FEATURE - March 2018

How Acupuncture Can be Used For Infertility

by Janet Lee, DACM, L.Ac., FABORM 

 

If you’ve had difficulty conceiving, you likely already know the stats: At least one in eight couples in the U.S. are affected by infertility. According to the Centers for Disease Control (CDC), 12 percent of women will have difficulty getting pregnant or carrying to term during their normal childbearing years. The process can be long, arduous and emotionally and financially draining. In some cases it can challenge the foundations of your relationship.

       

Thanks to advancements in technology, assisted reproductive techniques (ART) are improving every year. They’re still centered around manipulating hormones to grow as many follicles as possible in the hopes of getting one good egg to meet that one good sperm. But ultimately, even when the DNA and egg and sperm quality are acceptable, success still depends on the uterine environment and the woman’s overall health.

The ART process is drug- and time-intensive, not to mention invasive. It can hijack your body’s natural processes for months. And the cost—approximately $12,000 to $20,000 per “round” of in vitro fertilization (IVF) or $500 to $1,000 per intrauterine insemination (IUI), depending on where you live and the clinic—can be prohibitive as well.

 

Chinese medicine and infertility

Acupuncture, herbs, dietary recommendations and other techniques—all part of Chinese medicine—have been used to treat women’s health and infertility for centuries. It doesn’t generally boast technological advancements; the foundations of treatment have remained pretty much the same. What has changed is our ability to study and understand how it works, and this can alter how we approach treatment with our clients.

           

Some of the ways we believe acupuncture works to help with infertility are by increasing blood flow to the uterus and ovaries, stimulating hormones that lead to improved ovulation and cycle regularity, and triggering the release of endorphins and “endogenous opioids,” which calm the stress response. Other research has shown that certain Chinese herbs may help improve mitochondrial function in the egg (giving them more energy), and acupuncture may also help improve various sperm parameters.

           

Most of the research on Chinese medicine and fertility focuses on using it during the ART process. Specifically, acupuncture is often performed immediately before and after embryo transfer (the point during IVF when the fertilized egg is returned to the uterus). Studies found that this approach led to a 65 percent increase in birth rates.

Word got out and it became a standard “IVF protocol” for acupuncturists, whether they specialized in women’s health or not. As research has accumulated, the success rates have shifted, and recent research has shown a much smaller benefit. Still, the results have proved strong enough to prompt some of the top fertility centers in the country to offer acupuncture as a regular part of their fertility programs.

           

But many acupuncturists would argue that this is not really Chinese medicine. Simply putting needles in a client that you’ve never seen before—and may not see again—using the same points for everyone, isn’t applying the full power of Chinese medicine, which at its roots is complex and individualized.

 

Most acupuncturists who specialize in infertility use needling, herbs, cupping, Chinese massage, and lifestyle recommendations (and possibly other interventions, such as yoga or supplements, depending on their expertise) over a few months to address underlying issues that may be contributing to infertility. This approach is referred to as whole-systems Traditional Chinese Medicine (TCM). It’s more in line with how acupuncturists and Chinese medicine doctors practice in the real world with all of their clients, whether they’re coming for infertility, pain, or something else.

 

Finally, we’re starting to see research based on this method of treatment. A 2015 study—the first of its kind—published in the journal Reproductive BioMedicine Online evaluated more than 1,200 IVF cycles over a five-year period. Researchers found that those who had IVF with their own eggs and who received whole-systems TCM had a 27 percent higher live birth rate than those who received IVF alone. It was 21 percent higher than the group who did IVF along with pre-/post-embryo transfer acupuncture.

 

But when those results were statistically adjusted for age, previous IVF cycle and dosage of a key IVF drug (to make the groups more comparable), the whole-systems TCM group had approximately double the live birth rate of the other groups. Women who had an average of 12 acupuncture treatments leading up to embryo transfer had a better chance of having a live birth.

             

Taking the Next Step

This type of research is complex and impossible to do in a “controlled” environment (e.g., with placebo controls), but the results are encouraging. If you’re considering exploring Chinese medicine for infertility, either on its own or in conjunction with ART, here are some questions you should ask:

 

Do you specialize in reproductive medicine? Some acupuncturists specialize in women’s health and infertility while others prefer to see a variety of clients with different issues. You can still get good care with someone who takes a broader approach, but ideally you want to work with someone who understands what you’re going through on the Western medicine side of the equation and how Chinese medicine may affect that process.

The American Board of Oriental Reproductive Medicine (ABORM) certifies acupuncturists who have undergone extensive, specialized education and passed a rigorous exam, ensuring that they’re fluent in both the Eastern and Western side of infertility and ART. (You can find ABORM-certified practitioners at aborm.org.)

 

Will you work with my reproductive endocrinologist (RE)? Depending on the relationship, your acupuncturist might speak to your RE if he or she has a concern, but don’t expect them to take a “team” approach. They have different tools and expertise. This is why it’s key that your acupuncturist understands the ART process and potential health implications. (Most REs in the Kansas City area don’t have acupuncturists on staff or offer it as part of an IVF program.)

 

What’s involved in Chinese medicine fertility treatment? Acupuncture and Chinese herbs are the mainstays of fertility treatment, but your acupuncturist may also recommend some lifestyle changes (such as altering how you exercise, losing/gaining weight or making healthy alterations to your diet), stress-relief techniques and possibly supplements, such as CoQ10 or omega-3’s. Chinese herbs are powerful, and your RE may not want you to take herbs while you’re also doing IVF so be sure to discuss this with your acupuncturist and RE.

           

As with ART, there is no guarantee that you’ll get pregnant if you opt for acupuncture. Your practitioner should never promise that he/she can make it happen for you. Regardless, you can expect your overall health to improve with regular acupuncture treatments and healthy lifestyle changes.

 

How much does it cost? REs are very clear with patients about the potential costs of all aspects of ART, and your acupuncturist should be forthcoming as well. Treatment fees vary between practitioners, but you can expect to pay between $1,000 to $1,500 for 12 weeks of acupuncture leading up to IVF (that includes weekly treatments and some herbs).

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