The desire to have a child can be profound and deep, and the inability to do so can hit the heart of any family. When obstacles get in the way of this innate desire, it can cause anxiety, depression, and overall feelings of inadequacy. 

Statistics & Facts about Infertility

• Infertility affects about 10% of the reproductive age population.

• 25% of infertile couples have more than one factor that contributes to their infertility.

• In approximately 40% of infertile couples, the male partner is either the sole cause or a contributing cause of infertility.

• Irregular or abnormal ovulation accounts for approximately 25% of all female infertility problems.

• While vital for some patients, in-vitro fertilization and similar treatments accounts for less than 5% of infertility services.

• 12% of all infertility cases are a result of woman either weighing too little or too much.

Acupuncture may work to treat infertility in the following ways:

Acupuncture may cause the production of endogenous opioids, which may inhibit biological stress responses and be a hindrance to women trying to conceive. It may assist in the release of certain neurotransmitter that stimulate the secretion of gonadotrophin releasing hormone, which can then influence the menstrual cycle, ovulation, and overall fertility. Acupuncture may stimulate blood flow to the uterus by inhibiting uterine central sympathetic nerve activity (Manheimer, 2008). Western medicine’s basis for infertility is to treat the diagnosis with intra-uterine insemination (IUI), in-vitro fertilization (IVF), and other drugs (Clomid and Gonal-F) to help get the reproductive cycle back on track. These methods and drugs used to aid in conception can end up costing hopeful couples tens of thousands of dollars, even when success rates are below the 50% mark. The fertility industry brings in over $2 billion a year! Acupuncture is used as a therapy for many conditions, yet in recent years we see it gaining popularity in cases of infertility due to its effectiveness in stress reduction and increasing blood flow to the uterine lining. According to a study in the Journal of Human Reproduction, acupuncture was found to increase uterine artery blood flow for women undergoing IVF and embryo transfer. (Stener-Victorin, 1996).

Infertility is often presented as a female problem in popular media, but obviously it affects men as well. Let’s first talk about the men.

Male Infertility

Male fertility depends on the body’s ability to make normal sperm and deliver sperm during intercourse. Some factors that may impede this process are obstructions in the male anatomy, certain medications, low sperm count, hormones such as testosterone, chromosome count in the sperm itself, retrograde ejaculation, varicoceles, or immunologic infertility. For fertilization to occur, environmental conditions of the body and hormones have to within normal range in both partners (Urology, 2016).

Common problems arise in making and growing sperm. The sperm may not grow fully, be oddly shaped, not move the right way, or the male may have oligospermia or azoospermia (Urology, 2016).

Oligospermia is defined as low sperm count in the ejaculate. In 2010, the World Health Organization (WHO) defined low sperm count as less than 15 million sperm/mL, thus indicating low fertility for men. Low sperm counts can be an effect of hormonal imbalances or varicocele (Turek, 2013).

Azoospermia accounts for 5% of infertile men, a condition defined as the complete lack of sperm in ejaculate. This could be due to an issue producing sperm or there could potentially be a blockage such that the sperm, although normal, cannot reach the ejaculate (Turek, 2013). Blockages may be caused by a birth defect or infection (Urology, 2016).

Some issues with male fertility can be caused by inherited genetic traits. Simple lifestyle choices also can also lower sperm count such as drink alcohol, taking certain medications, and smoking. Long-term illness can also lead to low sperm count and may affect male infertility (Urology, 2016).

Asthenozoospermia, defined by reduced motility or absent sperm motility, is one of the main causes of male infertility.

Several risk factors for this condition are:

• Testicular issues

• Poor diet

• Smoking

• High alcohol consumption or drug consumption such as cocaine, cannabis, etc. (Ingenes, 2016).

• Age

• Cancer treatments such as chemotherapy and radiation therapy (Ingenes, 2016).

Asthenozoospermia can be diagnosed through a semen analysis. Treatments for men facing this infertility issue are similar to options a woman could choose from, such as IVF or IUI (Ingenes, 2016).

Teratozoospermia is a semen alteration in which there is a large number of spermatozoa with abnormal morphology (Teratozoospermia, 2015). This alteration produces male infertility since the un-proportioned spermatozoa are unable to swim in the right way so, therefore, they have a more difficult time reaching the egg. Once reaching the egg, disfigurements in the head may reduce this ability to penetrate the egg (Teratozoospermia, 2015). Diagnosis of teratozoospermia involves microscopic analysis of sperm to identify anomalies which may include abnormally structured heads, no tail, multiple tails, and an abnormal acrosome (teratozoospermia, 2016). Other diagnostic procedures may include hormonal analysis, or semen penetration assay (Teratozoospermia, 2016). Management and treatment of teratozoospermia include vitamin and mineral supplementation, anti-estrogen medication, or intra-cytoplasmic sperm injection (ICSI) (Teratozoospermia, 2016). Acupuncture treatment may also be effective for teratozoospermia.

Varicoceles are swollen veins in the scrotum, found in 16 out of 100 of all men. More common in infertile men (40 out of 100), they harm sperm growth by blocking proper blood circulation. Varicoceles may cause blood to flow back into the scrotum from the abdomen, thus making the testicles too warm to create normal sperm, resulting low sperm numbers (Urology, 2016). This condition can be treated surgically through varicocelectomy or varicoceles embolization. (Herndon, 2015).

Retrograde ejaculation is when semen goes backwards in the body, to the bladder, instead of out of the body, through the penis. This happens when nerves and muscles in the bladder do not close during climax. The semen may contain normal sperm, but the semen cannot reach the vagina (Urology, 2016). Retrograde ejaculation can be caused by surgery, medications or health problems of the nervous system. Signs are cloudy urine after ejaculation and less fluid or “dry” ejaculation (Urology, 2016).

Immunologic infertility is when body makes antibodies that attack and injure the sperm. This could be due to injury, surgery, or infection. According to the Urology Care Foundation, this is not a common cause of male infertility (Urology, 2016).

The Role of Hormones in Male Fertility

Hormones also play a role in a male’s ability to produce sperm. Hormones made by the pituitary gland tell the testicles to make sperm. Very low hormone levels cause poor sperm growth (Urology, 2016). Important hormones involved in the male reproductive system are Luteinizing Hormone (LH), Folicle Stimulating Hormone (FSH), Gonadotropin Releasing Hormone (GnRH), Inhibin, Aldosterone, and Testosterone (Hormonal 2016).

Chromosomes that are carried in the sperm carry half of the DNA to the egg. Changes in the number and structure of these chromosomes can affect fertility. For example, the male Y chromosome may be missing parts (Urology, 2016).

Medications for the following conditions may change of sperm production, function, and delivery.

• arthritis

• depression

• digestive problems

• infections

• high blood pressure

• cancer

Research & Male Infertility

In one study, researchers Jian Pei, Ph.D, Et. Al., sought to evaluate the ultramorphologic sperm features of idiopathic infertile men after acupuncture therapy. This controlled study and consisted of 40 male participants with idiopathic oligospermia, asthenospermia, or teratozoospermia. 28 of the patients received acupuncture twice a week over a period of 5 weeks. The samples from the treatment group were randomized with semen samples from the 12 men in the untreated control group (Pei, 2005). Evaluation of the TEM data showed a statistically significant increase after acupuncture in the percentage and number of sperm without ultra-structural defects in the total ejaculates. In other words, the acupuncture treatment showed an increase in the number of normal sperm. A statistically significant improvement was detected in acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibers of sperm organelles (Pei, 2005). On the other hand, the study found that specific sperm pathologies in the form of apoptosis, immaturity, and necrosis showed no statistically significant changes between the control and treatment groups before and after treatment (Pei, 2005).

Keep in mind that previously the FDA has attempted to define such dietary supplements as drugs or food additives and subsequently remove them from the market (CRNUSA, 2016). The Dietary Supplement Health and Education Act (DSHEA) of 1994 defines a dietary supplement as any product which contains one or more dietary ingredients such as a vitamin, mineral, herb or other botanical, amino acid or other ingredient used to supplement the diet. The DSHEA Act makes it clear that these products may not be regulated as food additives or drugs under most circumstances (CRNUSA, 2016). Therefore, protein supplements and other nutritional supplements are not regulated by the FDA and should be used with caution if attempting to conceive by both male and females.

Female Infertility

Women are typically the most fertile from mid-teens until 29. From the 30’s and beyond, infertility tends to become more pronounced. The American Fertility Society states that a couple is considered infertile when pregnancy has not occurred after one year of sex without contraception.

Physical activity, exercise, and fertility

Women who routinely engage in moderate exercise become pregnant more quickly than women who don’t.  Intense exercise may increase fertility if the individual has a high BMI and is not getting pregnant.. Furthermore, physical activity may even protect against infertility by regulating the hypothalamic-pituitary-gonadal axis, thus circulating sex hormones, reducing gonadotropin levels, reducing inflammation, and boosting immune function. Before and after becoming pregnant, staying active by engaging in regular, moderate exercise will help the patient have a healthy pregnancy and delivery.  According to research, exercising before and during the first trimester of pregnancy can lower the risk of developing pregnancy-related issues like gestational diabetes or pre-eclampsia.

Physical activity can also help reduce stress, anxiety, and release endorphins that boost mood.  Children born to active women are more likely to grow up to be active adults. You and your partner might find it beneficial to consider starting a fitness routine as part of your parent-preparation efforts.

Exercise can play a positive role in promoting fertility by contributing to overall health and well-being. While exercise alone might not guarantee fertility, it can help create a conducive environment for reproductive health. Here are some ways exercise can promote fertility:

• Improves Blood Circulation: Regular exercise enhances blood circulation, which can help deliver oxygen and nutrients to reproductive organs. Improved blood flow to the ovaries and uterus can support their proper function.

• Balances Hormones: Physical activity can help regulate hormonal balance, which is essential for healthy ovulation and menstrual cycles. Maintaining stable hormone levels is crucial for fertility.

• Manages Weight: Maintaining a healthy weight through exercise can have a positive impact on fertility. Both excessive weight and being underweight can disrupt hormonal balance and ovulation.

• Reduces Stress: Exercise is known to reduce stress and promote relaxation. High stress levels can affect hormone production and ovulation. Engaging in regular physical activity can help manage stress and its potential impact on fertility.

• Enhances Insulin Sensitivity: Regular exercise improves insulin sensitivity and helps regulate blood sugar levels. Insulin resistance can disrupt ovulation and fertility in women with conditions like polycystic ovary syndrome (PCOS).

• Boosts Mood and Mental Health: Exercise releases endorphins, which are natural mood lifters. Improved mental health and well-being can positively influence fertility by reducing psychological barriers.

• Supports Immune Function: Moderate exercise can strengthen the immune system, helping the body defend against infections that could potentially impact fertility.

• Promotes Healthy Pelvic Blood Flow: Certain exercises, like pelvic floor exercises and yoga, can help promote healthy blood flow to the pelvic area. This can support the health of the reproductive organs.

• Encourages Regular Menstrual Cycles: Regular exercise can help regulate menstrual cycles, making it more likely for ovulation to occur predictably.

• Enhances General Health: Overall, exercise contributes to better cardiovascular health, stronger bones, and a healthy body composition. These factors can indirectly impact fertility by creating a favorable environment for conception and pregnancy.

  It’s important to note that excessive or intense exercise, especially in combination with a very low body weight, can have negative effects on fertility. Extreme exercise regimens and excessive weight loss can lead to irregular menstrual cycles and disrupted ovulation. Balance is important.  Moderate and regular exercise that supports overall health without placing excessive stress on the body is generally recommended for promoting fertility.

Risk Factors for Infertility

To become and remain pregnant requires a variety of conditions be in alignment. The conditions within the female body on a physical, emotional, mental, and hormonal state must all be in harmony when sperm meets egg.

Diet, stress level, environmental conditions, diseases, including quality of sperm from her partner, or other risk factors can all prevent conception from taking place. Tobacco/alcohol use, being overweight/underweight, too little or too much exercise causing an irregular menstrual cycle are all contributing factors for a woman’s likelihood of becoming and staying pregnant.

Risk factors causing Infertility:

• Hormone Imbalances

• Irregular menstrual cycles

• Chronic stress

• Not enough eggs

• Attempting to become pregnant later in life

• Fibroids

• Exposure to harmful environmental toxins

• Lack of ovulation

• Blocked fallopian tubes.

Alcohol

Several studies have shown the link between alcohol consumption and infertility, yet the quantity level of consumption associated with risk remains unclear. The Department of Health recommends that women trying to conceive and pregnant women avoid alcohol consumption completely. Risk factors for infertility can vary between age, emotions, occupational/environmental risk, unprotected sex, smoking, being overweight or underweight. As women age, their chances of becoming pregnant diminish because of chromosomal abnormalities that may occur within the egg. As a result, the chances of miscarriage are higher.

Weight

Being overweight or underweight may also affect a woman’s ability to conceive. Body fat levels that are 10-15% above normal can increase estrogen stores in women, which throw off the reproductive cycle. Women with body fat levels 10-15% below normal weight may also have difficulty becoming pregnant because the body thinks it is starving and completely shuts down the reproductive process.

Smoking

It is important to reiterate the harmful effects of smoking on a woman looking to conceive. A woman who is attempting to become pregnant must remove herself from an environment of smoking because even close proximity exposes her and the potentially developing fetus to toxic chemicals such as nicotine, cyanide, and carbon monoxide. These chemicals are damaging to the heart, lungs, vascularity, and can increase the rate at which eggs are lost. According to the American Society of Reproductive Medicine, female smokers need more ovary-stimulating medications during IVF and still have fewer eggs and 30% lower pregnancy rates compared with IVF patients who do not smoke.

Blocked Fallopian Tubes

The fallopian tubes are where the male’s sperm cells arrive to meet with an egg cell after ovulation. The moment of fertilization occurs in the fallopian tubes, so this is a very significant anatomical structure to understand when it comes to infertility. Should the fallopian tubes become blocked or obstructed, the sperm can’t get through to the egg, and pregnancy may be impossible unless the blockage is resolved (Baby, 2016). A fallopian tube blockage can be detected by having an infertility assessment done by specialist. The test looks for “tubal patency”, meaning the ability of liquid to flow freely through the fallopian tubes. This test is often done by hysterosalpingogram (HSG), which is when a tube with dye that can be seen by x-ray is inserted into the vagina, and then guided into the uterus. Then, the x-ray can see the dye, and this will make it clear to see if any blockages are present in the fallopian tubes. This test can also find any other abnormalities such as fibroids, polyps, injuries, adhesions, or foreign objects that may be in the reproductive anatomy.

There are several conditions that may cause blocked fallopian tubes.

• They may be blocked from birth (congenital tubal obstruction) (Genea, 2016)

• Uterine fibroids

• Endometriosis

• Scar tissue on the fallopian tubes

• Unintentional damage to the tubes from previous surgery (Genea, 2016)

• Inflammation (otherwise known as salpingitis), and can also be seen in Pelvic Inflammatory Disease (PID) (Genea, 2016)

• Having a previous cesarean section.

Inflammation may be a common cause of blocked fallopian tubes and is usually attributed to sexually transmitted infections (STIs) such as chlamydia or gonorrhea (Genea, 2016). Pelvic inflammatory disease (PID) is a symptom of these two STIs. The inflammation occurs when the microorganisms of the STI travel from the cervix and vagina to the upper genital tract. PID is very serious because it can lead to permanent damage of the woman’s reproductive organs (CDC, 2016).

Treatment for Blocked Fallopian Tubes

In order to become pregnant naturally, surgery is available to remove the blockage from the fallopian tubes. Common surgeries for removing blockages in the fallopian tubes include microsurgery and laparoscopy (keyhole surgery), however, one or the other may be used depending on the patient’s specific condition (Baby, 2016). Hydrotubation, or tubal flushing, may be used if the tube is only partially blocked in an attempt to wash out the blockages with a saline solution (Baby, 2016). If both tubes are obstructed, there is the option of surgery as discussed previously, or in-vitro fertilization (IVF) can be another choice for some people. In IVF treatment, developing embryos are placed directly into the uterus, bypassing the issue of fallopian tube adhesions (Baby, 2016). Laparoscopy involves a laparoscope introduced through a small incision in the abdomen. A video camera is fitted to an endoscope (a thin telescopic instrument) so the specialist can view the images on a video monitor (IVF, 2016). Laparoscopy is performed under general anesthesia and takes about one to two hours (IVF, 2016). This surgery can remove adhesions, ovarian cysts, fibroids, and also for endometriosis (Reproductive, 2016).

Fibroids causing Infertility

There is a small percentage, 3% on average, that fibroids in the uterus may be a cause of infertility, however, it is important to be aware of this factor that can hinder a couple’s ability to conceive. Uterine fibroids are benign, non-cancerous growths of the smooth muscle tissue that grow within the uterine wall. Fibroids grow in response to stimulation by the hormone estrogen, which is normally produced in the body. These growths can show up as early as age 20, but tend to shrink post menopause when the body stops producing large amounts of estrogen (Stoppler, 2016). Women of African-American descent typically have higher chances of getting fibroids by the age of 35, compared to Caucasian women (Prodigy, 2009, BabyCentre, 2013). Additionally, if a woman is overweight, this will also increase the chances of getting a fibroid as estrogen levels rise as body fat increases, and high estrogen levels may also promote the growth of fibroids (Prodigy, 2009, BabyCentre 2013).

Certain factors can lead to an increased presence of fibroids

• Obesity or being over weight

• Having a menstrual period before age 10

• African American heritage (occurring 3-9 times more often than Caucasian women) (Stoppler, 2016).

• Never having given birth to a child

Even if the woman has fibroids and she is trying to conceive, she may not be aware of it as fibroids can sometimes produce no symptoms.

On the contrary, when women do experience symptoms, some of the most common include:

• Constipation

• Lower abdomen pain

• Increase in size around waste and change in abdominal contour

• Pressure on the bladder causing frequent urination

• Increase in menstrual bleeding (Stoppler, 2016).

• Inability to become pregnant after 1 year of consistent efforts (a uterine fibroid could be causing the infertility).

How can a fibroid be detected?

One of the following methods of detection can be used to detect a uterine fibroid. A laparoscopy, as discussed previously, can also be used to detect a uterine fibroid. This procedure entails a surgeon inserting a small fiber-optic camera into the abdomen through a small incision to look at the internal organ (Stoppler, 2016). An ultrasound may also be used to detect for uterine fibroids. There are several types of ultrasounds such as abdominal, trans-vaginal, or pelvic (Stoppler, 2016). Also, an endometrial biopsy may be used which is performed by taking a tissue sample from the uterus (Stoppler, 2016). Myomectomy (fibroid removal surgery) may be performed so the fibroids are removed from the walls of the uterus. Fibroids can grow large or remain small, and can arise from different areas of the uterus. For example, some fibroids develop within the endometrium of the uterus, and they are labeled as submucosal fibroids. These types of fibroids can alter the lining of a woman’s uterus and may potentially hinder her fertility (BabyCentre, 2013) (Klatsky, 2008) (RCOG, 2009). More commonly, fibroids develop within the muscular wall of the uterus, and this type are called intramural fibroids. In addition, this type of fibroids may cause infertility issues or may be attributed to a heavy and painful menstrual cycle. Subserosal fibroids are another type and these tend to grow outside of the uterus. This type of fibroid may put pressure on bladder or bowel, causing urgency to use the bathroom or constipation (BabyCentre, 2013).

The Role of Diet and Nutrition in Treating Infertility

We have all heard the adage “you are what you eat!” and this couldn’t be truer when it comes to infertility therapy and why it is so important that the food a patient eats daily supports the goal of pregnancy.

Below is a list of dietary suggestions that promote vitality, health, and wellness.

Include leafy green vegetables in a fertility promoting diet. They are high in fiber which helps manage weight and also assists in transporting waste out of the body.

• Eat fatty acids from plant sources such was nuts and deep-sea fish that are wild caught.

• Eat foods that are alkaline rather than acidic. The main reason for this is because acidic foods like meat, dairy, and grains produce acidic environments, and acidic cervical mucus is hostile to sperm. Sperm needs an alkaline environment to thrive. Some alkaline foods – non-citrus fruits like bananas, vegetables, sprouts, wheatgrass, herbs.

• Have protein from plant based foods such as legumes such as chickpeas or black beans to name a few, green peas, nuts, and edamame.

• Eat organic and hormone-free food products as much as possible.

• Eliminate caffeine, nicotine, and alcohol. Green tea can be used as a substitute for coffee as it has less caffeine and also comes with numerous anti-oxidant and health benefits.

• Eliminate processed junk foods such as candy, pastries, ice cream, white bread, soda, etc. These foods are high in sugar and highly processed carbohydrates that promote inflammation and decrease energy.

• Avoid supplements such as whey protein powder, and other muscle building or weight loss enhancing supplements. The effects of these supplements are unknown in pregnant women and many of which are not evaluated by the FDA. It is best to steer clear, and get nutrition from whole food sources.

• Avoid any unnecessary medications and over the counter drugs.

• Other nutritional components to add to a fertility promoting diet:

• Bee Pollen – rich in vitamins, minerals, nucleic acids, steroid hormones, improves overall health and immune system.

• Wheatgrass- enhances immune system and restores hormonal functioning.

• Folic Acid- important in cellular division and protects DNA.

• Vitamins A,C,E,B, selenium, and zinc all have been shown to enhance reproductive health. It is most beneficial to get the sources of these vitamins through the food they consume on a regular basis.

Herbal Supplements for Infertility

Black Cohosh

Also known as Actaea racemosa, black cohosh is an excellent herbal supplement for perimenopausal issues, but has benefits in fertility as well. This herb stimulates the ovaries and serves as an antispasmodic in relieving cramps caused by the menstrual cycle and menopausal symptoms. It is effective when the infertility ailments are caused by a hormonal imbalance (Sahgal, 2012). This herb is recommended to only be taken for 6 months, not long term. Please be advised black cohosh is not recommended for use during pregnancy (Barton-Schuster, 2016).

Evening Primrose Oil

Evening Primrose Oil has as an important influence on fertility, as it improves the quality of the cervical fluid and, consequently, the quality of the cervical mucous. This will become a more hospitable environment for the sperm, which will stay alive for up to five days, thereby increasing the chances of getting pregnant (Sahgal, 2012). Evening primrose oil also contains rich sources of omega-6 fatty acids such as linoleic acid (LA) and gamma linolenic acid (GLA). LA and GLA are needed by the body to make prostaglandin E, which act similarly to hormones because they instruct the cells involved in reproduction (uterine and cervical cells), what to do, and when to do it (Barton-Schuster, 2016).

Chaste Berry

Helps primarily in stimulating luteinizing hormone (LH) and regulating the menstrual cycle by balancing the hormonal functions. Luteinizing hormone is what the necessary hormone during ovulation. Chaste Berry also acts upon the pituitary gland, increasing the production of progesterone and reducing the level of prolactin. This herb may work well for women who have progesterone levels that are milk to moderately low (Chicago, 2009). Chasteberry has also been found to help women with Polycystic Ovarian Syndrome (PCOS) who suffer from hormonal imbalance (Sahgal, 2012). In addition, chasteberry is also good for minimizing fibrocystic breast symptoms, reducing PMS symptoms, controlling acne, and easing the pain of endometriosis by restoring hormonal balances (Chicago, 2009).

Red Raspberry Leaf

This herb is known as Rubus Ideaus, and works by strengthening the uterine lining and apparently lengthens the luteal phase of the menstrual cycle, increasing the chances of implantation. In addition, this herb contains minerals such as folic acid, copper, magnesium, and iron, all of which contain fertility enhancing properties (Sahgal, 2012).
 

Stress Management

When a woman is attempting to become pregnant and receiving acupuncture treatments, stress management must be a part of her treatment plan. Stress and depression can play a strong role in up to 30% of all infertility problems because these emotional states have a direct effect on the hormones required for a woman to get pregnant. According to Allen Morgan, MD and director of Shore Institute for Reproductive Medicine in Lakewood, N.J., when the hormones cortisol and epinephrine become elevated and remain high during periods of chronic stress, this can play a definite role in preventing pregnancy. In addition, Dr. Morgan also says that reducing stress may help to enhance proteins in the uterine lining that are involved in egg implantation and increase blood flow to the uterus.

Have an in depth talk with your patient to see what relaxation management techniques work best for them. Often times our patients will know what makes them feel at ease, but we see problems arise when these techniques are not habitual and a part of their day-to-day life. Create a plan with times and days that your patient can use for self-relaxation time, and follow up at each visit for progress in reducing stress levels, adjusting the plan as needed.

The Research on Acupuncture and Infertility

Research conducted on acupuncture with assisted reproductive technologies (ART), as well as acupuncture alone used to eliminate infertility, have shown varied results. In one study, lead by Wolfgang E. Paulus, M.D., the effect of acupuncture on pregnancy rates with ART was evaluated by comparing a group of 60 women receiving acupuncture before and after embryo transfer for 25 minutes, to a control group of 60 women who received only the embryo transfer. Pregnancy was defined as the presence of a fetal sac during an ultrasound 6 weeks after the therapy. The researchers discovered 34 out of 80 women in the acupuncture group achieved pregnancy, whereas only 21 out of 80 achieved pregnancy in control group, concluding that acupuncture appears to be a helpful addition to ART. The same team conducted a follow up study comparing “fake” acupuncture to real acupuncture with similar results for both groups, suggesting that acupuncture may have a placebo effect.

Another study, published in 2008 by Eric Manheimer, sought to evaluate the effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilization (IVF). The researchers found that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing IVF. Additional benefits, as listed from the Infertility Awareness Association of Canada, promote that acupuncture can improve the production and quality of ova, reduce the risk of miscarriage and ectopic pregnancy, and normalize the hypothalamic-pituitary-ovarian axis and menstrual cycle. Acupuncture is also a cost-effective treatment for women seeking to get pregnant, without the unwanted hormonal side effects of IVF.

A systematic review, dating July 2008, identified all high-quality research evidence relating to the literature for in vitro fertilization performed in conjunction with acupuncture treatments. Based upon the live birth data gathered from all the studies evaluated in this systematic review, it was concluded that there was no significant difference in IVF or embryo transfer outcome when acupuncture was used. According to the systematic review, “currently available literature does not provide sufficient evidence that adjuvant acupuncture improves IVF clinical pregnancy rate”. Although acupuncture can provide positive effects in the woman receiving treatment, and in some cases, increase the chances of becoming pregnant, more research needs to be conducted with a large sample of participants to understand acupunctures true efficiency in aiding infertility treatments.

Acupuncturist Dr. Aina Zhang also notably mentions that there is still limiting research being conducted on the conclusive effectiveness of acupuncture in treating infertility, due to lack of funding. Based upon reports in her own clinic, Dr. Zhang does not dismiss the success acupuncture can have on women seeking to become pregnant. From May to June 2006, she reported 18 pregnancies in her clinic after the women were treated from a few weeks to over a year.

Acupuncture Points:

Ear Triangular Fossa (fossa triangularis)

Upper inner part of the ear stimulates the uterus and fallopian tubes, regulates sympathetic nervous system, reduces blood pressure, and promotes feelings of calmness.

Yintang

Located between the eyebrows, this point helps the function of the pituitary gland for hormonal regulation. This point reduces anxiety, quiets the mind, reduces agitation and chronic headaches. This point is used around the time of implantation during ART.

KI16

When stimulated, this point regulates the intestines, stimulates the immune system, clears energy blockages, and calms the mind.

Ren 4

Represents the uterus and the source of life, stimulated for irregular menstruation, prolapse of uterus.

Zigong

Indications for use are prolapse of uterus, irregular menstruation, metorrhagia, dysmenorrhea, amenorrhea, and infertility

Ren 3

Represents the center of the body on the horizontal and vertical plane. This point regulates menstruation, nourishes the kidneys, benefits the urinary bladder, and removes stagnation or dampness from pelvis.

ST 30

Regulates the intestines, bloating, abdominal pain, and menstruation. Represents the crossing point of the penetrating meridian with the ovaries, fallopian tubes, and uterus.

Ren 12

Strengthens the spleen and stomach, relives damp conditions of the reproductive organs

Ren 14

Clears the heart of negative influences, obstructions, and calms the mind

Ren 15

Calms the mind and resolves anxiety, worry, emotional fears, upsets, or obsessions

 LV14

Helps to calm emotional imbalances, such as anger and irritability

UB 44

Relieves anxiety associated with inability to become pregnant

UB 15

Helps to achieve balanced mood

UB 17

Useful for blood related conditions, menstrual deficiencies such as scanty/light periods

Du 4

Helps to resolve sterility, increases energy flow through kidney and pelvic organs

UB 23

Located at the level of the kidneys, helps to modulate irregular periods, abnormal vaginal discharges,

UB 31, 32, 33

Increases blood flow to pelvic organs

 

Citations

1. Paulus, W.E., Zhang M., et, al. (April 2002). Acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertility and Sterility. Volume 77:4, 721-724.Doi: http://dx.doi.org/10.1016/S0015-0282(01)03273-3

2. Bouchez, C. & Nazario B. (2015). Stress and Infertility: Doctors offer insights on how daily stress can disrupt fertility and how relaxation can help. WebMD Feature. Retrieved June 28, 2015 from

3. Manheimer, E., Zhang G., et al. (March 8, 2008). Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilization: systemic review and meta-analysis. British Medical Journal, 336(7643):545-590. Doi: 1136/bmj.39471.430451.BE.

4. Stener-Victorin E, Waldenstrom U, Andersson SA, Wikland M. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Human Reprod 1996; 11: 1314–17.

5. Zhang, A. (2006). Infertility Awareness Association of Canada. Alternative and Complimentary Health. Treating Female Infertility with Acupuncture. Retrieved June 28, 2015.

6. El-Toukhy T, Sunkara SK, Khairy M, Dyer R, Khalaf Y, Coomarasamy A. (June 5, 2008). A systematic review and meta-analysis of acupuncture in in vitro fertilization. UK Department of Public Health and Epidemiology. Doi: 10.1111/j.1471-0528.2008.01838.x

7. Ying-Yang House Theory – Points Database

1. Centers for Disease Control and Prevention (CDC) – Infertility FAQs, 2015

2. Urology Care Foundation. The Official Foundation of American Urological Associates. Urologic Conditions – Male Infertility (2016).

3. The Turek Clinic. Oligospermia – Low Sperm Count. November 3, 2013.

4. Herndon, J., B, Wu. November 18, 2015. Varicocele. Health Line.

5. Hormonal Regulation of the Male Reproductive System. Boundless. 2016.

6. Natural Fertility Supplements: 6 Herbal Supplements. Sahgal, P. (MD). August 2, 2012.

7. Black Cohosh Benefits the Menstrual Cycle, Pain and Uterine Health. Barton-Schuster, Darlene (CH).

8. Enhance overall fertility with evening primrose oil. Barton-Schuster, Darlene (CH).

9. Parker WH. 2007. Etiology, symptomatology, and diagnosis of uterine myomas. Fertility and Sterility 87(4):725-736

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