Acupuncture is an ancient medical tool utilized in Traditional Chinese Medicine (TCM) and has been used to treat a variety of disorders. It may be used from something as simple as muscle pain to complex issues like fertility.
Acupuncture has been studied quite extensively over the last couple of decades for its role in improving fertility. The results have been pretty consistent: the use of acupuncture can improve the success rates in patients undergoing in-vitro-fertilisation (IVF) and intracytoplasmic injection (ICSI). This benefit is only seen when actual acupuncture needles are used to penetrate the skin (i.e. the use of laser acupuncture and acupressure do not show these benefits).
SYSTEMATIC REVIEW AND META-ANALYSIS
A systematic review and meta-analysis performed by Junyoung Jo and Yoon Jae Lee (published on December 20th, 2016) on the use of acupuncture in women with polycystic ovarian syndrome (PCOS) undergoing IVF or ICSI treatments shows that there are considerable benefits from acupuncture. They looked at various studies and found that, on average, the clinical pregnancy rate (CPR) was increased by 30% compared to the group of patients that didn't receive acupuncture. More importantly, the on-going pregnancy rate (OPR) was improved by about 99% compared the group that did not receive acupuncture.
HOW DOES ACUPUNCTURE WORK?
The points that are used during acupuncture are specific to each patient, although some studies show the consistent use of similar points in patients working to overcome infertility. The traditional theory is that the needles work to stimulate the production of Qi (energy) along the specific meridians that the govern the reproductive system, they move stagnation of energy, blood, and fluids, and help reduce stress.
From a scientific stand point, the research on fertility acupuncture suggests the following mechanisms by which fertility treatment success rates may increase:
1. Increased uterine blood flow
2. Decreased uterine muscle spasms
3. Modulate immune function
4. Relieve anxiety, depression, and stress
5. Reduced Anti-Mullerian Hormone (AMH) in Women with PCOS (usually AMH is a predictor of ovarian reserve, however, the levels of AMH are abnormally elevated in Women with PCOS)
OVARIAN HYPERSTIMULATION SYNDROME (OHSS)
OHSS is a very big concern during IVF and/or ICSI treatments, especially in patients with PCOS. It is a result of over-stimulation of the ovary from the ovulation trigger injection that contains human chorionic gonadotropin hormone (hCG). The syndrome can vary from mild, moderate, to very severe, and is associated with the following symptoms: abdominal distension, enlarged ovaries, and intraperitoneal fluid accumulation. In mild cases it just requires careful observation, in severe cases it may require hospitalization.
OHSS & ACUPUNCTURE
Acupuncture not only improves the success rates of IVF and ICSI, but it can also decrease the likelihood of OHSS in women with PCOS. The exact mechanism by which this occurs is not clear, but the hypothesis by the researchers is that the needles may decreased production of vascular endothelial growth factor, a very important mediator in the development of OHSS.
ADDITIONAL IMPLICATIONS FOR THE USE OF ACUPUNCTURE
Research has also suggested that acupuncture may be beneficial for Women that have decreased ovarian reserve improve their chances of success during IVF or ICSI. It is also suggested that the use of acupuncture can improve ovulatory function, improve insulin sensitivity, and decrease testosterone levels in Women with PCOS.
ELECTROACUPUNCTURE (EA)
EA is a form of acupuncture that uses microAmps of current to stimulate certain points. This is commonly used for Women with ovulatory dysfunction and/or PCOS as it has additional benefits in improving follicular development, ovulatory function, and improving insulin sensitivity.
CONCLUSION
Assisted Reproductive Techniques (ARTs) are very expensive procedures, and there is a lot of emotional investment that goes in to the process months before ART is even considered. Knowing that acupuncture improves IVF and ICSI success rates, decreases the risk of OHSS, and reduces stress and anxiety should be more than enough reason to convince couples considering ARTs to review the option of using fertility acupuncture to support their journey.
Reference:
Jo, J., & Lee, Y. J. (2017). Effectiveness of acupuncture in women with polycystic ovarian syndrome undergoing in vitro fertilisation or intracytoplasmic sperm injection: a systematic review and meta-analysis. Acupuncture in Medicine. doi:10.1136/acupmed-2016-011163