In recent years acupuncture has been increasingly used as an alternative and complementary treatment to Assisted Reproductive Technology (ART). Although there are only a few clinical studies published outside China to support this ancient therapy in the treatment of female infertility, reports from patients who have tried it are very favourable.

Reported benefits from published clinical studies

According to published clinical studies, acupuncture can:

• increase the success rate of in vitro fertilization (IVF) by 42%, with pre & post transfer acupuncture.
• relieve stress related to infertility and its treatment.
• improve the production and quality of ova.
• normalize the hypothalamic-pituitary-ovarian axis and menstrual cycle 3.
• reduce the risk of miscarriage and ectopic pregnancy.
• provide an alternative treatment for patients who are intolerant, ineligible, contraindicated or simply cannot afford conventional infertility treatment.

Observed benefits from clinical practices:

Benefits of acupuncture and Chinese herbal treatments include:

• It is an effective treatment for unexplained infertility.
• It has many desirable effects, such as a regulated menstrual cycle, reduced premenstrual syndromes (PMS), relieved physical and emotional stresses associated with infertility and subsequent treatment, and improved overall health.
• It has no short-term or long-term side effects.
• It offers new hope for patients who are unable to conceive with the help of ART alone.
• It is relatively inexpensive compared to western procedures.

Specific benefits, when adopting acupuncture and Chinese herbal treatments to supplement IUI/IVF programs, include:

• Improve the function of the ovaries to produce better quality eggs.
• Regulate the hormones to produce a larger number of follicles
• Increase blood flow to the uterus and increase the thickness of the uterine lining
• Relax the patient and decrease their stress
• Prevent the uterus from contracting
• Lessen the side effects of drugs used in IVF
• Strengthen the immune system
• Improve semen to create better quality and quantity of embryos
• Decrease chances of miscarriage

Pathology of female infertility in traditional Chinese medicine (TCM)

According to a study published in the Journal of Traditional Chinese Medicine, liver Qi (vital energy) Stagnation and Kidney Deficiencies account for 51.7% and 22.4% of female infertility patients. This is not surprising when you consider contemporary lifestyles and the demography of many female infertility patients. Liver Qi Stagnation is often associated with stress, a sedentary lifestyle, and a greasy diet. On the other hand, Kidney Deficiency is often the result of a very demanding lifestyle and the natural process of aging.

Younger infertility patients tend to have Liver Qi Stagnation and over 40 female patients tend to have Kidney Deficiency. Nevertheless, it's important to understand that this is just one piece of many a fertility patterns. In TCM, the liver plays a vital role in the reproductive system. Liver Qi moves the Blood and stagnation of Liver Qi is likely to cause Blood Stasis. In time, Blood Stasis may cause any of endometriosis, uterine fibroids and ovarian cysts, dysmenorrhoea, irregular or scanty menstruation, which leads to infertility. The kidney is the most important organ in the reproductive system. Any aspect of kidney deficiency, whether Yin, Yang or Essence Deficiency often leads to amenorrhea, anovulation, a small uterus, thin endometrium (e.g. a case study), low ova quality and premature ovarian failure.

Treatment of female infertility by traditional Chinese medicine

Like western medicine, the first step to successful treatment with TCM is proper diagnosis. Once the syndromes (the nature of illness) are diagnosed, the TCM practitioner has already formed an opinion on the pathogenic factors, pathogenesis, location, and prognosis. Patients having the same disease can have different syndromes. So each case may be treated differently.

For infertility patients, TCM treatments generally gear to female patient's menstrual cycle which can be categorized into four phases, while our treatments are specifically designed to assist each body function independently:

• menstruation period - when the body releases all the build-up in the uteriene wall that has not been used for conception, it is also the time to build up ovary functions and egg quality.
• follical period after menstruation - this signifies enhancement of ovary in preparation for ovulation.
• ovaulation - this kicks off to strengthen the uterine lining.
• luteal phase after ovulation - this is time to move the blood and to prepare for bleeding.

  Acupuncture and herbal treatments may vary by the changes of four phases. These treatments support and enhance the natural functions of our physical body and therefore improve the probability of conception when it occurs.

  Note: For more detailed description of these four phases, please click Basic Fertility 101.

  
  

  Acupuncture treatment protocols to complement ART

  The protocols for using acupuncture and herbal medicine to support fertility treatment are clearly explained in a book titled Acupuncture & IVF by Lifang Liang. Treatments complementary to IVF involve three phases: Pre-IVF, During IVF and Post-IVF.

  1. In the Pre-IVF phase, weekly acupuncture is recommended for at least three months to alleviate the side effects of medical treatments, increase the response to hormonal stimulation and improve the reproductive organs and overall health.
  2. In the 2nd phase, for the duration of the IVF treatment, weekly acupuncture plus pre & post transfer acupuncture is recommended. This will increase blood flow to the uterus and ovaries, reduce the stress response caused by IVF and calm the uterus to facilitate implantation.
  3. In the Post-IVF phase, weekly acupuncture for up to three months is recommended for pregnant patients to reduce their risk of miscarriage and ectopic pregnancy. It is essential for patients with a history of miscarriage and ectopic pregnancy to receive treatment during this phase.

  The above protocol can easily be modified to accommodate just about any ART procedure.

  
  

  Conclusion

  In recent years, acupuncture has been gaining support from patients and some fertility specialists. Many fertility clinics have started recommending acupuncture to their patients, and some US clinics now have acupuncturists on staff.

  Finding an experienced acupuncturist and faithfully following the requirements - whether itˇs drinking bitter herbal teas, changing your lifestyle or receiving regular acupuncture treatments - are the keys to successful fertility treatment.

  
  

  Recommended reading

  • The Infertility Cure: The Ancient Chinese Wellness Program for Getting Pregnant and Having Healthy Babies by Randine Lewis. Little, Brown and Company, 2004.
  • Fulfilling The Essence: the Handbook of Traditional & Contemporary Chinese Treatments for Female Infertility by Bob Flaws. Blue Poppy Press, 1999.
  • Acupuncture & IVF, Increase IVF Success By 40-60% by Lifang Liang, Blue Poppy Press, 2003.