Wednesday, June 12, 2013

Acupuncture and Infertility

What Does Acupuncture Actually Mean?

Acupuncture involves inserting and sometimes manipulating very thin needles into very specific points in the body. It's similar to physical therapy in that it is a process-oriented (i.e. ongoing) method of intervention. The insertion of the various needles are said to stimulate energy flow "Qi" (tee). Treatments for women with infertility commonly last three to four months spanning the time prior to insemination and after IVF. It's important to note that a commitment to acupuncture treatment means more than turning yourself over for needle manipulation. Most practitioners trained in Chinese medicine will conduct a complete physical workup that includes examination of the color of the tongue and taking of the pulse. The information from these preliminary activities helps the practitioner to understand the blood flow, body fluid balance and energy levels of the particular patient.

How Could Acupuncture Help a Woman Get Pregnant?

Because acupuncture appears to increase blood flow to vital organs, it may help in the regulation of hormone levels, and even improve ovarian and follicular function, making for healthier eggs. Also, blood flow to the uterus may increase, permitting for a thick lining of the endometrium that increases the chances that the uterus will hold implanted eggs to term with no miscarriage. For these reasons, it is not unrealistic to assume (and a few studies even seem to suggest) that acupuncture may improve the success rate of medical interventions such as in vitro fertilization (IVF).

Acupuncture is not going to help a woman get pregnant if her problem stems from something that needs surgical correction, such as a blockage in her fallopian tubes. But, in the special case of spasmed fallopian tubes (as opposed to blocked tubes) there may be some relief through acupuncture -- there have been cases in which spasmed tubes are de-spasmed (and therefore opened up) with acupuncture. That can be critical, because fallopian tubes must be open to permit an egg to travel past the cervix where it can be either inseminated or harvested.

Further, sometimes Acupuncture is combined with herbal medicine to treat hormonal imbalances, irregularities in a woman's menstrual cycle, and even some male factor infertility.

What do the Studies Really Say?

While many advocates claim that acupuncture can relieve almost any medical condition, it is now somewhat accepted that acupuncture can at least temporarily relieve pain and even regulate blood pressure by stimulating the central nervous system. These effects are achieved because the use of acupuncture causes the body to release endorphins which inhibit pain and gives the body the feeling of wellness. Endorphins may also release certain neurotransmitters and neurohormones, which some say encourage the body to heal itself.

A few studies have suggested acupuncture's benefits specifically when used in conjunction with IVF. A small German study in 2002 demonstrated a near doubling of pregnancy rates for women who received acupuncture both shortly before and shortly after embryo transfer. Another study in Great Britain produced similar results -- this study showed the odds of conceiving increased by about 65 percent for women who received acupuncture shortly before and after IVF procedures. Dr. Paul C. Magarelli, an infertility doctor at the Reproductive Medicine & Fertility Center in Colorado Springs, Colo., is co-author of an ongoing study into the use of acupuncture with IVF with Dr. Diane K. Cridennda, a licensed acupuncturist. While Magarelli was initially skeptical, he says he has been convinced by the data in his study that acupuncture improves a woman's chances of getting pregnant with IVF, and holding that pregnancy to term.

All of these studies were small in scale. One board-certified endocrinologist with the Reproductive Medicine Group in Tampa, Florida, Samuel Tarantino, acknowledges that existing studies have yielded good information, but the evidence is not yet sufficient to support a claim that acupuncture is a proven treatment for infertility. He attributes some of the reported success to a placebo effect. In other words, "if a patient believes it will work, it will work because of that. The brain has an intense power to heal itself." "It's impossible to say at this point," said Dr. Robert Schenken, president of the American Society for Reproductive Medicine, is another fertility specialist who feels that not enough controlled data from human clinical studies has been produced to draw any conclusions about acupuncture's effectiveness with infertile women.

If I want to use Acupuncture as Part of my Treatment, How Do I Go About It?

An increasing number of fertility centers have begun to offer acupuncture as an option as part of an IVF treatment protocol (bear in mind that even if your clinic offers it or gives you a referral, Insurance usually doesn't cover the cost of acupuncture, and a single treatment can cost anywhere from $75 up to $90). If you plan to use acupuncture as part of your overall treatment plan, consider beginning treatment three to four months before a medical procedure like artificial insemination or (IVF). Then, continue treatments both before and after insemination or embryo transfer. Do be sure to use an licensed acupuncturist with experience treating fertility. Your acupuncturist should not place needles in the abdomino-pelvic area after insemination or transfer.There is some risk that inadvertent mistakes in the placement of the needles by an acupuncturist who has not studied fertility could contribute to a miscarriage.

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