Acupuncture, Fertility Research Delivers Healthy Results
By: Jennifer Dubowsky, L.Ac. M.S.O.M., Dipl.Ac
Traditional Chinese Medicine (TCM) has been practiced for thousands of years. Amazingly, the first written gynecological records date back to the Shang dynasty (1500 BC- 1000 BC), but here in the U.S. and other Western countries, people are just beginning to understand and appreciate the effectiveness of Traditional Chinese Medicine.
It isn't easy to compare Traditional Chinese Medicine and Western medicine because there are profound differences that underlie the basic notions of your health, body and treatment. Western medicine often takes a more mechanistic view of people - your body may be treated as if it is a collection of machine parts rather than one whole, integrated system. Alternatively, Traditional Chinese Medicine sees individuals as personal ecosystems, with each part depending on, and influencing, all the other parts. This "whole body" approach means that treatment addresses the complete systems of your body rather than just attending to your symptoms. As a result of such a treatment strategy, most patients experience an improvement in their specific condition and also a better overall sense of health and well being.
TCM and Fertility: The Research
Let's define infertility. The American Fertility Society defines infertility as occurring when "a couple has 1 year of regular intercourse without contraception and has been unable to conceive."
There are many factors that may make your conception difficult to achieve and, even after conception, you may face problems bringing your pregnancy to term, which causes frustration, upset and increased stress. However, research using acupuncture to enhance fertility is providing reason for new optimism in the struggle with this old problem.
Traditional Chinese Medicine (TCM) can be used alone or in conjunction with Western medicine. A 2002 German study that received a lot of attention found significantly higher conception rates (42.5% vs. 26.3%) when acupuncture was used with IVF. More recently, two studies published in May 2006, showed that acupuncture can improve IVF success rates. First, in Germany, 225 women undergoing in vitro fertilization participated in a study. Of these, 116 patients received luteal phase (the phase after ovulation) acupuncture according to the principles of TCM and 109 people received a standard protocol of acupuncture. The treatment group using TCM principles had a significantly higher clinical pregnancy rate than the placebo group (33.6% vs. 15.6% respectively). Second, a Denmark study published at the same time examined the effect of acupuncture received on the day of embryo transfer vs. no acupuncture, and they also found a significant increase in pregnancy rates (39% vs. 26%). The researchers concluded that acupuncture on the day of embryo transfer improved the outcome of IVF. A third study published at the same time found the results too small to be considered clinically significant but these researchers also concluded that acupuncture was safe for women undergoing IVF.
Other research is showing acupuncture's effectiveness with men. A study published in 2005 demonstrated that sperm motility and quality improved after the men received treatment with acupuncture.
As further proof that TCM has gained acceptance and success, in September, 2005, the University of Maryland received $400,000 from The National Center for Complementary & Alternative Medicine, a division of the National Institute of Health, to research the benefits of Acupuncture combined with IVF.
In Vancouver on May 18, 2007, Dr. Paul Magarelli, an infertility physician at the Reproductive Medicine & Fertility Center, and Diane Cridennda, an acupuncturist at East Winds, both centers in Colorado Springs, Colorado, presented their research results which were published in Infertility and Sterility in April, 2007. This is one of several studies the two have completed. In the protocol, they used a minimum of 9 acupuncture treatments within 2 months before the embryo transfer. Since this was a research study, each patient received the same treatment. No modification in points was allowed. From a clinical TCM/acupuncture perspective, the treatment protocols were very limited compared to individulized treatment of each patient.
What were their results? Lorne Brown, Doctor of TCM, founder and clinical director of Acubalance Wellness Centre, the first TCM clinic in British Columbia dedicated to reproductive wellness, analyzed the data Dr. Magarelli presented and has posted the following conclusions on his website:
Acupuncture does not cause harm to fertility or negatively interfere with an IVF outcome.
Acupuncture can statistically improve the live birth rate from IVF to between 10-15%.
Acupuncture reduces the number of ectopic pregnancies in an IVF setting.
The acupuncture protocol (minimum of 9 treatments using set points) did not affect egg quality BUT it did improve the host. Therefore, it seemed to improve factors affecting implanation rather the egg quality itself.
The mechanism by which acupuncture improves implantation and live birth rates results from acupuncture's ability to regulate the body's hormone levels (particularly prolactin and cortisol) to mimic these hormone levels in a natural cycle.
Why Does TCM Work?
Why? "Acupuncture provides better circulation and better blood flow to the womb," said Dr. Raymond Chang, director of New York's Meridian Medical Group, who has been incorporating acupuncture into fertility treatments for the past decade. "It will give a better chance for the eggs to be nourished and therefore carried." Acupuncture seems to help some women because it improves circulation to your ovaries and to your uterus. It aids ovarian stimulation, improves the thickness of uterine lining, and therefore can help with implantation. Acupuncture is relaxing, which helps to lower your cortisol levels and increase progesterone output, important factors in decreasing your chance of having a miscarriage.
Western medicine works with an eye on the numbers. The main goal is to increase the quantity of eggs or sperm, thereby increasing your chances of a viable pregnancy. In contrast, Traditional Chinese Medicine is holistic and cumulative. It will likely include suggestions about diet and lifestyle as well as acupuncture. TCM is very personalized. Your practitioner will needle specific points and may suggest specific herbs, all depending on your body and your situation. When your body is healthy and balanced, you increase your chances of getting pregnant and producing a healthy child. The goal of acupuncture is to return your body to a state of health. The effects take time; the results get better over time. Even if your Western doctor does not understand the benefits of acupuncture, most physicians now agree that it does not cause harm.
"Nourish the Soil before Planting the Seed"
Plan ahead. The ideal time to begin preparing your body for a baby is three months before conception or an IVF cycle. This is the time to begin acupuncture treatments, but many couples wait until they are actively trying to conceive. In my practice, I recommend twice weekly treatments until we get a positive pregnancy test and once a week for the first trimester to reduce the risk of miscarriage.
Of course, making good nutritional choices is always important for both mother and child. Specific suggestions can be found in one of my previous articles, "The ABCs of Fertility: Acupuncture, Babies, Chinese Medicine" which can be read on Acufinder.com and on tcm007.com
You can also help your body's readiness by attending to the following suggestions:
Caffeine: Reduce or cut out coffee from your diet. A joint US/Swedish study of 562 women found that 1-3 cups of coffee increased miscarriage rate by 30% and more than 5 cups increased it by 40%. Also, in another study conducted during the first trimester of pregnancy, women who had a high caffeine intake showed an increased risk of repeated miscarriage.
Stress: Stress has been linked to irregularieties in ovulation and abnormal sperm development. When you can lower your levels of physiological stress, you have increased your chances of conception.
Sleep: Treatment in Chinese medicine always aims to improve your sleeping pattern. Lack of sleep has long been recognized as influencing fertility. It leads to physiological disruptions including the inhibition of growth hormones.
Alcohol: Women who drink alcohol may delay conception because it is poorly metabolised and can lead to a disturbance of the oestrogen/ progesterone balance. During IVF, men and women are both advised to avoid alcohol because, in women, it can lead to reduced egg production and, in men, it may reduce the number of healthy sperm.
Weight: Being too thin or too heavy can have an impact on how quickly you conceive. Excessive thinness is known to interfere with menstrual periods. Now, it is also believed that if both partners are overweight or obese, conception will take longer.
Smoking: Smokers have an increased rate of repeated miscarriage. Women smokers have been shown to have lower levels of oestrogen which may delay conception. Smoking is also thought to influence tubal factor infertility, and can cause early menopause. In men, smoking may damage sperm. When men stop smoking, their sperm count increases quickly.
By following the Chinese medicine approach to balancing your body, mind and spirit, you will not only boost your fertility but you will feel more energized, sleep better and experience a greater sense of wellbeing.
In summary, Acupuncture and Chinese herbs have a long history of benefiting fertility in many ways. Benefits of TCM include:
Improvements in your uterine lining
Increased blood flow to your uterus
Regulation of your hormones
Reduction of your stress associated with fertility problems
Improved function of your ovaries
Increased conception with or without ART
Increased live birth rates
Lower rates of ectopic pregnancies
And for men...
Improved semen quality and quantity
Reduce stress and improve well being
About the Author
Jennifer earned her Master of Science degree in Oriental Medicine from Southwest Acupuncture College, an accredited 4 year Master's program in Boulder, Colorado. She received her Diplomate from the NCCAOM, the National Certification Commission for Acupuncture and Oriental Medicine and completed an internship at the Sino-Japanese Friendship Hospital in Beijing, China. Jennifer has been in practice since 2001. She has a passion for her work and has researched and written articles on Chinese medicine. She holds a Bachelor of Science Degree in Kinesiology from the University of Illinois.
1. Paulus, W., et al. Fertility and Sterility. April, Vol. 77 (4):721-724, 2002.
2. Dieterle,S., Ying, G., Hatzmann, W., Neuer, A. Fertility and Sterility, May, Vol. 85 (5):1347-135, 2006.
3. Westergaard, L., Mao, Q., et al. Fertility and Sterility, May, Vol. 85 (5): 1341-1346, 2006.
4. Smith, C., Coyle, M., et al. Fertility and Sterility, May, Vol. 85 (5) 1352-1358, 2006.
5. Pei, J., Strehler, E., Noss, U. et al. Fertility and Sterility, July, Vol. 84 (1), pgs. 141-7, 2005.
6. Cnattingius, S. et al, New England Journal of Medicine Vol.343(25):1839-1845, Dec., 2000.
7. George, L., et al. Paediatric and Perinatal Epidemiology, Vol. 20 (2): 119-126, March, 2006.
The Infertility Cure: The Ancient Chinese Wellness Program for Getting Pregnant and Having Healthy Babies by Dr. Randine Lewis.
Human Reproduction Journal, Volume 11, Number 6, 1996.
Fertility and Sterility, Volume 78, Number 6, December 2002 Raised cortisol predicts spontaneous abortion Source: Proceedings of the National Academy of Sciences 2006. Early online publication