Acupuncture, frequently combined with herbal medicine, has been used for centuries to treat some but not all causes of infertility. For example, acupuncture and herbs will not work to address tubal adhesions which can occur as a result of pelvic inflammatory disease or endometriosis. However, in this situation, an individual could still benefit from acupuncture and herbs because of the potential effect of improved ovarian and follicular function. Additionally, acupuncture can increase blood flow to the endometrium, helping to facilitate a thick, rich lining.
When should acupuncture treatment begin?
Acupuncture is similar to physical therapy in that it is a process-oriented method of medical intervention. It is better to do more than less. Patients are commonly treated for three to four months before progressing to insemination, in vitro fertilization (IVF), or donor-egg transfer. This pacing of treatment seems to have a therapeutic effect.
In a study by Stener-Victorin et al from the Departments of Obstetrics and Gynecology Fertility Centre, Scandinavia and University of Gothenburg, women are encouraged to receive acupuncture treatments pre and post embryo transfer. Clinical observations from the Berkley Center for Reproductive Wellness suggest that the most effective fertility treatments involve a combination of acupuncture, herbal medicine, and traditional medicine. However, conception occasionally occurs when acupuncture and herbal medicines are used without traditional medical interventions.
When should I stop getting acupuncture?
Typically most miscarriages occur within the first three months of pregnancy. Consequently, treatment of patients may often last through week twelve to help prevent miscarriage.
Are the acupuncture points different after an insemination, IVF, or donor-egg transfer than before?
Acupuncturists should not place needles in the abdomino-pelvic area after insemination or transfer. There are 6 contraindicated acupuncture points which should be avoided when the patient is pregnant or pregnancy is suspected. These include Gallbladder 21, Stomach 12, Large Intestine 4, Spleen 6, Bladder 60, Bladder 67 and any points on the lower abdomen.
What are the risks of using acupuncture?
There are minimal risks in using acupuncture for fertility treatment. The risk of miscarriage may increase if incorrect acupuncture points are used during pregnancy. This is one reason why those choosing to include acupuncture in their treatment regimen should only be treated by an acupuncturist who specializes in treating fertility disorders. Acupuncture is generally safe regardless of a person's medical history.
What types of fertility patients typically get acupuncture?
Acupuncture can be used to treat any type of fertility disorder including spasmed tubes. Spasmed tubes are often de-spasmed with acupuncture, though blocked tubes will not respond to acupuncture. Acupuncture is often combined with herbal remedies to treat elevated follicle stimulating hormone (FSH), repeated pregnancy loss, unexplained (idiopathic) infertility, luteal phase defect, hyperprolactinemia (when not caused by a prolactinoma), polycystic ovarian syndrome (PCOS) with annovulatory cycles, and male factor including men affected with sperm-DNA-fragmentation.
Check our Research & Reviews tab for the latest research supporting the use of acupuncture as an adjunct for use with IVF treatment.
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Intro About traditional acupuncture: The evidence in UK
Infertility is the inability of a couple to get pregnant despite having regular unprotected sex. A couple is regarded as infertile if, after regular sexual intercourse, they have not conceived in two years. It is estimated that one in seven UK couples has difficulty conceiving (HFEA, 2006).
Identifiable causes of infertility include: ovulatory disorders in 27% of couples; tubal damage in 14% of couples; low sperm count or low sperm quality in 19% of couples. In 30% of couples the cause of infertility remains unexplained (NCCWCH, 2004). Female fertility declines with age, but the effect of age on male fertility is less clear (NICE, 2004). The difficulties couples encounter when facing fertility problems can lead to stress, which may further decrease chances of conception (Eugster & Vingerhoets, 1999). Acupuncture is a popular treatment choice for infertility (Smith 2010).
Eugster A, Vingerhoets AJ. Psychological aspects of in vitro fertilization: a review. Soc Sci Med. 1999 Mar;48(5):575-89.
Human Fertilisation and Embryology Authority (HFEA) Facts and figures for researchers and the media. (2006) www.hfea.gov.uk
National Collaborating Centre for Women's and Children's Health Fertility (NCCWCH) Fertility: assessment and treatment for people with fertility problems (full NICE guideline). Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk
National Institute for Health and Clinical Excellence (NICE) Fertility: assessment and treatment for people with fertility problems (NICE guideline). Clinical guideline 11. (2004) www.nice.org.uk
Smith JF, Eisenberg ML, Millstein SG, Nachtigall RD et al. The use of complementary and alternative fertility treatment in couples seeking fertility care: data from a prospective cohort in the United States. Fertil Steril. 2010;93(7):2169-74.
How acupuncture can help
Randomised trials in China have demonstrated significantly better pregnancy rates for acupuncture than medication (Yang 2005, Chen 2007, Song 2008), but these studies may not be of a high quality. In the West, clinical trials on acupuncture for natural fertility (i.e. not as an adjunct to assisted conception) are almost non-existent, though there is a small amount of positive evidence (Gerhard 1992, Stener-Victorin 2000, 2008, 2010).
Research has established plausible mechanisms to explain how acupuncture may benefit fertility:
regulating fertility hormones - stress and other factors can disrupt the function of the hypothalamic pituitary-ovarian axis (HPOA), causing hormonal imbalances that can negatively impact fertility. Acupuncture has been shown to affect hormone levels by promoting the release of beta-endorphin in the brain, which affects the release of gonadotrophin releasing hormone by the hypothalamus, follicle stimulating hormone from the pituitary gland, and oestrogen and progesterone levels from the ovary (Ng 2008, Huang 2008, Lim 2010, Stener-Victorin 2010). Further details of these processes are emerging, for example mRNA expression of hormones, growth factors and other neuropeptides (He 2009)
increasing blood flow to the reproductive organs - stress also stimulates the sympathetic nervous system, which causes constriction of ovarian arteries. Acupuncture inhibits this sympathetic activity, improving blood flow to the ovaries (Stener-Victorin 2006, Lim 2010), enhancing the environment in which ovarian follicles develop. It also increases blood flow to the uterus (Stener-Victorin 1996, Huang 2008), improving the thickness of the endometrial lining and increasing the chances of embryo implantation.
counteracting the effects of polycystic ovarian syndrome (PCOS) - PCOS is one of the most common causes of female infertility. By reducing sympathetic nerve activity and balancing hormone levels, acupuncture has been shown to reduce the number of ovarian cysts, stimulate ovulation, enhance blastocyst implantation and regulate the menstrual cycle in women with PCOS (Stener-Victorin 2000, 2008, 2009, Zhang 2009). It may also help to control secondary effects such as obesity and anorexia (Lim 2010).
Terms and conditions:
Terms and conditions The use of this fact sheet is for the use of British Acupuncture Council members and is subject to the strict conditions imposed by the British Acupuncture Council details of which can be found in the members area of its website www.acupuncture.org.uk.
Last modified on Friday, 02 December 2011 15:42