The Truth Behind Acupuncture and Chinese Treatments for Fertility

Acupuncture and Fertility - How does it work?

Acupuncture changes the messages to and from the nervous system. The nervous system plays an important role in day to day functioning of the body and controls everything, including the reproductive system. Acupuncture has several effects on the nervous system, though it is uncertain exactly how this occurs.

Research is developing methods to study how acupuncture improves infertility. The following are the most common theories:

Research has shown acupuncture to be effective at releasing a variety of chemicals, such as neurotransmitters and hormones. The nervous system responds to the change in the chemicals by correcting imbalances (physical and hormonal) in the body. Thus, when correct messages are relayed to the brain, it can help to correct reproductive hormonal imbalances.

One study indicated that acupuncture needles trigger the release of prostaglandins, which encourages nerve endings to transmit messages to the hypothalamus-pituitary-ovarian axis, the most important hormonal systems involved in the female reproductive system. By influencing the hypothalamus-pituitary-ovarian axis, the body will release other hormones such as gonadotropin-releasing hormone (GnRH), which influences reproductive functions like ovulation and menstruation.

Other studies have shown that acupuncture is effective at activating the parasympathetic nervous system. It is responsible for calming the body and can be triggered through meditation and yoga. Acupuncture can stimulate the parasympathetic to release natural relaxants, called endorphins and encephalins. When endorphins and encephalins are circulating through the body, blood vessels will open up, increasing blood flow to the uterine tissue, nourishing the endometrium and encouraging the implantation of an embryo.

Studies theorize that improving hormonal release and dilating blood vessels has a direct effect on the ovaries, fallopian tubes and uterus. It is also important to remember that reproductive hormones are carried by the blood stream and improved blood flow allows hormones to reach the reproductive system. The theory continues to postulate that if the ovary is properly stimulated, it will produce a healthy egg, which will allow the corpus luteum to secrete appropriate levels of progesterone and prepare the uterus for implantation. This theory can explain how acupuncture can improve the success rate of IVF/IUI's. 

Finally, acupuncture successfully treats stress. Every infertility patient faces huge stresses in any part of their journey, with IVF patients manifesting the highest levels. Stress disrupts the proper balance of reproductive hormones (especially progesterone) between the brain, the pituitary and ovary. Imbalances results in various menstruation cycle issues, such as early ovulation, poor luteal phase, and PMS symptoms. Some infertility can be caused purely by long term stress and depression, resulting in cycles with no ovulation.

Chinese Herbs and Fertility - How does it work?

There are over ten thousand herbal substances documented in China. Most herbal substances come from plants and through out the years have been found to treat specific symptoms. Most American practitioners use a core group of 200 herbs.

Chinese herbs are very different from most supplements at your local health food store; they are rarely given as a single herb and are prescribed as a combination of 8 to 20 herbs customized to specifically treat the patient's infertility. A good practitioner will change the patient's formula each week to target specific points in the menstrual cycle.

Chinese herbalists are not required to have a license to dispense formulas and some acupuncturists prescribe formulas to patients with no educational knowledge. If your acupuncturist prescribes herbs, ask if they completed 3 years of Chinese herbology and passed the national certificate test with NCCAOM. Practitioners who sell herbal formulas with no educational background may not have the knowledge to avoid drug interactions or side effects. 

Chinese herbs come in many forms. Most common would be raw herbs that the patient cooks and drinks the liquid from the process. The tea from this method is strong and quick acting. The disadvantage of raw herbs is the cooking time (1 hour of brewing time per bag) and the bitter taste.

Chinese herbs can be given in granules, a powder like substance, which dissolves in a cup of hot water. With this method, the herbs have already been cooked, are easy to brew and do not taste as strong. Both methods permit the practitioner to develop a combination of herbs for the patient's specific issues and are the primary treatment method for specialized practitioners.

Finally, Chinese herbs can be taken as pills, capsules and tincture. These forms are useful when the patient does not like the taste of herbs or travels a lot. Yet, they can not be formulated to treat specific symptoms and take much longer to correct infertility issues. 

What do Chinese herbs contain?

Herbs have many strengthening and therapeutic effects and have been found to contain a variety of nutrients and vitamins, which act as precursors to hormone formation. Chinese herbs have only been introduced into the American market in the last 20 years, thus research has not investigated the pharmaceutically effects. Studies from China have suggested some formulas can regulate LH receptors, decrease FSH levels, and the improve receptiveness of progesterone receptors. Yet, more research is needed before any finally conclusions can be made.

Should I take Chinese herbs and are they safe?

You should talk with your practitioner about this particular topic. As a practitioner I see many infertility cases where herbs play a major role in correcting hormonal imbalances. I believe herbs are generally very safe when prescribed by a Board Certified Herbalists. A Board Certified Herbalist has completed schooling and passed a certification test by NAACOM.  

In my practice, I only use raw herbs from Kamwo (www.kamwo.com) and granules from Crane (www.craneherb.com) both very reputable companies. Their herbs are tested for contamination, purity and authenticity.

Chinese herbs can cause side effects; the most common symptoms are stomach upset, headaches or sleepiness. Otherwise Chinese herbs are safe and with an educated practitioner any serious side effects should not occur. Some patients are uncertain about herbs and request treatment with acupuncture solely. A good practitioner will discuss all options with the patient and respect your requests.

Treatment Questions

How long will I be in treatment?

Acupuncture is not the quick fix. The general rule for treatment protocol will be at least 3 menstrual cycles to balance hormones and smooth out menstrual irregularities. Younger women require fewer treatments compared to an older client. Although this is not guarantee, since younger women can present with serious health issues, such as PCOS, POF or high FSH. In very difficult cases, the treatment time is very important and can be longer. As a woman’s cycle becomes regular with treatment, some weeks in the month can be skipped. Patients must be ready to dedicate the time and emotional focus to gain the best outcome from acupuncture. 

Can acupuncture treat gynecological disorders which can cause infertility?

Yes. Acupuncture can treat gynecological issues, such as PCOS, irregular menstrual cycles, endometriosis, mid cycle bleeding, PMS and luteal phase defect. Each problem responds differently to acupuncture and treatment protocols vary with the age of the client. Some disorder such as fibroids, polyps and blocked fallopian tubes are difficult to treat and your practitioner will discuss realistic treatment outcomes. 

Who is your typical patient?

Fertility patients are typically between the ages of 30 to 45. Most have had failed ART procedures or told their only option is donor egg. Older women generally have issues with poor egg quality or repetitive miscarriage. Other clients are preparing for their next ART procedure and are looking for extra support physically and emotionally.  Occasionally husbands come for acupuncture to treat low sperm count or poor mobility.

What is the expectation of Acupuncture, Chinese Herbs and IVF?

When should I start acupuncture with IUI/IVF procedures?

It is best to start acupuncture well in advance of ART procedures to have the best affect and to prevent stress levels from increasing. A patient starting an ART procedure is advised to have weekly treatments with multiple treatments in a week when egg retrieval and transfer are scheduled. Some women feel once the transfer is completed acupuncture is no longer helpful, but acupuncture can be important to relieve stress while waiting for the pregnancy to be confirmed. Plus, it can help to relax the uterus to encourage implantation and discourage a possible miscarriage.

As mentioned, the best outcomes are related to the care and work in the 3 months before starting IVF procedures.

Can I combine Chinese herbs with ART procedures?

It is best to take herbs before starting ART procedures to get the best benefit without any interactions. Yet, this is a difficult topic and depends on each patient's scenario. The patient will need to know if their reproductive specialist is open to the idea of Chinese herbs with fertility drugs.

Some infertility specialists allow Chinese herbs to be used during the ART procedure, others prefer the patient only utilizes acupuncture. A good practitioner will work with your infertility specialist and give herbs when the timing is appropriate.

How do I a pick a practitioner?

When picking a practitioner, you should find one that specializes in infertility or women's reproductive disorders. Generally their practice will have a high percentage of infertility cases. In my practice 50% of my clients are in treatment for infertility. The practitioner should not specialize in every health ailment, since each health topic has a huge amount of information to understand. You would not go to your general doctor for infertility treatments. Don't go to an acupuncturist who advertises that they specialize in infertility and everything else. Ask if the acupuncturist has taken continuing education classes to keep up on their knowledge.

It is important to feel a certain comfort and connection with the acupuncturist. The acupuncturist should support your goals and provide emotional support when times get difficult.

The acupuncturist should complete an extensive history intake on your case and modify the treatments to your diagnosis. The best benefit of acupuncture is its ability to adapt to each patients situation, thus one patient will be treated with one set of acupuncture points, while another will receive a completely different set. You should receive personalized treatments.

Finally, be cautious of certified acupuncturists. There is a difference between a licensed acupuncturist and a certified acupuncturist. A licensed acupuncturist has completed a master program in acupuncture and is required by state law to have over 2600 hours in a clinic setting before receiving their license.

A certified acupuncturist is usually a doctor or chiropractor who has completed a 300 hour course that can be taken via a home video class. A certified acupuncturist does not need to complete clinic hours before treating patients. Some doctors have completed acupuncture school and are well versed in the theory behind picking points, so remember to ask a certified acupuncturist about their acupuncture schooling.