Research

Acupuncture, Fertility Research Delivers Healthy Results

Traditional Chinese Medicine (TCM) has been practiced for thousands of years. Amazingly, the first written gynecological records date back to the Shang dynasty (1500 BC- 1000 BC), but here in the U.S. and other Western countries, people are just beginning to understand and appreciate the effectiveness of Traditional Chinese Medicine. It isn’t easy to compare Traditional Chinese Medicine and Western medicine because there are profound differences that underlie the basic notions of your health, body and treatment. Western medicine often takes a more mechanistic view of people – your body may be treated as if it is a collection of machine parts rather than one whole, integrated system. Alternatively, Traditional Chinese Medicine sees individuals as personal ecosystems, with each part depending on, and influencing, all the other parts. This “whole body” approach means that treatment addresses the complete systems of your body rather than just attending to your symptoms. As a result of such a treatment strategy, most patients experience an improvement in their specific condition and also a better overall sense of health and well being. Below is a selection of studies that can shed some light on the effectiveness of various traditional treatments in an experimental environment categorized by specialty.

General Fertility

Findings suggest positive regulation of the HPA axis may be an underlying mechanism by which acupuncture provided the significant improvements to antenatal depression, stress, and distress observed in this cohort.

Investigation of Hypothalamic Pituitary Adrenal Axis and Oxytocinergic System Changes in a Pragmatic Randomized Controlled Feasibility Trial of Acupuncture for Antenatal Depression.

Simone M. Ormsby, BSc Hons, BHSc, PhD,1 Hannah G. Dahlen, BN Hons, MCommN, PhD, FACM,2 and Caroline A. Smith, MS, PhD1 2023

  • This study demonstrated that acupuncture is an effective method for ovulation induction as well as the remission of ovarian hyperstimulation syndrome (OHSS) which is caused by ovulation induction drugs. OHSS is at least uncomfortable and at worst life threatening.
  • Substitution of Acupuncture for HCG in Ovulation Induction – Cai Xuefen, Obstetrical & Gynecological Hospital, Zhejiang Medical University, Zhejiang Province
  • The researchers reviewed the existing scientific rationale and clinical data on acupunctures influence on the outcome of female fertility. They concluded that because acupuncture is nontoxic and relatively affordable, its indications as an adjunct to IUI or IVF treatments or as an alternative to conventional hormone induction of ovulation deserves serious consideration.
  • Role of acupucture in the treatment of female infertility – Raymond Chang, M.D., The Institute of East-West Medicine, The Department of Internal Medicine, Weill Medical College of Cornell University. Pak H. Chung, M.D., The Department of Internal Medicine, Weill Medical College of Cornell University. Zev Rosenwaks, M.D., The Center for Reproductive Medicine and Infertility.
  • This study reveals that even sub-clinical  issues such as hypothyroidism can lead to difficulty getting pregnant as well as a higher rate of miscarriages. It also states that the quality of eggs, rather then the quantity retrieved, is more important for positive outcomes.  This reflects the view of Traditional Chinese Medicine which works to improve the potential multitude of sub-clinical imbalances that can exist and coexist in the “infertile” patient.  By using TCM, and other natural means, the body’s healing intelligence corrects these imbalances on its own.  Hence quality is fostered rather than quantity forced.
  • Improved IVF Outcomes After Treatment of Subclinical Hypothyroidism in Infertile Women – Rahman AH, Abbassy HA, Elatif Abbassy AA.
  • This study shows that in women who do not ovulate or ovulate irregularly (especially those with polycystic ovaries) Electro-Acupuncture can help by depressing sympathetic activity. This was observed as an increase of hand skin temperature along with a lowering of the level of blood Beta Endorphines in the women where ovulation was achieved.
  • Relationship Between Blood Radioimmunoreactive Beta-Endorphin and Hand Skin Temperature During The Electro-Acupuncture Induction of Ovulation – Chen Bo Ying M.D. Lecturer of Neurobiology, Institute of Acupuncture Research, and Yu Jin, MD., Prof of Gynecology, Obstetricus and Gynecology Hospital Shanghai Medical University, Shanghai, People’s Republic of China

IVF/IUI

Effects of acupuncture on pregnancy outcomes in women undergoing in vitro fertilization: an updated systematic review and meta-analysis

The authors of this large meta-analysis in 2022 looked at all randomized controlled trials that compared acupuncture to any control in people undergoing IVF. They excluded trials that used a placebo needle on real acupuncture points. They did, however, include trials with placebo needles placed elsewhere. They included 25 studies with 4,757 participants in their analysis, and here are a few critical results.

  • Acupuncture vs any control increased live births by 33%
  • Acupuncture vs no treatment increased live births by 23%
  • Acupuncture vs placebo increased live births by 52%

A new study looked at 2,330 patients who completed a Frozen Embryo Transfer cycle. Personalized acupuncture (not a simple protocol that was applied universally to everyone) was used as an additional therapy in 579 patients on their transfer day. They compared these patients with 1,751 patients who did not add Acupuncture on the day of embryo transfer.

The two groups were different in some ways. Specifically, the folks who chose to add acupuncture were a bit older and more of them were diagnosed with Diminished Ovarian Reserve or ovulatory-related infertility.

They found a strong association of benefit when personalized acupuncture was added to FET compared with no acupuncture. Acupuncture was associated with a 55% increase in the odds of live birth (OR=1.55, 95% CI 1.29-1.88; p<0.00001), and a 42% decrease in the risk of biochemical pregnancy (OR=0.58 95% CI 0.41-0.83), p=0.002.

https://reproductiveacupuncture.com/wp-content/uploads/2022/11/Acupuncture-FET-study-2022.pdf

Recent meta-analyses found acupuncture is effective to increase live births by 30% when acupuncture was compared with no treatment in nine trials of 1,980 women… Additionally, acupuncture was 42% more effective to increase live births when women had previously failed an IVF cycle…

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6918533/pdf/acu.2019.1392.pdf

  • Research on acupuncture for infertility has proven to be very helpful in demonstrating it’s positive impact on outcomes. This study, however, reveals that Whole Systems Traditional Chinese Medicine (WSTCM) dramatically outperforms the results from research protocols. In other words, the way that acupuncturists treat patients in a clinical setting, giving them a unique diagnosis and treatment plan, offers superior outcomes over the research setting where everyone is treated with the same protocol. https://www.researchgate.net/publication/273478109_Impact_of_Whole_Systems_Traditional_Chinese_Medicine_on_In_Vitro_Fertilization_Outcomes
  • To evaluate whether acupuncture improves rates of pregnancy and live birth when used as an adjuvant treatment to embryo transfer in women undergoing in vitro fertilisation.
  • Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. https://www.ncbi.nlm.nih.gov/pubmed/18258932
  • In this study acupuncture was administered 25 minutes before and after embryo transfer during in vitro fertilization. Pregnancies were documented in 42.5% of the acupuncture group, whereas the pregnancy rate was only 26.3% in the control group.
  • Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy – Wolfgang E. Paulus, M.D., Department of Reproductive Medicine, Christian-Lauritzen-Institut. Mingmin Zhang, M.D., Department of Traditional Chinese Medicine, Tongji Hospital, Tongji Medical University, Wuhan, People’s Republic of China. Erwin Strehler, M.D., Department of Reproductive Medicine, Christian-Lauritzen-Institut. Imam El-Danasouri, Ph.D., Department of Reproductive Medicine, Christian-Lauritzen-Institut. and Karl Sterzik, M.D. Department of Reproductive Medicine, Christian-Lauritzen-Institut
  • Two hundred twenty-eight women were divided into either an acupuncture group or a control group. The acupuncture group received treatment three times around embryo transfer during in vitro fertilization. The control group received sham acupuncture with placebo needles. The pregnancy rate was 31% in the acupuncture group and 23% in the control group. This is not considered statistically significant but a later study suggests that sham acupuncture (although not as effective as the true acupuncture) still has a positive effect on outcomes.
  • Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer – Caroline Smith, Ph.D., Meaghan Coyle, B.Hlth.Sc. (Acup.), and Robert J. Norman, M.D.

Pregnancy Acupuncture Research

In a study of 386 pregnant women published in the British medical Journal the usual physiotherapy treatment for pelvic pain (a pelvic belt, patient education and home exercises) was compared to standard treatment plus acupuncture and standard treatment plus extra physiotherapy stabilizing exercises. Treatment was given over 6 weeks
Pain was measured by a visual analogue scale and by an independent examiner before and after treatment. Their conclusion was that “Acupuncture was superior to stabilizing exercises in the management of pelvic girdle pain in pregnancy, with acupuncture the treatment of choice for patients with one sided sacroiliac pain, one sided sacroiliac pain combined with symphysis pubis pain and bilateral sacroiliac pain”.
Elden H, Ladfors l, Fagevik Olsen M, Ostaard H, Hagberg H. Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised singleblind controlled trail. BMJ 2005;330:761.

593 women who were less than 14 weeks pregnant suffering nausea and vomiting were randomized into 4 groups (an acupuncture group who received a traditional acupuncture diagnosis, an acupuncture group that received acupuncture at a single point, a sham acupuncture group and a control group that received no treatment)
The outcomes of treatment were measured in terms of nausea, dry retching, vomiting and health status.
While all acupuncture groups reported improvement with nausea and dry retching, it was the traditional acupuncture group that had the fastest response.
Patients receiving traditional acupuncture also reported improvement in five aspects of general health status (vitality, social function, physical function, mental health and emotional role function) when compared to improvement in two aspects in the other groups
This study followed up on the pregnancy outcomes for all women receiving treatment. Data was collected on perinatal outcome, congenital abnormalities, pregnancy complications and problems of the newborn.
No differences were found between study groups in the incidence of these outcomes suggesting that there are no serious adverse effects from the use of acupuncture treatment in early pregnancy.
The authors concluded that “Acupuncture is a safe and effective treatment for women who experience nausea and dry retching in early pregnancy”.
Smith C, Crowther C, Beilby J. Acupuncture to treat nausea and vomiting in early pregnancy: a randomized trial. Birth.2002, Mar:29 (1):1-9.
Smith C, Crowther C, Beilby J. Pregnancy outcome following women’s participation in a randomised controlled trial of acupuncture to treat nausea and vomiting in early pregnancy. Complement Ther Med. 2002 Jun; 10(2):78-83.

In 1994 the following research was published in Journal of American Association (JAMA) to evaluate the efficacy and safety of moxibustion on Zhiyin BL-67 to correct breech presentation.
130 women with a breech presentation and having their first baby at 33 weeks gestation received moxibustion while 130 women, also with a breech presentation and who were also primigravidas, received no intervention.
The moxibustion was administered for seven days. Women were then assessed and a further seven days of moxibustion treatment given if the baby’s position had not changed.
Outcomes were measured in terms of foetal movements, as counted by the mother for one hour each day for one week, and the number of cephalic presentations both at 35 weeks gestation and at delivery.
At 35 weeks gestation 75.4% in the intervention group had changed to cephalic (47.7% in the control). In terms of foetal movement the moxibustion group experienced a greater number of movements (a mean of 48.45 compared to the control group with a mean of 35.35).
The Authors concluded “That in prigravidas at 33 weeks gestation with breechpresentation, moxibustion treatment for one to two weeks at Zhiyin BL-67 increased foetal activity during the treatment period and cephalic presentation at 35 weeks and at delivery”.
Cardini F, Weixin H. Moxibustion for correction of breech presentation. JAMA 1998; 280:1580-1584

Research on the use of acupuncture to prepare women for labour first appeared in 1974 with a study by Kubista and Kucera. Their research concluded that acupuncture once a week from 37 weeks gestation was successful in reducing the mean labor time of the women treated (acupuncture group, labor time 6 hours and 36 minutes compared to eight hours and 2 minutes in the control).
In 1998 research Zeisler used the acupuncture points treating from 36 weeks gestation. Concluding that acupuncture treatment had a positive effect on the duration of labor by shortening the first stage of labor, defined as the time between 3cm cervical dilation and complete dilation (acupuncture group a median duration of 196 minutes compared to the control group time of 321 minutes)
An observation study by Betts and Lenox in 2004 looked at the effect of using prebirth acupuncture on 169 women as part of their routine antenatal care.
In the acupuncture group there was an overall 35% reduction in the number of inductions (for women having their first baby this was a 43% reduction) and a 31% reduction in the epidural rate when compared to the local population. When comparing midwifery only care there was a 32% reduction in emergency caesarean delivery and a 9% increase in normal vaginal births.
The authors concluded that prebirth acupuncture appeared to provide some promising therapeutic benefits in assisting women to have normal vaginal births and that a further randomized controlled study is warranted.
Kubista E, Kucera H. Geburtshilfe Perinatol 1974; 178 224-9. 
Zeisler H, Tempfer C, Mayerhofe Kr, Barrada M, Husslein P. Influence of acupuncture on duration of labour Gynecol Obstet Invest 1998; 46:22-5. 
Betts D, Lennox S. Acupuncture for prebirth treatment: An observational study of its use in midwifery practice. Medical acupuncture 2006 May; 17(3):17-20

Research was undertaken to evaluate whether acupuncture at term can influence cervical ripening and thus reduce the need for postdates induction.
On their due dates 45 women were randomized into either an acupuncture group (25) or a control group (20). The acupuncture group received acupuncture every two days.
The women in both groups were examined every other day for cervical length. If women had not delivered after 10 days labour was induced by administering vaginal prostaglandin tablets.
The time from the woman’s due date to delivery was an average of 5 days in the acupuncture group compared to 7.9 days in the control group, and labour was medically induced in 20% of women in the acupuncture group compared to 35% in the control group.
The authors concluded that acupuncture supports cervical ripening and can shorten the time interval between the woman’s expected date of delivery and the actual time of delivery.
Rabl M, Ahner R, Bitschnau M, Zeisler H, Husslein P. Acupuncture for cervical ripening and induction of labour at term – a randomised controlled trail. Wien Klin Wochenschr 2001; 113 (23-24): 942-6.

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