About the author: Irina Szmelskyj is an award-winning fertility acupuncturist, a co-author of a best-selling textbook ‘Acupuncture for IVF and Assisted Reproduction: An Integrated Approach to Treatment and Management’. Irina is also a lecturer on the subject of acupuncture for infertility and IVF and is an award-winning acupuncturist specialising in reproductive medicine practicing at True Health Clinics in Huntingdon, Cambridgeshire and CAM Therapies in Cambridge, UK.
Research shows that acupuncture improves fertility by regulating reproductive hormones, it can increase the number of good quality (mature) eggs, improves sperm parameters, optimises uterine environment for implantation and reduces stress and anxiety levels.
Did you know that at least one in four couples seek acupuncture to help them conceive? This is because there is a growing body of evidence that acupuncture can positively influence fertility and IVF outcome. In one study it was found that acupuncture almost doubled IVF pregnancy rates. This short article summarises the mechanisms by which acupuncture may improve fertility and IVF success rates.
1. Acupuncture regulates female reproductive hormones
Female reproductive hormones, many of which are released by the brain, very strictly regulate reproductive functions. One such hormone is Follicle Stimulating Hormone (FSH). As its name suggests, FSH stimulates ovarian follicular growth and development. If FSH is raised, this means that brain has to work extra hard to develop and grow ovarian follicles and the eggs within them. Women who have raised FSH levels do not respond well to IVF ovarian stimulation medication and produce very few eggs.
A very recent major review of the published research literature concluded that acupuncture positively alters how reproductive hormones are secreted. This is likely to help women respond better to ovarian stimulation medication.
2. Acupuncture may improve the quality and increase the quantity of eggs
All the reproductive hormones as well as nutrients necessary for ovarian follicles to develop and grow are delivered to the follicles directly through the blood supply that goes to them. Therefore, the better the blood flow, the more efficient is the delivery of hormones and nutrients and the greater the potential to produce better quality eggs.
Several research studies have shown that acupuncture increases blood flow to a woman’s reproductive organs by relaxing and opening up the blood vessels. Thus the response to IVF stimulation treatment is likely to be better in women, who have a good blood supply to their ovaries, thereby allowing better delivery of IVF medication. This could lead to more and better quality eggs being produced.
3. Acupuncture improves sperm quality and quantity
Up to 40% of infertility cases are at least in part caused by poor male fertility. Some people working in the field of fertility medicine believe that, so long as men have some sperm, IVF will overcome male factor infertility, particularly if a specialist fertilisation technique called Intra-Cytoplasmic Sperm Injection (ICSI) is used. In the ICSI technique a single sperm is injected into an egg. However, ICSI pregnancy rates are virtually the same as with conventional IVF treatment (33 vs. 32.4%).
One of the possible explanations why IVF/ICSI does not overcome all male infertility issues is because it cannot alter the quality of sperm; it only attempts to select the ‘best looking’ sperm. As the embryo is made of 50% mother’s DNA and 50% father’s DNA, if quality of the sperm is poor, it is likely that the resulting embryo quality will also be poor, and the embryo will not implant.
Preliminary research investigating the effects of acupuncture on male fertility has found that acupuncture can positively influence sperm parameters, including sperm concentration, motility, vitality and count. There is also some evidence that acupuncture treatment of male partners increases fertilisation rates, thus providing couples with more embryos. Acupuncture may possibly regulate testosterone levels based on the findings of some researchers. It is extremely important that a male partner has the optimal of level of testosterone in their body in order to have adequate sperm production.
4. Acupuncture helps with embryo implantation
A growing body of evidence suggests that acupuncture increases embryo implantation rates. For example, in one recent study it was found that acupuncture significantly improved clinical pregnancy rates in patients with a history of two or more failed IVF cycles.
Embryo implantation is dependent on good blood supply to the uterus. Research shows that good blood supply to the uterus just before egg retrieval is associated with improved IVF conception rates. As previously mentioned, acupuncture can successfully increase the blood flow to the reproductive organs.
Implantation is also dependent on a normally functioning immune system. In some women, problems with the immune system stop the embryo from implanting. A considerable body of human and animal research shows that acupuncture helps to regulate the immune system.
5. Acupuncture reduces stress
Research shows that a diagnosis of infertility causes the same emotional suffering as a diagnosis of cancer. Unfortunately, high stress levels in patients that are struggling to conceive can further reduce their chances of conception. Stress can affect reproductive hormones, reduce sperm quality and quantity, it can cause the menstrual cycles to become shorter and this may shorten the luteal phase, therefore, not allowing enough time for the embryo to implant.
Several studies have shown that acupuncture reduces anxiety and stress symptoms in fertility patients. In particular, acupuncture reduces cortisol levels, one of the body’s major stress hormones.
The world’s largest professional medical reproductive organisation The American Society for Reproductive Medicine (ASRM) recommends that infertile patients should try acupuncture as one of the ways to manage their infertility related stress.
Acupuncture is a safe and effective non-pharmacological way to improve IVF success rates. However, it is not a quick fix solution. In many cases acupuncture treatment may need to be started at least two to three months before starting IVF (in some complex cases even earlier). This is because ovarian follicles and the eggs within them take over a year to develop, and sperm takes around three months to be produced. Acupuncture treatment may also need to be continued throughout all stages of IVF and in pregnancy.
Finally, just an important cautionary note. A good understanding of Traditional Chinese Medicine and acupuncture will get results in many patients. But, in more complex cases it might not be enough on its own. I therefore believe it is vitally important that you see an acupuncturist who has sufficient specialist knowledge of the complexities of fertility and reproductive medicine and who has experience of treating subfertile patients and patients undergoing IVF.