FAQ about Acupuncture and infertility

FAQ about Acupuncture and fertility treatments (such as Cycle monitoring with drugs, IUI, IVF)

Research in Acupuncture and Infertility

FAQ about Diet and Lifestyle Issues

When during my cycle should I get acupuncture done? Should I come just before ovulation?

Acupuncture treatments should be done on a regular basis throughout your cycle. You can expect a limited effect by receiving acupuncture only around ovulation time. Compared to many of the fertility drugs which provide a powerful effect for a short duration, the immediate effect of acupuncture treatment is, in general, very subtle. The cumulative effect from regular acupuncture treatments, however, can produce significant long lasting benefits.


Do you use different types of acupuncture treatments depending on the time of the cycle?

At ATP Acupuncture & Chinese Medicine, the treatments are often slightly modified in order to induce more specific effects depending on the time of the cycle. For example, more specific protocol may be used when applying acupuncture after ovulation, in order to maintain a low stress level and in an attempt to support the implantation. The technique used at ATP Acupuncture & Chinese Medicine is special Chinese acupuncture, which is so gentle that it can be applied safely throughout the cycle.


How exactly does acupuncture influence the female reproductive system?

Acupuncture has been reported to promote the circulation of blood in the pelvic cavity and improve ovarian function (Chang et al. 2002). Acupuncture treatment may be beneficial in promoting follicle production(Emmons et al. 2000), enhancing uterine blood flow(Stener-Victorin et al. 1996) and improving uterine lining thickness (Kobayashi et al. 2003; Suzuki et al. 2002).


How does acupuncture assist in improving the likelihood of pregnancy?

Although we have mentioned several possible effects of acupuncture on the female reproductive system, one should not regard acupuncture as a cure for infertility. Our approach focuses on optimizing a patient's entire organic system and is intended to improve overall health. As a result, fertility may be greatly enhanced.

Within the modern medical approach to fertility, there still exists a fair amount of controversy and disagreement among the reproductive specialists. However, there are two factors that every specialist agrees upon. First, when the woman is younger, the IVF success rate is significantly higher. Second, when the woman is healthier, the success rate of IVF is also increased. Thus, acupuncture can be used to improve one's overall health status, thereby positively enhancing the results of IVF.


If aging negatively affects fertility, does acupuncture reverse the aging process?

There is a strong correlation between age and reproductive health. However, it is important to remember that there are two types of aging: chronological and biological. While everyone ages at the same speed chronologically, the biological aging process differs greatly among each individual. That is the reason why each woman goes into menopause at a different time of their lives. So while it is generally true that the quality of a woman's eggs declines as she ages, eggs of some women in their forties can be excellent quality due to slow biological aging.

It is not possible to stop chronological aging, however, we can definitely influence the progress of biological aging. Abusive lifestyle factors such as poor diet, smoking, stress, and insufficient sleep all accelerate the cell oxidation and the biological aging process. Practicing a healthy lifestyle in addition to regular acupuncture treatments will have a positive impact in slowing down the aging process.

We have reservation in using the statement that acupuncture can reverse the aging process. However, we have had a few cases at our clinic in recent years in which women over 50 who were postmenopausal began to have regular menstruation after receiving acupuncture on a regular basis for general health.


My FSH is too high. Does acupuncture correct hormonal imbalance?

An increasing number of women are visiting acupuncture clinics seeking help in correcting the hormone imbalances (FSH, LH, progesterone, prolactin etc.) they are suffering from.

Regular acupuncture treatments can be very helpful in regulating hormonal imbalances, although it should be noted that acupuncture does not directly alter the female hormones. Rather, acupuncture is considered to influence the hormonal regulation centers in the brain and autonomic nervous system (i.e., the hypothalamic-pituitary-ovarian axis) and as a result, improvement in hormonal status can occur over time.


As I receive a series of treatments, how do you and I know that acupuncture is working for me?

If you are not presently on hormones, we recommend that you record your basal body temperature (BBT) every morning. The BBT chart is not the best method available to detect the exact time of ovulation, however, it is an excellent method to get an idea about the female hormone fluctuation pattern and can be used as a one of the indexes to know your progress by observing changes in the BBT pattern from month to month.

As mentioned earlier, the focus of our acupuncture approach is to help improve overall health. Therefore, as patients receive a series of acupuncture treatments, many of them experience enhanced feelings of well-being such as more restful sleep, better digestion, decreased anxiety, increase of energy, etc. These physical and emotional shifts can only positively influence the chance of conceiving regardless of whether one is trying naturally or undergoing medical reproductive treatment.


Where are you going to place the needles?

The location of acupuncture points will vary from patient to patient and from treatment to treatment. Some of the most well-known acupuncture points, traditionally used to influence the function of the female reproductive organs, are located on the lower back, lower abdomen, and legs. The points on the lumbar, sacrum, and low abdominal regions are particularly important in consideration of female anatomy and the related nerve segmental innervations. The points on head, neck, upper back and arms are used in order to stimulate autonomic nervous system and further induce the relaxation response.


What else besides the acupuncture points determines the effect of the treatment?

In North America most students learn to treat a patient by matching the condition with the prescribed acupuncture points in the textbook. Thus, there are many practitioners who tend to only focus on selection of acupuncture points, and not pay enough attention to other equally (if not more) important variables to provide effective acupuncture. Consistent efficacy cannot be expected by simply inserting needles at specific points in the body. Research experiments clearly demonstrate that even when the same acupuncture point is stimulated, the physiological response varies greatly (sometimes even in opposite directions) depending on how (the depth of the needle, the intensity, etc.) and when the point is stimulated.

What is the success rate of acupuncture treatment for infertility?

At ATP Acupuncture & Chinese Medicinewe are not producing the success rate statistics. We are also unaware of any acupuncture clinics providing their success rate (please keep in mind that "claim" and "statistics" are totally different animals).

Infertility is caused by a variety of factors and it is well known that fertility rates vary significantly depending on various factors such as age and co-existing medical conditions. It is important to consider those variables when calculating statistics. Also, it is necessary that separate statistics are produced for patients who conceived naturally with acupuncture and for patients who underwent assisted reproductive technologies (ART) or any other medical fertility treatment in conjunction with acupuncture. Furthermore, statistics derived from an insufficient number of cases in each group contain a large margin of error (as a reference, to obtain statistics within 5% of error, more than 96 cases per group per year are required). These are just a few examples of methodological difficulties regarding success rate statistics. Lastly, statistics can be easily manipulated and success rate can vary greatly depending on the criteria and rules used when calculating the statistics.





FAQ about Acupuncture and fertility treatments (such as Cycle monitoring with drugs, IUI, IVF

Do you provide acupuncture treatments in conjunction with medical fertility treatments?

A number of patients have been receiving acupuncture at our clinic while undergoing IVF or IUI treatments. We also have patients who have been going through cycle monitoring with or without fertility drugs.


During the IVF cycle, my hormone levels will be intentionally skewed by medications. How will acupuncture affect my hormone levels at this time?

Acupuncture has some effect in balancing hormonal systems, likely by influencing the hormonal regulation center of the brain, thus it only influences them within a homeostatic range. Hormonal medication on the other hand has much more powerful and direct effect and can skew the hormone status outside of the normal homeostatic range. In circumstances such as this, acupuncture only influences the body to respond better within the pharmaceutical intervention. Regulating the hormones during the IVF cycle is the sole responsibility of the fertility specialist - to monitor the blood on a consistent basis along with all the dosages and the medication protocols.


I am undergoing IVF treatment and am considering receiving acupuncture treatments as well. Are there any negative effects on my fertility treatment?

Acupuncture, especially the procedure used by acupuncturists at ATP Acupuncture & Chinese Medicine is extremely gentle using a superficial Chinese acupuncture technique. The procedure is virtually non-invasive and its main effect is to aid relaxation. Hence, there should be absolutory no negative impact with this type of treatment (Please refer to Acupuncture FAQ for more general adverse effects of acupuncture).


I will be undergoing IVF. When should I start acupuncture?

While some patients respond to acupuncture quickly, acupuncture certainly does not work overnight. Most patients require a series of ongoing treatments over a few months to a year. The recommended treatment schedule is based on consideration of a variety of factors in each individual case. In many cases, we recommend that you start acupuncture treatment at least 2 months prior to the commencement of the IVF cycle and that you continue for 1 to 2 times a week until the day of the transfer.

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Research in Acupuncture and Infertility

I would like to get acupuncture according to the protocol used in a German study. What are your thoughts on this method?

In April 2002, German researchers reported that they had increased the success rate by nearly 50% in women undergoing in vitro fertilization (IVF) using acupuncture(Paulus et al. 2002). Their results are quite impressive especially when considering that they had administered only two short acupuncture treatments. We definitely have yet to see further replicated studies to confirm their findings and applicability under different settings. It is important to remember that the results obtained by the German group are only applicable to a very limited patient population under very restricted circumstances as in the research study.

In the German study, acupuncture was only applied immediately before and after the embryo transfer, which means that there was no influence of the acupuncture on the patients' eggs. Quality of eggs is a large factor to consider in fertility and the study only enrolled couples who had good quality embryos (Type I or II). Further, the mechanism of how the intervention worked according to this protocol is totally unknown as they have failed to demonstrate any meaningful changes in the uterine pulsatility index (indicator of blood flow in the uterus) before and after acupuncture versus the control. Just like other research studies, this German study was designed only to address one main research question. This study was not designed to determine when or how acupuncture would best be administered. It is very unlikely that most patients would obtain consistent clinical outcome by simply using the acupuncture points they listed in the study. Their conclusions should not be widely extrapolated.


Are there any other research articles showing the efficacy of acupuncture for fertility?

Besides the German study mentioned, there are other studies suggesting the positive influence of acupuncture on the female reproductive system(Gerhard et al. 1992; Stener-Victorin et al. 1996; Stener-Victorin et al. 2000) and using acupuncture treatment in conjunction with ART on difficult infertility cases(Kobayashi et al. 2003; Suzuki et al. 2002; Takahashi et al. 2002). However, the acupuncture treatment methods used, such as the acupuncture points, type of stimulation and duration and frequency of acupuncture treatment, varied greatly among each study.

Although any useful and applicable information from the research will be reflected in the design of your treatment protocol, currently there is too little data existing to develop any standardized acupuncture protocol for the treatment of infertility. At present, any acupuncture protocol and treatment schedule should be individually designed based on each patient's medical history and constitution. After all, individualized care is the main tenet of acupuncture as practiced for many years in the Orient.


How strong is the evidence of efficacy of acupuncture for infertility?

At present, evidence of the efficacy of acupuncture for infertility is for the most part anecdotal and there are only several pieces of scientific data available as cited above. In addition, all of the previous studies suffer from some methodological shortcomings such as small sample size or missing control (comparison) group, etc. It should be noted that although they have used completely different acupuncture protocols, authors of different previous research studies in acupuncture and infertility suggested the alteration of autonomic nervous system (ANS) as the possible mechanism of why acupuncture worked on fertility problems in their studies.

As indicated, while there is not enough 'direct' evidence linking acupuncture and fertility, sufficient data does exist indicating the relationship between stress and infertility or unsuccessful IVF (Chrousos et al. 1998; Eugster et al. 1999; Gallinelli et al. 2001; Matsubayashi et al. 2003; Smeenk et al. 2005). It is well known that ongoing emotional stress creates imbalance in the ANS (sympathetic dominant state). Relaxation on the other hand, activates the parasympathetic branch of the ANS which is important for maintenance of proper regulation of our internal function including reproductive organs. A number of previous studies have demonstrated that acupuncture does influence the activity of ANS(Agelink et al. 2003; Middlekauff et al. 2002; Nishijo et al. 1995; Tanaka 1996).