Subchorionic Hemorrhage: What are they and what you need to know

Photo of a seated woman holding her abdomen with the words "subchorionic hemorrhage" over the photo
Subchorionic hemorrhage is a common cause of vaginal bleeding in pregnancy.

Subchorionic Hemorrhage

Lately we’ve had a few patients with subchorionic hemorrhage come through our office doors. We wanted to take a moment and share what SCH is, what do if you have one, and how acupuncture might be able to help.

First, what is a SCH?

A subchorionic hemorrhage is a collection of blood between the chorion (the outermost membrane that surrounds the fetus) and the uterine wall. It is a common cause of vaginal bleeding in early pregnancy, affecting up to 20% of women. Most subchorionic hemorrhages are small and go away on their own without any problems for the pregnancy. However, larger hemorrhages can increase the risk of some complications. The exact cause of subchorionic hemorrhages is unknown, but they are thought to be caused by a tear in the chorion.

Second, what should you do?

Any time you have any bleeding in pregnancy, your first call should be to your OB or RE. They can run some blood work and do an ultrasound to make sure your pregnancy is healthy and rule out miscarriage. They may recommend additional progesterone, bed rest, pelvic rest, or other treatments.

Third, how can acupuncture help?

To be clear, acupuncture should never be used in lieu of treatment from your doctor, we always recommend an integrative approach. There is evidence that acupuncture combined with progesterone can “improve the effective rate of patients with threatened abortion in early pregnancy complicated with subchorionic hematoma, regulate immune factors, promote the hematoma absorption, and has a better synergistic effect” with progesterone. It can also help alleviate anxiety as any bleeding during pregnancy is terrifying!

If you have questions, feel free to give us a call, 865-315-3845 or email us at info@TennesseeReproductiveAcupuncture.com, we’re always happy to help!

Fertility Myths: Separating the Truth from Fiction

Friends, family, and the internet are full of well-meaning advice meant to help those trying for a child. However, much of this information is, at best, a well-meaning half truth. We took a few of the most common fertility myths we come across and tried to break them down.

You have to wait one year to see a fertility doctor:

This advice encouraging couples to wait one year assumes they are under 35 and that the female partner has regular cycles. If you have irregular cycles, are over 35, have a history of endometriosis, PCOS, etc please contact your doctor sooner than one year. We’ve seen so many couples wait the “recommended year” while they only have 2 periods in a year, etc. Early testing and interventions can reduce months of heartache and get you on the correct treatment path sooner. When in doubt, check with your doctor to see what they might or might not recommend. One caveat, there are some insurance companies that will not pay for fertility testing until the couple has been trying for a year, so do your due diligence to avoid an unexpected medical bill.

A fertility clinic will always recommend IVF

There is such a stigma around seeking help from a fertility clinic. This stigma, fortunately, is a huge myth! Going to a see a reproductive endocrinologist (aka fertility doctor) will ensure that you get the best testing at the right times to get to the root of your issue. Once you have arrived at your diagnosis, a treatment plan will be presented to you that might start with monitoring a cycle, medication (while trying on your own at home), surgery, IUI, and in some cases IVF. You’ll have the opportunity to discuss this plan with your partner, doctor and even get a second opinion to make sure you’re getting the best care possible. There are so many treatment options prior to IVF for most couples.

We believe knowledge can empower your treatment decisions and know that it can help us determine what acupuncture can and cannot do for you. In addition, once you are pregnant, fertility clinics will monitor your blood levels immediately and re-run those tests frequently to address any issues as early as possible and give you peace of mind during the often stressful first few weeks of pregnancy.

If you are under 35, you won’t have fertility issues

Yes, fertility declines with age and women see a biggest drop after 35. Men also see a less pronounced decline in fertility with age. If you have been having unprotected sex for over a year, have irregular cycles, or other concerning symptoms or relevant medical history, please seek out the care of your OB/GYN or make an appointment with a reproductive endocrinologist. On the flip side, being over 35 does not mean you don’t have a chance of getting pregnant. Many of our patients are over 35 and many go on to become pregnant.

Infertility is the women’s fault

First off, I hate the word fault. We’d never use that word to describe any other health condition, so let’s throw that out right now. Secondly, male factor infertility accounts for 1/3rd of all infertility cases. Female factor accounts for another 1/3 and a combination of male and female account for the other 1/3. In fact, one of the first tests your doctor will (or should) run is a semen analysis. A full diagnostic workup by a reproductive endocrinologist can help pinpoint your issues and guide appropriate treatment.

Ovulation always happens at cycle day 14

It is often assumed that ovulation always occurs at cd 14, but this couldn’t be further from the truth. Ovulation can vary from woman to woman and even from cycle to cycle. Medications, stress, illness, etc can change the timing of ovulation as well. We recommend tracking your cycles with one of the many apps on the market and using ovulation predictor kits to determine when your ovulation occurs. Timing intercourse at the wrong time can be a reason a couple isn’t becoming pregnant.

If you just relax….

Stress DOES NOT cause infertility. We always tell our patients that if stress caused infertility, no one going through fertility treatment would become pregnant. What is true is that infertility causes stress. It is also linked to higher rates of depression and anxiety. This journey can be long and tough. It is important to take care of yourself so you can be your best self throughout the ups and downs. Acupuncture can help to reduce stress, which we see as a way to support our patients on this journey. We also recommend seeking the support of a therapist who specializes in infertility to help you navigate this time in your life.

Why We Recommend Theralogix

One thing we often get asked about is supplementation and herbs to support fertility. While not every supplement is appropriate for every patient or in every situation, we often suggest some supplements to help support your fertility journey. For instance, being on a good quality prenatal is always recommended while trying to conceive.

At The Tennessee Center for Reproductive Acupuncture, the brand we recommend the most is Theralogix. We wanted to take a moment and share why this company does a great job with their supplements and specifically supplements for fertility. As always, please consult your medical doctor before starting any supplements. The following comes from Theralogix’s website:


Why we recommend Theralogix supplements

1.  Medical Advisory Board Oversite 

The Theralogix Medical Advisory Board (MAB) is a multi-disciplinary group comprised of physicians, nationally reputed scientists, and faculty members from leading U.S. medical schools. Each product formulation has been approved by the MAB after detailed review of the scientific data.

The MAB continues to meet regularly to conduct extensive reviews of scientific research and to offer guidance on improving existing formulations or developing new products.

2.  Research-Based Formulations

Theralogix will never sell a product that is not backed by solid scientific evidence. That is our promise to you.

3. High Quality Ingredients

Theralogix works in conjunction with top manufacturers to source the highest-quality ingredients for our products. Theralogix often specifies the raw material to be sourced, typically because we believe there is an advantage with a specific raw ingredient in quality, performance (bioavailability or other performance measure), or because a material is used in supporting research.

Whenever possible Theralogix will disclose the specific supplier of key raw materials on product labels.  All raw materials must meet the sourcing and testing requirements of the NSF International Certification program.  Theralogix will not source any ingredient that cannot be tested, identified, or that is not standardized.

4. Current Good Manufacturing Practices 

Theralogix products are produced by the highest-quality, U.S.-based manufacturing facilities under conditions that exceed the Current Good Manufacturing Practice (cGMP) standards set forth by the FDA.

cGMP refers to the Current Good Manufacturing Practice regulations enforced by the Food and Drug Administration (FDA). cGMPs assure that manufacturers follow proper design, monitoring, and regulations when producing dietary supplements. Adherence to the cGMP regulations assures the identity, strength, quality, and purity of nutritional supplements.

5.  Independent Testing and Certification

It is important to know precisely what is in the supplement you choose to take. To achieve that assurance, Theralogix works closely with NSF® International, a not-for-profit organization that is the world leader in standards development, product certification, education, and risk management for public health and safety.  

NSF certification guarantees that the product contains exactly what is stated on its label, that there are no contaminants or other ingredients that are not listed on the label, and that cGMPs established by the FDA have been met during the production of the product.

Since our founding in 2002, every eligible Theralogix product is tested and certified through the NSF International Dietary Supplement Certification Program. 

In addition to certification and testing by NSF International, Theralogix also voluntarily submits its products that contain fish oil for further testing.  International Fish Oil Standards (IFOS)tests for contaminants and heavy metals such as mercury, lead, and polychlorinated biphenyls (PCBs).  The fish oil used in our products is certified sustainable by the Marine Stewardship Council (MSC).

6.  Transparent Labeling

Theralogix follows a clean label policy. All products are artificial dye-free, gluten-free, and contain no proprietary blends or undisclosed ingredients.  We strive to reduce or eliminate excipients as much as possible within our production process. Theralogix bottles are made with materials that are recyclable.   

7.  Clinical Trials

Theralogix products have been used in over a dozen clinical trials conducted by esteemed universities and research institutions across the United States. Several of these clinical trials have been funded by the National Institutes of Health (NIH), one of the world’s foremost medical research centers. 

Our products have been chosen for use in clinical trials because of their high-quality ingredients and verified content-accuracy.  We are truly honored to be trusted by so many of the country’s leading research institutions.

8. Our Nutrition Experts

Nutritional Science is the core of our company. From our Chief Scientific Officer to our registered dietitians, we are here to help you achieve optimal health. We strive to ensure our science-based formulations will deliver the highest-quality nutrients to support your individual needs. For answers to your nutrition questions, please call 1-888-899-3899, ext. 2 to speak with one of our registered dietitians.

Please use our PRC Discount Code to receive Theralogix’s best pricing. We receive a small commission from every sale using our PRC code.

Mask Policy Update 2022

We would like to announce that we are changing our mask policy.

We feel that, after being masked in the clinic for two years, current COVID-19 conditions, and a fully vaccinated and boosted staff, warrant a change in our policy. We are no longer requiring masks in the office. What does this mean for the clinic? 

While we are lifting our previous mask policy, masks are still available to anyone who prefers to wear one; and all of our staff and providers are more than happy to mask upon request. 

While masks will not be required we are continuing our cleaning, sanitizing, and hand washing practices and will revisit our policies as needed. 

If you have any questions please feel free to reach out to us at any time.

Updated COVID-19 Policy 2021-2022

TN Center for Reproductive Acupuncture COVID-19 Policy: 

Clinics will remain closed during any stay at home mandated by local or federal government with exceptions made on a case by case basis. We will follow any and all local and/or federal guidelines with respect to elective medical procedures. 

Employee Policies: 

  1. Each employee must wash hands when arriving for their shift and before and after any amount of patient contact. 
  2. Each employee must wear a mask during their shift.
  3. Self assess health before arriving at the clinic and do not report to work if you: 
    1. Have a fever over 100.4 degrees. 
    2. Have any COVID symptoms. 
    3. Have been exposed to COVID-19 and are symptomatic. If you are asymptomatic: 
      1. Vaccinated employee: You may return to work after a negative test
      2. Unvaccinated employee: required to quarantine per CDC guidelines. 
  4. Follow any updated CDC, local, or federal guidelines not covered by this document. 
  5. Minimize time patients spend in the waiting area. 
  6. All Employees and sublet tenants  must be vaccinated by 1/1/2022. Exceptions only allowed on a case by case basis following CDC guidelines. Exemption requests must be submitted in writing with necessary documentation. Regular COVID 19 testing may be required. 

Cleaning protocols: during the COVID-19 outbreak, strict cleaning protocols are to be followed: 

  1. All surfaces used are disinfected with a COVID approved cleaner  after each patient. This includes but is not limited to: 
    1. Treatment room door knobs
    2. Table and face cradle
    3. Call buttons
  2. Sheets are washed with Tide detergent on a hot cycle and changed in full between each patient 
  3. These and any other shared items must be disinfected with alcohol after every use and at the beginning and end or shift or before and after another staff member uses them: 
    1. Phone. 
    2. Ipad (also to be cleaned after each use by a patient)
  4. Wipe down these and other commonly touched surfaces with a COVID approved cleaner at least daily:
    1. Reception desk
    2. Bathroom
    3. Front door knobs/closet door knobs
    4. Kitchen and other staff areas

Patients will not be seen if they:

  1. Have been exposed to COVID-19 in the last 14 days
    1. If they are vaccinated and asymptomatic, they can be seen with a negative COVID test
  2. Have a fever over 100.4 degrees, or other COVID-19 symptoms
  3. Refuse to abide by clinic policies

Clinic Policies: 

  1. Patients are asked to arrive on time for their appointment to minimize time in the waiting room.
  2. Patients are asked to come alone to their visit unless they are accompanying a minor or on case by case expectations for other circumstances. 
  3. Patients and guardians are required to wear a cloth mask during their visit. 
  4. Patients and guardians are asked to wash hands with soap and water immediately upon arriving for their appointment. 

When Should I Start Acupuncture for My IVF Cycle?

Acupuncture and IVF: When to start treatment   

As you know by now, acupuncture makes a great compliment to an IVF cycle and can help improve pregnancy rates, and reduce miscarriage rates. But is there an optimal time to begin treatment? Short answer is yes, but the timing will vary based on cycle type and patient diagnosis. 

Let’s back up and talk about dosage:

Acupuncture is a therapy based treatment, so it is usually done in a series of treatments to treat various symptoms. Much like exercise, it is best done regularly and frequently. You probably won’t get a six pack by hitting the gym once a month…. Acupuncture is the same way. 

Another way to think about it is through the concept of dosing. Say you have a major headache and your doctor recommends 400mg of a medication to relieve it and you only take 50mg. You still have your headache. Does this mean the medication didn’t work? No. Any treatment has a proper dosage for maximum effectiveness and acupuncture is no different. In acupuncture, the dosage is the frequency of treatment. The more severe the symptoms, the more frequent the acupuncture to treat it. 

In fertility, the concept of dosing is used to provide maximum benefit during specific times throughout the cycle with consideration for each couple’s situation and type of cycle. 

Type of cycle and acupuncture start recommendations: 

Retrieval Cycle

4-12 weeks prior to cycle. 

The three month window of preconception acupuncture is recommended in cases of low ovarian reserve, poor egg or embryo quality. This window represents the full life cycle of the egg so we consider this an optimal time to use holistic treatments, dietary changes, and lifestyle changes to support your egg health.

One month is typically adequate for other diagnoses like endometriosis, male factor, polycystic ovarian syndrome, etc.

Frozen Embryo Transfer

4 weeks prior to the cycle start. In a frozen embryo cycle, 8-11 treatments before transfer is ideal to optimize results.

Natural Cycle IVF or Mini-stim IVF

 4 weeks prior to the start of the cycle.

We refer to these treatments as preconception acupuncture. The treatments are designed to improve blood flow, regulate hormones, and reduce stress in advance of your cycle. 

Here is a great Q&A session with the doctors at Long Island IVF and their acupuncturist going over the benefits of frequent treatment leading up to an IVF cycle. 

Acupuncture During the Cycle

Once your cycle begins, we will increase our treatment frequency to twice weekly until your retrieval or transfer. For our purposes we consider the “start” when you begin ovarian stimulation medication, estrogen, or cycle day 1 in a natural cycle IVF.  

For embryo transfer cycles, whether fresh or frozen, we will see you around the transfer itself and again 5-7 days after the transfer to support implantation. 

All of these treatments work to support your body, help to improve outcomes and keep you comfortable and relaxed during your cycle. In research, these protocols show an increase in pregnancy rates, live birth rates, and a decrease in miscarriage. 

For more information or questions on how this might work with your specific cycle, please give us a call, send an email (info@TennesseeReproductiveAcupuncture.com), or schedule an appointment online. We are always happy to help! 

Clinic Reopening May 4th!

Thank you for your continued patience and understanding during this time. We are excited to announce that are reopening next week on Monday May 4th!!Now with this excitement we are also putting in place some policies to keep our clinic a safe place for all. Please read the following updates precautionary measures and policies we are implementing to maintain best practices during this time.

Clinic Policies: 

1. Please arrive on time for your appointment or wait indoor vehicle instead of coming into the waiting room. 

2. Patients are asked to come alone to their visit unless they are accompanying a minor. 

3. Patients and guardians are asked to bring and wear a cloth mask during their appointment. Staff will also be wearing masks. 

4. Patients and guardians are asked to wash hands with soap and water immediately upon arriving for their appointment. 


Upon the arrival your temperature will be taken and you will be asked the following questions:  

  1. Have you been in close contact with a confirmed case of COVID-19? 
  2. Are you experiencing cough, shortness of breath, or a sore throat? 
  3. Have you had a fever in the last 48 hours? 
  4. Have you had a new loss of taste or smell? 
  5. Have you had vomiting or diarrhea in the last 24 hours?


Patients will not be seen if they: 

  1. Answered yes to any of the above questions. 
  2. Have a fever over 100.4 degrees. 

 These precautionary measures are from TN’s guidelines for reopening and will changed as needed to keep everyone as safe as possible as we navigate this next phase. Please be patient with us as we will also be keeping a lighter schedule to ensure enough time to properly clean and create a safe space for our staff and patients. 


Keep an eye on our social media pages and connect with us! We will continue to be available via email, social media, phone if you would like to schedule or reach out with questions during this time. 

With our hearts, 

Sarah and Alex

Clinical Precautions for COVID-19

At Tennessee Center for Reproductive Acupuncture, we’re proactively taking steps to reduce the risk of the COVID-19 coronavirus to our patients and staff, especially now with a confirmed case of coronavirus in Tennessee. We’d like to share with you a few preventative measures to ensure the health and well-being of our patients and staff, as well as some links to helpful public health information. Our aim is to make our clinic a healthy place for all.

Many of our patients present with common non-contagious/non-serious upper respiratory symptoms such as allergies, asthma or a lingering cough following a cold, which we will continue to treat these conditions as they do not pose a risk to others. 

If you are sick, the best option is to stay home. The main symptoms of COVID-19 are fever, coughing and shortness of breath. Call your primary care physician if you’re in need of medical attention for these concerns. If you need to cancel your appointment due to illness, you will not be charged. We understand and will happily help you reschedule.

Some things to remember:

  • Please use hand sanitizer when you check in at the front desk, or wash your hands in the bathroom. We also have hand sanitizer in the treatment rooms. Feel free to help yourself. When washing your hands, please wash for at least 20 seconds.
  • We change sheets, pillowcases and face cradle covers after each patient.
  • We regularly sanitize surfaces that are frequently touched such as door knobs, doors and faucets. We clean our bathroom regularly. 
  • Cough or sneeze into your elbow rather than onto your hands. If you sneeze or cough on your hands or into tissues or a handkerchief, please wash your hands or use hand sanitizer afterwards.
  • If you are coughing for any reason, please wear a mask. We understand it may be from allergies, asthma, or even heartburn, but it will help alleviate concerns from others sharing the space.
  • Avoid touching your mouth, nose, eyes and face with unwashed/non-sanitized hands.

Here are some more guidelines and links to inform you about how to take care of yourself and recommended practices regarding covid-19:

CDC Facts About COVID-19

FAQ by an Intensive Care and Infectious Disease Physician

American Society of Acupuncturists Covid-19 Fact Sheet

Business and Employer Guidelines

We appreciate your understanding. With your participation we can continue to serve the patients who need us and keep our clinic a healthy and safe place for all. Thank you.

Infertility and Loneliness

We work with many individuals and couples to support their fertility goals.

Infertility comes with many complex emotions. Dealing with infertility and loneliness can be a double strike. From day to day, minute to minute, emotions can range from excitement and joy at a positive test result, a response to medication, or a particular symptom to devastation, sadness, or anger over another failed cycle, miscarriage, or dead end. Through what can only be described as a rollercoaster, one prevailing feeling often shines through. 

Loneliness. 

For many of the couples that come for acupuncture at our office here in Knoxville, their support system is very small, or even non-existent. Other than their spouse, support may only come from a very small group of people; a trusted friend, mother, etc. I can’t think of many other stressful life events that aren’t shared, overshared, discussed, laughed or cried about with a larger group of support people. 

And nobody brings over casseroles when you’re going through infertility. 

Is social media helpful?

Even in the event one does decide to break the silence and share their situation, they’re often met with well-meaning, but not helpful comments like “just relax,” “my friend took this vitamin, you should try it,” “have you thought about adoption?” Or, worse yet, they slowly drop off their level of communication and effectively vanish from their lives.

What about the other areas of daily life?

And this isolation just doesn’t stop at social relationships. It can extend to work or other hobbies. Living through infertility often means playing a game of “what if.”

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Constantly wondering if/when treatment might be successful can create situations where women might put off going for a promotion, changing jobs, etc to prepare for what might be.

Infertility itself can even be a reason to put careers on hold. Sometimes a job might be a good fit for the flexibility needed for fertility treatment, or health insurance at a job might even cover treatment. 

Finding a connection.

For some, social media is a great outlet where one can even remain anonymous if they prefer. There are countless groups based on diagnosis, clinic, region, cycle, etc. But when they log off, that connection is gone.

Some couples turn to counseling or therapy to work on communication and coping skills. For others, their place of worship plays a vital role.  

Be a support.

I don’t have an answer to solve this loneliness (though I wish I did…), but I want you to know that we hear you and our thoughts are with you. The one thing we all can do is learn from this and be that support to other struggling with infertility.

If we are chosen to be that, maybe they’ll have just a little bit less loneliness as they walk their own journey. Hopefully, over time, with advocacy and more openness, this will all be a thing of the past.

Here in Knoxville we are lucky to have many organizations and support groups that are also willing to help with those struggling through infertility and loneliness. Please reach out and let us know how we can support you.

Theralogix Supplements: Online Store Now Available

Check out Theralogix’s new online store with our provider discount already applied!

Theralogix sells excellent quality prenatal vitamins, CoQ10, our favorite inositol for PCOS, and many other supplements including our recommended male “prenatal” vitamin, Conception XR RHF.


We wanted to share a link to their online store with our provider discount already factored in so you can order your supplements from the comfort of your own home and not have to hassle with in-office ordering. Or, if you’d prefer to use the code directly with your order, our Provider Reference Code is 137923.

Click below to be taken right to the site!

 

Please see your provider for specific supplement recommendations or with any questions and always check with your physician before starting any supplements.