Attempting to conceive a baby can be a difficult and stressful time for couples having infertility problems. Even with in vitro fertilization and hormone therapy the chances of pregnancy are not guaranteed and the average amount of times the procedure must be performed is 2.5 times before positive results are seen.
The reasons for infertility are many. They include decreased sperm count and quality of sperm in the male; uterine tube blockages; abnormal ovulation or irregular release of the egg; hormone dysfunction and history of sexually transmitted disease that was not treated properly. In addition, the social pressure on females undergoing fertility treatments can in itself cause increased stress, which can wreak havoc on their hormonal systems.
Today, more couples are turning toward alternative methods for enhancing fertility, and Traditional Chinese Medicine is getting impressive results in some cases. Acupuncture has been used for thousands of years and is known for its effectiveness in the treatment of various musculoskeletal conditions as well as other conditions such as nausea and anxiety. The World Health Organization has acknowledged the powerful healing effects of acupuncture and has released a document outlining over 40 conditions recognized as treatable with acupuncture.
Acupuncture helps infertile couples through a multifaceted approach which addresses problems with stress, hormonal imbalances, organ function, blood flow to reproductive organs, and uterine receptivity to fertilized eggs.
Traditional Chinese Medicine states that there exists channels or meridians which flow throughout the body. Chi or energy flows through these meridians and allows the body to function optimally. Any pain, dysfunction or disease is a result of blockages in the meridians. Acupuncture works by placing needles at specific locations (known as acupoints) throughout the body which clears the blockages. Therefore, traditional acupuncture as related to infertility clears blockages that may be preventing the woman’s body from conceiving.
A common mechanism that may contribute to infertility in women is endometrial receptivity. Following fertilization of the egg, implantation must occur in the lining of the uterus known as the endometrium. In some cases of infertility, the uterus may not create an optimal environment for implantation. One of these causes can be attributed to decreased blood flow to the uterus via the uterine arteries.
Swedish researchers looked at the role that acupuncture can play in the treatment of infertility and in particular its effect on uterine blood flow.1 The pool of women used as test subjects had infertility problems and were diagnosed with decreased blood flow into the uterus which affects endometrial receptivity. When there is a decreased flow of blood into the uterus, treatment options are few and conception is difficult. Using specific points which correspond to the innervation of the uterus, researchers measured the amount of blood flow in women undergoing in vitro fertilization (IVF) treatment. The results showed that there was a significant increase in the blood flow into the uterus with the acupuncture treatment. Researchers attributed the effect of acupuncture to its influence on increased uterine arterial blood flow into the uterus which in turn would increase the chance for oocyte implantation.
In addition, researchers in Germany in 2001 looked at the traditional methods of acupuncture to determine its efficacy with the use of traditional points based on Traditional Chinese Medicine combined with assisted reproductive techniques with embryo transfer (in vitro fertilization or IVF).2 The acupoints chosen were used to relax the uterus. The main purpose of the study was to evaluate whether acupuncture accompanying embryo transfer increases clinical pregnancy rates.
A total of 160 patients participated in the study, 80 patients receiving acupuncture and assisted reproductive techniques and 80 patients undergoing assisted reproductive techniques without acupuncture. Treatment consisted of an acupuncture treatment before and after IVF. The results showed that the pregnancy rate for the acupuncture group was considerably higher than the control (42.5% acupuncture group versus 26.3% control group).
Even with IVF procedures, the chance for pregnancy remains 6-10% (women over 40) to 30-35% (women under the age of 35).3
The use of assisted reproductive techniques combined with acupuncture has been gaining popularity. A fertility centre in Colorado Springs, Colorado utilizes both techniques.4 The protocol used combines both techniques reported on in the Swedish and German research papers. Initially, the patient undergoes two treatments a week for four weeks of treatment before the IVF transfer which prepares the uterus’ endometrium for implantation by increasing arterial blood flow using acupoints based on the Swedish study. Pre- and post-embryo transfer, the patient is given acupuncture to relax the uterus as outlined in the German study.
Their results are significant. They report that 16% more women are getting pregnant and 23% are having births. This combined technique shows a definite clinical advantage in combining acupuncture with IVF.
The effect of acupuncture on infertility can be summarized with the following:
• Fertility Hormone Regulation
Acupuncture has been known to control pain through stimulating the release of beta-endorphin. In addition, beta-endorphin works to influence the source of women’s ovulatory and fertility hormones (the hypothalamic-pituitary-ovarian axis) and control hormones that regulate women’s ovulation and fertility which include gonadotropin releasing hormone, follicle stimulating hormone, luteinizing hormone and human choronic gonadotropin.5
• Sympathetic Nervous System Normalization
Increased sympathetic nervous system activity can cause detrimental effects to the reproductive system. Effects include decreased blood flow to the organs and endometrial thickness and morphology. As the Swedish study demonstrated, acupuncture caused a central sympathoinhibitory effect that contributed to increased uterine artery blood flow and in turn increased endometrial thickness, which enhances implantation.
• Stress Reduction
Psychological stress can have a negative effect on couples facing fertility problems. Stress leads to the release of stress hormones and causes detrimental effects on mechanisms responsible for normal ovulatory menstrual cycle. The success of acupuncture for reducing stress and anxiety is due to its beta-endorphin release and sympathetic calming effects.
Based on clinical evidence and cases, acupuncture has a role in enhancing one’s chance in becoming pregnant. Although most research is based on combining acupuncture with IVF, acupuncture as a sole treatment can also increase rates of conception based on its physiologic effects and can be used by women who are contraindicated for assisted reproductive technique or hormone therapy.
References
1. Stener-Victorin, E., Waldenstrom, U., Andersson, S. and Wikland, M. (1996) Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Hum Reprod Biol., 11:1314-7
2. Paulus, WE., Zhang, M., Strehler, E., El-Danasouri, I and Sterzik, K. (2002) Influence of acupuncture on pregnancy rates in patients who undergo assisted reproduction therapy. Fert Steril., 77:721-4
3. American Society for Reproductive Medicine. (2003) Assisted Reproductive Technologies: A Guide for Patients, 11
4. DePow, J. (2004) "East meets West: Acupuncture and Reproductive Medicine." New Mexico Woman
5. Aso, T., Motohashi, T., Murata, M., Nishimura, T. and Kakizaki, K. (1976) The influence of acupuncture stimulation on plasma levels of LH, FSH, progesterone and estradiol in normal ovulating women. Am J Chin Med., 4:391-401
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