TCM NATURE HEALTH CENTER

(By Carrie Elizabeth Sklar)

For the 4.5 million couples experiencing infertility each year, acupuncture may be just what the doctor ordered. Acupuncture can increase fertility by reducing stress, increasing blood flow to the reproductive organs and balancing the endocrine system, according To several studies and medical research. Acupuncture can improve almost every cause of infertility. While 40 percent of infertility is caused by problems in the female, such as anovulation and endometriosis, another 40 percent is caused by problems in the male, such as low sperm counts or motility. The remaining 20 percent is caused by unknown factors.

How Does Acupuncture Do It?

One of the ways acupuncture increases fertility is by reducing stress, which is often a key factor in the fertility of both men and women. When people are under stress, the hormone cortisol is released in the brain. This alters the brain's neurochemical balance, thus changing hormone levels and disrupting the pituitary balance that is key to the reproductive cycle. Because of the delicate balance between the hypothalamus, pituitary and reproductive glands, stress is capable of preventing a woman from ovulating entirely. Stress can also cause spasms in both the fallopian tubes and the uterus, which can interfere with movement and implantation of a fertilized egg. In men, stress can alter sperm counts, motility, and cause impotence. Acupuncture counters the effects of stress and cortisol by releasing endorphins in the brain, which exert a calming effect.

More Causes of Infertility

Hormonal balance does not have to be disrupted by cortisol to cause infertility. The most common female infertility factor is an ovulation disorder, in which the release of a mature egg from the ovary is prevented, usually because of a hormonal imbalance. Without enough progesterone, for example, the fetus is unable to attach to the uterus. High levels of prolactin, the hormone that stimulates the production of breast milk, can also prevent ovulation.

High levels of follicle stimulating hormone (FSH) can also impair the female's ability to become pregnant. However, according to San Francisco infertility specialist Miki Shima in the February 2004 issue of Alternative Medicine, "if your FSH levels are nine or below, and there are no physical obstructions, traditional Chinese medicine alone can substantially improve your odds" of conception.

An imbalance in reproductive hormones can also negatively affect male reproductive function, such as sperm motility and production. However, the fertility drugs that stimulate ovulation in women by regulating the hypothalamus and pituitary, the glands that control reproductive hormones, don't perform nearly as well for men (success rates are about a third of those for women), nor have they been approved for men by the FDA.

According to Shima, men over the age of 45 are likely to have low sperm motility as well as misshapen sperm, which can prevent conception. Shima, who is the president of the Japanese-American Acupuncture Foundation, says, "both of these problems are very responsive to Chinese medicine and supplements."

While the fertility drugs commonly prescribed for women can produce a 20 to 60 percent pregnancy rate, they also commonly include such side effects as abdominal tenderness, bloating, fluid retention, weight gain, and nausea. Some studies show that they may also cause breast cancer.

More on Acupuncture for Infertility

Acupuncture, by contrast, produces few or no side effects while performing the same function as the drugs do: stimulating the hypothalamus to effectively balance the endocrine system and its hormones.

Deborah and Pete Mokris know from personal experience how much acupuncture can increase both sperm count and sperm motility. According to Deborah, "We tried zucchini flour pollen, vitamin C, standing on my head after lovemaking and every old-wives tale we came across. Pete's sperm count and motility remained low: about 7 million to 14 million motile sperm. We did intrauterine insemination twice. Our hopes rose and fell as the negative results persisted."

It was then that Pete started getting regular acupuncture treatments. "After two months of treatment, we had another semen analysis done," Deborah said. "The sperm count had skyrocketed to 117 million with a 65 percent motility! We went for one more intrauterine insemination, and again it was unsuccessful. It was then [that] I decided to try acupuncture. Within three weeks of treatment, I conceived."

Acupuncture also increases fertility by strengthening the immune system, which can play an important role in conception. Studies show that the endorphins released by acupuncture can raise the amount of white blood cells, T-cells and anti-bodies in the body, which increase the body's level of immunity. According to Chatelaine Magazine, 20 to 25 percent of miscarriages are due to immune system problems.

Shima agreed with these findings in Alternative Medicine: "Where Western medicine concentrates solely on the reproductive organs, Chinese medicine works to strengthen ad balance all systems of the body, using a combination of acupuncture, herbs and nutritional supplements."

Acupuncture can also increase fertility by increasing blood flow in the body. This can provide a woman's reproductive organs with more nourishment and can increase the density of the uterine wall. For women who cannot become pregnant because of endometriosis, in which the uterine lining grows outside the uterus, acupuncture can increase blood flow to relax and quiet the endometrium - something Western doctors achieve through progestogen hormonal therapies.

"The main reason why a lot of doctors are so excited about acupuncture is the relaxation of the uterus," said Donna Keefe, a licensed acupuncturist and faculty member at Pacific College of Oriental Medicine in San Diego, Calif. In her private practice, Keefe treats about 32 patients a week for infertility.

What Does the Research Say?

Increasing the flow of blood throughout the body can also help with male fertility problems. If men are experiencing problems with impotence, an increase in blood flow can increase potency. According to a study conducted by the Guangzhou University of Traditional Chinese Medicine in which 29 patients were treated for sexual impotence with weekly acupuncture from 1997 to 1999, 72 percent recovered normal sexual function. Short of assisted reproductive techniques, Western medicine doesn't offer many solutions to men with low sperm counts or motility. Keefe said that acupuncture can increase motility as quickly as the night a couple wants to conceive.

Other studies show that when used in conjunction with in vitro fertilization (IVF), acupuncture is even more successful at increasing fertility. IVF involves the mixing of sperm and egg outside the human body. After fertilization takes place, the fertilized egg is surgically placed in the woman's uterus. While the average cost of each IVF procedure is ,400, the American Society of Reproductive Medicine reports that it has a 25 percent success rate in women under 35.

Researchers at the Christian-Lauritzen-Institut in Ulm, Germany reported this year that acupuncture can increase the success rate of IVF. Of 160 women undergoing IVF, half were given acupuncture both before and after the procedure. The pregnancy rate for the 80 women who received acupuncture was 42.5 percent, while those who did not receive acupuncture had only a 23 percent success rate.

A study published in the April 2002 issue of Fertility and Sterility magazine also supports the fact that acupuncture increases fertility. Researchers examined 80 patients who received acupuncture while undergoing IVFs. After six weeks, 42 percent of the women who received acupuncture became pregnant, compared to 26 percent who became pregnant without acupuncture.

More from Acupuncture Fertility Experts

Shima's personal experience with infertility corroborates this evidence; according to Shima, "Many of my patients are women undergoing IVF or egg donation, and I've found that adding acupuncture, supplements and herbs to the mix can raise their success rate by 15 to 25 percent."

According to Raymond Chang of Cornell University and Meridian Medical in New York in an interview with Reuters Health, studies show that women who used acupuncture without any other fertility treatments were just as likely to conceive in the same period of time as women who took fertility drugs.

Keefe said that she always prefers when her patients try to conceive naturally rather than using IVF. Along with acupuncture, Keefe usually prescribes Chinese herbs to increase nourishment.

"Infertility is usually due to some sort of imbalance," Keefe said. "Herbs nourish that balance - they nourish the blood. Acupuncture moves qi, which facilitates the movement of blood, but acupuncture doesn't build blood. And of course the menses are based on the condition of the blood."

Keefe will occasionally also instruct patients to use food therapy, exercises such as qi gong, and stress reduction techniques to increase fertility. However, when receiving acupuncture in conjunction with an IVF, Keefe never prescribes Chinese herbs because their effects on fertility drugs haven't been researched.

One of the reasons Keefe prefers her patients to attempt natural conception is because of the hormonal imbalances procedures like IVF can cause. "When you go into an IVF, you shut down the body's natural processes and use hormones to produce a false cycle," Keefe said. "That can be hard on a woman's hormonal system."

Problems With IVF

VF can sometimes create complications for the unborn child. According to the Wall Street Journal, more than 12 scientific papers have been published in the past year suggesting a connection between fertility treatments and low-birthweight infants or disorders such as hypospadia, heart malformations, chromosomal abnormalities or other major birth defects.

Keefe said that some of her patients report that their insurance companies won't cover IVF, an already expensive procedure, because of possible health risks. "We don't know if [IVF] may cause ovarian cancer," Keefe said. "There just hasn't been enough research."

Acupuncture vs. IVF

One of the obvious benefits of acupuncture is that it lacks the side effects associated with IVF and other Western fertility treatments, such as hormonal therapies and surgery. And considering its success rate, acupuncture may even make other treatments unnecessary.

Keefe said that she began treating a patient who was considering an IVF, and after seven acupuncture treatments, she became pregnant before she could even undergo a surgical procedure. Keefe also spoke of another patient who had tried six IVFs with no success, but after three months of acupuncture, had recently conceived. With patients who try to conceive naturally, Keefe estimates that she has an 80 percent success rate, though the number of acupuncture treatments needed and the length of time it takes each couple to conceive varies, since every individual is different. Shima recommends at least four months of weekly acupuncture treatments.

Dawn Morrin was preparing to go on fertility drugs to conceive when she decided to try acupuncture first. "It was only six weeks after beginning the acupuncture that I found out that I was finally pregnant," Morrin said. "After 20 months of waiting, we were elated. Acupuncture was the only thing I had changed in my lifestyle during that last cycle, so I firmly believe that it was our saving grace."

Acupuncture is also extremely cost-effective in comparison to IVF. While one IVF treatment can cost over ,000 - with no guarantee of success - the average cost per individual for one acupuncture treatment is between and . However, when patients do chose to have IVF, Keefe said that it's best to get acupuncture treatments both before and after the procedure. While the IVF may disrupt the body's natural cycle and cause undue stress, receiving acupuncture in conjunction with that process helps keep the body balanced, increasing the chances of conception.

Keefe said that she continues to treat her patients throughout the first trimester. These continued treatments keep stress levels down to avoid miscarriages, as well as help with the nausea and back pain commonly experienced by women during pregnancy.

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