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Research on Acupuncture & TCM for Fertility

ACUPUNCTURE + IVF

  • Paulus W et al, Fertil Steril (2002). Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy, Fertility and Sterility;Vol 77 721-724.

    • 160 patients with good quality embryos underwent IVF. They were divided into the following two groups through random selection: embryo transfer with acupuncture, and embryo transfer without acupuncture. Acupuncture was performed for 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy. Clinical pregnancies were documented in 42.5% in the acupuncture group, whereas pregnancy rate was only 26.3% in the control group.

  • Hullender Rubin Lee, et al. (2015). Impact of whole systems traditional Chinese medicine on in vitro fertilization outcomes. Reproductive Biomedicine Online; pii:S1 472-6483(15)00092.

    • In this study, 1231 IVF patient records were assessed and outcomes were compared. They compared IVF with no treatment, IVF with just acupuncture, and IVF with Whole Systems Traditional Chinese Medicine (WS-TCM). (WS-TCM is what practiced at FMIM, and is an intervention of 12 acupuncture sessions before IVF, herbal medicine, diet, and lifestyle recommendations).The primary outcome was live birth. WS-TCM was associated with greater odds of live birth at 61%, compared with IVF alone (48%), or embryo transfer with acupuncture only (51%). WS-TCM was associated with increased live births compared with all groups, in donor and non-donor cycles.

  • Balk J et al, Compl Therapies in Clinical Practice (2010). The relationship between perceived stress, acupuncture, and pregnancy rates among IVF patients: A pilot study, Complementary Therapies in Clinical Practice 16,154–157.

    • These researchers at a university IVF clinic in Pittsburgh were interested to investigate the relationship between acupuncture, stress and pregnancy rates. The patients who received acupuncture on the day of embryo of transfer had a pregnancy rate of 55.6% compared with the control group pregnancy rate of 35.5%

  • Dalton-Brewer N et al (2010). Uses of Acupuncture Before and After Embryo Transfer, Human Fertility, Vol 12 No 4 212 – 255.

    • This report describes outcomes for all patients who attended the London Bridge Fertility, Gynecology and Genetics Centre in London over a 2-year period and who had acupuncture. In the acupuncture group positive pregnancy rates/ET were 44.6% comparing favorably with the non-acupuncture historic control group. When they analyzed outcomes in different age groups they discovered that acupuncture intervention was particularly effective in woman in the 35 - 39 and the over 40 group.

  • Smith JF, Eisenberg ML, Millstein SG, et al. The use of complementary and alternative fertility treatment in couples seeking fertility care: data from a prospective cohort in the United States. Fertility and sterility. May 1 2010;93(7):2169-2174.

  • Domar AD, Conboy L, Denardo-Roney J, Rooney KL. Lifestyle behaviors in women undergoing in vitro fertilization: a prospective study. Fertility and sterility. Mar 2012;97(3):697-701 e691.

  • Aelion A, Barbieri E, Shastri S, Grill E, Chung P, Rosenwaks Z. The use of complementary medical therapies (CMT) in infertility patients. Fertility and Sterility. 2009;92(3):S33-S34.

  • Petok WD, Braverman AM, Gallagher SM, Stern JE. Fertility treatment stress: what clinics offer and patients perceive. Fertility and sterility. 2013;100(3):S412.

  • Perry TE, Cueva S, Scoccia B, Hirshfeld-Cytron J. Usage and attitudes toward complementary and alternative medicine (CAM) among uninsured infertility patients. Fertility and Sterility. 2013;100(3):S320-S321.

STRESS + IVF + ACUPUNCTURE

Acupuncture significantly reduces stress and anxiety of IVF.

  • Isoyama et al, 2012; de Lacey et al, 2011; Balk et al, 2010; Domar et al, 2009; So et al, 2009; Smith et al, 2006.

IMPROVEMENT IN BLOOD FLOW

Acupuncture improves uterine lining. Napadow et al, 2008 wrote that: “acupuncture regulates uterine and ovarian blood flow (OBF), and that the effect is most likely mediated as a reflex response via the ovarian sympathetic nerves, and that the response is controlled via the supraspinal pathways.”

  • Stener-Victorin et al, 1996; Stener-Victorin et al, 2006; Yu et al, 2007.

ACUPUNCTURE + NATURAL CONCEPTION

  • Cochrane, S et al, Fertil Steril (2016). Prior to Conception: The Role of an Acupuncture Protocol in Improving Women’s Reproductive Functioning Assessed by a Pilot Pragmatic Randomized Controlled Trial. Evidence-Based Complementary and Alternative Medicine 2016, 1-11 doi:10.1155/2016/3587569

    • In this study researchers aimed to explore acupuncture as an opportunity to promote natural fertility by undergoing a course of both acupuncture and lifestyle modifications, when compared to an active control group which underwent lifestyle modification alone. Those receiving the acupuncture conceived within an average of 5.5 weeks compared to 10.67 weeks for the lifestyle only group. The women who received the acupuncture protocol experienced an increase in their fertility awareness, wellbeing, improved menstrual cycles, and conceived in half the time.

ACUPUNCTURE + MALE FERTILITY

Recent studies have shown that acupuncture can effectively increase sperm production, improve sperm movement (motility, increase the percentage of healthy sperm, improve the levels of hormones responsible for fertility and increase the rate of pregnancy when used in conjunction with ART studies.

  • Pei J et al. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. 2005 Jul;84(1):141-7 Fertility and Sterility.

    • Forty men with at least one of three problems with their sperm were treated with acupuncture twice a week for 5 weeks. A statistically significant increase after acupuncture in the percentage and number of sperm with no structural defects was demonstrated compared to the control group of patients who received no treatment. They concluded that male infertility patients could benefit from having acupuncture.

  • Dieterle et al. A prospective randomized placebo-controlled study of the effect of acupuncture in infertile patients with severe oligoasthenozoospermia. Fertility and Sterility, 2009 Oct.

    • 28 infertile patients with severe oligoasthenozoospermia (high percentage of poorly swimming sperm ie poor mobility) received acupuncture according to the principles of traditional Chinese medicine (TCM) and 29 infertile patients received placebo acupuncture. The men in the study who received acupuncture had significant improvements in the percentage of sufficiently motile sperm.

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

    • A prospective, controlled and blind study put two randomized groups of infertile men into an acupuncture group and a control group. After 10 treatments, the patients in the acupuncture group demonstrated a significant increase in the percentage of normal forms compared to the control group.

MECHANISMS

  • Cochrane S, Smith CA, Possamai-Inesedy A, Bensoussan A. Acupuncture and women's health: an overview of the role of acupuncture and its clinical management in women's reproductive health. International journal of women's health. 2014;6:313-325.

    • This study shows that acupuncture may impact fertility, ovulation, and menstrual regularity by triggering neurotransmitters which in turn increase GnRH, acupuncture may stimulate blood flow by inhibiting central sympathetic nerve activity, and acupuncture may stimulate production of endogenous opioids, which may inhibit the central nervous system’s outflow and the biological stress response.

ACUPUNCTURE SAFETY

  • MacPherson H, Thomas K, Walters S, Fitter M. The York acupuncture safety study: prospective survey of 34,000 treatments by traditional acupuncturists. British Medical Journal. 2001;323:486-487.

  • Witt CM, Pach D, Brinkhaus B, et al. Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form. Forsch Komplementmed. Apr 2009;16(2):91-97.

  • Birch S, Alraek T, Norheim AJ. Acupuncture adverse events in China: a glimpse of historical and contextual aspects. J Altern Complement Med. Oct 2013;19(10):845-850.

  • Park J, Soon Y, White AR, Lee H. The safety of acupuncture during pregnancy: a systematic review. . 2014 2014:1-10.

ACUPUNCTURE DOSAGE

  • Stener-Victorin, 1996. Acupuncture improved OBF after 8 treatments.

  • Jedel et al, 2011. Low freq EA decreased hyperandrogenism and regulated menstrual cycles after 16 weeks of treatment.

  • Johansson et al, 2013. Acupuncture increased ovulation frequency in PCOS patients with 10-14 weeks of treatment 2x/week.

  • Hullender Rubin et al, 2014; Magarelli et al, 2009. Acupuncture improves live births when administered at a larger dose (9-12 visits prior to ET).

  • Manheimer et al 2013; Cheong et al, 2013. Acupuncture performed on on the day of ET does not appear to benefit IVF outcomes when compared to any controls at this time. However, compared to a “no acupuncture” control, we do see benefits.