Acupuncture and IVF

One question that often arises at ilumina is how often to get acupuncture when going through an IVF cycle. The answer is simple and complex. Here is my general recommendation if you are starting an IVF cycle and the goal is to promote ovarian response, optimize hormones, and increase the quantity and quality of the the uterine lining. Please note that if  pathological hyperstimulation/ OHSS occurs acupuncture is an excellent treatment and can often "save" the cycle.

  • Ovarian Suppression phase- (around 4-6 weeks before egg retrieval) Acupuncture 2x per week
  • Ovarian Stimulation phase- (around 2 weeks before egg retrieval) Acupuncture 2-3x per week
  • One treatment between egg retrieval and embryo transfer
  • Acupuncture 20 minutes before and 20 minutes after embryo transfer (this is performed at the REI office by an ilumina practitioner)
  • One treatment 3-5 days after embryo transfer
  • Then once a week afterwords, if pregnant acupuncture once a week through the first trimester

For advance maternal age, poor ovarian response, elevated FSH, poor embryo quality or male factor infertility I would recommend a much more extensive treatment plan for 3-6 months before IVF which would include: acupuncture, individualized Chinese herbal formulas, vitamins and supplements, diet and exercise and meditation. For more information on how and why Chinese medicine is so effective for IVF preparation please see the book Making Babies: A Proven 3-Month program for Maximum Fertility. If you are looking for an acupuncturist in your area to support your IVF cycle please see the website for the American Board of Oriental Reproductive Medicine's website. This professional organization credentials acupuncturists in reproductive medicine.  If you are interested in the research that shows the efficacy and mechanism of action for acupuncture and IVF please see the comprehensive review  of research put together by my friend and colleague Diane Cridennda L.Ac.For over 10 years ilumina Healing Sanctuary's practitioners have been treating male and female infertility and attending IVF embryo transfers. We have experience and trusted relationships with all of the fertility clinics in the greater Phoenix area. We look forward to working with you on your journey to parenthood.Dana Price DOM, L.Ac., Dipl.OM, FABORMilumina Healing Sanctuary7520 E Camelback RoadScottsdale, Arizona 85251(602)957-2602

September 10 Lecture: Enhance Fertility with Dr. Dana Price

ilumina Healing Sanctuary Lecture SeriesTopic: Enhance Fertility

Date: September 10, 2012 Time: 6:00 to 7:00 pm Location: ilumina on Camelback

Dr. Dana Price DOM, L.Ac., FABORM will be presenting information on Enhancing Fertility with Traditional Chinese Medicine. Dana has been in practice since 1999 and has been sought after for her experience and expertise.

Please call 602-957-2602, or email office@iluminahealing.com to reserve your space.

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."

Acupuncture Today Editorial Staff

References

Hopps CV, Goldstein M. Male infertility: the basics.

Levine D. Boxers or briefs: myths and facts about men's infertility.

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.

 

Oriental Medicine and Male Sexual Disorders

Throughout Chinese history its society has been dominated by men. As this is an unfortunate reality it has also lead Chinese Medicine to be able to focus its medical knowledge on treating men's health and longevity. As far back as the Yellow Emperor's reign many classical texts were devoted to increasing men's sexual performance and health. Although centuries have past since the Yellow Emperor began inquiring about health and wellness, men today still look for various ways to stay healthy sexually.Sexual health is not the only concern for men today. As men age they begin battling with various other male disorders. Aside from impotence, men also suffer from conditions affecting urination, the prostate and testicles.

How Chinese Medicine Views Sexual Disorders and Men's Health

Chinese Medicine can help treat various male disorders. At the center of treating all male disorders are the Kidneys. Although other organ systems tend to be involved such as the Liver, Spleen, Bladder, and Heart the kidneys are usually at the core of the problem. One of the kidneys major functions according to Chinese Medicine is storing Jing (essence). Jing is one of three treasures, Qi and Shen (spirit) being the other two. “The life-giving processes of nature are manifest in the concept of Jing. It can be understood as the sap of life, the irreducible essence that contains all the critical ingredients needed to make new life that shares characteristics with its source.” As Jing has a direct connection with sperm in men you can begin to see why premature ejaculation and other sexual disorders are important to treat for the Chinese.

As a man ages Jing naturally depletes. As a man turn 40 the decline of kidney qi begins and with that Jing. Men experience their own kind of Men-opause as they age. This is different then that experienced by woman as there is no single physiological change. This is still a time that brings many imbalances in men as estrogen begins to be the dominant hormone in the body.

Another reason why the kidneys are the focus of treatment is its close connection with urinary function. According to Chinese Medicine the kidneys govern the opening and closing. This function corresponds to urinary incontinence as well as premature ejaculation. Both of these functions depend upon the kidneys strength and control to govern these functions properly. If this ability is weakened someone might experience frequent urination, dribbling, or incontinence.

Acupuncture and Impotence

One condition that we hear about often on the television, in the newspapers and magazines, and on the radio is impotence. As mentioned previously, Chinese Emperors viewed sexual function as an important part of health and longevity. If an Emperor had impotence he would seek the advice of his medical staff, and in the case of Huang Di, the Yellow Emperor, her would ask the advice of Su Nu. Impotence is known as yang wei, which literally means flaccidity. Impotence refers to the inability to attain erection or the ability to attain only partial erection. This can be caused by several underlying reasons; however some of the more common causes are overindulgence in sexual activity and emotional disturbances.

Prostate Health

The condition of an enlarged prostate gland as a man ages is called benign prostatic hypertrophy (BPH). In BPH the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra. Symptoms commonly seen with BPH are:

  • a hesitant, interrupted, weak stream
  • urgency and leaking or dribbling
  • more frequent urination, especially at night

These conditions, if left untreated, could lead to more serious conditions such as prostate cancer, urine retention, urinary tract infections, bladder or kidney damage, bladder stones, and incontinence.

BPH according to Chinese Medicine is categorized into diseases relating to urination. Historically there was no mention of an enlarged prostate. The Chinese had no way of knowing that a mans prostate was enlarged, but they were aware of the symptoms it caused. These symptoms of frequent nighttime urination, painful urination, and difficult urination were observed and thus categorized as disease categories which are used today to diagnose and treat BPH.

Male Infertility

Male infertility is rarely spoken about but can frequently be the problem when couples are having trouble conceiving. In many cases men have poor quality sperm or a decreased quantity. According to the World Health Organization guidelines normal sperm count consists of 20 million sperm per ejaculate, with 50 percent motility and 60 percent normal morphology (form). The amount of semen in the ejaculation matters, too. If the concentration is less than 20 million sperm per milliliter of ejaculate, it may impair fertility. Still, if the sperm show adequate forward motility -- the ability to swim -- concentrations as low as 5 to 10 million can produce a pregnancy. It is important to remember that only 25 years ago, counts of 100 million sperm per ejaculate were the norm. Time, the effects of our environment and/or lifestyle seem to be gradually degrading male sperm counts. Within Chinese medicine once again the kidneys play an important role in semen production and quality; however this is not the only cause for infertility in men. Many times infertility is caused by dampness in Chinese Medicine. One major way that dampness is produced is through poor and improper dietary habits. The Standard American Diet (SAD) is a large contributor to health problems and that remains true with infertility.

For a study in Fertility and Sterility, Volume 71, Number 4 (April 1999), pp.684-689, on the Comparison of the sperm quality necessary for successful intrauterine insemination with World Health Organization threshold values for normal sperm, visit the http://www.inciid.org/fertinews/whothreshold.html

What Acupuncture Can Treat

Here is a brief list of Male Health problems that Oriental Medicine and Acupuncture can help:

  • Premature Ejaculation
  • Low Sperm Count
  • Diminished Sperm Motility
  • Impotence
  • Hernias
  • Testicular Pain
  • Prostatitis
  • Benign Prostatic Hypertrophy
  • Male Infertility
  • Male Climacteric (men-opause)

References:

  1. The World Health Organization
  2. “ A Brief History of Qi” by Zhang Yu Huan and Ken Rose – Paradigm Publications, Brookline Mass, 2001
  3. “Practical Therapeutics of Traditional Chinese Medicine” – by Yan Wu and Warren Fischer – Paradigm Publications, Brookline, Mass, 1997
  4. “ A Handbook of TCM Urology and Male Sexual Dysfunction” – BY Anna Lin, Blue Poppy Press, Inc. Boulder Colorado, 1999

By: Marc Sklar DA, L.Ac., MSOM