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| Infertility - questions and answers |
Click here to schedule an acupuncture appointment in NYC Queens or/and send alternative medicine and
healing without medications acupuncture specialist Licenced in NYC your health question or call "Feel Good
Acupuncture" at 646-327-7267.
healing without medications acupuncture specialist Licenced in NYC your health question or call "Feel Good
Acupuncture" at 646-327-7267.
Studies on the Effectiveness of TCM and Acupuncture in both Male and Female Infertility
Studies on Women
A study by conducted at the National Institutes of Health and the University of Oxford shows evidence that stress affects fertility.
Researchers charted the ovulation cycles of 274 English women aged 18-40 years who were trying to conceive, and who
participated in the Oxford Conception Study led by Cecilia Pyper, MB. BS. On the sixth day of her cycle, each woman collected a
sample of her saliva, which was subsequently tested for alpha-amylase, an indicator of the body’s response to physical or
psychological stress. The women’s saliva samples were also analyzed for cortisol, another hormone produced by the adrenal
glands in response to stress. Each woman took part in the study until she became pregnant, or at the end of six menstrual cycles.
Stress significantly reduced the probability of conception each day during the fertile window, possibly exerting its effect through the
sympathetic medullar pathway. CONCLUSION: The researchers found that, all other factors being equal, women with high alpha-
amylase levels were less likely to conceive than were women with low levels, during the fertile window-- the six days when
conception is most likely to occur. Researchers did not find a correlation between cortisol levels and the chances of conception.
"The study results suggest that finding safe ways to alleviate stress may play a role in helping couples become pregnant," said
Alan E. Guttmacher, M.D., director of the NICHD. "Women trying to get pregnant should identify the stressors in their lives and work
to alleviate them through yoga, acupuncture or relaxation therapy", suggests Dr. William Hurd, division chief of the Reproductive
Endocrinology and Infertility Center at University Hospitals Case Medical Center.1
This study aimed to evaluate whether acupuncture improves therates of pregnancy and live birth when used as an adjuvant
treatment to embryo transfer in women undergoing in vitro fertilisation. Eligible studies where randomised controlled trials that
compared needle acupuncture administered within one day of embryo transfer with sham acupuncture or no adjuvant treatment,
with reported outcomes of at least one of clinical pregnancy, ongoing pregnancy, or live birth were compared. Seven trials with
1366 women undergoing in vitro fertilisation were included in the meta-analyses. Complementing the embryo transfer process with
acupuncture was associated with significant and clinically relevant improvements in clinical pregnancy (odds ratio 1.65, 95%
confidence interval 1.27 to 2.14; number needed to treat (NNT) 10 (7 to 17); seven trials), ongoing pregnancy (1.87, 1.40 to 2.49;
NNT 9 (6 to 15); five trials), and live birth (1.91, 1.39 to 2.64; NNT 9 (6 to 17); four trials). Current preliminary evidence
suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women
undergoing in vitro fertilisation by up to 65%.
Swedish researchers looked at the role that acupuncture can play in the treatment of infertility and in particular its effect on uterine
blood flow.3 The pool of women used as test subjects had infertility problems and were diagnosed with decreased blood flow into
the uterus which affects endometrial receptivity. When there is a decreased flow of blood into the uterus, treatment options are few
and conception is difficult. Using specific points which correspond to the innervation of the uterus, researchers measured the
amount of blood flow in women undergoing in vitro fertilization (IVF) treatment. The results showed that there was a significant
increase in the blood flow into the uterus with the acupuncture treatment. Researchers attributed the effect of
acupuncture to its influence on increased uterine arterial blood flow into the uterus which in turn would increase the chance for
oocyte implantation.
Researchers in Germany looked at the traditional methods of acupuncture to determine its efficacy with the use of traditional points
based on Traditional Chinese Medicine combined with assisted reproductive techniques with embryo transfer (in vitro fertilization or
IVF). The acupoints chosen were used to relax the uterus. The main purpose of the study was to evaluate whether acupuncture
accompanying embryo transfer increases clinical pregnancy rates.
A total of 160 patients participated in the study, 80 patients receiving acupuncture and assisted reproductive techniques and 80
patients undergoing assisted reproductive techniques without acupuncture. Treatment consisted of an acupuncture treatment
before and after IVF. The results showed that the pregnancy rate for the acupuncture group was considerably higher
than the control (42.5% acupuncture group versus 26.3% control group). Acupuncture is a useful tool for improving the
pregnancy rate after ART.
The purpose of this study was to provide an overview of the use of acupuncture as an adjunct therapy for in vitro fertilization (IVF),
including an evidence-based evaluation of its efficacy and safety and an examination of possible mechanisms of action. Evidence
from clinical trials and case series suggests that acupuncture may improve the success rate of IVF and the quality of
life of patients undergoing IVF and that it is a safe adjunct therapy. The reviewed literature suggests 4 possible
mechanisms by which acupuncture could improve the outcome of IVF: modulating neuroendocrinological factors; increasing blood
flow to the uterus and ovaries; modulating cytokines; and reducing stress, anxiety, and depression.
Some centres across North America now use assisted reproductive techniques combined with acupuncture. A fertility centre in
Colorado Springs, Colorado utilizes both techniques.6 The protocol used combines both techniques reported on in the Swedish
and German research papers. Initially, the patient undergoes two treatments a week for four weeks of treatment before the IVF
transfer which prepares the uterus’ endometrium for implantation by increasing arterial blood flow using acupoints based on the
Swedish study. Pre- and post-embryo transfer, the patient is given acupuncture to relax the uterus as outlined in the German study.
There, results show that 16% more women get pregnant and 23% are having births. This combined technique of acupuncture
with IVF is superior to IVF alone.
Researchers attempted to evaluate the effectiveness of acupuncture on the reproductive outcome in patients treated with IVF or
intracytoplasmic sperm injection (ICSI). Clinical and ongoing pregnancy rates were significantly higher in the group that received
acupuncture as compared with controls (37 of 95 [39%] vs. 21 of 87 [26%] and 34 of 95 [36%] vs. 19 of 87 [22%]). Researchers
concluded that acupuncture significantly improves the reproductive outcome of IVF/ICSI, compared with no
acupuncture.
Acupuncture and Poor IVF Responders; A further study in April 2004 confirmed a significant increase in the number of pregnancies
in patients who demonstrated elevated peak FSH and a longer history of infertility. This study had an IVF pregnancy rate of
53% in the acupuncture group compared to 38% in the non-acupuncture control group.
Acupuncture Reduces Pain After IVF. In this study, 286 women were randomly assigned to receive either electroacupuncture
plus para-cervical block or alfentanil (a powerful analgesic) plus paracervical block during oocyte aspiration (egg retrieval). Both
interventions induced adequate analgesia, however the electroacupuncture group reported significantly less abdominal pain, other
pain, nausea and stress than the medication group, and required significantly less additional analgesic medication.
A clinical and experimental study of integrated traditional Chinese and western medicine in the past 45 years. The study included
observations on the induction of ovulation with acupuncture, and the treatment of polycystic ovary syndrome (PCOS) using
acupuncture and herbal remedies. Acupuncture and herbs successfully promoted ovulation, affected serum FSH, and
resolved the PCOS, resulting in ovulation.
This study was designed to evaluate if electro-acupuncture (EA) could affect oligo-/anovulation and related endocrine and
neuroendocrine parameters in women with polycystic ovary syndrome (PCOS). Repeated EA treatments induced regular ovulations
in more than one third of the women with PCOS. Electro-acupuncture offers an alternative to pharmacological ovulation
induction.
This study was designed to determine the effect of luteal-phase acupuncture on the outcome of IVF/intracytoplasmic sperm
injection (ICSI). The clinical pregnancy rate and ongoing pregnancy rate (33.6% and 28.4%, respectively) were significantly higher
in the group that received acupuncture than in the control group (15.6% and 13.8%). The study concluded that luteal-phase
acupuncture has a positive effect on the outcome of IVF/ICSI.
Over a period of three years, acupuncture was offered to patients entering assisted reproduction therapy. Acupuncture sessions
were given at varying, but usually weekly, intervals during the in vitro fertilisation (IVF) cycle, and immediately before and after
embryo transfer. Twenty two patients (average age 36.2 years) were treated over a total of 26 IVF cycles and 15 pregnancies were
achieved, as determined by presence of foetal heartbeat on ultrasound at four weeks post embryo transfer. There was a
success rate of 57.7% in the acupuncture group compared with 45.3% for patients in the IVF unit not treated with
acupuncture (P > 0.05). Relaxing effects were noted following acupuncture and it is speculated that this may have contributed to
the increase in pregnancy rate for the acupuncture group.
This study aimed to compare the therapeutic effects of acupuncture and Western medicine for promoting ovulation on endocrine
dysfunctional infertility. Two hundred and forty cases of infertility were randomly divided into an acupuncture group (n = 160) and a
Western medicine group (n = 80). They were treated with acupuncture and clomiphene respectively and their therapeutic effects
were compared. The pregnancy rate was 65.0% in the acupuncture group and 45.0% in the Western medicine group with
a significant difference between the two groups (P < 0.05).
The researchers in this study looked at one group of women with polycystic ovary syndrome who received a specific type of
acupuncture called “electro-acupuncture” for four months. A second group of women were provided with heart rate monitors and
instructed to exercise at least three times a week. A third group received no intervention. The study showed that activity in the
sympathetic nervous system was lower in the women who received acupuncture and in those who took regular exercise than it was
in the control group. The acupuncture treatment brought further benefits. Those who received acupuncture found that their
menstruation became more "normal". In addition, those that received acupuncture had their levels of testosterone reduced
significantly. This is important because elevated testosterone levels are closely connected with the increased activity in the
sympathetic nervous system of women. The researchers concluded that acupuncture and exercise can bring relief to women with
polycystic ovary syndrome (PCOS).
Research on Acupuncture during Pregnancy
Acupuncture treatment reduces pelvic and back pain in pregnancy. In this Swedish study, 72 pregnant women suffering from pelvic
or low back pain were randomly assigned to an acupuncture group or a control group. Traditional acupuncture points were
needled in individualised treatments, once or twice a week until the disappearance of symptoms or delivery in the acupuncture
group. Treatment was given for at least three weeks, twice weekly for the first two weeks, then once a week. The control group
received no treatment. During the study period the pain decreased in 60% of patients in the acupuncture group compared to 14%
of the controls, dropping to 43% and 9% respectively at the end of the study.
Moxibustion aids in the correction of breech presentation. Traditional Chinese medicine uses moxibustion (burning herbs to
stimulate acupuncture points) of acupoint BL 67 (Zhiyin, located beside the outer corner of the fifth toenail), to promote version of
fetuses in breech presentation. 130 subjects were randomized to the intervention group received stimulation of acupoint BL 67 by
moxa (Japanese term for Artemisia vulgaris) rolls for 7 days, with treatment for an additional 7 days if the fetus persisted in the
breech presentation. The 130 subjects randomized to the control group received routine care but no interventions for breech
presentation. Subjects with persistent breech presentation after 2 weeks of treatment could undergo external cephalic version
anytime between 35 weeks' gestation and delivery. Among primigravidas with breech presentation during the 33rd week of
gestation, moxibustion for 1 to 2 weeks increased fetal activity during the treatment period and cephalic presentation after the
treatment period and at delivery.
In many Western countries breech presentation is an indication for elective Cesarean section. In order to correct fetal presentation,
the stimulation of the acupoint BL67 by moxibustion, acupuncture or both has been proposed. Since no studies had previously
been carried out on Western populations, pregnant Italian women at 33–35 weeks gestational age carrying a fetus in breech
presentation were enrolled in a randomized, controlled trial involving an active BL67 point stimulation and an observation group.A
total of 240 women at 33–35 weeks of gestation carrying a fetus in breech presentation were randomized to receive active
treatment (acupuncture plus moxibustion) or to be assigned to the observation group. The study concluded that acupuncture plus
moxibustion is more effective than observation in revolving fetuses in breech presentation. Such a method appears to be a valid
option for women willing to experience a natural birth.
The objective of this study was to review the effectiveness of needle acupuncture in treating the common and disabling problem of
pelvic and back pain in pregnancy. Acupuncture, as an adjunct to standard treatment, was superior to standard treatment alone
and physiotherapy in relieving mixed pelvic/back pain. Women with well-defined pelvic pain had greater relief of pain with a
combination of acupuncture and standard treatment, compared to standard treatment alone or stabilizing exercises and standard
treatment. Evidence supports the proposition that acupuncture useful in treating pregnancy-related pelvic and back
pain.
This study compared ongoing pregnancy and live birth rates in spontaneous users and non-users of complementary and
alternative medicines (CAMs) during a 12-month period of assisted reproduction technique (ART) treatment. 728 women about to
have ART for the first time completed self-report assessments prior to treatment. The ongoing pregnancy and live birth rate was
31.3% lower in CAM users (42.2%) compared with non-users (61.4%). The researchers concluded ONLY that concurrent
CAM use should be monitored during ART. A main limitation to this study was that the researchers could not ascertain which
type of CAM was most associated with lower pregnancy rates. Acupuncture was not specifically studied. Total Wellness Centre
insists that all patients undergoing concurrent Western fertility and traditional Chinese medical treatments inform both their medical
doctor and TCM practitioner of all treatments they are undergoing.
Acupuncture aids in the treatment of depression during pregnancy. A total of 150 pregnant women who met Diagnostic and
Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder were randomized to receive either
acupuncture specific for depression or one of two active controls: control acupuncture or massage. Treatments lasted 8 weeks (12
sessions). Fifty-two women were randomized to acupuncture specific for depression, 49 to control acupuncture, and 49 to
massage. Women who received acupuncture specific for depression experienced a greater rate of decrease in symptom severity
compared with the combined controls or control acupuncture alone. They also had significantly greater response rate (63.0%) than
the combined controls (44.3%) and control acupuncture alone (37.5%). Symptom reduction and response rates did not differ
significantly between controls (control acupuncture, 37.5%; massage, 50.0%). CONCLUSION: The short acupuncture protocol
demonstrated symptom reduction and a response rate comparable to those observed in standard depression
treatments (pharmaceuticals) of similar length and could be a viable treatment option for depression during
pregnancy, or for depression in the general population. The potential risk to the fetus associated with pharmaceuticals can
be avoided using natural therapies such as acupuncture.
Studies on Men
The aim of this controlled study was to assess the effectiveness of acupuncture on the sperm quality of males suffering from
subfertility related to sperm impairment. Semen samples of 16 acupuncture-treated subfertile patients were analyzed before and
one month after treatment (twice a week for 5 weeks). In parallel, semen samples of 16 control untreated subfertile males were
examined. Two specimens were taken from the control group at an interval of two-eight months. The fertility index increased
significantly (p< .05) following improvement in total functional sperm fraction, percentage of viability, total motile spermatozoa per
ejaculate, and integrity of the axonema (p< .05), which occurred upon treatment. The intactness of axonema and sperm motility
were highly correlated (corr. = .50,p< .05). This study strongly suggests patients exhibiting a low fertility potential due to
reduced sperm activity may benefit from acupuncture treatment.
Forty men with idiopathic oligospermia, asthenospermia, or teratozoospermia were studied.23 Twenty eight of the patients received
acupuncture twice a week over a period of 5 weeks. The samples from the treatment group were randomized with semen samples
from the 12 men in the untreated control group. Statistical evaluation using transmission electron microscopy 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. 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.
Researchers searched for the best method for increasing the quality of abnormal sperm. One hundred and sixty-eight cases of
infertility were randomly divided into a treatment group of 85 cases and a control group of 83 cases. The treatment group were
treated with needle-picking (acupuncture) at specific bilateral points. Their therapeutic effects were observed in 3 hospitals. The
study resulted in a total effectiveness rate of 83.5% and a pregnancy rate of the patient's partner of 78.8% in the treatment group,
and a corresponding rate of 54.2% and 43.4% in the control group, which represents a very significant difference between the two
groups (P < 0.01). Reproductive hormones improved significantly after treatment (P < 0.01); after treatment, superoxide dismulase
(SOD) activity and Zn content in semen were elevated and cadmium level decreased significantly in the treatment group (P < 0.05).
The research shows that needle-picking therapy (acupuncture) can significantly improve and regulate endocrine
function, increase the quality 3f semen and elevate pregnancy rate of the patient's partner for the patient of primary
abnormal sperm.
Classic therapies are usually ineffective in the treatment of patients with very poor sperm density. This study aimed to determine
the effect of acupuncture on these males. Semen samples of 20 patients with a history of azoospermia were examined by light
microscope (LM) and scanning electron microscope (SEM), with which a microsearch for spermatozoa was carried out. These
examinations were performed before and 1 month after acupuncture treatment. The control group was comprised of 20 untreated
males who underwent two semen examinations within a period of 2–4 months. A definite increase in sperm count was
detected in the ejaculates of 10 (67%) of the 15 azoospermic patients. Seven of these males exhibited post-treatment
spermatozoa that were detected even by LM. The sperm production of these seven males increased significantly, from 0
to an average of 1.5±2.4×106 spermatozoa per ejaculate (Z=−2.8, P≤0.01). Males with genital tract inflammation exhibited the
most remarkable improvement in sperm density (on average from 0.3±0.6×106 spermatozoa per ejaculate to 3.3±3.2×106
spermatozoa per ejaculate; Z=−2.4, P≤0.02). Two pregnancies were achieved by the IVF-ICSI procedure. It is concluded that
acupuncture may be a useful, nontraumatic treatment for males with very poor sperm density, especially those with a history of
genital tract inflammation.25
The purpose of this study was to assess the clinical effects of the combined therapy of acupuncture with herbal drugs on male
immune infertility and on antisperm antibody (AsAb). 100 male cases of infertility with positive AsAb were divided randomly into two
groups, each consisting of 50 cases. The results showed that the total effective rate in the acupuncture-drug group was 90%; while
that of the control group was 64%, the comparison showing a statistically significant difference (P<0.05). The positive rate of blood
serum and/or AsAb in both the two groups decreased in varying degrees, but the negative-turning rate of AsAb in the acupuncture-
drug group was more obvious, the comparison showing also a significant difference (P<0.05). The combined therapy of
acupuncture with herbal drugs has definite therapeutic effects on male immune infertility, which can regulate AsAb
and raise the immunity of the patients.
Further studies are available relating to a host of medical ailments. Please contact us for details.
Back to main Infertility Page
References:
Most of these studies may be found on MedLine (Pubmed), a free database of medical journals. This list is not exhaustive as
studies are ongoing and are published frequently. For a list of present and planned studies, a good place to review is the
Cochrane Library online.
1. Germaine M. Buck Louis, Ph.D.a, Kirsten J. Lum, M.S.a, Rajeshwari Sundaram, Ph.D.a, Zhen Chen, Ph.D.a, Sungduk Kim, Ph.D.
a, Courtney D. Lynch, Ph.D.b, Enrique F. Schisterman, Ph.D.a, Cecilia Pyper, B.S., M.B.c, Stress reduces conception probabilities
across the fertile window: evidence in support of relaxation. 05 August 2010 (10.1016/j.fertnstert.2010.06.078).
2. Manheimer E, Zhang G, Udoff L, Haramati A, Langenberg P, Berman BM, Bouter LM., Effects of acupuncture on rates of
pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis., BMJ. 2008 Mar 8;336
(7643):545-9. Epub 2008 Feb 7.
3. Stener-Victorin, E., Waldenstrom, U., Andersson, S. and Wikland, M. (1996) Reduction of blood flow impedance in the uterine
arteries of infertile women with electro-acupuncture. Hum Reprod Biol., 11:1314-7
4. Paulus, WE., Zhang, M., Strehler, E., El-Danasouri, I and Sterzik, K. (2002) Influence of acupuncture on pregnancy rates in
patients who undergo assisted reproduction therapy. Fert Steril., 77:721-4
5. Anderson BJ, Haimovici F, Ginsburg ES, Schust DJ, Wayne PM, In vitro fertilization and acupuncture: clinical efficacy and
mechanistic basis. Altern Ther Health Med. 2007 May-Jun;13(3):38-48
6. DePow, J. (2004) "East meets West: Acupuncture and Reproductive Medicine." New Mexico Woman
7. Fertility and Sterility. 2006 May;85(5):1341-6. Epub 2006 Apr 5.
8. Fertility and Sterility, Volume 81, Issue (Supplement #), Page 20, (April 2004)
9. Hum Reprod 2003; 18: 1454-60
10. Zhong Xi Yi Jie He Xue Bao, Integrated traditional Chinese and western medicine should make new contribution to the
reproductive health of women, 2004 Mar;2(2):83-5.
11. Acta Obstet Gynecol Scand., Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome, 2000
Mar;79(3):180-8
12. Dieterle S, Ying G, Hatzmann W, Neuer A, Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic
sperm injection: a randomized, prospective, controlled clinical study.Fertil Steril. 2006 May;85(5):1347-51. Epub 2006 Apr 17
13. Johnson D., Acupuncture prior to and at embryo transfer in an assisted conception unit--a case series, Acupunct Med. 2006
Mar;24(1):23-8
14. Zhongguo Zhen Jiu. Controlled study on acupuncture for treatment of endocrine dysfunctional infertility, 2005 May;25(5):299-
300.
15. Elisabet Stener-Victorin, Elizabeth Jedel, Per Olof Janson, and Yrsa Bergmann Sverrisdottir1, Am J Physiol Regul Integr Comp
Physiol 297: R387-R395, 2009.
16. Acta Obstet Gynecol Scand 2004; 83(3): 246-50.
17. JAMA. 1998;280:1580-1584.
18. The Journal of Maternal–Fetal and Neonatal Medicine 2004;15:247–252
19. Ee CC, Manheimer E, Pirotta MV, White AR., Acupuncture for pelvic and back pain in pregnancy: a systematic review., Am J
Obstet Gynecol. 2008 Mar;198(3):254-9.
20. J. Boivin; L. Schmidt, Human Reproduction. 2009;24(7):1626-1631.
21. Manber R, Schnyer RN, Lyell D, Chambers AS, Caughey AB, Druzin M, Carlyle E, Celio C, Gress JL, Huang MI, Kalista T,
Martin-Okada R, Allen JJ., Acupuncture for depression during pregnancy: a randomized controlled trial, Obstet Gynecol. 2010 Mar;
115(3):511-20.
22. Sherman; F. Eltes; V. Wolfson; N. Zabludovsky; B. Bartoov, Institute of Chinese Medicine, Tel Aviv, IsraeMale Fertility
Laboratory, Department of Life Sciences, Bar-Ilan University, Ramat Gan, Isreal, Effect of Acupuncture on Sperm Parameters of
Males Suffering from Subfertility Related to Low Sperm Quality Systems Biology in Reproductive Medicine, Volume 39, Issue 2
September 1997 , pages 155 - 16S.
23. J. Pei, E. Strehler, U. Noss, M. Abt, P. Piomboni, B. Baccetti, K. Sterzik, Fertility and Sterility, Volume 84, Issue 1, Pages 141-147
24. Zhongguo Zhen Jiu. 2006 Jun;26(6):389-91.
25. S Siterman, F Eltes, V Wolfson, H Lederman, B Bartoov (2000) Does acupuncture treatment affect sperm density in males with
very low sperm count? A pilot study Volume 32 Issue 1 Page 31-39, January 2000
26. Fu B, Lun X, Gong Y. Effects of the combined therapy of acupuncture with herbal drugs on male immune infertility--a clinical
report of 50 cases. J Tradit Chin Med. 2005 Sep;25(3):186-9.
Studies on Women
A study by conducted at the National Institutes of Health and the University of Oxford shows evidence that stress affects fertility.
Researchers charted the ovulation cycles of 274 English women aged 18-40 years who were trying to conceive, and who
participated in the Oxford Conception Study led by Cecilia Pyper, MB. BS. On the sixth day of her cycle, each woman collected a
sample of her saliva, which was subsequently tested for alpha-amylase, an indicator of the body’s response to physical or
psychological stress. The women’s saliva samples were also analyzed for cortisol, another hormone produced by the adrenal
glands in response to stress. Each woman took part in the study until she became pregnant, or at the end of six menstrual cycles.
Stress significantly reduced the probability of conception each day during the fertile window, possibly exerting its effect through the
sympathetic medullar pathway. CONCLUSION: The researchers found that, all other factors being equal, women with high alpha-
amylase levels were less likely to conceive than were women with low levels, during the fertile window-- the six days when
conception is most likely to occur. Researchers did not find a correlation between cortisol levels and the chances of conception.
"The study results suggest that finding safe ways to alleviate stress may play a role in helping couples become pregnant," said
Alan E. Guttmacher, M.D., director of the NICHD. "Women trying to get pregnant should identify the stressors in their lives and work
to alleviate them through yoga, acupuncture or relaxation therapy", suggests Dr. William Hurd, division chief of the Reproductive
Endocrinology and Infertility Center at University Hospitals Case Medical Center.1
This study aimed to evaluate whether acupuncture improves therates of pregnancy and live birth when used as an adjuvant
treatment to embryo transfer in women undergoing in vitro fertilisation. Eligible studies where randomised controlled trials that
compared needle acupuncture administered within one day of embryo transfer with sham acupuncture or no adjuvant treatment,
with reported outcomes of at least one of clinical pregnancy, ongoing pregnancy, or live birth were compared. Seven trials with
1366 women undergoing in vitro fertilisation were included in the meta-analyses. Complementing the embryo transfer process with
acupuncture was associated with significant and clinically relevant improvements in clinical pregnancy (odds ratio 1.65, 95%
confidence interval 1.27 to 2.14; number needed to treat (NNT) 10 (7 to 17); seven trials), ongoing pregnancy (1.87, 1.40 to 2.49;
NNT 9 (6 to 15); five trials), and live birth (1.91, 1.39 to 2.64; NNT 9 (6 to 17); four trials). Current preliminary evidence
suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women
undergoing in vitro fertilisation by up to 65%.
Swedish researchers looked at the role that acupuncture can play in the treatment of infertility and in particular its effect on uterine
blood flow.3 The pool of women used as test subjects had infertility problems and were diagnosed with decreased blood flow into
the uterus which affects endometrial receptivity. When there is a decreased flow of blood into the uterus, treatment options are few
and conception is difficult. Using specific points which correspond to the innervation of the uterus, researchers measured the
amount of blood flow in women undergoing in vitro fertilization (IVF) treatment. The results showed that there was a significant
increase in the blood flow into the uterus with the acupuncture treatment. Researchers attributed the effect of
acupuncture to its influence on increased uterine arterial blood flow into the uterus which in turn would increase the chance for
oocyte implantation.
Researchers in Germany looked at the traditional methods of acupuncture to determine its efficacy with the use of traditional points
based on Traditional Chinese Medicine combined with assisted reproductive techniques with embryo transfer (in vitro fertilization or
IVF). The acupoints chosen were used to relax the uterus. The main purpose of the study was to evaluate whether acupuncture
accompanying embryo transfer increases clinical pregnancy rates.
A total of 160 patients participated in the study, 80 patients receiving acupuncture and assisted reproductive techniques and 80
patients undergoing assisted reproductive techniques without acupuncture. Treatment consisted of an acupuncture treatment
before and after IVF. The results showed that the pregnancy rate for the acupuncture group was considerably higher
than the control (42.5% acupuncture group versus 26.3% control group). Acupuncture is a useful tool for improving the
pregnancy rate after ART.
The purpose of this study was to provide an overview of the use of acupuncture as an adjunct therapy for in vitro fertilization (IVF),
including an evidence-based evaluation of its efficacy and safety and an examination of possible mechanisms of action. Evidence
from clinical trials and case series suggests that acupuncture may improve the success rate of IVF and the quality of
life of patients undergoing IVF and that it is a safe adjunct therapy. The reviewed literature suggests 4 possible
mechanisms by which acupuncture could improve the outcome of IVF: modulating neuroendocrinological factors; increasing blood
flow to the uterus and ovaries; modulating cytokines; and reducing stress, anxiety, and depression.
Some centres across North America now use assisted reproductive techniques combined with acupuncture. A fertility centre in
Colorado Springs, Colorado utilizes both techniques.6 The protocol used combines both techniques reported on in the Swedish
and German research papers. Initially, the patient undergoes two treatments a week for four weeks of treatment before the IVF
transfer which prepares the uterus’ endometrium for implantation by increasing arterial blood flow using acupoints based on the
Swedish study. Pre- and post-embryo transfer, the patient is given acupuncture to relax the uterus as outlined in the German study.
There, results show that 16% more women get pregnant and 23% are having births. This combined technique of acupuncture
with IVF is superior to IVF alone.
Researchers attempted to evaluate the effectiveness of acupuncture on the reproductive outcome in patients treated with IVF or
intracytoplasmic sperm injection (ICSI). Clinical and ongoing pregnancy rates were significantly higher in the group that received
acupuncture as compared with controls (37 of 95 [39%] vs. 21 of 87 [26%] and 34 of 95 [36%] vs. 19 of 87 [22%]). Researchers
concluded that acupuncture significantly improves the reproductive outcome of IVF/ICSI, compared with no
acupuncture.
Acupuncture and Poor IVF Responders; A further study in April 2004 confirmed a significant increase in the number of pregnancies
in patients who demonstrated elevated peak FSH and a longer history of infertility. This study had an IVF pregnancy rate of
53% in the acupuncture group compared to 38% in the non-acupuncture control group.
Acupuncture Reduces Pain After IVF. In this study, 286 women were randomly assigned to receive either electroacupuncture
plus para-cervical block or alfentanil (a powerful analgesic) plus paracervical block during oocyte aspiration (egg retrieval). Both
interventions induced adequate analgesia, however the electroacupuncture group reported significantly less abdominal pain, other
pain, nausea and stress than the medication group, and required significantly less additional analgesic medication.
A clinical and experimental study of integrated traditional Chinese and western medicine in the past 45 years. The study included
observations on the induction of ovulation with acupuncture, and the treatment of polycystic ovary syndrome (PCOS) using
acupuncture and herbal remedies. Acupuncture and herbs successfully promoted ovulation, affected serum FSH, and
resolved the PCOS, resulting in ovulation.
This study was designed to evaluate if electro-acupuncture (EA) could affect oligo-/anovulation and related endocrine and
neuroendocrine parameters in women with polycystic ovary syndrome (PCOS). Repeated EA treatments induced regular ovulations
in more than one third of the women with PCOS. Electro-acupuncture offers an alternative to pharmacological ovulation
induction.
This study was designed to determine the effect of luteal-phase acupuncture on the outcome of IVF/intracytoplasmic sperm
injection (ICSI). The clinical pregnancy rate and ongoing pregnancy rate (33.6% and 28.4%, respectively) were significantly higher
in the group that received acupuncture than in the control group (15.6% and 13.8%). The study concluded that luteal-phase
acupuncture has a positive effect on the outcome of IVF/ICSI.
Over a period of three years, acupuncture was offered to patients entering assisted reproduction therapy. Acupuncture sessions
were given at varying, but usually weekly, intervals during the in vitro fertilisation (IVF) cycle, and immediately before and after
embryo transfer. Twenty two patients (average age 36.2 years) were treated over a total of 26 IVF cycles and 15 pregnancies were
achieved, as determined by presence of foetal heartbeat on ultrasound at four weeks post embryo transfer. There was a
success rate of 57.7% in the acupuncture group compared with 45.3% for patients in the IVF unit not treated with
acupuncture (P > 0.05). Relaxing effects were noted following acupuncture and it is speculated that this may have contributed to
the increase in pregnancy rate for the acupuncture group.
This study aimed to compare the therapeutic effects of acupuncture and Western medicine for promoting ovulation on endocrine
dysfunctional infertility. Two hundred and forty cases of infertility were randomly divided into an acupuncture group (n = 160) and a
Western medicine group (n = 80). They were treated with acupuncture and clomiphene respectively and their therapeutic effects
were compared. The pregnancy rate was 65.0% in the acupuncture group and 45.0% in the Western medicine group with
a significant difference between the two groups (P < 0.05).
The researchers in this study looked at one group of women with polycystic ovary syndrome who received a specific type of
acupuncture called “electro-acupuncture” for four months. A second group of women were provided with heart rate monitors and
instructed to exercise at least three times a week. A third group received no intervention. The study showed that activity in the
sympathetic nervous system was lower in the women who received acupuncture and in those who took regular exercise than it was
in the control group. The acupuncture treatment brought further benefits. Those who received acupuncture found that their
menstruation became more "normal". In addition, those that received acupuncture had their levels of testosterone reduced
significantly. This is important because elevated testosterone levels are closely connected with the increased activity in the
sympathetic nervous system of women. The researchers concluded that acupuncture and exercise can bring relief to women with
polycystic ovary syndrome (PCOS).
Research on Acupuncture during Pregnancy
Acupuncture treatment reduces pelvic and back pain in pregnancy. In this Swedish study, 72 pregnant women suffering from pelvic
or low back pain were randomly assigned to an acupuncture group or a control group. Traditional acupuncture points were
needled in individualised treatments, once or twice a week until the disappearance of symptoms or delivery in the acupuncture
group. Treatment was given for at least three weeks, twice weekly for the first two weeks, then once a week. The control group
received no treatment. During the study period the pain decreased in 60% of patients in the acupuncture group compared to 14%
of the controls, dropping to 43% and 9% respectively at the end of the study.
Moxibustion aids in the correction of breech presentation. Traditional Chinese medicine uses moxibustion (burning herbs to
stimulate acupuncture points) of acupoint BL 67 (Zhiyin, located beside the outer corner of the fifth toenail), to promote version of
fetuses in breech presentation. 130 subjects were randomized to the intervention group received stimulation of acupoint BL 67 by
moxa (Japanese term for Artemisia vulgaris) rolls for 7 days, with treatment for an additional 7 days if the fetus persisted in the
breech presentation. The 130 subjects randomized to the control group received routine care but no interventions for breech
presentation. Subjects with persistent breech presentation after 2 weeks of treatment could undergo external cephalic version
anytime between 35 weeks' gestation and delivery. Among primigravidas with breech presentation during the 33rd week of
gestation, moxibustion for 1 to 2 weeks increased fetal activity during the treatment period and cephalic presentation after the
treatment period and at delivery.
In many Western countries breech presentation is an indication for elective Cesarean section. In order to correct fetal presentation,
the stimulation of the acupoint BL67 by moxibustion, acupuncture or both has been proposed. Since no studies had previously
been carried out on Western populations, pregnant Italian women at 33–35 weeks gestational age carrying a fetus in breech
presentation were enrolled in a randomized, controlled trial involving an active BL67 point stimulation and an observation group.A
total of 240 women at 33–35 weeks of gestation carrying a fetus in breech presentation were randomized to receive active
treatment (acupuncture plus moxibustion) or to be assigned to the observation group. The study concluded that acupuncture plus
moxibustion is more effective than observation in revolving fetuses in breech presentation. Such a method appears to be a valid
option for women willing to experience a natural birth.
The objective of this study was to review the effectiveness of needle acupuncture in treating the common and disabling problem of
pelvic and back pain in pregnancy. Acupuncture, as an adjunct to standard treatment, was superior to standard treatment alone
and physiotherapy in relieving mixed pelvic/back pain. Women with well-defined pelvic pain had greater relief of pain with a
combination of acupuncture and standard treatment, compared to standard treatment alone or stabilizing exercises and standard
treatment. Evidence supports the proposition that acupuncture useful in treating pregnancy-related pelvic and back
pain.
This study compared ongoing pregnancy and live birth rates in spontaneous users and non-users of complementary and
alternative medicines (CAMs) during a 12-month period of assisted reproduction technique (ART) treatment. 728 women about to
have ART for the first time completed self-report assessments prior to treatment. The ongoing pregnancy and live birth rate was
31.3% lower in CAM users (42.2%) compared with non-users (61.4%). The researchers concluded ONLY that concurrent
CAM use should be monitored during ART. A main limitation to this study was that the researchers could not ascertain which
type of CAM was most associated with lower pregnancy rates. Acupuncture was not specifically studied. Total Wellness Centre
insists that all patients undergoing concurrent Western fertility and traditional Chinese medical treatments inform both their medical
doctor and TCM practitioner of all treatments they are undergoing.
Acupuncture aids in the treatment of depression during pregnancy. A total of 150 pregnant women who met Diagnostic and
Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder were randomized to receive either
acupuncture specific for depression or one of two active controls: control acupuncture or massage. Treatments lasted 8 weeks (12
sessions). Fifty-two women were randomized to acupuncture specific for depression, 49 to control acupuncture, and 49 to
massage. Women who received acupuncture specific for depression experienced a greater rate of decrease in symptom severity
compared with the combined controls or control acupuncture alone. They also had significantly greater response rate (63.0%) than
the combined controls (44.3%) and control acupuncture alone (37.5%). Symptom reduction and response rates did not differ
significantly between controls (control acupuncture, 37.5%; massage, 50.0%). CONCLUSION: The short acupuncture protocol
demonstrated symptom reduction and a response rate comparable to those observed in standard depression
treatments (pharmaceuticals) of similar length and could be a viable treatment option for depression during
pregnancy, or for depression in the general population. The potential risk to the fetus associated with pharmaceuticals can
be avoided using natural therapies such as acupuncture.
Studies on Men
The aim of this controlled study was to assess the effectiveness of acupuncture on the sperm quality of males suffering from
subfertility related to sperm impairment. Semen samples of 16 acupuncture-treated subfertile patients were analyzed before and
one month after treatment (twice a week for 5 weeks). In parallel, semen samples of 16 control untreated subfertile males were
examined. Two specimens were taken from the control group at an interval of two-eight months. The fertility index increased
significantly (p< .05) following improvement in total functional sperm fraction, percentage of viability, total motile spermatozoa per
ejaculate, and integrity of the axonema (p< .05), which occurred upon treatment. The intactness of axonema and sperm motility
were highly correlated (corr. = .50,p< .05). This study strongly suggests patients exhibiting a low fertility potential due to
reduced sperm activity may benefit from acupuncture treatment.
Forty men with idiopathic oligospermia, asthenospermia, or teratozoospermia were studied.23 Twenty eight of the patients received
acupuncture twice a week over a period of 5 weeks. The samples from the treatment group were randomized with semen samples
from the 12 men in the untreated control group. Statistical evaluation using transmission electron microscopy 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. 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.
Researchers searched for the best method for increasing the quality of abnormal sperm. One hundred and sixty-eight cases of
infertility were randomly divided into a treatment group of 85 cases and a control group of 83 cases. The treatment group were
treated with needle-picking (acupuncture) at specific bilateral points. Their therapeutic effects were observed in 3 hospitals. The
study resulted in a total effectiveness rate of 83.5% and a pregnancy rate of the patient's partner of 78.8% in the treatment group,
and a corresponding rate of 54.2% and 43.4% in the control group, which represents a very significant difference between the two
groups (P < 0.01). Reproductive hormones improved significantly after treatment (P < 0.01); after treatment, superoxide dismulase
(SOD) activity and Zn content in semen were elevated and cadmium level decreased significantly in the treatment group (P < 0.05).
The research shows that needle-picking therapy (acupuncture) can significantly improve and regulate endocrine
function, increase the quality 3f semen and elevate pregnancy rate of the patient's partner for the patient of primary
abnormal sperm.
Classic therapies are usually ineffective in the treatment of patients with very poor sperm density. This study aimed to determine
the effect of acupuncture on these males. Semen samples of 20 patients with a history of azoospermia were examined by light
microscope (LM) and scanning electron microscope (SEM), with which a microsearch for spermatozoa was carried out. These
examinations were performed before and 1 month after acupuncture treatment. The control group was comprised of 20 untreated
males who underwent two semen examinations within a period of 2–4 months. A definite increase in sperm count was
detected in the ejaculates of 10 (67%) of the 15 azoospermic patients. Seven of these males exhibited post-treatment
spermatozoa that were detected even by LM. The sperm production of these seven males increased significantly, from 0
to an average of 1.5±2.4×106 spermatozoa per ejaculate (Z=−2.8, P≤0.01). Males with genital tract inflammation exhibited the
most remarkable improvement in sperm density (on average from 0.3±0.6×106 spermatozoa per ejaculate to 3.3±3.2×106
spermatozoa per ejaculate; Z=−2.4, P≤0.02). Two pregnancies were achieved by the IVF-ICSI procedure. It is concluded that
acupuncture may be a useful, nontraumatic treatment for males with very poor sperm density, especially those with a history of
genital tract inflammation.25
The purpose of this study was to assess the clinical effects of the combined therapy of acupuncture with herbal drugs on male
immune infertility and on antisperm antibody (AsAb). 100 male cases of infertility with positive AsAb were divided randomly into two
groups, each consisting of 50 cases. The results showed that the total effective rate in the acupuncture-drug group was 90%; while
that of the control group was 64%, the comparison showing a statistically significant difference (P<0.05). The positive rate of blood
serum and/or AsAb in both the two groups decreased in varying degrees, but the negative-turning rate of AsAb in the acupuncture-
drug group was more obvious, the comparison showing also a significant difference (P<0.05). The combined therapy of
acupuncture with herbal drugs has definite therapeutic effects on male immune infertility, which can regulate AsAb
and raise the immunity of the patients.
Further studies are available relating to a host of medical ailments. Please contact us for details.
Back to main Infertility Page
References:
Most of these studies may be found on MedLine (Pubmed), a free database of medical journals. This list is not exhaustive as
studies are ongoing and are published frequently. For a list of present and planned studies, a good place to review is the
Cochrane Library online.
1. Germaine M. Buck Louis, Ph.D.a, Kirsten J. Lum, M.S.a, Rajeshwari Sundaram, Ph.D.a, Zhen Chen, Ph.D.a, Sungduk Kim, Ph.D.
a, Courtney D. Lynch, Ph.D.b, Enrique F. Schisterman, Ph.D.a, Cecilia Pyper, B.S., M.B.c, Stress reduces conception probabilities
across the fertile window: evidence in support of relaxation. 05 August 2010 (10.1016/j.fertnstert.2010.06.078).
2. Manheimer E, Zhang G, Udoff L, Haramati A, Langenberg P, Berman BM, Bouter LM., Effects of acupuncture on rates of
pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis., BMJ. 2008 Mar 8;336
(7643):545-9. Epub 2008 Feb 7.
3. Stener-Victorin, E., Waldenstrom, U., Andersson, S. and Wikland, M. (1996) Reduction of blood flow impedance in the uterine
arteries of infertile women with electro-acupuncture. Hum Reprod Biol., 11:1314-7
4. Paulus, WE., Zhang, M., Strehler, E., El-Danasouri, I and Sterzik, K. (2002) Influence of acupuncture on pregnancy rates in
patients who undergo assisted reproduction therapy. Fert Steril., 77:721-4
5. Anderson BJ, Haimovici F, Ginsburg ES, Schust DJ, Wayne PM, In vitro fertilization and acupuncture: clinical efficacy and
mechanistic basis. Altern Ther Health Med. 2007 May-Jun;13(3):38-48
6. DePow, J. (2004) "East meets West: Acupuncture and Reproductive Medicine." New Mexico Woman
7. Fertility and Sterility. 2006 May;85(5):1341-6. Epub 2006 Apr 5.
8. Fertility and Sterility, Volume 81, Issue (Supplement #), Page 20, (April 2004)
9. Hum Reprod 2003; 18: 1454-60
10. Zhong Xi Yi Jie He Xue Bao, Integrated traditional Chinese and western medicine should make new contribution to the
reproductive health of women, 2004 Mar;2(2):83-5.
11. Acta Obstet Gynecol Scand., Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome, 2000
Mar;79(3):180-8
12. Dieterle S, Ying G, Hatzmann W, Neuer A, Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic
sperm injection: a randomized, prospective, controlled clinical study.Fertil Steril. 2006 May;85(5):1347-51. Epub 2006 Apr 17
13. Johnson D., Acupuncture prior to and at embryo transfer in an assisted conception unit--a case series, Acupunct Med. 2006
Mar;24(1):23-8
14. Zhongguo Zhen Jiu. Controlled study on acupuncture for treatment of endocrine dysfunctional infertility, 2005 May;25(5):299-
300.
15. Elisabet Stener-Victorin, Elizabeth Jedel, Per Olof Janson, and Yrsa Bergmann Sverrisdottir1, Am J Physiol Regul Integr Comp
Physiol 297: R387-R395, 2009.
16. Acta Obstet Gynecol Scand 2004; 83(3): 246-50.
17. JAMA. 1998;280:1580-1584.
18. The Journal of Maternal–Fetal and Neonatal Medicine 2004;15:247–252
19. Ee CC, Manheimer E, Pirotta MV, White AR., Acupuncture for pelvic and back pain in pregnancy: a systematic review., Am J
Obstet Gynecol. 2008 Mar;198(3):254-9.
20. J. Boivin; L. Schmidt, Human Reproduction. 2009;24(7):1626-1631.
21. Manber R, Schnyer RN, Lyell D, Chambers AS, Caughey AB, Druzin M, Carlyle E, Celio C, Gress JL, Huang MI, Kalista T,
Martin-Okada R, Allen JJ., Acupuncture for depression during pregnancy: a randomized controlled trial, Obstet Gynecol. 2010 Mar;
115(3):511-20.
22. Sherman; F. Eltes; V. Wolfson; N. Zabludovsky; B. Bartoov, Institute of Chinese Medicine, Tel Aviv, IsraeMale Fertility
Laboratory, Department of Life Sciences, Bar-Ilan University, Ramat Gan, Isreal, Effect of Acupuncture on Sperm Parameters of
Males Suffering from Subfertility Related to Low Sperm Quality Systems Biology in Reproductive Medicine, Volume 39, Issue 2
September 1997 , pages 155 - 16S.
23. J. Pei, E. Strehler, U. Noss, M. Abt, P. Piomboni, B. Baccetti, K. Sterzik, Fertility and Sterility, Volume 84, Issue 1, Pages 141-147
24. Zhongguo Zhen Jiu. 2006 Jun;26(6):389-91.
25. S Siterman, F Eltes, V Wolfson, H Lederman, B Bartoov (2000) Does acupuncture treatment affect sperm density in males with
very low sperm count? A pilot study Volume 32 Issue 1 Page 31-39, January 2000
26. Fu B, Lun X, Gong Y. Effects of the combined therapy of acupuncture with herbal drugs on male immune infertility--a clinical
report of 50 cases. J Tradit Chin Med. 2005 Sep;25(3):186-9.
