Female Infertility

In recent years, increasing numbers of infertility patients are using acupuncture during their IVF to increase the rate of pregnancy. The tremendous growth began with the publication of Dr. Paulaus Wolfgang’s ground breaking clinical study in 2002.

Groundbreaking Study

The study found that clinical pregnancy rate was 41.5% higher in treatment group when patients received pre and post ET (embryo transfer) acupuncture. Two subsequent clinical studies, conducted by Lars Westergaard et al and Stefan Dieterle et al also demonstrated that acupuncture around ET increased the clinical pregnancy rate by 33.3% and 55.5%, respectively. That is an impressive 43.43% average improvement for a 2% of incremental cost of the IVF, assuming $200 for pre and post IVF acupuncture, and $10,000 for an IVF.

Increased Awareness & Acceptance

The proliferation of Internet technologies, such as Google and chart-room, provided easy access to aforementioned clinical studies and a platform for infertility patients to share their positive experience with acupuncture among IVF patients.

In 2010, acupuncture, as a viable alternative and complementary therapy to western ART (Assisted Reproductive Technology), received a major boost when celebrities, such as Julie Snyder, and international super star Celine Dion, publicly endorsed acupuncture in their successful pursuit of parenthood.

The year 2012 marks another turning point – half of the Montreal’s infertility clinics are either offering on-site, pre and post embryo transfer acupuncture or planning to do so in the near future, due to an ever increase amount of support from recent clinical studies and patients’ demand.

Finding an experienced acupuncturist and faithfully following the requirements – whether it’s drinking bitter herbal teas, changing your lifestyle or receiving regular acupuncture treatments – are the keys to successful fertility treatment.

Chinese Medicine treatment

Like western medicine, the first step to successful treatment with TCM is proper diagnosis. Once the syndromes (the nature of illness) are diagnosed, the TCM practitioner has already formed an opinion on the pathogenic factors, pathogenesis, location, and prognosis.

In my practice, I pay more attention to the syndromes than the disease itself. This means that if I find the same disease in a number of patients and determine that they have different syndromes, I treat each case differently. For example, two female patients each have polycystic ovarian syndromes (PCOS), but one patient’s PCOS is caused by Spleen and Kidney Deficiency, and the other by Liver Qi Stagnation. In treating each of these patients, I would use very different acupuncture points and herbs.

When the diseases presented in different patients are different, but the syndromes are the same, I treat the patients similarly. For example, if I have three infertility patients, one with PCOS, another with endometriosis and a third with premature ovarian failure (POF), and I find that they are all caused by Kidney Deficiency, then I would use very similar acupuncture points and herbs to treat these three patients.

Depending on the diagnosed syndromes, the patient’s personal constitution and diagnosis from the fertility clinic, I then outline a treatment objective. To achieve the treatment objective, I often use a combination of acupuncture and Chinese herbal medicine. Sometimes, nutritional supplements and dietary regulation are also used

Infertility

In recent years, increasing numbers of infertility patients are using acupuncture during their IVF to increase the rate of pregnancy. The tremendous growth began with the publication of Dr. Paulaus Wolfgang’s ground breaking clinical study in 2002.

Groundbreaking Study

The study found that clinical pregnancy rate was 41.5% higher in treatment group when patients received pre and post ET (embryo transfer) acupuncture. Two subsequent clinical studies, conducted by Lars Westergaard et al and Stefan Dieterle et al also demonstrated that acupuncture around ET increased the clinical pregnancy rate by 33.3% and 55.5%, respectively. That is an impressive 43.43% average improvement for a 2% of incremental cost of the IVF, assuming $200 for pre and post IVF acupuncture, and $10,000 for an IVF.

Increased awareness and acceptance

The proliferation of Internet technologies, such as Google and chart-room, provided easy access to aforementioned clinical studies and a platform for infertility patients to share their positive experience with acupuncture among IVF patients.

Complementary therapy is embraced

Most recently, acupuncture, as a viable alternative and complementary therapy to western ART (Assisted Reproductive Technology), received a major boost when celebrities, such as Julie Snyder, and international super star Celine Dion, publicly endorsed acupuncture in their successful pursuit of parenthood.

Finding an experienced acupuncturist and faithfully following the requirements – whether it’s drinking bitter herbal teas, changing your lifestyle or receiving regular acupuncture treatments – are the keys to successful fertility treatment.

Male Infertility

Acupuncture has been increasingly used as an alternative and complementary treatment for female infertility, in recent years. However, the significant therapeutic potential of acupuncture, in the treatment of male infertility, is still largely unknown. Male factors are contributory in at least 50% of infertile couples (Collins, 1989), and yet it is notoriously difficult to treat. There are several non-surgical therapies, but the current trends is toward using micro-surgical techniques, such as ICSI, MESA and TESE, which exclusively use the best few sperms of however poor quality1.

Presently, there are a few dozens of published clinical studies published to support this ancient therapy in the treatment of male infertility. The results of these clinical studies are encouraging and have shown significant potentials to increase both the quantity and quality of sperm.

In my clinical observation, male infertility patients generally respond slower but better than their female counterparts. Since the sperm may take two and half months to form, the effectiveness of the treatment for certain conditions could only be assessed after three to six months.

On the other hand, I have observed that male patients are, unfortunately, much less likely to follow the full course of treatment. It is unclear if this phenomenon is due to lack of information, education or willingness to try an unfamiliar alternative treatment.

Unexplained Infertility

For up to 40% of Infertility patients, their infertility has no apparent cause after a full series of Western medicine tests and assessments are completed.

Don’t despair, an experienced acupuncturist can provide a complete assessment from Chinese medicine’s perspective. In most cases, reasons could be found. Please contact Sinocare for additional information.

Case Study

To illustrate the healing potential of acupuncture and Chinese herbal medicine, I list three recent case histories for your reference.

Male Patient History Western Medicine Diagnosis & Treatment Chinese Medicine Diagnosis & Treatment
Age 33,
Secondary Infertility: 24 months		 Lower sperm count and low motility; sperm antibody Kidney Essence and Qi deficient; acupuncture weekly and herbs daily for 4 months
Age 36
Primary Infertility: 24 months		 Poor morphology 10%; poor motility (7% moving rapidly) Kidney Qi deficient; herbal medicine daily for 7 months
Age 33
Primary Infertility: 18 months		 Low sperm count (13.2 million/ml); poor motility (3% moving rapidly) Damp-heat accumulation in liver/gall bladder meridian; acupuncture weekly and herbal medicine daily for 5 months

Observed Benefits

There are many additional benefits that I have observed during my twenty years of practice:

  • It is an effective treatment for unexplained infertility.
  • It offers new hope for patients who are unwilling or unable to conceive with the help of Assisted Reproductive Technology (ART) alone.
  • It relieves physical and emotional stresses associated with infertility and its treatment.
  • It has virtually no short-term or long-term side effects.
  • It is relatively inexpensive and may be covered by private insurance.

Reported Benefits

According to recently published clinical studies (please go to Research section for a comprehensive list of relevant studies and articles), acupuncture and Chinese herbal medicine could significantly:

  • Increase the percentage of normal-form sperm for idiopathic infertility patient.
  • Increase sperm motility and intactness of the axonema.
  • Increase the sperm quality (morphology) .
  • Reduce the existence of sperm antibody.
  • Reduce varicocele.
  • Improve overall quality of sperms (counts, motility and morphology) , and moderately improve azoospermia.
  • Remedy retrograde ejaculation and erectile dysfunction.
  • Reduce sperm disomy (an extra chromosome).

Age and Female Infertility

One of the most common causes of female infertility today is delayed childbearing years, i.e. age. It is a simple fact of life that female fertility decreases significantly after mid thirties. Due to large numbers of my patients are in this category, I wrote the following content specifically for female infertility patients beyond age of 40 or prior to age of 40 but displayed premature sign of aging in their reproductive system.

As we are all keenly aware, even with recent advance in assisted reproductive technology, it is still a great challenge to help this group of women to get pregnant. Acupuncture could be used as an effective complementary and/or alternative therapy to improve their reproductive function and achieve viable pregnancies for this group of women. In our clinical practice, long term acupuncture treatment has been observed to potentially:

  • Improve follicle reserve
  • Reduce FSH readings
  • Improve ovarian response during IVF stimulation
  • Increase success rate of embryo transfer during IVF
  • Raise possibility of natural pregnancy

In other words, high FSH and Premature Ovarian Failure, low follicle reserve or low response to ovarian stimulation medication does not automatically means to an end of a woman’s reproductive function. Over the years, I have helped numerous women in this category to get pregnant, though it is not an easy task, but definitely not impossible.

Chinese Medicine Pathology

As you can imagine, the pathology of female infertility in Traditional Chinese Medicine (TCM) can be very complex. The terms used in TCM, such as Kidney, Liver and Blood, have different meanings from those of Western medicine, and are capitalized here to show that the meaning isn’t the same. They are widely used for lack of better translations. If you’d like to learn more about TCM and infertility, refer to the books recommended in Resource – Book – Infertility section of our website.

According to a study published in the Journal of Traditional Chinese Medicine, liver Qi (vital energy) Stagnation and Kidney Deficiencies account for 51.7% and 22.4% of female infertility patients. This conclusion is hardly surprising when you consider current lifestyles and the demography of many female infertility patients. Liver Qi Stagnation is often associated with stress, a sedentary lifestyle, and a greasy diet. Kidney (whether Yin, Yang or Essence) Deficiency on the other hand is often the result of a very demanding lifestyle and the natural process of aging.

These percentages confirm my own clinical observation which is that younger infertility patients tend to have Liver Qi Stagnation and older (over 40) patients tend to have Kidney Deficiency. However, it’s important to understand that this finding is just one piece of the puzzle as almost all fertility patients show more than one pattern.

Kidney – One of the major functions of the Kidney is to store the Kidney Jing (the Essence of life), which includes Prenatal Jing (inherited from parents, and not replaceable) and Postnatal Jing (acquired from food and replaceable). The Kidney Jing can be transformed into Blood and Kidney Qi, which becomes the source of human growth, development and reproduction.

According to Chinese medicine, the variation of Kidney Jing supply produces significant physiological changes in a woman’s life every seven years. At 7, a girl starts to mature into a young woman; at 14, she has her first menstruation and is able to conceive; at 21 and 28, she reaches her most fertile years; at 35, her fertility starts to diminish; at 42, her fertility is mostly lost and at 49, a woman’s Kidney Jing is depleted, and therefore, she has her menopause.

Liver – two of the major functions of the Liver are to regulate Qi and Blood and to store Blood

Spleen – The main functions of the spleen are to transform food nutrients to Qi, Blood and Postnatal Jing, to maintain proper humidity in the body and to keep the Blood circulating within the Vessels.

According to TCM theory, the Liver plays a vital role in the reproductive system. Liver Qi moves the Blood and stagnation of Liver Qi is likely to cause Blood Stasis. In time, Blood Stasis may cause endometriosis, uterine fibroids and ovarian cysts, dysmenorrhoea, irregular menstruation and scanty menstruation, which are all known contributors to female infertility.

The Kidney is the most important organ in the reproductive system, and any aspect of Kidney deficiency, whether Yin, Yang or Essence Deficiency often leads to amenorrhea, anovulation, a small uterus, thin endometrium, low ova quality and premature ovarian failure.

The Spleen is also a very important organ in the reproductive system. Unfortunately, over eating of cold, uncooked food, cold climate, unrestrained consumption of sweet food, overactive mind and not active body life style all negatively affected Spleen health. It is very common in clinical setting to see patients with various level of Spleen deficiency. A deficient Spleen is likely to cause scanty or abundant menstruation, spotting, prolonged menstruation, repeated miscarriages etc.