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In Vitro Fertilisation (IVF) & Acupuncture

Assisted reproduction technology (ART) has rapidly gained acceptance by all those for whom conception has been difficult to achieve.  Recent advances in IVF means that couples using this approach have a clinical pregnancy rate of 36% and a viable pregnancy rate of 29% per embryo transfer.

The procedure for IVF is as follows: The woman’s ovaries are stimulated with drugs to produce a number of ripe eggs which are then collected by a needle inserted through her vaginal wall.  These eggs are placed in a Petri dish and mixed with a sperm sample, provided whilst the eggs are being collected.  The eggs are monitored over five days and then one or two embryos will be returned to the uterus.

Jansen (1997) 1 explains that IVF treatment is more likely to be successful if there is a clear reason for infertility, providing that the treatment corrects the problem properly and does not, through side effects (of drugs or surgery) interfere with any other aspect of reproduction.

IVF and TCM

A TCM practitioner will take into account the Western diagnosis given to explain infertility, which provides him or her with some details about the disorder and may indicate prognosis.  However, the treatment offered is planned on the basis of an entirely different system of diagnosis which is based on Chinese Medical diagnostic principles.

In treating patients undergoing IVF, the practitioner will work with the patient to balance her body.  For example, much attention is given to the detail of the menstrual cycle; its regularity, variability and flow. This is a key diagnostic tool in measuring the progress of treatment.  In some cases the woman may need to reflect on her diet, stress levels or general health. Diet and lifestyle play a key role in the treatment of fertility problems and TCM can support her throughout this process.

Where there is no obvious cause of infertility, TCM is able to diagnose and treat the underlying causes which are preventing conception.

Is Acupuncture Helpful in the treatment of Infertility?

There is considerable research into the effectiveness of TCM in assisting orthodox fertility treatments.  Paulus et al (2002)2, in a prospective randomised study, showed that women treated with acupuncture had a 42.5% success rate as against a 26.3% success rate for the control group.  Further research published in 2006 by Westergaard et al3 indicates that acupuncture on the day of embryo transfer significantly improves the reproductive outcome.

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References:

1 Jansen, R P S (1997) Getting pregnant Sydney, Allen and Unwin

2 Paulus, W E., Zhang, M, Strehler, E., El-Danasouri, I., Sterzk, K (2002) ‘Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy’ Fertility and Sterilty vol 7, no 44 pp 721-724

3 Westergaard, L G., Mao, Q., Krogslund, 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, randomised trial’ Fertility and Sterility, Vol 85, no 5, pp1341-1346

Further Reading:

If you are interested in reading more about Traditional Chinese Medicine, or its relationship with IVF treatment, the following titles are available to purchase from our clinic:

Acupuncture & IVF: Increase IVF Success by 40-60% by Lifang Liang, Blue Poppy Press, 2004.

Chinese Medicine by Duo Gao, Carlton Books, 2004.

Male Infertility

Infertility affects approximately one in five couples of reproductive age, and male infertility is the cause of an estimated 40% of these cases. Male infertility is usually investigated by sperm analysis. According to the World Health Organisation, a man is fertile if his ejaculate satisfies the following criteria:

  • Volume: more than 1 millilitre
  • Sperm Count: more than 20 million sperm per millilitre
  • Motility: more than 50% of the sperm move vigorously and purposefully
  • Shape: more than 14% of the sperm are not deformed

In modern times the quality of male sperm is declining, probably due in part to the effect of environmental pollutants. Cigarette smoking and the use of recreational and some prescription drugs can also lower sperm counts; the pace and stress of modern consumerism may also have its effect, as may a poor diet, or poor digestion  due to eating in a hurry or whilst doing other things. Apart from lifestyle changes in line with the above, there is only a limited amount of conventional treatment for male infertility.

Male Infertility and TCM

In TCM, reproduction is associated with what is known as Shen, which refers to the body systems governing reproduction and sexuality, and is considered to be the root of all our energy. Shen is referred to as the ‘Root of Life’ and is related, in some ways, to the western medical conception of the kidneys. The main cause of male infertility in TCM is an  imbalance in the Shen, or more accurately an imbalance in the Yin and Yang of the Shen.

If the Shen lacks Yang, this means that the active, warm, rising aspect of male sexuality is impaired, with symptoms such as loss of libido and impotence; the sperm count may be low and the sperm motility poor. In addition, there may be more general symptoms such as lethargy, coldness and backache.

If on the other hand it is the Yin of the Shen which is lacking, the male sexual apparatus may function properly, and indeed there may be a high libido, although premature ejaculation may be a problem. Sperm may be plentiful, but they may tend to be poor quality. Yin deficiency may also manifest as restlessness and feeling hot at night.

TCM treatment  involves strengthening the Yin or Yang of the Shen as appropriate, using acupuncture and  herbal therapy. Treatment may also be aimed at harmonising the energy of  other organ systems, since any imbalances present there may also be affecting the Shen.

Is Acupuncture Helpful in the treatment of Infertility?

Although more research needs to be done in this area, there is promising evidence for the effectiveness of TCM in treating male infertility. For example, one study of 54 cases of infertility (due to various causes) found a success rate of almost 80%1. Another study looking specifically at men with low sperm count found significant increases  in men who had previously undetectable levels of sperm in the ejaculate 2.

References:

1 Zhiyun Q (1996) Clinical observation of 54 cases of male infertility treated by acupuncture and moxabustion Journal of Chinese Medicine 52 12-13

2 Siterman S, Eltes F, Wolfson V, et al (2000) Does acupuncture treatment affect sperm density in males with very low sperm count? Pilot study Andrologia 32 (1) 31-39

Female Infertility

A couple will be diagnosed as infertile if there is no pregnancy after two years of trying to conceive. In about 40% of cases the cause is female infertility, with male infertility implicated in another 40%. In 20% of cases conventional medicine offers no explanation; this is termed as unexplained infertility. Common causes of female infertility include:

  • Problems with ovulation, possibly due to such conditions as thyroid problems, Polycystic Ovarian Syndrome (PCOS), or premature ovarian failure
  • Problems with the womb or fallopian tubes, perhaps due to endometriosis or fibroids
  • Stress, which can affect libido and interfere with ovulation
  • Being over or under weight, which can affect ovulation
  • Ageing: a woman’s fertility begins to decline significantly as she passes her mid-thirties

Conventional medicine treats infertility with drugs, surgery, artificial insemination and Assisted Reproduction Techniques (ART).

Female Infertility and TCM

The approach of TCM to female infertility is quite different from that of conventional medicine. The latter is technologically very sophisticated and can give quick results; but on the other hand it is often expensive, invasive and may involve unwanted side effects. TCM is more gradual and holistic; it seeks to restore harmony and balance to the reproductive system and the menstrual cycle, and in fact to the woman as a whole, so that nature can once more take its proper course. Sometimes the two approaches can work well together, for instance in women who have acupuncture before and during their IVF treatment (please see our leaflet “Acupuncture and IVF” for more information). Some women, however, prefer to rely on the natural re-balancing of their energy that TCM facilitates. Indeed it might be argued that infertility is nature’s way of saying that the body is currently incapable of nourishing a foetus to create the basis for a healthy life, and that relying solely on ART bypasses nature in a way which may, in the end, have consequences both for the mother and for that new life.

TCM treatment is individualised for each woman; we usually recommend that a woman thinks in terms of coming regularly over the course of three menstrual cycles. During this time we can monitor her rate of progress and the improvement in her fertility by paying attention to changes in her periods, pre-menstrual symptoms, body temperature and other signs and symptoms. Depending on the person, in addition to acupuncture we may  prescribe herbal remedies, dietary modifications and gentle Chi Kung exercises.

The TCM approach is especially popular with couples who suffer from ‘Unexplained Infertility’. This is usually because the imbalances in the woman or man’s Qi are not so great as to manifest in any conditions that are recognised in Conventional Medicine. TCM therapists however can usually identify these imbalances relatively easily and thus prescribe a course of treatment to help readjust and harmonise the Qi. In the case of unexplained infertility, of course, it is often best if both partners are having treatment concurrently. Please refer to our leaflet on male infertility for more information on this subject.

Is Acupuncture Helpful in the treatment of Infertility?

The World Health Organisation1 considers the therapeutic effect of acupuncture for female infertility has been shown,  but  further proof is needed. Among more recent studies  gathering this proof are a 2007 review2 which concludes that acupuncture exerts long lasting beneficial effects for PCOS patients, including effects on ovulation and endocrine systems.

References:

1 WHO (2002): Review and Analysis of Reports of Controlled Clinical Trials

2 Stener-Victorin, E et al Journal of Neuroendocrinology 20 (3), March 2008

Disclaimer
The Sean Barkes Clinic does not claim to cure any conventional medical disease states.  Traditional Chinese Medicine seeks to re-establish and maintain the harmonious function of the human body-mind using tried and tested principles that have been discovered and matured over millennia.  A Western medical diagnosis provides very little by way of insight in informing a Chinese Medical diagnosis.  Patients usually recognise their own condition in terms of the medical disease category that they have been given by their GP or other conventional medical practitioner.  The research presented here is merely an indication of the potential to draw parallels between Traditional Chinese Medicine and Modern Western Medicine.

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