Optimizing Fertility

It is essential that couples planning a pregnancy optimize their health and well being for the best possible fertility outcome. Preconception health care is more important than ever in view of the prevalence of fertility issues today and it lays the foundation for preparing the body, mind and spirit of both parents for a vital pregnancy and birth.

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Thinking forward to the health of a baby yet to be born should be emphasized, encouraging parents to think beyond the urgency of just getting pregnant to focusing on creating the healthiest child possible.

Traditional Chinese Medicine has a long tradition in preparing men and women for conception with the understanding that the health or “pre-natal Qi” of the parents is passed on to a child. Cultivating reproductive energies through nutrition, lifestyle practices, acupuncture and herbal medicine were strongly held cultural practices that are relevant to this day.

Acupuncture and Herbal Medicine therapies are effective in addressing the following factors related to fertility:

  • Stress reduction, relaxation
  • Regulate hormone imbalances to address luteal phase defects, amenorrhea, polycystic ovaries, endometriosis, uterine fibroids, premenstrual and perimenopausal symptoms
  • Improves ovarian function follicle production
  • Improves ovarian blood flow which increases ovarian response
  • Increases uterine blood flow to improve endometrial lining
  • Strengthens the immune system
  • Male factor infertility: improves sperm count, motility and morphology
  • Advanced maternal age, recurrent miscarriage
  • Decreases uterine contractility during implantation
  • Decreases the chance of certain kinds of miscarriage

Stress and Fertility

Stress impacts infertility and infertility impacts stress; this is the cycle commonly seen among infertility patients. Whether reacting to major events or continual day to day life stressors the nervous system is stimulated into a fight or flight response. Nerve fibers connect the brain directly to both the fallopian tubes and the uterus through the autonomic nervous system. Prolonged stress responses lead to elevated levels of cortisol and adrenaline, stress hormones which inhibit the body’s response to progesterone and interrupt ovulation. Stress hormones can also cause spasms to occur in both the fallopian tubes and the uterus which disrupt implantation while shunting circulation away from the uterus and ovaries depriving them of necessary blood and nutrients.

A recent study published by The American Society of Reproductive Medicine stated that women who had acupuncture showed beneficial changes in serum levels of stress hormones compared to the control group of women who did not have acupuncture. Read the abstract of the study here.

Acupuncture is an effective way to reduce stress. Specific acupuncture techniques are employed to decrease excessive sympathetic activation and enhance the parasympathetic system to correct imbalances in the autonomic nervous system and in turn the endocrine system. Acupuncture releases endorphins and serotonin which have a strong calming effect on the body by reducing heart rate, lowering blood pressure and relaxing the muscles. Acupuncture also improves blood circulation throughout the body oxygenating tissues and specifically blood flow to the reproductive organs.

Nutritional Medicine

In building a foundation of health for pregnancy, dietary and nutritional factors cannot be underestimated. Reproductive health is highly dependent on balanced blood sugar, highly functioning elimination and detoxification pathways, and balanced nutrition. Nutritional status is best assessed using blood panels that can be interpreted to determine the patient’s imbalances and nutritional deficiencies. Accurate nutritional supplementation along with the appropriate dietary modifications for each patient, ensure that their body chemistry is balanced and their nutritional status is optimal.

Treatment

The recommended course of treatment to achieve pregnancy is minimally three to six months. Some patients may take less time to achieve pregnancy, and some take longer. Success varies and depends on the underlying fertility issue, and health status of each person and their commitment to their treatment, including dietary and self care.

It is best to start treatment before trying to conceive as it takes about 90 days to influence changes in a woman’s menstrual cycle, to improve ovulation and uterine lining, regulate hormones and address conditions such as PCOS or endometriosis. It also takes about 150 days for an egg to grow from a follicle in its resting state to a mature egg ready to be released and the influences of treatment on those follicles to manifest. Lastly it will often take as much time to truly integrate lifestyle and dietary changes that will be a large part of healing and progress.

Appropriate diagnostic testing will be determined for each patient including blood chemistry panels, saliva hormone testing and metabolic health assessments as well as fertility charting. An individualized program of nutritional supplementation, herbal medicine, acupuncture, and self care practices will be prescribed dependent on each person’s needs and goals.

How can acupuncture correct hormonal imbalances?

Many hormonal problems are due to glitches in the delicate signaling of the endocrine system, which may alter a pathway by which the body produces hormones. A slight aberration can throw the entire system off so it no longer functions smoothly. Research has shown that acupuncture has a regulating influence on these hormonal pathways, and assists our own internal energies to restore endocrine harmony. Acupuncture can assist in correcting and fine tuning the complex interplay of hormonal signals of the hypothalamic-pituitary-gonadal axis, crucial to creating a healthy hormonal environment to sustain implantation and a healthy pregnancy.

Acupuncture and Assisted Reproductive Technologies/IUI & IVF

By pairing the high tech advances of modern assisted reproductive technologies with the complementary therapeutics of Chinese Medicine, ART patients can benefit from the best of both worlds. Studies have shown that the combination of Eastern and Western medicine results in higher pregnancy rates. Chinese Medicine views infertility as both a pathogenesis and weakened state of the body. Infertility therefore is a condition of systemic imbalance and aging. While Western medicine is capable of regulating reproductive physiology, Chinese medicine’s intent is to rebalance and improve the overall function of the body’s systems, returning the body to its homeostatic state in preparation for implantation and a healthy pregnancy.

  • Increases follicular development with some patients in ART cycles with the combination of TCM and fertility drugs especially in patients labeled as “poor responders”. This can be seen in either an increased production of eggs or increased fertilization rates in IVF.
  • Increases uterine blood flow to improve thickness of the endometrial lining improving conditions for implantation
  • Strengthens and regulates the immune system
  • Regulates the endocrine system and ovulation, especially for women with polycystic ovarian syndrome
  • Promotes relaxation and reduces the release of stress hormones that negatively impact fertility
  • Decreases uterine contractility to calm the uterine tissue and facilitate implantation
  • Lessens the side effects of drugs used during IVF
  • Decreases the chance of certain types of miscarriage
  • Male factor infertility: improves sperm count, motility and morphology

Treatment:

Optimizing FertilityFor the best possible results acupuncture combined with herbal, dietary and lifestyle counseling can be used before, during and after ART. Chinese medicine helps prepare both partners for ART by working to improve ovarian function and the immune system as well as reducing stress and improving the quality and quantity of sperm and seminal fluid. For the female partner specific acupuncture and herbal medicine protocols are used to promote ovulation and address any cycle irregularities including endometriosis, fibroids, PCOS, heavy bleeding and amenorrhea. Specific Chinese medical protocols for the male partner are employed to treat low sperm count, poor motility, abnormal morphology and problems with seminal liquefaction.

Ideally it is best to start treatment prior to undergoing IUI or IVF. Depending on the causative factors and status of a patient’s reproductive health, ideally a course of treatment consists of acupuncture, herbal and nutritional therapy weekly for three months or more in preparation for a procedure as it takes about 90 days to begin to affect changes in a woman’s menstrual cycle. Many women may not be aware of the benefits of Chinese Medicine for fertility until they have already started trying to conceive or have started Western fertility treatments. In these cases, it’s best to start treatment as soon as possible. It’s never too late to start using TCM to improve your fertility.

Once a woman’s imbalances are addressed and her reproductive health is stabilized the next phase of care begins as she approaches her IUI or IVF cycle. Specific protocols are employed throughout each phase of the ART cycle. Specific points are used to stimulate the ovaries, others to increase uterine blood flow and other protocols are chosen prior to and following embryo transfer. Treatment is individualized to fit each patient’s needs and medical patterns according to Chinese Medicine.

After a successful implantation has taken place Chinese medicine can also be helpful in preventing miscarriage not related to chromosomal abnormalities. For this purpose it may be used either preventively when the woman is asymptomatic or even after symptoms of threatened miscarriage have appeared.

Here are some abstracts of studies related to Acupuncture and its effects on the outcome of IVF.

  1. Acupuncture & IVF poor responders: a cure?
  2. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture
  3. A Pilot Study Evaluating the Combination of Acupuncture with Sildenafil on Endometrial Thickness
  4. ACUPUNCTURE AND GOOD PROGNOSIS IVF PATIENTS:SYNERGY
  5. CHANGES IN SERUM CORTISOL AND PROLACTIN ASSOCIATED WITH ACUPUNCTURE DURING IVF
  6. Stress reduces conception probabilities across the fertile window: evidence in support of relaxation
  7. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy.
  8. Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study
  9. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility

Acupuncture & IVF poor responders: a cure?

Author: Magarelli P, Cridennda D

Publication Date: 2004

Publisher: 81 Suppl 3 S20 Fertility and Sterility

Conclusions: Significant increases in pregnancy outcomes were confirmed by this study and the data uniquely supported the advantage of acupuncture in patients with normal Pulsatility index. We also demonstrated that both acupuncture treatment protocols could be used together with a synergistic effect. Finally, this study is the first to demonstrate that the use of acupuncture in patients with poor prognoses (elevated Peak FSH, longer history of infertility, poor sperm morphology) can achieve similar pregnancy rates to normal prognosis patients.

Magarelli P,Cridennda D, Fertil Steril,2004;81 Suppl 3 S20 Fertility and Sterility 

Objective: The purpose of the study was to determine the influence of two acupuncture protocols on IVF outcomes and secondly to identify the appropriate patient groups that would most benefit from this adjunctive therapy.

Materials and Methods: In this retrospective study, data was extracted from medical records of patients RE&I clinic & acupuncture clinics between January 2001 and November 2003. All patients completing an IVF cycle with transfer were included. One RE&I provided the IVF care and a consortium of acupuncturists overseen by the author provided the strict acupuncture protocols. PR per transfer were the endpoints measured. Data was analyzed by student’s t test and Multiregression with Wilcox ranking (MRW).

Results: 147 patients were included in the study and of those 53 had Acupuncture (Ac) and 94 did not (Non-Ac group). Demographic data between these Ac and Non-Ac groups respectively indicated remarkable equity (Table 1). Fertility Factors also demonstrated equity and there were no differences in Diagnoses, IVF Protocols and type of Gonadatrophin protocols used.

Factors that demonstrated significance were: Length of time infertile, Peak FSH, PI for total group without MRW; PI for MRW groups reversed this (Table 2) and finally average: Sperm Morphology, Peak E2, Peak P4 prior to HcG: and endometrial thickness. PR before Wilcox ranking were the same: 40% v 38%. MRW analysis revealed FSH, Length of time trying to get pregnant, Sperm Morphology and E2 levels as significant: 6.5, 4.1, 4.0 and 1.6 respectively. When the Ac group was modified (15 Ac patient dropped), PI was elevated from 1.76 to 1.94 resulting in a significant elevation compared to the Non-Ac group, p 0.01. Also PR changed from 40% before to 53% after and this value was significantly greater than the Non-Ac group (38%), p 0.01.

Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture

Author: Stener-Victorin E, et al

Publication Date: 1996

Publisher: Human Reproduction

Previous studies have shown that reduced blood flow in the uterine arteries is associated with a decreased pregnancy rate following IVF-embryo transfer. This study reported in Human Reproduction (the official journal of the European Society of Human Reproduction and Embryology) shows that after eight acupuncture treatments, blood flow to the uterus was markedly increased. Research carried out by one group of IVF clinics in California has shown that using this protocol to increase blood flow to the uterus, combined with acupuncture on the day of transfer, has resulted in a significant improvement in pregnancy rates.

Abstract

In order to assess whether electro-acupuncture (EA) can reduce a high uterine artery blood flow impedance, 10 infertile but otherwise healthy women with a pulsatility index (PI) ≥3.0 in the uterine arteries were treated with EA in a prospective, non-randomized study. Before inclusion in the study and throughout the entire study period, the women were down-regulated with a gonadotrophin-releasing hormone analogue (GnRHa) in order to exclude any fluctuating endogenous hormone effects on the PI. The baseline PI was measured when the serum oestradiol was ≤0.1 nmol/1, and thereafter the women were given EA eight times, twice a week for 4 weeks. The PI was measured again closely after the eighth EA treatment, and once more 10–14 days after the EA period. Skin temperature on the forehead (STFH) and in the lumbosacral area (STLS) was measured during the first, fifth and eighth EA treatments. Compared to the mean baseline PI, the mean PI was significantly reduced both shortly after the eighth EA treatment (P < 0.0001) and 10–14 days after the EA period (P < 0.0001). STFH increased significantly during the EA treatments. It is suggested that both of these effects are due to a central inhibition of the sympathetic activity

A Pilot Study Evaluating the Combination of Acupuncture with Sildenafil on Endometrial Thickness

Author: Yu W et.al

Publication Date: 2007

Publisher: Presented at the Pacific Coast Reproductive Society Annual Conference

This small pilot study examined the effect of Viagra and acupuncture on the uterine linings of women who had a history of thin linings (<8mm) in previous IVF cycles (including patients who had previously used Viagra alone). They used the above mentioned protocols which improve blood flow to the ovaries and uterus. The researchers found that after acupuncture treatment the thickness of the lining improved to 10 mm or more in all participating patients.

Abstract

Endometrial thickness has been shown to be an important prognostic factor of successful embryo implantation. If the endometrial thickness is less than 9 mm, there is a significant reduction in live birth rates. Though there is conflicting data, preliminary evidence suggests that the administration of vaginal Sildenafil can markedly improve endometrial thickness and result in increased live IVF births. Our clinical observations are consistent with this. However, other clinics report inconsistent results. Therefore, we hypothesized that the difference in response between clinics may involve other factors. When we looked into this, we found that many of our patients were simultaneously receiving acupuncture treatments.

Studies on acupuncture have demonstrated positive effects on implantation rates, ongoing pregnancy rates and the number of live births. Acupuncture has also been shown, via measurements of pulsatility index, to significantly increase blood flow to the uterus. Decreases in pulsatility index have been shown to significantly improve pregnancy rates. Researchers have also found that acupuncture has direct effects on the endometrium. Some of these include increases in progesterone receptor concentration, a reduction in COX-2, and an increase in the activity of nitric oxide synthase. Therefore, the purpose of our investigation was to evaluate the effects of combining acupuncture and Sildenafil suppositories on endometrial lining.

Results: All four subjects achieved endometrial lining thickness of greater than or equal to 10 mm following the administration of the combination of acupuncture and Sildenafil, including one patient whose lining did not exceed 5 mm in a previous cycle. Another patient, who had not responded to Sildenafil alone in a prior IVF cycle, responded to the combination of Sildenafil and acupuncture. We also noted that endometrial thickness in most patients continued to increase post-hCG administration.

Conclusions: This pilot study is consistent with previous reports that acupuncture improves uterine lining measurements over previous cycles. This preliminary data supports the potential for a synergistic action between acupuncture and Sildenafil. We hypothesize these effects may be due to acupuncture’s ability to upregulate nitric oxide synthase. However, we cannot rule out other mechanisms of action since acupuncture has also been shown to affect many other parameters. The results of this preliminary data may also suggest a role for a similar combination in treating erectile dysfunction. Further testing and data is necessary to verify these results.

ACUPUNCTURE AND GOOD PROGNOSIS IVF PATIENTS:SYNERGY


 
Authors: P. C. Magarelli, D. K. Cridennda, M. Cohen. Reproductive Medicine & Fertility Center, Colorado Springs, CO; East Winds Acupuncture, Inc., Colorado Springs, CO.

FERTILITY AND STERILITY®, Proceedings from the 2004 ASRM meeting in Philadelphia

OBJECTIVE: To determine the role of electro stimulation acupuncture and traditional combined with auricular acupuncture on IVF outcomes in good prognosis patients.

DESIGN: Retrospective case controlled clinical study. Acupuncture Consortium for treatment standardization. Reproductive Endocrinology & Infertility IVF Private Practice and Traditional Chinese Medicine Acupuncture Clinics.

MATERIALS AND METHODS: One hundred fourteen infertile patients undergoing controlled ovarian hyperstimulation with gonadotropins and GnRH agonist and antagonist for IVF-ET (2001 to 2003) in private practice IVF clinic. Only IVF patients with normal Day 3 FSH, normal uterine artery pulsatility indices, sperm morphologies over 7% normal by Kruger Strict Criteria and good response to ovarian hyperstimulation protocols (i.e., E2 over 2000 pg/ml) were analyzed.Intervention (s): Electrostimulation acupuncture – reduction of Pulsatility Index (PI) of the uterine artery and Traditional combined with Auricular acupuncture – Pre/Post embryo transfer protocols were used alone or in combination and resultant pregnancy outcomes were measured after IVF treatments. Main Outcome Measure(s): Cycles were grouped according to those that received No Acupuncture (Non-Ac) and those that received either one or both acupuncture treatments (Ac). Comparisons were made between Acupuncture treated IVF patients and Non-Acupuncture treated IVF patients in clinical pregnancies, ongoing pregnancies and birth outcomes. The statistics used for this analysis included; Tests for normal distribution: chi-square test, Kolmogorov-Smirnov Test Unpaired T-tests Stepwise Multiple regression Variance ratio test (F-Test) One-Way analysis of variance (ANOVA) with Student-Newman- Keuls (SNK) test for pair wise comparison of subgroups.

RESULTS: Total IVF cases 114, 53 with Acupuncture (Ac) and 61 without Acupuncture (Non-Ac). Demographics, Infertility Diagnoses, and Treatment Protocols were statistically the same between both groups and by design, the following parameters were similar: Sperm Morphology; Peak Day 3 FSH; Average Pulsatility Index; Peak E2 at hCG; and Post hCG P4. These parameters earned the designation of Good Prognosis group. Preg- S80 Abstracts Vol. 82, Suppl. 2, September 2004 nancy rates (PR) and Miscarriage rates (SAB) were statistically improved at the p < 0.05 levels in those patients that received Acupuncture (51% v 36% PR and 8% v 20% SAB in the AC v Non-Ac groups). There were no ectopic pregnancies in the Ac group and 9% in the Non-Ac group, p < 0.008. Finally, Birth rates (BR) per cycle start and per pregnancy were significantly higher in the Ac group, with 23% more births/pregnancy significant at the p < 0.05 level.

CONCLUSION: The use of adjunctive therapies in IVF protocols is gaining popularity. In previously published data, Acupuncture was reserved for Poorer Prognosis patients and enhanced outcomes were observed. In this study, we demonstrated that Good Prognosis patients would also benefit from inclusion of published Acupuncture protocols. This is also the first publication of Birth outcome data in Acupuncture treated IVF patients. Acupuncture significantly increased birth outcomes; it significantly decreased ectopic pregnancies and miscarriage rates. These data uniquely support a definitive role of both Electrostimulation and Traditional combined with Auricular Acupuncture in IVF in Good Prognosis IVF patients.

CHANGES IN SERUM CORTISOL AND PROLACTIN ASSOCIATED WITH ACUPUNCTURE DURING IVF 

Author: Magarelli, PC, D Cridennda, M Cohen

Publication Date: 2009

Publisher: Fertily & Sterility 2009 in press Fertility and Sterility

Conclusion: The researchers found that the women who had acupuncture showed beneficial changes in serum levels of stress hormones compared to the control group of women who did not have acupuncture. This may have implications for both egg quality and implantation. In addition, the pregnancy and live birth rate was significantly higher in the acupuncture group.

A number of women going through IVF were given acupuncture to increase blood flow through the uterine arteries in the immediate weeks before egg collection. The researchers found that the women who had acupuncture showed beneficial changes in serum levels of stress hormones compared to the control group of women who did not have acupuncture. The acupuncture treatments appear to normalize levels of cortisol and prolactin which have been artificially depressed by the IVF drugs. This may have implications for both egg quality and implantation. In addition, the pregnancy and live birth rate was significantly higher in the acupuncture group.

Abstract

Objective: To determine whether changes in serum cortisol (CORT) and PRL are affected by acupuncture (Ac) in Ac-treated IVF patients.

Design: Prospective cohort clinical study.

Setting: Private practice reproductive endocrinology and infertility clinic and private practice acupuncture consortium.

Patient(s): Sixty-seven reproductive-age infertile women undergoing IVF.

Intervention(s): Blood samples were obtained from all consenting new infertility patients and serum CORT and serum PRL were obtained prospectively. Patients were grouped as controls (IVF with no Ac) and treated (IVF with Ac) according to acupuncture protocols derived from randomized controlled trials.

Main Outcome Measure(s): Serum levels of CORT and PRL were measured and synchronized with medication stimulation days of the IVF cycle (e.g., day 2 of stimulation, day 3, etc.). Reproductive outcomes were collected according to Society for Assisted Reproductive Technology protocols, and results were compared between controls and those patients treated with Ac.

Result(s): CORT levels in Ac group were significantly higher on IVF medication days 7, 8, 9, 11, 12, and 13 compared with controls. PRL levels in the Ac group were significantly higher on IVF medication days 5, 6, 7, and 8 compared with controls.

Conclusion(s): In this study, there appears to be a beneficial regulation of CORT and PRL in the Ac group during the medication phase of the IVF treatment with a trend toward more normal fertile cycle dynamics. (Fertil Sterile 2008;-:-–-. 2008 by American Society for Reproductive Medicine.)

Stress reduces conception probabilities across the fertile window: evidence in support of relaxation

Author: Buck Louis GM et al

Publication Date: 2011

Publisher: Fertility and Sterility, 95, 7, pg 2184 – 2189

While this study did not involve IVF patients, its conclusions nevertheless have relevance to women trying to fall pregnant with IVF. The study showed a clear relationship with higher stress levels and reduced conception rates. This may be one of the ways that acupuncture, which reduces stress hormones, can improve fertility.

Abstract

OBJECTIVE: To assess salivary stress biomarkers (cortisol and alpha-amylase) and female fecundity.

DESIGN: Prospective cohort design.

SETTING: United Kingdom.

PATIENT(S): 274 women aged 18-40 years who were attempting pregnancy.

INTERVENTION(S): Observation for six cycles or until pregnancy: women collected basal saliva samples on day 6 of each cycle, and used fertility monitors to identify ovulation and pregnancy test kits for pregnancy detection.

MAIN OUTCOME MEASURE(S): Salivary cortisol (mug/dL) and alpha-amylase (U/mL) concentration measurements; fecundity measured by time-to-pregnancy and the probability of pregnancy during the fertile window as estimated from discrete-time survival and Bayesian modeling techniques, respectively.

RESULT(S): Alpha-amylase but not cortisol concentrations were negatively associated with fecundity in the first cycle (fecundity odds ratio = 0.85; 95% confidence interval 0.67, 1.09) after adjusting for the couples’ ages, intercourse frequency, and alcohol consumption. Statistically significant reductions in the probability of conception across the fertile window during the first cycle attempting pregnancy were observed for women whose salivary concentrations of alpha-amylase were in the upper quartiles in comparison with women in the lower quartiles (highest posterior density: -0.284; 95% interval -0.540, -0.029).

CONCLUSION(S): Stress significantly reduced the probability of conception each day during the fertile window, possibly exerting its effect through the sympathetic medullar pathway.

Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy.

Authors: Paulus WE1, Zhang M, Strehler E, El-Danasouri I, Sterzik K.

Publication Date: April 2002

Publisher: Fertility and Sterility

Abstract

OBJECTIVE: 

To evaluate the effect of acupuncture on the pregnancy rate in assisted reproduction therapy (ART) by comparing a group of patients receiving acupuncture treatment shortly before and after embryo transfer with a control group receiving no acupuncture.

DESIGN: 

Prospective randomized study.

SETTING: 

Fertility center.

PATIENT(S): 

After giving informed consent, 160 patients who were undergoing ART and who had good quality embryos were divided into the following two groups through random selection: embryo transfer with acupuncture (n = 80) and embryo transfer without acupuncture (n = 80).

INTERVENTION(S): 

Acupuncture was performed in 80 patients 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy.

MAIN OUTCOME MEASURE(S): 

Clinical pregnancy was defined as the presence of a fetal sac during an ultrasound examination 6 weeks after embryo transfer.

RESULT(S): 

Clinical pregnancies were documented in 34 of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group.

CONCLUSION(S): 

Acupuncture seems to be a useful tool for improving pregnancy rate after ART.

Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study

Authors: Stefan Dieterle M.D.,  Gao Ying M.D., Wolfgang Hatzmann M.D., Andreas Neuer M.D.

Published Date: May , 2006

Publisher: Fertility and Sterility, 85, 5, pgs 1347-1351

Objective

To determine the effect of luteal-phase acupuncture on the outcome of IVF/intracytoplasmic sperm injection (ICSI).

Design

Randomized, prospective, controlled clinical study.

Setting

University IVF center.

Patient(s)

Two hundred twenty-five infertile patients undergoing IVF/ICSI.

Intervention(s)

In group I, 116 patients received luteal-phase acupuncture according to the principles of traditional Chinese medicine. In group II, 109 patients received placebo acupuncture.

Main Outcome Measure(s)

Clinical and ongoing pregnancy rates.

Result(s)

In group I, the clinical pregnancy rate and ongoing pregnancy rate (33.6% and 28.4%, respectively) were significantly higher than in group II (15.6% and 13.8%).

Conclusion(s)

Luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI.

Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility

Author: Pei J et al

Publication Date: 2005 July

Publisher: Fertility and Sterility

A group of infertile men who had pathological semen analyses, according to WHO criteria, were treated with acupuncture twice a week for five 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. A general improvement of sperm quality, specifically in the ultrastructural integrity of spermatozoa, was seen after acupuncture.

Abstract

OBJECTIVE: To evaluate the ultramorphologic sperm features of idiopathic infertile men after acupuncture therapy.

DESIGN: Prospective controlled study.

SETTING: Christian-Lauritzen-Institut, Ulm, IVF center Munich, Germany, and Department of General Biology, University of Siena, Siena, Italy.

PATIENT(S): Forty men with idiopathic oligospermia, asthenospermia, or teratozoospermia.

NTERVENTION(S): 28 of the patients received acupuncture twice a week over a period of five weeks. The samples from the treatment group were randomized with semen samples from the 12 men in the untreated control group.

MAIN OUTCOME MEASURE(S): Quantitative analysis by transmission electron microscopy (TEM) was used to evaluate the samples, using the mathematical formula based on submicroscopic characteristics.

RESULT(S): Statistical evaluation of the TEM data showed a statistically significant increase after acupuncture in the percentage and number of sperm without ultrastructural defects in the total ejaculates. A statistically significant improvement was detected in acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibers of sperm organelles. However, specific sperm pathologies in the form of apoptosis, immaturity, and necrosis showed no statistically significant changes between the control and treatment groups before and after treatment.

CONCLUSION(S): The treatment of idiopathic male infertility could benefit from employing acupuncture. A general improvement of sperm quality, specifically in the ultrastructural integrity of spermatozoa, was seen after acupuncture, although we did not identify specific sperm pathologies that could be particularly sensitive to this therapy.