Fertility: Female

The principles of Traditional Chinese Medicine aim to restore and maintain a balanced system and strengthen your inner health, thereby enhancing the environment for conception to take place. At the complementary medicine practice we develop individualised treatment plans incorporating acupuncture, nutrition and herbal medicine to enhance the chances of natural conception and support assisted reproductive treatment.

We ideally treat the couple not just the individual so lifestyle and nutritional advice will be given where appropriate for your partner also. Male fertility factors account for around 30% of fertility difficulties whilst in 20% of cases there are issues with both the man and woman. Male factor issues can be helped through nutrition, acupuncture and herbs.

A preconception treatment period of four to six months is recommended. During this time nutritional and lifestyle factors can be addressed in addition to acupuncture and herbal medicine as appropriate. Getting your nutritional state in order prior to conception will not only improve your chances of a natural conception but also ensure the optimum nutrition for both baby and mother during pregnancy. Your nutritional state during conception and pregnancy can have an impact on the future health of your child.

If you do not conceive naturally this will not have been lost time. If you decide to move on to fertility treatment then the time spent on improving your health will give you a greater chance for a successful outcome.

Our role during Fertility Treatment
We support couples undergoing Assisted Reproductive Technology (ART) such as IVF (in vitro fertilization), ICSI (Intracytoplasmic sperm injection) and IUI (Interuterine insemination).

What we can hope to achieve through treatment

• Improve the quality of egg cells (oocytes) and sperm, both these take 3 months
• Improve embryo quality
  
• Improve blood flow to the uterus and quality of the endometrium
  
• Regulation of hormones
  
• Help to reduce stress levels for couples
  
• Reduce side effects of drugs
  
• Strengthen the immune system
  
• Reduce the chance of miscarriage

In Great Britain around 27,000 couples a year undergo infertility treatment. The rate of success for IVF conception is approximately 20 - 30%. When acupuncture is used as a complementary therapy to IVF in studies, the rate of success has been as high as 42%.

The use of acupuncture during Assisted Reproduction Technology (ART) is beginning to be used widely and studies have shown that acupuncture treatment can positively influence the outcome of ART.

In 2002 the Fertility and Sterility journal published a study by Paulus et al. researching the used of acupuncture before and after IVF embryo transfer. The acupuncture group achieved a 42.5% pregnancy rate compared with the non acupuncture group which achieved a 26.3% pregnancy rate.

In 2006 the Fertility and Sterility journal published a study by Westergaard et al. which reinforced the findings of the 2002 study. The clinical pregnancy rate in women receiving acupuncture on the day of embryo transfer was 39% versus 26% in the non acupuncture group. The ongoing pregnancy rate for the acupuncture group was 36% versus 22% in the non acupuncture group.

In the same issue of Fertility and Sterility, Dieterle et al. reported their findings on
the effect of acupuncture on the outcome of IVF and ICSI. This study involved 225 women, 116 received acupuncture during the luteal-phase of their IVF/ICSI cycle whilst 109 received placebo acupuncture. In the true acupuncture group the clinical pregnancy rate was 33.6% versus 15.6% in the placebo acupuncture group. The ongoing pregnancy rate was also significantly higher at 28.4% in the acupuncture group versus 13.8% in the placebo group.

Uterine artery impedance is the measure of resistance of blood flow through the uterine arteries to the uterus and fallopian tubes. Stimulation of the sympathetic nervous system (which can be caused by stress) causes contraction of the uterine artery and inhibits blood flow to the uterus, fallopian tubes and ovaries. When blood flow to the uterus is “impeded” it is referred to as elevated uterine artery impedance. Uterine artery impedance greater than 3 means that in most cases, implantation will not occur. In 1996 the journal of Human Reproduction published a study by Stener-Victorin et al., which showed that electroacupuncture significantly reduced high uterine artery blood flow impedance.

In 2005 Magarelli, Cridennda and Cohen presented their study entitled 'Acupuncture: Impact on Pregnancy Outcomes in IVF Patients' at the 12th World Congress on Human Reproduction. This was a retrospective study involving 130 IVF cycles. There were 82 in the non-acupuncture group, and 48 in the acupuncture group. They found that whilst the pregnancy rates for the acupuncture group where statistically similar to the non-acupuncture group the rate of miscarriage, ectopic pregnancies and multiple births were significantly lower in the acupuncture group. In addition live birth rates were 42% in the acupuncture group versus 38% in the non-acupuncture group. These authors are organizing a multicentre prospective study to confirm and expand on this research.

In 2002 the Fertility and Sterility journal published a review of existing scientific rationale and clinical data in the utilization of acupuncture in the treatment of female infertility. This review was authored by R, Chang MD, P, Chung MD and noted reproductive endocrinologist Zev Rosenwaks, MD. They concluded there was a clear link between treatment and the brain hormones involved in conception. More specifically they noted that acupuncture increases production of endorphins, the body's natural "feel good" brain chemical that also plays a role in regulating the menstrual cycle. They noted that acupuncture also appears to have a neuroendocrine effect, impacting a three-way axis between the two areas of the brain involved with hormone production (the hypothalamus and pituitary glands) and the ovaries. They also concluded that the effects of acupuncture may impact on uterine blood flow.

References

Dieterle, S. Ying, G. Hatzmann, W. Neuer, A. 2006. Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study. Fertility and Sterility. 85 (5). 1347-135

Magarelli, P. Cridennda, D. Cohen, M. 2005. Acupuncture: Impact on Pregnancy Outcomes in IVF Patients. 12th World Congress on Human Reproduction, Venice Italy.
Paul Magarelli, M.D., Ph.D. Reproductive Medicine & Fertility Center, Colorado Springs www.475-baby.com
Diane Cridennda, L.Ac. East Winds Acupuncture www.eastwindsacupuncture.com

Paulus, W., M.D. Zhang, M. Strehler, E. El-Danasouri, I. Sterzik, K. 2002. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertility and Sterility. 77(4). 721-724.

Stener-Victorin, E. Waldenstrom, U. Andersson, S. Wikland, M. 1996. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Human Reproduction. 11(6): 1314-7.

Westergaard, M. Qunhui, M. Kroglsund, M. Sandrini, S. Lenz, S. Grinsted, J. 2006. Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Fertility and
Sterility. 85(5). 1341-1346