Acupuncture for Infertility

Canadian infertility rates are twice what they were twenty years ago.  Up to 16% of heterosexual couples in Canada have difficulty conceiving and are looking for help.  As more heterosexual and homosexual couples and single women seek out ways to fulfill their desire to have children use of assisted reproductive technology (ART) has increased substantially.  With the rise of ART, we are also seeing a rise in men and women seeking out natural ways to enhance fertility or to improve the success rates of ART.  Acupuncture is the most popular natural fertility treatment either alone or in combination with ART.

Acupuncture and ART

The past 20 years have seen an explosion in the number of research studies demonstrating impressive results when combining acupuncture with ART.  A 2002 study performed by Paulus and colleagues in Germany rocked the reproductive world when it showed that women who received acupuncture with in-vitro fertilization (IVF) had a 42.5% success rate, compared to a 26.3% success rate for those who did not get acupuncture.  Considering the cost of IVF (both financial and emotional) this impressive result got the attention of both fertility specialists and people with infertility.

Many further studies have confirmed what Paulus reported in 2002.  In 2006 a study found that acupuncture during the second half of the menstrual cycle more than doubled pregnancy rates (33.6% vs 15.6%) for women undergoing IVF or ICSI (intracytoplasmic sperm injection – a type of IVF).  A second study in 2006 reported that acupuncture on the day of IVF embryo transfer (with acupuncture treatment administered both before and after the transfer) increased pregnancy rates from 26% to 39%.

These studies and many others like them demonstrate the profound impact acupuncture can have during assisted reproductive technology procedures.

Acupuncture and Female Infertility

Female factor infertility is implicated in half of all couples with difficulty conceiving.  There are many lifestyle, physical and hormonal issues that can lead to female fertility concerns.  Lack of ovulation, luteal phase defect, endometriosis, prolonged menstrual cycle, shortened menstrual cycle, polycystic ovarian syndrome, uterine fibroids, hypothyroidism, hyperthyroidism, recurrent miscarriage, pelvic inflammatory disease and unexplained fertility can all be addressed with acupuncture treatment.

How can acupuncture do all these diverse things?  Acupuncture works on multiple systems in our body with widespread and diverse effects.  Some of the ways acupuncture impacts fertility include:

1. Regulate the hormone cycle: Acupuncture can regulate and support a balanced hormone cycle with a regular 27-30 day cycle, good quality fertile mucus, pain free ovulation, minimal premenstrual symptoms and a pain free period with appropriate bleeding (colour, quantity, no clots).
2. Regulate ovulation: Acupuncture and Traditional Chinese Herbal therapies support ovulation occurring regularly on day 13 to 15 of a regular cycle, indicating that the egg is being released at its optimal developmental time.
3. Increase blood flow to the uterus and ovaries: Acupuncture increases the blood flow to the ovaries and uterus, enhancing thickness and quality of the uterine lining, decreasing IVF failure and recurrent miscarriage. No medication currently exists that can increase blood flow to the uterus – acupuncture is the only intervention that has been shown to consistently have this effect.
4. Enhance egg development: Clinically acupuncture has been shown to positively influence the integrity of eggs released – this may be due to increasing the blood supply to the developing follicles or by increasing the nutritional supply to the egg via the fluids that surround and nourish it.
5. Enhance the internal environment of the fallopian tubes: Acupuncture aims to improve the elasticity and the secretions of the fallopian tubes, facilitating the passage of the fertilized egg into the uterus.
6. Promote embryo implantation: Acupuncture used during IVF results in higher rates of viable pregnancy.  Additionally, acupuncture was found in a 2004 study by the American Society for Reproductive Medicine to lower miscarriage, reduce tubal pregnancy and increase live birth rate.
7. Correct hormonal imbalances: Acupuncture can be used to influence hormonal secretion at the level of the pituitary, hypothalamus, thyroid, adrenals or ovaries.  Acupuncture can balance excess or deficient hormone levels and support a hormonal state that allows pregnancy to occur and proceed naturally.
8. Decrease stress and enhance maternal health during fertility treatments and pregnancy: Stress is one of many factors that may negatively impact fertility.   Acupuncture treatments have been shown to decrease stress during fertility treatments and can support a balanced, healthy lifestyle for the mother.

Acupuncture and Male Infertility

Male factor infertility is also implicated in half of all infertile couples.  Male fertility requires three important features: adequate production of sperm in the testes, a clear path for sperm to travel through the seminal tract, and satisfactory delivery of the sperm to the waiting egg.  Low sperm count, poor sperm motility, poor sperm morphology (shape), anti-sperm antibodies, and low testosterone are all imbalances that may be addressed through acupuncture, usually in combination with nutritional and herbal supplements.

Acupuncture Treatments

Acupuncture treatments are tailored to your personal imbalance.  The timing and frequency of acupuncture sessions depends on your health and fertility concerns, your age, your menstrual cycle and your current state of balance/imbalance.  For women undergoing ART it is recommended in clinical studies that you begin having acupuncture a minimum of 8-12 weeks prior to IVF procedures.

Acupuncture points are selected based on clinically proven protocols (Paulus protocol, Stener-Victorin protocol), as well as points based on Traditional Chinese Medicine diagnoses and indications.  Your individual acupuncture point prescription may vary with your menstrual cycle, with different points being used based on the timing and length of your cycle.

For women undergoing IVF, your Naturopathic Doctor can accompany you on the day of embryo transfer to administer acupuncture before and after your procedure.  Discuss the option of on-site acupuncture with Dr. Watson in the weeks prior to your procedure.

Is Acupuncture Right for You?

The best way to determine if acupuncture is right for you is to have a consultation with a Naturopathic Doctor who is experienced in the treatment of fertility and proficient in acupuncture.  Dr. Lisa Watson offers free 15 minute consultations during which time you can ask questions regarding acupuncture and fertility and whether or not it would be recommended for you.

References

Betts D. The Essential Guide to Acupuncture in Pregnancy and Childbirth.  2006.

Dieterle, S., et al. Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study. Fertil Steril. 2006 May;85(5):1347- 51.

Gurfinkel E, et al. “Effects of acupuncture and moxa treatment in patients with semen abnormalities.” Asian J Androl. 2003 Dec;5(4):345-8.

Johnson D.  “Acupuncture prior to and at embryo transfer in an assisted conception unit – a case series.” Acupunct Med. 2006:24(1):23-28.

Kirkey S.  Infertility rates rising for Canadian couples.  Postmedia news.  February 15, 2012.  Accessed online May 22, 2012.  Available online at: http://www.canada.com/health/Infertility+rates+rising+Canadian+couples/6157547/story.html

Paulus WE, Zhang M, Strehler E, El-Danasouri I, Sterzik K. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertil Steril 2002;77(4):721-4.

Stener-Victorin E, et al. “Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer. Acupunct Med. 2006 Dec;24(4):157-63. Review.

Westergaard. LG, et al. “Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial.” Fertil Steril. 2006 May;85(5):1341-6.

Zhang, M, et al. “Influence of acupuncture on idiopathic male infertility in assisted reproductive technology.” J Huazhong Univ Sci Technolog Med Sci. 2002;22(3):228-30.