr-old infertility patient from Orange County who had tried on their own for 3 years without success. She came to see Dr. Lee in early Aug. 2005. She had not had a period for about 4 months with a high FSH of 56. She was in menopause with hot flashes and sweating so severe that her clothes needed to be changed every 2 hours at night. She came 2 to 3 times a week and by the end of Sept. 05, the hot flashes had began to decease. In early Oct. 05 her high FSH was dropping but only slightly (49.4). She continued acupuncture and herbs 3x/wk and by early Nov. 05, the hot flashes were mostly gone. Her FSH got down bellow 25. She happily got her 1st period on 11-5-05 after missing it for 6 months. She still comes at rate of 3x/wk and taking herbs. By early Dec. 05, her FSH was at 8. She got pregnant NATURALLY on 1/10/06. Bottom line: With Dr. Lee’s individualized and effective acupuncture and Chinese herbal treatments, a high FSH number does not always mean one is at the end of the egg reserve. One still has the chance of achieving pregnancy with her own egg.
High FSH=95, Age=39,
8-28-07 update New Record, FSH=95, Pregnant naturally!
A 39-yr-old infertility patient from Ventura County who had been having high FSH ranging from 23 to 25. She failed 2 IUI prior to seeing Dr. Lee on 5-13-06. Dr. Lee found that she had two major areas of imbalance and started acupuncture treatments and herbs designed for her particular case right away. After 18 acupuncture treatments in 3 months, her high FSH got down to 14.4 and E2=45. 8 more treatment later, she got pregnant naturally. But, due to chromosome abnormality, she miscarried at 9th week. Due to stress and miscarriage, her FSH shot up to 95. She continued with acupuncture and herbs for 8 more times. As of 8-4-07, she is pregnant again naturally and is getting her weekly miscarriage-prevention acupuncture treatments.
Note: Not every high FSH patient gets pregnant. There are cases of high FSH of 66 to 125 that did not respond to the acupuncture and herbal treatments.