Acupuncture for Fertility, Anovulation, PCOS and ART

Different research studies show that acupuncture is effective for Fertility, Anovulation, PCOS, Assisted Reproductive Technologies (ART)

Acupuncture and Fertility

A new clinical study concludes that acupuncture and Chinese herbal medicine have potent effects in reversing infertility. Several types of patients suffering from infertility participated in the study including those using IVF, IUI and those using no biomedical assistance. All types showed significantly improved successful pregnancy rates.

The researchers cited prior investigations measuring the biological mechanisms by which acupuncture enhances fertility. The researchers note that beta-endorphins and related neurotransmitters stimulated by acupuncture causes the secretion of gonadotropin-releasing hormone (GnRH). This exerts a regulatory effect on the menstrual cycle and ovulation. Acupuncture has been shown to enhance the micro- circulation of blood in the uterus through the inhibition of excess sympathetic nerve activity in the uterus. The researchers also note that their research is consistent with another investigation finding acupuncture successful in improving IVF outcomes.

The researchers note that the success rate of IVF is 24% (for 4 or more embryos transferred) as a standalone therapy. The combination of IVF with acupuncture has a significantly higher success rate of 42.5%. They note that the improved success rate is both indicates a safe and economical way to assist women undergoing fertility.

 A total of 52.38% of women in the study conceived with acupuncture and/or herbal medicine without biomedical assistance. Another 9.52% conceived with acupuncture and/or herbs combined with IVF (in vitro fertilization) and 4.76% conceived with IUI (intrauterine insemination) combined with acupuncture.

Most women conceived within the first 12 months of the clinical trial. Measurements were made up to two years from the onset of acupuncture therapy. Several women did not complete the full 2 year course of the study. The study’s success rate may have been higher if all participants completed the full 2 year treatment regime. The women in the study consisted of 85.7% with primary infertility and 14.3% with secondary infertility.

No adverse events were reported as a result of acupuncture and herbal medicine treatments.

Acupuncture was the primary treatment method in this current investigation. Chinese herbal medicine supplemented acupuncture in several cases. Based on a Traditional Chinese Medicine (TCM) differential diagnosis, herbal formulas Chai Hu Shu Gan San and Tao Hong Si Wu Tang were used. These formulas were added in cases wherein theTCM diagnostics indicated liver qi stagnation and blood stasis in the uterus respectively.

Patients were admitted to the study if they met 5 inclusion criteria and did not meet 6 exclusion criteria. Patients had to be of child bearing age and between 21 and 45 years of age. Patients were required to be married with no conception after a least one year of unprotected sex during the fertile phase of the menstrual cycles. Patients had to be non-smokers and non-alcoholics. Patients needed to be willing to receive acupuncture and/or Chinese medicinal herbs and the husband had to have a healthy sexual activity ability and sperm analysis was required to be normal.

Acupuncture Treatment

Initially, acupuncture was administered 2-3 times per week following menstruation. During ovulation, acupuncture was administered on 3 consecutive days. This typically landed on days 12, 13 and 14. During the luteal phase, acupuncture was administered at a rate of approximately 2-3 times per week.

There are a broad range of issues leading to infertility. The causes range from dysfunction of the uterus, fallopian tubes and ovulation to hormonal imbalances. The researchers note that studies show that acupuncture regulates the hypothalamic- pituitary-ovarian axis and therefore menstruation. Additional research demonstrates that acupuncture regulates endocrine system functions and therefore addresses hormonal disorders. In TCM, the diagnoses of blood stasis and liver qi stagnation were common to many of the participants. Based on these principles, the focus of the treatments were to enhance circulation in the uterus and ovaries to improve fertility.

The researchers note that “acupuncture shows promising success in treating female infertility as compared with IVF (in vitro fertilization) alone without acupuncture….”

They also note that acupuncture and herbal medicine show a “positive effect” on treating several types of female infertility. They note that acupuncture with or without herbal medicine supplementation shows promise in the treatment of female infertility.

Anovulation Infertility

Additional research concludes that acupuncture is successful for the treatment of infertility. A clinical trial was conducted at the Department of Acupuncture and Moxibustion at Ruikang Hospital, an affiliate of Guangxi University of Chinese Medicine. A total of 40 cases were invested using a standard treatment protocol of electroacupuncture combined with moxibustion. The effective rate for the treatment regime was 85% based on the pregnancy rate documented in follow-up visits.

The researchers measured the effects of acupuncture and moxibustion on anovulatory infertility, a type of infertility caused by the lack of ovulation. Following the treatment regime, FSH, LH and E2 levels improved. In addition, the thickness of the endometrium increased and the follicle diameter increased. The higher pregnancy rates and objective testing resulted in the research team finding acupuncture and moxibustion successful in enhancing fertility for women with anovulatory infertility.

Acupuncture for PCOS

In other research, investigators concluded that acupuncture was able to improve “menstrual frequency and decrease circulating androgens in women with polycystic ovary syndrome (PCOS).” Infertility is an unwanted complication associated with some forms of PCOS, polycystic ovarian syndrome, and acupuncture showed significant clinical improvements in the women studied.

Another study published in the American Journal of Physiology – Endocrinology and Metabolism concludes that low frequency electroacupuncture improved menstrual frequency and balanced sex steroid levels in women with PCOS. The study measured improvements in a wide range of endocrine variables such that the researchers concluded that electroacupuncture may help induce ovulation in women attempting to conceive since participants showed significant improvements in monthly menstrual frequency. There are similarities in the acupuncture point selection in this study with the study of women with anovulatory infertility.

Acupuncture for Assisted Reproductive Technology

Additional research demonstrates a consensus among acupuncture experts on best practice treatment protocols for acupuncture enhancement of assisted reproductive technology (ART) fertility treatments. ART includes all fertility treatments in which both the eggs and sperm are handled. ART includes in vitro fertilization (IVF) and intrauterine insemination (IUI). In this study, researchers set out to determine if a consensus exists on high priority acupuncture points for the enhancement of ART.

ART has been used in the USA since 1981. Although acupuncture and Chinese medicine for the treatment of infertility is a time honored practice, the combination of acupuncture with ART has emerged in recent years as an effective approach for improving pregnancy and live birth rates. In this study, researchers administered 3 rounds of questionnaires to 15 international acupuncture fertility experts to determine if a consensus exists on best practice protocols.

The investigation revealed that several key components are central to acupuncture in combination with ART. The timing of an acupuncture treatment in relation to the menstrual cycle is of great importance. An acupuncture treatment administered between day 6 and 8 of the “stimulated ART cycle” is optimal. In addition, it is ideal to have two acupuncture treatments “on the day of embryo transfer.”

Sperm Motility and Acupuncture

Male infertility is also of major concern. Researchers conclude that acupuncture restores sperm motility. Laboratory experiments measured the effects of electroacupuncture on infertility by stimulating acupoints located on the scalp, abdomen and legs.

The researchers measured “a trend of improved motility and increased number of motile epididymal spermatozoa in the H+EA (electroacupuncture) group.” The researchers note that electroacupuncture enhances “cell proliferation through improvement of Sertoli cell functions.” Sertoli cells are activated by follicle- stimulating hormone and are located in the convoluted seminiferous tubules, the anatomical structure in the testes where spermatozoa are produced.

 

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