Complementary Medicine & Fertile Wellness

Need an Acupuncturist who Specializes in Infertility?

So you want to find an acupuncturist who specializes in the treatment of infertility. So too do thousands of others suffering with infertility. Here’s the catch though; there are very, very few. There are many, many acupuncturists who treat infertility patients but this is analogous to me doing an ivf procedure; I wouldn’t know how to because I don’t have the necessary training.

A chiropractor specializes in treating musculoskeletal disorders, a podiatrist specializes in treating foot disorders, an ophthalmologist specializes in treating eye disorders and a neurologist specializes in treating nerve disorders.  Each one of these ‘specialists’ took classes that made them ‘special’ in their area of study.  I am using the word ‘special’ here to denote ‘expert’.

Upon visiting most print advertising by acupuncturists you will see that they ‘specialize’ in everything from acne to zollinger-ellison syndrome. These A to Z acupuncturists by the sheer fact that they say they treat all of these disorders is a sure tip-off that they do not specialize in any one of them. 

Remember, it takes years of continuous study and clinical practice to be a specialist; it takes seeing hundreds or thousands of patients with the same type of disorder to become an expert in all the subtleties and shades-of-gray associated with the disorder in which the practitioner specializes.

How can you tell if the acupuncturist you call is really a specialist in infertility?

When you call the clinic, ask the nurse/secretary or practitioner what they specialize in. They will answer you by asking you what your physical complaint is. Don’t tell them. Simply ask them again: “what is your specialty?”  This is the first step.  After they tell you (very rarely!) that they specialize in the treatment of infertility, visit their web-site. Once there, you should see nothing other than text and topics associated with infertility. If you see this to be the case (very, very rarely!), then you are in luck.

How can you tell if the acupuncturist is good?

You may want to know the following:

a.       How long have they been in practice?

b.      Are they licensed and Board certified in acupuncture and herbal medicine?

c.       What kind, and how much continuing education have they had in the topic of infertility?

d.      Have they written on the subject?

e.      Do they have a good relationship with one or more reproductive endocrinologists?

f.        Can they give you a reproductive endocrinologist as a personal reference?

g.       Are they available to treat you on the weekends if your IVF embryo-transfer occurs on a week-end. If not, can they guarantee coverage?

How Can You Find a Specialist?

There are not many options. The best one available at this time is www.aborm.org.  ABORM, or The American Board of Oriental Reproductive Medicine is an organization that those going through fertility challenges has been in need of for years. 

The purpose of the Board is to help educate and certify acupuncturists wishing to specialize in treating infertility cases.  The acupuncturists must take course work and sit for a rigorous examination. Upon passing the exam they receive the prestigious title of FABORM, Fellow, American Board of Oriental Reproductive Medicine. This nomenclature indicates a fairly high level of competence in the specialty of infertility and clinical applications of treatment.  Anyone who is certified by the ABORM is a legitimate infertility/acupuncture specialist.

Other options

One option that I provide to patients throughout the country and the world is telephone consultations. After conducting a telephone consultation with a patient, I can do several things: 1) create an herbal medicine prescription for the patient and, 2) create an acupuncture treatment protocol for the patient, and, 3) interface with their acupuncturist (even and especially if they do not specialize in the treatment of infertility) and manage the case from afar. The acupuncturist will, in essence, be my hands. I confer with the patient on a monthly basis to re-evaluate changes in their clinic status, change their herbal medicine prescription and alter the acupuncture protocol if necessary.

Because the infertility ‘market’ is booming, more and more opportunists are finding their way into the market place. But beware, it takes more than one saying that one is a specialist to be one.

Find Out More

Dr. Berkley's New Post-Pregnancy Treatment Protocol

For the past ten years I never needled the abdomen of a pregnant woman for fear of causing miscarriage. This method of behavior stems in part from fear of over-stimulating blood flow to the embryo or placenta. This thinking as I have recently discovered, is incorrect. It has taken me ten years of study and research to enable me to fully understand what is happening in the uterus after a successful pregnancy and why abdominal acupuncture for the first three months of pregnancy is not only safe but serves significantly to prevent miscarriage.

At the luteal phase or secretory phase of the menstrual cycle the predominant hormone is progesterone. Progesterone is created from the follicle that has ovulated the mature egg. This follicle is now know as the 'yellow body' or corpus lutuem. The corpus luteum, under the influence of luteininzing hormone which emanates from the anterior pituitary in the brain secretes progesterone. This action is done to enable the uterine lining to be amenable to a successful embryo implantation and pregnancy. If pregnancy is not successful, the corpus luteum becomes atretic (dies) and progesterone levels diminish and menstruation starts.

When a woman does successfully become pregnant, the LH which is required to maintain high levels of progesterone (P) no longer comes from the anterior pituitary gland in the brain. It comes in fact, from the developing blastocyst itself. The blastocyst (developing baby), secretes HCG or Human Chorionic Gonadotropin which has a very similar molecular structure to LH and the HCG causes the corpus lutum to continue to secrete P until the placenta is fully formed at which point the placenta itself secretes appropriate amounts of P to help maintain pregnancy.

So, if the developing blastocyst is repsonsible for secreting HCG to keep itself alive it made sense to me to use very few and well placed needles in the abdomen to gently stimulate blood flow to the blastocyst so that P would continue to be secreted from the corpus luteum.  This, in my opinion is one of the major ways that miscarriage prevention can be achieved with acupuncture. I am the first one to arrive at this idea and have been using it with great success.

After 6 or 7 weeks the placenta is formed and it secretes P. The corpus luteum is no longer necessary. But, one of the major causes of miscarriage is innapropriate blood flow to the placenta. But clinically what does this mean. Blood carries oxygen, hormones and nutrients to the placenta and excretes dead cells from it. These dead cells are called 'debris'. By continuing to use abdominal acupuncture, we continue to stimulate (gently) blood flow to the placenta maintaing its ability to secrete P, estrogen, human placental lactogen, relaxin and other hormones necessary for the maintenance of a healthy pregnancy and milk production after giving birth.

I am constantly studying Western medicine and anatomy and physiology and translating my findings into a Chinese medical model which serves to increase a useful knowledge base to help couples achieve pregnancy. However, achieving pregnancy is only half the battle. The other half is maintaining a healthy pregnancy.  The focus of many acupuncturists is to help their patients become pregnant. This too is my first goal, but only my first. My second goal is to maintain a viable pregnancy and this is where my research and studies are now taking me. 

I am pleased to say that at this point our successful pregnancy cases are remaining in the 30 to 40% bracket but our take-home-baby rates are climbing. It is to early to publish numbers but that will come over time. Suffice it to say, this new Berkley Center protocol is working wonders for chronic miscarriers.

All the best on your journey!

Dr. Berkley

Read More

Nutrition

We are pleased to welcome Kathie Alli, our Holistic Health & Nutrition Counselor. Kathie is a graduate of the Institute for Integrative Nutrition here in New York City. 

Kathie is now helping patients at the Berkley Center for Reproductive Wellness achieve their general health goals as well as their fertilily health goals.  Of course one can not exist without the other.

Kathie brings her nutritonal experience, compassion, love and a very nurturing and compassionate approach to patient care.

We are proud of her achievements and we know that she will be an enormous asset to those wishing to improve their physical and emotional health through dietary and life-style changes. Kathie is highly qualified to help make your goals realities!

She offers a free mini-consultation for those wishing to find out more about her program.

Kathie can be reached at 877-965-BABY. Find out more at berkleycenter.com

Great People Make Great Companies!

It is imperative that any business hire the absolute best talent possible. Though this goal is well known, achieving it is quite difficult.

I want to say it out loud that I have been blessed by having the good fortune of making the above goal a reality.

1. Julia Wannamaker, my General Manager, has completely turned my practice around. She has taken charge of marketing, patient relations, accounting, hiring, training and motivating the whole team. She is a whirlwind lady who gets things done!  She is talking about leaving to go down south. Anyone who reads this, please call her at 212-685-0985 and ask her to stay! Thank you Julia for your amazing contributions.

2. Kathi Alli, our NEW Holistic Health & Nutrition Counselor saw her first patient today at The Berkley Center and I am so proud of her. She is a brilliant nutritionist, filled with love and joy and an unending desire to help patients achieve their dream of having a baby. I welcome you Kathi to this new position and I know that you are going to be great and so too are your patients!

3. Eileen Gallagher, our NEW Scheduling Coordinator, is doing so, so well. She is very gentle, caring and supportive on the phone and in person. She makes every patient feel right at home. She has her own inimitable charm and everyone is crazy about her. I am too!

4. Karen Kelly, Maya Abdominal Massage therapist and Doula has been with the Berkley Center for quite sometime now. I can tell you this: people walk into her office stressed and leave walking on a cloud! Karen has helped many women re-align their uteri whether retro or anteverted. She has help patients reduce fibroids and increase endometrial lining thickness. Karen has also helped to deliver many, many babies.  She is fabulous.

I want to thank all of you great team members for making the Berkley Center for Reproductive Wellness the 'Go To' place for Complementary medicine in New York City.

Bless you all!

Dr. Berkley

Director, The Berkley Center for Reproductive Wellness

Berkley Center & Batzofin Fertility Services

A Historical Moment in Reproductive Medicine!

I am incredibly pleased to announce that The Berkley Center for Reproductive Wellness & Batzofin Fertility Services have developed an association whereby we will be able to provide a true 'East Meets West' approach to patient care.

The Berkley Center for Reproductive Wellness will be providing acupuncture, customized herbal medicine, nutritional counseling and Maya abdominal massage all specifically designed to treat female and male fertility issues.

Batzofin Fertility Services will be providing high-tech reproductive medicine approaches which include intra-uterine-insemination, in-vitro-fertilization, donor-egg transfers and surrogacy services.  All blood-work and diagnostic evaluations including ultrasound, hysterosalpingography, hysteroscopy, etc. will be performed on site!   Batzofin Fertility Services will have a State-Of-The-Art embryology lab with a highly trained expert embryologist at the helm.

Dr. Joel Batzofin, an internationally recognized expert in the field of Assisted Reproductive Technology (ART) who has helped pioneer many important developments in the field, was born in South Africa. He graduated from the University of Witwatersrand Medical School. After an internship in South Africa, Dr. Batzofin immigrated to the United States where he completed a residency in Obstetrics and Gynecology at Harvard Medical School in Boston, Mass. and graduated in 1983. He then did a fellowship in Reproductive Endocrinology and Infertility at Baylor College of Medicine in Houston, Texas, where he graduated in 1985. This was followed by a second fellowship in Reproductive Andrology and Male Infertility. Dr. Batzofin is therefore well qualified to address both male and female infertility issues.

Why Dr. Batzofin?  There are reproductive medicine clinics and there is Batzofin Fertility Services. Herein lies the difference: Dr. Batzofin is a master diagnostician who has had many successes where other doctors have failed. He is similar in his approach to diagnostics to a high-level detective. He will dig relentlessly until he finds out why conception has not occurred. You see, any reproductive endocrinologist can do multiple IUI's or IVF's; maybe, if luck prevails, success will manifest.  Dr. Batzofin prefers to spend more time trying to figure out why conception has not yet occurred and treating the underlying cause.

Dr. Batzofin is a leading expert on immunological disorders that frequently contribute to infertility.

Together, Drs. Batzofin and Berkley have taken a revolutionary step in patient care. We have found that by including the services that the Berkley Center has to offer with conventional high-tech- reproductive medical approaches, successful, take home baby rates have increased.

The other great news is that The Berkley Center for Reproductive Wellness and Batzofin Fertility Services are housed in the same facility at 16 East 40th Street! So, you only have to make one stop to have all of your reproductive needs met.  All pre and post embryo transfer acupuncture will be done right here, so you don't have to travel.

We invite you to join our family so that we may, as a team, help you to start yours!

Batzofin Fertility Service can be reached at: 212- 679-2289

The Berkley Center for Reproductive Wellness can be reached at: 877-965-BABY

Endometriosis: A New Perspective

It's Sunday May 27th, 1:35PM and I'm up in Green Wood Lake, New York. I'm siting on the porch of a beautiful home, listening to Bach Violin Concertos, feeling the beautiful slight breeze against my neck and looking forward to having my first glass of South African Excellsior Shiraz in about a half hour.  For the better part of yesterday and today I have been studying the reproductive effects of endometriosis and I am amazed at the beauty of how the body works and am in awe of what devastating effects on reproduction are manifest when it does not work properly.

I am always trying to look at traditional Chinese medicine with new eyes to see how it can best be used to treat reproductive disorders. Looking with new eyes means respecting the classical writings of the Masters but taking into consideration new data derived from studying Western medicine and understanding pathology from a biological perspective as opposed to strictly from a TCM perspective.  Many practitioners of TCM would think this is sacrilege but I think that lack of recognition of new data which can lead to better treatment outcomes is sacrilege.  Integration of all data including Classical information pertaining to disease-states obtained thousands of  years ago from Masters of Chinese medicine in combination with Western medical advances in diagnostics and treatments of diseases will undoubetdly yield the best outcomes. This is a case where one plus one equals three!

For example, the typical practitioner of TCM views endometriosis as a pattern of disharmony called stagnation of qi and stasis of blood. This diagnosis is from the Classics. It is only partially correct which means in essence that it is incorrect.  Based upon my research and studies I have concluded that the true differential diagnosis of endometriosis from a TCM perspective can only be qi stagnation and blood stasis with heat-toxin brewing internally.  How can this be, the TCM practitoner might ask? The endometriosis patient presents with pain pre-menstrually ( blood stasis) and pain with the period which is  either dull and aching ( qi stagnation and blood vacuity) or sharp and stabbing (blood vacuity engendering blood stasis). So, there it is: stagnation of qi and blood with possible blood vacuity. But, if one were to study the Western medicine literature on endometriosis one would find that the pain associated with endometriosis is derived from three etiologies: 1) The actions of inflammatory cytokines in the peritoneal cavity; 2) bleeding from endometrial implants; and 3)direct infiltration of nerves in the pelvic floor (neural inflammation).  Therefore, it becomes obvious that heat-toxin brewing is very much part of the etiology of pain related to endometriosis as well as infertility which is not anatomically related. This information is gleaned from the integration of the Classic TCM knowledge (qi stagnation and blood stasis) and modern Western analysis (inflammatory cytokines). Therefore, this proves that the Classics though of immense value, are only of partial value. The power of TCM is exponentially potentiated when integrated with Western medical findings. This is congruence of old and new and East meets West in medical information, analytics and treatment protocols.

When using acupuncture to treat endometriosis (which is essentially worthless without the inclusion of herbal medicine), one must not only invigorate the qi and blood with points such as Large Intestine 4 and Liver 3, but also, clear heat with the utilization of points such as liver 2, kidney 2, spleen 10, and liver 8. Herbal medicine must include herbs that move qi and invigorate blood, clear heat and resolve toxins. This new method of treatment will surely yield improved pregnancy outcomes when endometriosis is causative of infertility for reasons other than anatomical obstruction.

Find Out More

 

Couple grateful to Mike Berkley

My husband and I would like to encourage those on the long, hard road of infertility. We began our infertility journey in our mid 30's and tried many types of alternative treatment before moving on to western medical intervention. Our first IVF was successful and I was 39 when our daughter was born. We were working with a very respected, well-known reproductive endcrinologist in the midwest and wanted to do IVF a second time when I was 42. This physician told us WE WOULD NEVER CONCEIVE AGAIN and he would not do it. I did some research and found Dr. Berkley's clinic in NYC. We were planning the IVF attempt with another clinic that specializes in services for older women. We wanted to use Dr. Berkley during this process to increase our chances of a successful IVF outcome. We contacted him for the initial phone appointment and Dr. Berkley was wonderful!!!! He was warm, thorough, and took a lot of time. He was so knowledgeable. He encouraged us to call with questions/concerns and always replied quickly. This was quite a change from the other infertility specialists we had worked with -- we never would hear from the doctor unless we had a scheduled appointment. Dr. Berkley prescribed herbs that I took each day and we ordered them from a Chinese pharmacy in NYC. Dr. Berkley gave specific directions to a local acupuncturist for weekly treatments (she thought he was fabulous to work with). WE DID THIS FOR 3 MONTHS AND TO OUR GREAT SURPRISE AND DELIGHT I BECAME PREGNANT NATURALLY. We had a healthy baby boy in April of 2006. It is difficult to express the gratitude we feel toward Dr. Mike Berkley. We can't recommend him enough and words don't begin to express our appreciation. We tell many people about him so they can avoid more of the pitfalls of the infertility nightmare. Our only regret is that we haven't met Dr. Berkley in person -- we did this all over the phone and computer. It was not hard, complicated, invasive, or expensive compared to so many other treatments. Thanks Mike!!! We sincerely hope other people will use the Berkley services. Polly & Paul

Acupuncturists - This is For You!

15% of Americans are afflicted with infertility. Certainly this is a disorder that can be effectively treated with Chinese medicine. But our success can be greater with a shift in attitude. As practitioners of Chinese medicine we must be able to understand not only pathological factors but etiologies too. For example, a pathology leading to male factor infertility is low sperm count.

Many TCM practitioners will automatically render treatment based upon the TCM diagnosis arrived at through the four examinations. This is all well and good and appropriate according the context of our training. There is, however, an inherent problem with this type of diagnosis.

Let’s use a case history for illustrative purposes: A forty-five year old male presents with the main complaint of low sperm count. His constellation of signs and symptoms include mild erectile dysfunction, dribbling urination status-post voiding, he craves salty foods and has tinnitus and has a chronic sore knee secondary to unresolved childhood Osgood-Schlatter disease.

We may conclude perhaps that there is a dual vacuity of kidney qi and essence, and treat accordingly. Many practitioners of Chinese medicine would be happy to diagnose this case as I have illustrated above yet their treatments would not yield the desired outcome. Why? Because the etiology of this pathology is manifest as a result of a varicocele of long standing.

As a result of this varicocele, qi has stagnated, blood has become static and heat has become trapped in the liver channel locally at the level of the affected testicle.

It is important to note that there are no signs or symptoms in this patient of blood stasis or heat. Not in the tongue and not in the pulse and not in other presenting signs and/or symptoms. This type of presentation is not uncommon. I refer to it as a ‘hidden pathology’. It is a standard method of operation that one must arrive at a differential diagnosis not matter how confusing the case may be and treat accordingly and if the treatment is ineffective, dig deeper, look more closely, reanalyze and alter the diagnosis and try another approach.

This is a clumsy approach and with greater knowledge our system of diagnosis can become more economic and more accurate. In China, one hundred or five hundred or three thousand years ago, the doctors did not have the distinct advantage that we, as modern day practitioners have. That is, Western medical science.

If for example, the modern day TCM doctor did his or her full intake on the above patient and then simply inquired “have you been evaluated by a urologist?” the answer to the riddle would have been instantly revealed if the patient had and come back to your office with a Western diagnosis of vericocele. Thus, as a result of a urological examination we are able to state with certainty that the TCM diagnosis is stagnation and binding of liver qi and stasis of liver blood transforming heat; not kidney vacuity!

If the patient had not been worked-up by a urologist we would be treating uselessly. Greater knowledge affords greater treatment options. As the Spanish saying goes: “Saber es poder”, knowledge is power!

What we have at our finger tips today that Chinese practitioners of even fifty years ago were deprived of is the availability of a knowledge-base that can positively affect our diagnoses and our treatment outcomes. I am not suggesting that there is a direct clinical analogue from a Western medical diagnosis to a TCM pattern differentiation in every case, but frequently, in internal medicine there is. Let’s say that we have a patient whose main complain is azoospermia. Once again, we treat according to the probable diagnosis of jing-essence vacuity. But if the patient was diagnosed as having Klinefelter's syndrome one could say with confidence that the diagnosis is pre heaven jing-essence vacuity and detriment which, in my opinion, in this case, is untreatable as the pathomechanism is genetically derived.

So, now we have treated this patient with herbs and acupuncture for six months to no avail. If you treated him for six years, results would not differ. We have taken his money, raised his hopes and proceeded in a way which could negatively impact the reputation of Chinese medicine.

Here is another all too familiar classic story: A thirty-three year old female patient presents at the clinic with the main complaint of primary infertility. She is afraid of Western doctors and really believes in alternative medicine and has heard wonderful things about your skills. In fact, you helped a good friend of hers to become pregnant. So, you treat the patient; and treat her, and treat her some more. You use many point protocols and many herbal formulas. You supplement the kidneys and boost the spleen. You sooth the liver and nourish the blood. You fail. Why? Because this patient has severe bilateral adhesions on the salpinges secondary to pelvic inflammatory disease. You cannot help this patient and your advice at the first interview should have been to visit a Reproductive Endocrinologist and have a full work-up.

Dan Inosanto who was one of Bruce Lee’s martial arts teachers wrote: “Absorb what is useful and discard the rest” I highly recommend that we, as healthcare providers absorb the useful diagnostic data which is presently available to us from the Western side. Until we do, we will not truly be practitioners of integrated medicine. Having an understanding of Western medical science will improve our analytic and diagnostic skills and as a result will improve the results of our treatments and as important, help us determine who is treatable and who isn’t.

Stop Smoking - Get Pregnant!

The health risks of tobacco smoking are well known with regard to diseases of the heart, lungs, and blood vessels. Substantial harmful effects of cigarette smoke on fertility have become apparent, but are not generally appreciated. Cigarette smoking has a negative impact on the ability to become pregnant and carry a pregnancy to term. Impact of cigarette smoking on reproduction in women: Virtually all scientific studies support the conclusion that smoking has an adverse impact on fertility.

The prevalence of infertility is higher, and the time it takes to conceive is longer, in smokers compared to nonsmokers. Active smoking by either partner has adverse effects, and the impact of passive cigarette smoke exposure is only slightly smaller than for active smoking.

Research indicates that cigarette smoking is harmful to a woman’s ovaries and the degree of harm is dependent upon the amount and the period of time a woman smokes.

Smoking appears to accelerate the loss of eggs and reproductive function and may advance the time of menopause by several years. Components in cigarette smoke have been shown to interfere with the ability of cells in the ovary to make estrogen and to cause a woman’s eggs (oocytes) to be more prone to genetic abnormalities.

Smoking is strongly associated with an increased risk of spontaneous miscarriage and possibly ectopic pregnancy as well. Pregnant smokers are more likely to have low birth weight babies and premature birth. The incidence of sudden infant death syndrome (SIDS) also increases in households where someone smokes.

Impact of cigarette smoking on assisted reproductive therapy outcomes: Nearly twice as many in vitro fertilization (IVF) attempts are required to conceive in smokers than in nonsmokers.

Studies of IVF have reported that female smokers require higher doses of gonadotropins to stimulate their ovaries, have lower peak estradiol levels, fewer oocytes obtained, and more canceled cycles, lower implantation rates, and undergo more cycles with failed fertilization than nonsmokers.

Miscarriage rates are also increased. The adverse effect of cigarette smoking is more noticeable in older women. Overall, the reaction in natural fertility associated with smoking may not be overcome by assisted reproductive technologies.

Impact of cigarette smoking on reproduction in men: Men who smoke cigarettes have a lower sperm count and motility and increased abnormalities in sperm shape and function. The effect of smoking on male fertility, however, is more difficult to discern because it is difficult to create studies to address that question. Although the effects of cigarette smoking on male fertility remain inconclusive, the harmful effect of passive smoke on the fertility of female partners and the evidence that smoking adversely affects sperm quality suggest that smoking in men should be regarded as an infertility risk factor.

Smoking cessation as a treatment issue in couples undergoing fertility therapy: One important investigation showed that cessation of smoking for at least two months before attempting IVF significantly improved chances for conception. Although long-term cigarette smoking can have an irreversible effect on ovarian function, the harmful effect on treatment outcome may, in part, be reversed if smoking is discontinued prior to entering into fertility therapy.

Summary: The best available scientific data indicate that cigarette smoking strongly contributes to infertility. Smoking should be discouraged for both male and female partners in couples with a history of infertility or recurrent miscarriage. Smoking cessation may improve natural fertility and success rates with infertility treatment.

At the Berkley Center for Reproductive Wellness we have a smoking-cessation program set up which encompasses acupuncture, herbal medicine and life-style counseling. And, it really works! Increase your fertility by Putting Down the Stogies Now!

Lose Weight, Increase Fertile Wellness

Encourage Healthy BMI in Patients Before IVF
Study of 5,800 IVF cycles shows a trend toward decreasing success rates with increasing BMIs.

PHILADELPHIA

— Patients considering in vitro fertilization should be encouraged to aim for a healthy body mass index before they start treatment, results of a large retrospective study suggest.

“There was a trend toward decreasing success rates with increasing BMIs,” reported lead investigator David Ryley, M.D., of Beth Israel Deaconess Medical Center Boston, and Boston IVF, a private fertility clinic.

The study reviewed more than 5,800 fresh, non-donor in vitro fertilization (IVF) cycles at Boston IVF in which the patient's BMI had been recorded, he reported at the annual meeting of the American Society for Reproductive Medicine.

Patients were divided into five groups according to BMI: under 20 kg/m², 20-24.9 kg/m², 25-29.9 kg/m², 30-34.9 kg/m², and more than 35 kg/m². Women with a BMI of more than 40 kg/m² are not allowed to undergo IVF at the center, he said.

There was no difference between the groups with respect to the number of mature follicles, number of oocytes retrieved, number of mature oocytes, the number of cycles per patient, and the number of embryos transferred. Still, patients in the highest BMI category had a significantly lower implantation rate and clinical pregnancy rate, compared with the other BMI groups.

Although the clinical pregnancy rate ranged from about 27% to almost 33% in the lower BMI categories, it was not quite 22% in the highest BMI category.

Similarly, the implantation rate ranged from 18% to 20% in the lower BMI categories, but it was only 13% in the highest BMI category.

Unlike previous published studies on this topic, the current study did not find an association between extremely low BMI and poor IVF success rates, Dr. Ryley said.

“The best data in the literature suggest that severely low BMIs under 20, or under 18, affect the hypothalamic-pituitary axis, such that patients have irregular menstrual cycles and, therefore, have an impaired chance of fertility,” he told this newspaper. “But in our study the patients with the lowest BMIs actually had the highest pregnancy rates—although the difference was only significant when compared with the highest BMI category.”

The study's findings are consistent with other reports of how excess weight can impact hormonal balance and the quality of oocytes and embryos, he said. Weight loss can often correct problems such as hyperinsulinemia and polycystic ovarian syndrome, which can in turn increase fertility.

But physicians should also know how to manage an IVF cycle in an overweight patient who has not lost weight.

“We know that patients with high BMIs require higher doses of medications, particularly gonadotropins, to stimulate folliculogenesis, and they often require longer cycles,” Dr. Ryley said. “By increasing the doses of these medications, you can often get an adequate number of oocytes. However, in many of these patients, hormonal imbalances may have a deleterious effect on the quality of oocytes you get.”

To find out more about lowering your BMI,  Find Out How To Lose Weight!