Fox News Coverage on Acupuncture Fertility

Acupuncture seems to help some women because it improves circulation to the ovaries  — which makes for healthier eggs — and to the uterus, which increases the chances that the lining will be strong enough to hold those eggs to full-term.

"Acupuncture provides better circulation and better blood flow to the womb. It will give a better chance for the eggs to be nourished and therefore carried."

There's also the fact that acupuncture can be a stress-reliever during an emotional time.

"Trying to get pregnant is incredibly stressful, they're crossing their fingers. The longer they're trying to get pregnant, the worse it gets ... Part of [acupuncture's success] is simply relaxation. When the body is relaxed, all systems function better."

The Colorado study Magarelli and Cridennda presented at a conference this fall is one of a series the pair have done with acupuncture and in vitro.

That one looked at 114 patients who had a good chance of IVF being effective, some who did acupuncture and some who didn’t. It found, among other things, that there were fewer miscarriages, more pregnancies and a 7 percent higher birth rate among those who got acupuncture treatment over those who didn’t, according to Magarelli.

It piggybacked off other research the team did on 147 “poor responders” to IVF, which found that the pregnancy rate was 40 percent, with 11 percent more babies born, among those who did acupuncture with in vitro fertilization compared to those who didn’t.

In March, Magarelli and Cridennda released findings in Italy involving patients with an average prognosis for IVF success. Those yielded clear numbers that the pregnancy rate increased with acupuncture by 24 percent, according to Magarelli.

“What got us was that now we were seeing a firm trend toward getting more people pregnant,” he said.

The Colorado research seems to support some findings of two earlier studies, one in Germany by lead researcher Dr. Wolfgang E. Paulus — published in ASRM's “Fertility and Sterility” (search) in April 2002 — and one in Sweden by lead researcher Elisabet Stener-Victorin in the 1990s.

Of course, even those who believe in acupuncture concede that while the existing studies have yielded good information, there still isn't sufficient evidence, or a broad enough sample of patients tested, to call acupuncture a proven remedy.

"We are convinced, but scientifically you need proof — or so-called proof," Chang said. "There is a whole set of proof from lab experiments and animal studies to human studies, but it's very difficult to do human studies."

Schenken noted that even though there might be one set of data showing positive results, "it really needs to be corroborated, preferably with several different studies and different patient populations." For example, there can be bias when the entire study sample comes from the same clinic, or when patients know they're doing something different from usual.

Schenken said he doesn't get asked about acupuncture often, but when patients do, "we don't recommend it, but we do not discourage it."

Surrey takes a similar approach. In his opinion, the data "is not bad" on the theory that acupuncture can help when administered before IVF, but as far as acupuncture generally improving fertility or helping after the embryo transfer in IVF, "there really isn't a whole lot of data on that."

But at the very least, "there is absolutely nothing to show that it's harmful if it's done with a trained and appropriately skilled acupuncturist," he said. It's a notion that nearly everyone in the medical field — whether they believe in needles and Qi or not — seems to agree upon.

As for the couples trying to bring a child into the world — particularly through a complicated, invasive procedure like IVF— anything that helps the process along is welcome.

Meanwhile, researchers and experts in the field are excited at what they're seeing in the studies. Chang said he's currently working with NYU Medical Center on a trial that looks at IVF with and without acupuncture.

"The first time I went, I was completely terrified. My husband went with me and held my hand," she said. "I could feel the muscles in my liver jump and an electric current going through my body. It was very strange but also felt right."

She said being monitored by both her obstetrician and Koos helped reassure her about what was going on during her high-risk pregnancy.

"She would tell me things about how I was doing physically and then I would go to the doctor and he would tell me the same thing," remembers Appert, who works as a professor.

Regardless of the skeptics, Appert said she's relieved that she was finally able to have a nearly full-term baby of her own. At 4 pounds, 6 ounces, Henry has been in intensive care but otherwise is doing "fine."

"It really was a miracle," the new mom gushed. "It's one of these weird things that Western medicine can't explain."

Find out how to start your journey on Fertility Acupuncture with Mike Berkley at the Berkley Center located in New York City. 

Berkley Center Interviews with Resolve Magazine

When a prospective patient decides to pursue Acupuncture as a means of reproductive assistance they must first seek out a licensed and Nationally Board certified acupuncturist.  An acupuncturist does not have to be board certified to practice legally, he or she must only be licensed. However, board certification means that the practitioner has participated in continuing education classes and or taught and or written and published papers regarding medicine. Thus, if a practitioner is board certified, there is some assurance that the individual cares enough about his or her patient’s to stay on the cutting edge, educationally. There is no licensure required to practice herbal medicine. Anyone can do so. It is therefore essential to make sure that your acupuncturist is Board Certified in herbal medicine. Though it is completely legal to prescribe herbal medicine without a license, the effects can be disastrous. An herbalist who is board certified has undergone required study and training mandatory for the award of board certification. 

Anyone who is having difficulty conceiving is a good candidate as long as the reason for their infertility is functional and not anatomical. In other words, acupuncture and herbal medicine cannot treat and correct a retroverted uterus or unblock or unscar fallopian tubes. Acupuncture and herbal medicine are good modalities to treat elevated FSH levels PCOS, hypothalamic amenorrhea, thin uterine lining, poor motility, poor morphology and low sperm count. If a male has a vericocele, it requires a surgical procedure

Q: What educational background should an acupuncturist have?

A: An acupuncturist should be state licensed and nationally board certified. Acupuncture school takes from between three and a half to four years to complete. The best schools of acupuncture include bioscience and biomedical coursework as well as studies in Chinese medicine theory and practice.

Q: How does a woman find a good acupuncturist?

A: By recommendation. Sometimes, people in chat rooms can refer an acupuncturist with whom they’ve had a good experience.  There are web sites with referral capabilities such as www.acupuncture.com  Organizations such as the American Infertility Association and Resolve can refer people to acupuncturists who specialize in infertility.

Q: What associations oversee the field?  Are acupuncturists part of the American Medical Association. Who regulates them?

A: Acupuncturists are not a part of the American Medical Association.  The National Certification Commission for Acupuncturists and Oriental Medicine is the overseeing board for acupuncturists. They are located at 11 Canal Center Plaza, Suite 300, Alexandria, VA  22314  Their phone number is:  703/548-9004  and their Fax number is:  703/548-9079.  Also, the American Association of Oriental Medicine has a web site where referrals to acupuncturists may be found. Their site is http://www.aaom.org/

Q: What is the success rate of acupuncture for aiding fertility.

A: I can only speak about my own success rate, which is about one in twenty.  The population of women whom I treat is over thirty-five years old and has some presenting pathology.  They have elevated follicle stimulating hormone or a blocked fallopian tube, or PCOS or have difficulty implanting due to the inability of the uterine lining to thicken.  Hence, this population is basically the “worst case scenario” population.  Many of my patients  have undergone two to three IVF’s without success.  Their next step is either donor egg implantation or adoption.  So I am basically the last stop.  Out of that population, my success rate is approximately one in twenty.

Q: Are there some women who do not conceive after treatments?

A: Yes. 

Q: What exactly is herbal medicine and how do you use it in conjunction with acupuncture?

A: The art of Chinese formulas and traditional Chinese medicine has undergone significant change throughout the centuries.  Starting out as fairly crude potions with magical overtones, it has developed into sophisticated therapeutic tools.  The earliest of the formularies extend s to the end of the third century, B.C.  Herbs have different tastes or properties and affect different things in the body.  Some herbs are acrid which disperse; some are sour which restrain and retain;  some are sweet, which moderate and tonify; some are bitter, which strengthen; and some are salty, which soften.

A formula is comprised of plants, flowers, stems, seeds, bark and various other  substances containing medicinal qualities, the particular configuration of which is dictated by the organizing principles of the treatment strategy.  If the pattern of a disorder is misdiagnosed, the treatment strategy will be incorrect.  Therefore, its derivative formula will be ineffective.  For example, a patient presents with fever, irritability, thirst, red face and flooding big pulse.  If the practitioner ignores the fact that the fever is low, the thirst is for warm beverages and the pulse is also deficient, he can misdiagnose the pattern and prescribe an incorrect formula.  No matter how cleverly the formula is modified, the results will be disappointing because the patient is really suffering from a disorder that remains undiagnosed based on the inexperience of the practitioner. 

To maximize the benefit of the treatment and minimize its side effects, it is very important to determine which aspects of the disorder in a particular patient are most significant.  In traditional Chinese medicine, this is known as distinguishing the manifestations of the disorder from its root cause.  The following distinctions are used when making this determination.

The strength of the patient’s normal qi or energy is the root.  And the strength of the pathogenic influence is the manifestation.  The ideology or the cause of the disease is the root and its presentation is the manifestation.  During the course of a disease, the underlying primary disorder is the root and the secondary complications are the manifestations.  With respect to the location of a disease, the internal aspect is the root and the external aspect is the manifestation. Clinically, it is important to distinguish the root from the manifestation of a disease so that treatment can be directed accordingly and fine-tuned according to the precise need of the patient at a particular time. The rules governing treatment of the root and manifestation are as follows:

• For acute disorders, treat the manifestation.
• For chronic disorders, treat the root.
• Simultaneous treatment of the root and manifestation can also occur.

Formulas are used depending upon the strength or lack thereof of the patient or strength or lack thereof of the presenting pathology.  Other things, such as the season, the environment and the overall picture of the individual patient including their weight, diet, lifestyle habits, etc., are taken into consideration. 

Herbal formulas can be served up in various ways. One type of formula is known as a decoction.  The ingredients are placed in water or a mixture of wine and water and then boiled for a specified period of time.  The formulas also come in powders.  The ingredients are ground up and sifted into a relatively uniform powder and then are ingested or applied externally.  They also come in pills.  Ingredients are finely grounded or pulverized, a liquid or other viscous medium is added and round pills are formed. 

There are also soft extracts, liquid extractions, syrups and semi-solid extracts.  There are medicinal wines, lozenges, tablets, granules and injections as well. 

Herbs and herbal formulae are critical part of the treatment of gynecological disorder in general and infertility in particular.

Q: About how many visits or treatments does a patient need to have before conception?

A: The treatment frequency for a patient undergoing a protocol for infertility is as follows: they receive acupuncture treatment one time per week and they take herbal medicine two to three times a day, seven days a week for a period of three months.  The patient should conceive within that period.  If they do not conceive within that period, their chances of conception after subsequent IVF are much greater than if they had IVF without first undergoing the acupuncture and herbal medicine treatment protocol.  When a patient undergoes acupuncture treatment and takes herbal medicine, their internal environment is brought to the point of maximum achievable health.  Acupuncture and herbal medicine help the body to become the absolute best that it can be internally, thereby allowing and assisting reproductive health to be at its peak.

Pregnancy after Infertility EMOTIONS

There are many stories from the patients at the Berkley Center. There is one in particular that resonate with us that was shared on the Internet. Please read and understand some emotions that are common in Infertility patients and the journey we can assist you on.

Emotionally, the first few months of pregnancy may feel strange. The baby may feel very separate from you. You may feel preoccupied with your body, and aware of every little twinge or strange sensation. Morning sickness and fatigue may be intense. You and your partner may question if and when to tell people your good news.

It is important to tell at least one close friend or relative for two reasons: one is to be able to share your joy and concerns with another person beyond your husband and medical team, and the other is to have at least one additional person know that you are pregnant in case you have a miscarriage.

During the first trimester your anxiety levels may be high. Some women don't dare hope that things will work out. Many women who have just learned that they are pregnant report having terrible dreams that focus on something happening to the baby. You may avoid buying comfortable clothes that will reveal your pregnancy to others. Emotional ups and downs are common. Tears flow easily and feelings of joy, fear and ambivalence about the pregnancy and parenting all can surface.

Making the transition to an obstetrical practice can be difficult. It takes energy to interview and select an obstetrician and it is hard to say goodbye to the infertility practice that has been so much a part of your life. Often in this first trimester women say, "I don't feel part of the fertile world or the infertility world -- I just feel different."

Sexual intimacy may be affected not only because the infertility has affected sexual intimacy but also because some couples fear they may jeopardize the pregnancy by having intercourse. The wife may also be feeling so exhausted that her sexual interest is nonexistent.

As a couple, you may feel that you don't fit into the world of your infertility friends and you don't fit into the world of couples who conceive easily without any of the traumas of infertility. Friends and family may wonder why you can't just "relax and enjoy the pregnancy". Because you have been through infertility and because this is such a precious pregnancy, there may be a tendency to feel that you can't express your complaints about the discomforts associated with pregnancy. It may feel as if you are not entitled to have any negative thoughts or experiences in this pregnancy.

If you had a previous pregnancy loss it may be hard for you to attach to the idea that there is a life within you. Some women guard against disappointment by not bonding and not investing emotionally in the pregnancy. But other women bond quickly and immediately begin planning details for after the birth of the baby. It is not uncommon for husbands to seem less involved and somewhat detached from pregnancy. This can be a safety mechanism that husbands use because they fear that the pregnancy might not work out and that they have to stay strong for their wife in case something does happen to the pregnancy.

As the news of your pregnancy progresses and the first medical hurdles are crossed, you may find that you are thinking about your relationship with your parents. For some women, old mother-daughter conflicts can resurface. Thoughts about your own childhood and how you were parented and how you will do it differently can become a concern for you.

Study: Acupuncture Improves Fertility in Men, Too

In many cultures, women are unfairly blamed for the inability of a sexually active couple to conceive. In reality, men suffer from infertility issues just as frequently as women. According to statistics from the National Infertility Association (an organization also known as RESOLVE), between 35 percent and 40 percent of infertility problems among couples are actually caused by male conditions. Several factors may be responsible for male infertility, including low sperm count, abnormal sperm shape and size, and reduced motility. Lifestyle, genetics, and physiological changes can also raise or lower male fertility levels, and can significantly affect a man's ability to produce offspring. Previous research has shown that acupuncture can improve fertility levels in women. Fewer studies on male infertility have been conducted, although evidence suggests that acupuncture can have an effect on sperm production and quality, without causing any changes in behavior or sexual desire. A recent trial published in Fertility and Sterility has shown just how effective acupuncture can be in the treatment of this condition, leading to significant increases in the number of normal sperm and equally significant reductions in structural defects.

In the study, 28 men who were diagnosed with idiopathic infertility received acupuncture twice a week over a period of 5 weeks. The following acupuncture points were used as main points: Guan yuan (Ren 4), shen shu (UB 23, bilateral), ci liao (UB 32, bilateral), tai cong (Liv 3, bilateral), and tai xi (KI 3, bilateral). Secondary points included zhu san li (ST 36, bilateral), xue hai (SP 10, bilateral), san yin jiao(SP 6, bilateral), gui lai (ST 29, bilateral), and bai hui (Du 20). Needles were inserted to a depth of between 15 and 25 millimeters, depending on the region of the body being treated. Needles were manipulated for 10 minutes to achieve de qi, then left in place for another 25 minutes before being removed.

Semen samples were collected from each of the men after a 3-day period of sexual abstinence. Two samples were collected from each patient: one obtained the day before treatment began, the other after the last acupuncture treatment. Samples from the treatment group were then randomized with semen samples from 12 untreated control patients and analyzed.

Compared to the control group, motility levels increased significantly in semen samples in the men receiving acupuncture. While median motility levels increased from 32% to 37% in the control group, they increased from 44.5% to 50% in the acupuncture group.

The number and percentage of healthy sperm also increased dramatically in the acupuncture patients. At baseline, only 0.06% the sperm among men in the acupuncture group was considered "healthy," while the median number of healthy sperm calculated in ejaculate was 0.04 x 10 6 (40,000). After 10 sessions of treatments, the median percentage of healthy sperm had increased more than four-fold, to 0.26%, while the median number of healthy sperm per sample had reached 0.2 x 10 6 (200,000).

In addition, significant changes in sperm structure and quality were seen in the samples from the acupuncture group. Before treatment, only 22.5% of the sperm samples in the acupuncture patients contained normal-shaped acrosomes, a cap-like structure that develops over the anterior portion of a sperm cell's nucleus. After treatment, the median percentage of normal acrosome shapes showed a "statistically significant improvement" to 38.5%.

Similarly, the percentage of sperm with a normal axoneme pattern increased significantly among men receiving acupuncture. (The axoneme is a microscopic structure that contains a series of tubules arranged in a distinct pattern, and is believed to aid in sperm motility.) Prior to the start of the study, the correct axoneme pattern was present in 52% of sperm in the control group, but only 46.1% in the acupuncture group. After 5 weeks of therapy, the median percentage increased to 52.2% in acupuncture patients, but actually decreased to 38.2% in the control group.

While acupuncture appeared able to improve the overall quality and structural integrity of sperm, it was ineffective against some common sperm pathologies. Apoptosis levels (programmed cell death) in sperm samples were reduced slightly, but not to a statistically significant degree. Median percentages of necrosis (unprogrammed cell death) and sperm immaturity also decreased slightly in the acupuncture group, but not to a level considered statistically significant.

The authors concluded that despite the inability of acupuncture to significantly reduce some sperm abnormalities, the treatment could be used to improve overall sperm quality, leading to the possibility of increased fertility.

"In conjunction with ART or even for reaching natural fertility potential, acupuncture treatment is a simple, noninvasive method that can improve sperm quality," the authors concluded. "Further research is needed to demonstrate what stages and times in spermatogenesis are affected by acupuncture, and how acupuncture causes the physiologic changes in spermatogenesis."

References

1. Hopps CV, Goldstein M. Male infertility: the basics. Available online.
2. Levine D. Boxers or briefs: myths and facts about men's infertility. Available online.
3. Pei J, Strehler E, Noss U, et al. Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertility and Sterility July 2005;84(1):141-7.

Repost via http://www.acupuncturetoday.com/archives2005/oct/10infertility.html