Polycystic ovarian syndrome (PCOS) can significantly affect chances of conceiving due to both follicle development/ovulatory issues and poor endometrial receptivity (negatively affecting implantation rates). One of the mainstay treatment options used in conventional medicine for supporting ovulation and fertility with PCOS is the medication letrozole (inhibits the activity of an enzyme called aromatase in the body).
How does Letrozole support treatment of PCOS?
Letrozole decreases the production of estrogen in the body and this signals the pituitary gland to produce more follicle stimulating hormone (FSH), which encourages the growth of the follicles. In many cases of PCOS the amount of FSH produced is suppressed in the brain and instead more luteinizing hormone (LH) is produced, which in turn increases the production of androgen hormones, further driving the hormonal imbalance seen in Patients with PCOS. So when FSH levels increase, the follicles can start to respond and grow quicker than before.
Not all patients respond optimally to letrozole:
However, some patients notice that they are still not getting pregnant after multiple cycles of letrozole. Two common causes that can cause this to happen are a thin uterine lining (not thick enough for optimal chances for implantation to occur), and if the follicles grew in size with the medication but no enough for the Patient to ovulate.
New study utilizing fertility acupuncture in conjunction with letrozole for Patients with PCOS:
A newly published clinical trial evaluated if adding fertility acupuncture in conjunction with a letrozole treatment cycle improved outcomes for Patients when compared to those using letrozole only.
The new clinical trial found that when the appropriate fertility acupuncture protocol for PCOS was utilized in conjunction with the medication the following outcomes were observed:
Follicle size increased significantly: by day 12 of the treatment cycle the dominant follicle size in the acupuncture + medication group was approximately 6 mm larger when compared to the medication only group. This is significant as most fertility clinics aim for a dominant follicle size above 15-20mm+ (this may vary from clinic to clinic)
Endometrial lining thickness increased significantly: the uterine lining was approximately 1.3 mm thicker in patients that utilized acupuncture. This can be crucial for patients sitting just below the 7 mm threshold that is often set as a minimum to proceed with a treatment cycle.
Endometrial receptivity improved: both pulsatility index (PI) and resistance index (RI) improved. Both of these parameters help to measure blood flow and were used to estimate endometrial receptivity.
How does acupuncture increase fertility with PCOS?
The main mechanism of action the researchers pointed to in this trial was that there was a decrease in the sympathetic tonic activity with the addition of fertility acupuncture. Decreased sympathetic tone reduces the signals for vasoconstriction of blood vessels and may be the reason for improved blood flow to the uterus and reproductive organs. The researchers recommended larger trials to confirm their findings.
This article is being shared as educational content and is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor. Please discuss with your healtcare provider and only make changes to your medications regimen if recommended by your doctor and under their guidance and supervision.