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By Katie Stevenson, Dr. Hailing Fu, O.M.D., Mark P. Trolice, M.D.
Introduction
Stress and Infertility
Ovulation Induction
Polycystic Ovarian Syndrome
Endometrial Receptivity
Conclusion
Introduction
Acupuncture has been the primary source of healthcare in China for more than 3,000 years. It works on the theory that disease and malfunction in the body result from blockage in the flow of vital energy (Qi) and blood. By removing these blockages and restoring normal flow the body is able to restore health and optimum organ function.
Through the use of hair thin metallic needles, trained Chinese Medical doctors are able to find and remove these blockages of blood and Qi allowing tissues and organs to heal themselves. In the case of infertility, the needles along with Chinese herbal remedies encourage the body to restore normal function of the uterus, the ovaries and the neuro-endocrine system needed for healthy ovulation and egg fertilization.
According to T. Hanlon (1), In-vitro Fertilization (IVF), when used with Acupuncture and Chinese herbal formulas, is able to increase the chance of pregnancy. Researchers from The Center for Reproductive Medicine and Infertility, Weill Medical College of Cornell University, New York, New York, have found that acupuncture helps:
- Reduce stress hormones that interfere with ovulation.
- Normalize hormones that regulate ovulation so an egg is released.
- Increase blood flow to the uterus, improving the chances of embryo implantation.
Stress and Infertility
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Based on research conducted at the Weill Cornell Medical Center, stress was determined to be a key factor in infertility.
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Again, based on research conducted at the Weill Cornell Medical Center, stress was determined to be a key factor in infertility. A vicious cycle exists whereby stress can cause infertility and in turn, infertility can cause stress. This can disrupt the pituitary balance that is important in the reproductive cycle, preventing a woman from producing hormones responsible for a normal ovulating menstrual cycle.
This resulting impact on the hypothalamic-pituitary-ovarian axis can be a major factor in infertility. In men, stress can alter sperm counts and motility and risk erectile dysfunction.
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In men, stress can alter sperm counts and motility and risk erectile dysfunction.
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Acupuncture provides a non-pharmacologic alternative to antidepressant and anxiolytic drugs in reducing depression and stress, respectively, in women and men undergoing infertility treatment. Acupuncture appears to reduce stress by releasing endorphins in the brain. Studies suggest that certain effects of acupuncture are mediated through endogenous opioid peptides in the central nervous system especially Beta-endorphins (an endorphin produced in the pituitary gland that is a potent pain suppressant). Because these neuropeptides influence gonadotropin secretion through their action on GnRH, acupuncture may affect the menstrual cycle through these same neuropeptides.
Acupuncture impacts centrally on the hypothalamic-pituitary-ovarian axis and peripherally on the uterus.
Ovulation Induction
While acupuncture treatment impacts Beta-endorphin levels which in turn affect GnRH secretion and the menstrual cycle, we can hypothesize the influence it has on ovulation and fertility. Various investigators have shown that in normal ovulating women acupuncture influenced levels of FSH and LH. Acupuncture has also been used as a surrogate for hCG in ovulation induction successfully by Cai. Chen and Yu showed that electro acupuncture normalized the hypothalamic-pituitary -ovarian axis. Stener-Victorin et al found improvement when using electro acupuncture for ovulation induction on 24 oligo/ amenorrheic women with PCOS.
Polycystic Ovarian Syndrome
They suggested that patients with Polycystic Ovarian Syndrome should consider acupuncture as an adjunct to pharmacological ovulation induction. According to Sklar acupuncture stimulates the hypothalamus to balance the endocrine system, performing the same function as fertility medications but producing few or no side effects. Chinese Herbal remedies containing kidney tonics aim at promoting the growth and maturation of ovarian follicles, while blood-invigorating herbs are used to induce ovulation. When used in conjunction with IVF, acupuncture may increase success.
Endometrial Receptivity
Endometrial thickness and uterine artery blood flow are important for implantation of human embryos during the transfer stage of IVF. With its central sympathoinhibitory effect on the sympathetic nervous system, acupuncture may contribute by dilating uterine arteries and blood vessels thereby increasing blood flow to the endometrium. Herbal tonics aim to promote blood flow to the uterus and other organs to enhance endometrial receptivity.
Conclusion
The role of acupuncture in the treatment of female infertility appears to have neuroendocrine effect on the hypothalamic-pituitary-ovarian axis through the release of opioids and other peptides in the central and peripheral nervous system. The peripheral impact of acupuncture improves uterine blood flow and hence endometrial thickness.
Additionally, acupuncture appears to reduce stress and thereby may assist with fertility. Since acupuncture is nontoxic, affordable and accepted by more patients it is increasingly being utilized by in the treatment of infertility.
Katie Stevenson is a third year student in Chinese Medicine. Dr. Hailing Fu, O.M.D. has completed her doctorate in Oriental Medicine and is on the staff of Fertility C.A.R.E. She has practiced medicine for 18 years specializing in acupuncture and formulating herbal prescriptions.
To learn more about your Acupuncture options, contact Dr. Fu directly at (407) 851-3701; she is located in our Fertility C.A.R.E. offices.
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