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Acupuncture for Infertility Enhancement

"Chang Acupuncture & Associates, Inc. is a unique acupuncture clinic which combines acupuncture with an impressive grasp of western practices and the treatments their patients are undertaking.  They are dedicated to working with couples coping with fertility disorders and are constantly trying to find the best approach for their complex problems by keeping abreast of the latest research.  By combining Eastern and Western methods, we are able to synergize treatment modalities, getting the best that each discipline has to offer for any given situation.

As a previous patient of Chang Acupuncture, I have found all of their practitioners to be professional, thorough, knowledgeable, and caring.  Our clinic has also worked with Chang Acupuncture on numerous occasions with mutual patients.  We have found that including acupuncture with conventional fertility treatments has helped many patients reduce stress.  It may also help increase egg quality, improve uterine blood circulation and optimize semen quality.  For your alternative health care and acupuncture needs, I recommend Chang Acupuncture wholeheartedly."
- Dr. Steven R. Lindheim, M.D., M.M.M., F.A.C.O.G., Director, 3rd Party Reproduction and Scientific Director, Fertility Specialists Medical Group and The San Diego Center for Reproductive Surgery

Nothing is more important than experience.
Chang Acupuncture & Associates, Inc. specializes in women’s health and fertility enhancement. 80% of our current patients are being treated for a fertility related disorder. Our extensive experience has led to a high success rate  of almost 66% pregnancy rate with patients who have at least 3 consecutive months of treatment.  With almost 30 years of collective experience, we've helped hundreds of couples conceive and carry through to term.

We recognize that every person and couple having difficulty conceiving need individualized treatment because no 2 people present with the exact same issues. With that customized approach, acupuncture treatment can be an effective means to aid conception in many cases.

We can significantly increase your chances of conception if your infertility is due to:

• Unexplained causes
• Poor sperm quality (low count, motility, and/or morphology) 
• Recurrent miscarriage 
• Poor response to fertility medication
• Amenorrhea (no menses) 
• Endometriosis 
• Irregular and Anovulatory Menstrual Cycles 
• Luteal Phase Defect (LPD)
• Pelvic Inflammatory Disease (PID) 
• Premature Ovarian Failure (POF) 
• Polycystic Ovarian Syndrome (PCOS) 
• Stress 
• Poor Egg Quality 
• Thin and Unresponsive Endometrium (uterine lining) 
• Cervical / Uterine Factors 
• Immunological Factors 
• Fallopian Tube Factors

We believe the reason for the significantly higher success rate in our clinic is that with over 10 years experience of specializing in fertility enhancement, we've developed our own protocol using acupuncture to gently encourage the body to do what it wants to do naturally - that is, to conceive. Balancing the body with emphasis on the hormonal system will allow conception in time.

Testimonials 

FAQs

1. What is infertility?
Infertility is defined as the inability to conceive after one year of unprotected intercourse (6 months if the woman is over age 35) or the inability to carry a pregnancy to live birth.  It affects approximately 7.3 million people in the U.S., representing 12% of women of childbearing age, or 1 in 8 couples.  The diagnosis of infertility is usually given to couples who have been attempting to conceive for at least 1 year without success.  A couple ages 29-33 with a normal functioning reproductive system has only a 20-25% chance of conceiving in any given month. After six months of trying, 60% of couples will conceive without medical assistance.

Conception and pregnancy are complicated processes that depend upon many factors: 1) the production of healthy sperm by the man, 2) healthy eggs produced by the woman; 3) unblocked fallopian tubes that allow the sperm to reach the egg; 4) the sperm's ability to fertilize the egg when they meet; 5) the ability of the fertilized egg (embryo) to become implanted in the woman's uterus; and 6) sufficient embryo quality.

Finally, for the pregnancy to continue to full term, the embryo must be healthy and the woman's hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result.

Is infertility a woman’s problem?
It is a common assumption that infertility is related to the woman, when in reality only 1/3 of infertility cases are related to the woman alone. 1/3 of infertility problems are related to men and the remaining 1/3 is made up of a combination of fertility factors between the couple or unknown causes. Unknown causes account for approximately 20% of infertility cases.

What causes infertility in men?
The most common male infertility factors include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. In rare cases, infertility in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality.

What causes infertility in women?
The most common female infertility factor is an ovulation disorder. Other causes of female infertility include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis. Congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids are associated with repeated miscarriages. Aging is also an important factor in female infertility. The ability for ovaries to produce eggs declines with age, especially after age 35.
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2. How does acupuncture help treat infertility?
Acupuncture affects the central nervous system to regulate the pituitary and the hormonal system. Acupuncture also promotes circulation of blood and energy throughout your body, especially to the reproductive organs (ovaries, uterus, testicles) which is extremely important to help you conceive. Some manifestations of poor blood and energy flow are: premenstrual symptoms, ovulatory pain, endometriosis, blocked tubes, fibroids, clotting in the menstrual blood, headaches associated with your cycle, high FSH levels, and suboptimal sperm analysis. While the above signs and symptoms in and of themselves may not necessarily be the primary cause of your inability to conceive, they do reveal internal blockages of energy and blood which may contribute to infertility.

Acupuncture is able to increase the chances of pregnancy through natural conception, IUI, and IVF because it has been clinically shown to:

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3. Do you provide acupuncture treatments in conjunction with IUI or IVF?
Absolutely. 2/3 of our patients receive acupuncture while undergoing IUI or IVF treatments to improve their chances of success.

We also offer pre- and post-transfer treatments for IVF patients to be performed at your fertility center.  One important study showed a 43% pregnancy rate with patients who had acupuncture immediately before and after their transfer as compared to a 26% pregnancy rate with no acupuncture.  These treatments may help improve the uterine environment for implantation of the embryo.  For more information about this specific procedure, please call us before your transfer so we may make arrangements with your doctor.  We have established relationships with most San Diego fertility doctors so providing these treatments is usually a simple process.
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4. I am undergoing IUI or IVF treatment and am considering receiving acupuncture treatments as well. Are there any negative effects on my fertility treatment?
Absolutely not!  In fact, acupuncture will help improve your chances by decreasing your body's physiological reaction to stress, reducing the side effects of medications, and supporting your uterus for implantation. In these cases, using acupuncture garners more successful results than IUI or IVF.

We will always adjust our treatment to complement the medications injections that you are currently taking. We believe that this can greatly increase the effectiveness of the drugs while decreasing their side-effects. 

A study published in Fertility and Sterility found that using acupuncture with IVF achieved a 42% clinical pregnancy rate in the test group, compared to 26% in the control group that did not receive acupuncture. This study involved giving acupuncture for just one day, shortly before and after the transfer of embryos. Clinically, this rate increases to at least 66% with broader support of both Chinese herbs and acupuncture in preparation for and support throughout the IVF procedure.

Chinese medicine can help to improve the success rate of IUI and IVF in a number of ways -

• Improve the function of the ovaries to produce better quality eggs
• Regulate the hormones to produce more follicles & decrease FSH levels
• Increase blood flow to the uterus to promote follicular development & implantation of the embryo
• Regulate estrogen & progesterone levels to thicken the uterine lining
• Relax the patient & decrease their stress which helps prevent the uterus from contracting, thereby improving the implantation process and preventing miscarriage
• Decrease the side effects of fertility medications used in IUI and IVF
• Help the ovaries respond better to the stimulating medications by producing more follicles & good quality eggs
• Strengthen the immune system to decrease the likelihood of miscarriage
• Improve semen quality & quantity to improve the health of the embryo, which in turn reduces the risk of miscarriage

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5. I will be undergoing IVF. When should I start acupuncture?
If this is your first IVF cycle, we recommend you start at least a month before embryo transfer. With one or two sessions per week, we can help you prepare your body for pregnancy. However, if your previous IVF cycles have failed, you must come in as early as possible before undergoing another cycle. In most of our patients who have experienced failed cycles, there is a major disorder in the body that needs to be treated before they can successfully conceive.

However, if you have already started your cycle, we offer pre- and post-transfer treatments for IVF patients to be performed at your fertility center.  One important study showed a 43% pregnancy rate with patients who had acupuncture immediately before and after their transfer as compared to a 26% pregnancy rate with no acupuncture.  These treatments may help improve the uterine environment for implantation of the embryo.  For more information about this specific procedure, please call us as soon as possible so we may make arrangements with your doctor.  We have established relationships with most San Diego fertility doctors so providing these treatments is usually a simple process.
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6. I have seen a lot of scientific literature that shows acupuncture can help increase the success rate of IVF, but can it also help couples who are trying to conceive naturally?
Absolutely & unequivocally – YES!!  Many of our patients want to try a more natural route before going to more invasive procedures or after unsuccessful ART cycles.  In our experience, acupuncture is just as effective for couples who are trying to conceive naturally as for those going through medicated cycles.  The reason why there is a relatively small amount of literature for natural conception is because IVF clinical trials are easier to control and run.
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7. How long will it take for me to get pregnant with acupuncture?
The length and course of treatment depends on many factors including the cause and nature of the infertility and the way the individual patient responds.  Most patients (men and women) need a minimum of 3 months of treatment with most couples conceiving between 6 to 12 months. For women, consistent treatment is important so specific hormonal adjustments can be made at each week of the cycle using acupuncture and herbs. Missing a week of treatment may lose an important opportunity to heal a particular segment of the four-phase menstrual cycle (menstruation, follicular phase, ovulation, and luteal phase). A minimum of three consecutive cycles (twelve treatments) begins to regulate a woman's system regardless of biological age.

The average length of treatment for PCOS and endometriosis is 10-12 months. Among our female patients who became pregnant, 10% took up to three months, 70% took up to one year and 20% took more than one year. Of our male patients, whose partners became pregnant, 40% achieved improvement within four months and a further 50% within six months; 10% took more than one year.

You’ll usually continue treatment until the third month of pregnancy or – in the case of recurrent miscarriages – until the time has passed at which your latest miscarriage occurred.

However, if you will be using acupuncture with IUI or IVF, the treatment period will vary depending on the success of the procedure. If the procedure is unsuccessful, most continue acupuncture for as long as they want to try to conceive. Because of the cumulative healing effect of acupuncture and its ability to increase one's fertility quotient, most patients continue acupuncture for the duration of time that the individual is trying to conceive. Remember that trying to get pregnant is a statistical game. The more you try, naturally or with medicated cycles, the better your chances are. This applies to acupuncture as well – the longer you allow it to correct and balance your body, the better your chances are – naturally or with ART.
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8. When during my cycle should I get acupuncture done? Should I come just before ovulation?
Acupuncture treatments should be done on a regular basis throughout your cycle. You can expect a limited effect by receiving acupuncture only around ovulation time. Compared to many of the fertility drugs which provide a powerful effect for a short duration, the immediate effect of acupuncture treatment is, in general, very subtle. The cumulative effect from regular acupuncture treatments, however, can produce significant long lasting benefits.
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9. Do you use different types of acupuncture treatments depending on the time of the cycle?
The treatments are often slightly modified in order to induce more specific effects depending on the time of the cycle. For example, one specific acupuncture protocol may be used after ovulation to maintain a low stress level and to support embryo implantation. Another protocol may be used before ovulation to promote timely ovulation and proper development of the follicle and egg.
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10. I use an ovulation predictor kit. Why should I bother to take my temperature and check my cervical mucus?
Recognizing the changes in the cervical mucus alerts you to your most fertile days since fertile mucus precedes ovulation. The fertile mucus thus indicates that ovulation is about to happen at which point the ovulation predictor kit (OPK) can be used to confirm the approximate day of ovulation. This can allow you to decrease the number of strips used from the kit. The basal body temperature (BBT) chart records the temperature of the body on waking and confirms that ovulation has occurred. For more detailed information on how to decipher your body's signs, read "Taking Charge of Your Fertility" by Toni Weschler. Recording these changes over time will build an individual profile which is informative especially if you have difficulty conceiving as these are diagnostic tools used by an acupuncturist knowledgeable in infertility treatment. Any irregularities in the temperature and fertile mucus can be effectively addressed with acupuncture and herbs.
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11. Can acupuncture help if my infertility is due to "unexplained infertility"?
Unexplained infertility is the most common diagnosis for women having difficulty conceiving.  It is a frustrating diagnosis because of its inability to explain your fertility difficulties despite exhaustive tests done on you and your spouse. So, if nothing is wrong, what is wrong?  This does not mean that there is not a problem. It means that, due to insufficient medical knowledge and current technology, the medical solution is difficult to find. However, Chinese Medicine is able to identify the hormonal imbalances that may interfere with your ability to conceive. Subtle fertility problems can be discovered during the initial consult by carefully examining the different stages of your menstrual cycle and evaluating every aspect of the your physical and mental health, nutrition and lifestyle.  Treatment will address any imbalance elicited from the medical history overview to optimize your fertility health since these problems can not only be fully explained, but also treated successfully, with acupuncture and Chinese herbs.
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12. Can acupuncture help if my infertility is due to a Thin Uterine Lining (as may be indicated by a light menses)?
Absolutely. Acupuncture is extremely effective in preparing the uterus for pregnancy. We believe that much of our success in treating infertility arises from our techniques for increasing blood flow and nutrients to the uterus and balancing hormone levels. These treatments benefit not only those who suffer from a thin uterine lining, but every woman who is trying to become pregnant.
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13. Can acupuncture help if my infertility is due to a Blocked Fallopian Tube?
The answer depends on the cause of the blockage. If the blockage is due to chronic inflammation or scarring from infection, then acupuncture treatment may take several months or even years to be effective. On the other hand, if there is no physical blockage of the tube, but rather a decreased tube diameter due to stress or cramping, then acupuncture will have a much better and faster effect.
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14. Can acupuncture help if my infertility is due to Endometriosis?
Yes. Endometriosis causes infertility because of endometrium-like tissue growth on the ovaries and its connecting ligaments and blood vessels. Not only does this restrict blood flow to the reproductive organs, but it may also cause immense pain and discomfort. Our treatments will thus be directed at 1) reversing the root cause of the endometriosis 2) improving blood flow to the ovaries and 3) reducing any associated pain and discomfort. 
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15. Can acupuncture help if my infertility is due to Ovarian Cysts or PCOS?
Ovarian cysts can arise when there is a hormonal imbalance that disrupts the normal female menstrual cycle, leaving an unruptured egg inside the ovary, which can then grow to become a cyst. The majority of ovarian cysts are benign and do not cause any symptoms. However, when they do become enlarged and multiply, a condition called PCOS, they can interrupt the normal functioning of the ovaries.

For women who have benign cysts, we recommend receiving acupuncture treatment to reduce the chances of developing further complications. For women who are already diagnosed with PCOS and PCOS-related infertility, we can help by treating the root cause of the PCOS. Treatments will be focused on balancing and regulating important hormones related to PCOS. Once these problems are addressed, we will focus on re-establishing and increasing blood flow and nutrients to the uterus and ovaries. Patients will observe more regular menstruation, less pain, and increased fertility.

A study published in the June 2009 issue of American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, shows exercise and electro-acupuncture treatment can reduce sympathetic nerve activity in women with polycystic ovarian syndrome (PCOS).  The study also found the electro-acupuncture treatments led to more regular menstrual cycles, reduced testosterone levels and reduced waist circumference.

Researchers looked at looked at whether acupuncture or exercise could decrease the sympathetic nerve activity in women with PCOS. Twenty women were divided into three groups; low-frequency electro-acupuncture, exercise and untreated controls. The acupuncture group underwent 14 treatments during the 16-week study. The exercise group took up regular aerobic exercises that were faster than walking three days a week for 30-45 minutes, while maintaining a pulse frequency about 120 beats per minute. The control group was not specifically designed to do anything differently.

Following the 16-week study, both the acupuncture and exercise groups significantly decreased muscle sympathetic nerve activity, while the acupuncture group saw a drop in waist size. The acupuncture group experienced fewer menstrual irregularities and a significant drop in testosterone, while the exercise group saw neither. Exercise had no effect on the irregular or non-existent menstrual cycles that are common among women with PCOS, nor did it reduce waist circumference. However, exercise did lead to reductions in weight and body mass index. These findings are important because women with PCOS often have elevated sympathetic nerve activity, which plays a role in hyperinsulinemia, insulin resistance, obesity and cardiovascular disease.

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16. Can acupuncture help if my infertility is due to Poor Egg Quality?
Absolutely. Although there is a strong correlation between age and reproductive health, it is important to remember that there are two types of aging: chronological and biological. While everyone ages at the same speed chronologically, the biological aging process differs greatly among each individual. That is the reason why each woman goes into menopause at a different time of their lives. So while it is generally true that the quality of a woman's eggs declines as she ages, eggs of some women in their forties can be excellent quality due to slow biological aging.

It is not possible to stop chronological aging, however, we can definitely influence the progress of biological aging. Abusive lifestyle factors such as poor diet, smoking, stress, and insufficient sleep all accelerate the cell oxidation and the biological aging process. Practicing a healthy lifestyle in addition to regular acupuncture treatments will have a positive impact in slowing down the aging process.

We have seen many cases of infertility that were caused primarily by poor egg quality. These patients often have other signs of poor circulation, such as cold extremities and low energy. In these cases, the root cause of the poor egg quality is most often due to decreased circulation to the uterus and the ovaries. If we find that is the case, our treatment will be focused on increasing blood flow and nutrients to this area. Western studies have shown that acupuncture can significantly alter blood flow to the uterus.

Another important factor in age-related infertility is the husband/male partner.  Just as age affects egg quality, increasing age also decreases sperm quality.  Treating the male partner at the same time will significantly increase the success rate of conception.
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17. Can acupuncture help if my infertility is due to high FSH?
Yes. There are many causes of high FSH, but in our experience, it is often attributed to mature age and written off as a natural decline of ovarian function. We have observed that many women suffering from high FSH may also have one or more of the following symptoms: 1) poor circulation (cold hands and feet), 2) neurological disorders, and 3) endocrine disorders. If we find that poor circulation is the cause, our treatments will be aimed at improving blood flow and nutrients to the uterus and ovaries, as Western studies have shown that acupuncture can significantly increase blood flow to the uterus and regulate hormone levels. If we find that a neurological disorder is the cause, our treatments will be aimed at improving neurological function. And lastly, if an endocrine problem is the root cause of the infertility, our treatments will be directed towards improving endocrine function.
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18. Can acupuncture help if I'm over 40?
The benefits of acupuncture and herbal therapy for the infertile couple can be found in early Chinese medical literature dating back to the 11AD. Not only do these therapies assist in regulating the menstrual cycle and invigorating the sperm, but they also serve to enhance the function of the whole body. This "whole body" health approach, in turn, provides a key to unlock the unlimited potential in healing which our bodies are capable of. This is especially appropriate for the over 40 couple as it stimulates overall health to effect reproductive health and a reduction of biological age.
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19. As I receive a series of treatments, how do you and I know that acupuncture is working for me?
If you are not presently on hormones, we recommend that you record your basal body temperature (BBT) every morning. The BBT chart is not the best method available to detect the exact time of ovulation, however, it is an excellent method to get an idea about the female hormone fluctuation pattern and can be used as a one of the indexes to know your progress by observing changes in the BBT pattern from month to month.

The focus of our acupuncture approach is to help improve overall health. Therefore, as patients receive a series of acupuncture treatments, many of them experience easier menses and enhanced feelings of well-being such as more restful sleep, better digestion, decreased anxiety, increase of energy, etc. These physical and emotional shifts can only positively influence the chance of conceiving regardless of whether one is trying naturally or undergoing medical reproductive treatment.
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20. Where are you going to place the needles?
The location of acupuncture points will vary from patient to patient and from treatment to treatment. Some of the most well-known acupuncture points, traditionally used to influence the function of the female reproductive organs, are located on the lower back, lower abdomen, and legs. The points on the lumbar, sacrum, and low abdominal regions are particularly important in consideration of female anatomy and the related nerve segmental innervations. The points on head, neck, upper back and arms are used in order to stimulate autonomic nervous system and further induce the relaxation response.
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21. What else is important in addition to receiving acupuncture?
Regular Quality Sleep - Having regular quality sleep is extremely important for fertility as studies show low fertility rates and early pregnancy losses among shift workers. Regular, quality sleep is particularly important if a woman is suffering from an irregular menstrual cycle, anovulation, amenorrhea, or PCOS, all of which can be considered to be part of a biological rhythm disorder.

Stress and Relaxation - Despite the well-known link between infertility and stress, anxiety, and/or depression, the importance of stress management and relaxation is often underestimated. We believe stress contributes, at least to a certain degree, in almost all cases of primary infertility, unexplained failed IVF, and unexplained miscarriages. Prolonged stress over the years can lead to the conditions that cause infertility. Stress hormones can interfere with ovulation and cause the uterus to contract to prevent proper implantation.

Regular practice of stress management and relaxation exercises is very important. However, in this day and age, everyone is exposed to all kinds of stress and realistically it is impossible to avoid stress. In fact, the medical tests and treatments for infertility are some of the major sources of stress for many women trying to conceive.

In our clinic, we find that regular massage helps reduce the stress level in the body and improves circulation to the reproductive organs.  Our Fertility Massage done before ovulation or during medicated ovarian stimulation for IUI and IVF specifically helps the body relax to respond better during ovulation.

In addition, the following suggestions for optimizing the likelihood of achieving pregnancy in couples attempting conception who have no evidence of infertility were established by the American Society of Reproductive Medicine in collaboration with the Society for Reproductive Endocrinology and Infertility.

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Recommendations:

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22. Do my medications affect my fertility?
Some medications may decrease your fertility because they can adversely affect the fertile cervical mucus produced around the time of ovulation.

Acupuncture and herbs can be effective in restoring the fertile cervical mucus, thus increasing your fertility. Treatment which emphasizes quantity and quality of fertile mucus is especially important if sperm numbers or motility are low. An environment which maximizes survival of sperm and encourages entry to the uterus may be all the advantage sub-optimal sperm need.
Drugs can also affect male fertility:

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23. Can you recommend any books that can help enhance fertility? 

24. Why should I come to you? You are not on my list of in-network acupuncturists covered by my insurance.
As specialists in fertility enhancement, we take post-graduate advanced training in the treatment of infertility with acupuncture and herbal medicine. Most acupuncturists are general practitioners and will be able to give you sufficient care. However, because of their lack of familiarity with fertility issues, your results may take longer and not be as successful since the inexperienced infertility practitioner will be learning as he/she treats you, costing you precious time and money.
Fertility does not mean just the ability to conceive. Remember that pregnancy is only the first step to achieving the end result of having a healthy baby. The comprehensive approach involves conceiving and then nurturing a pregnancy to full term, by preventing miscarriage. Top ↑

Chang Acupuncture & Associates, Inc.
7969 Engineer Road, Suite 209, San Diego, CA 92111
Phone: (858) 495-0771

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