Acupuncture & Fertility

What is the research telling us?

Vicki Ball M.BHSc (Acu)

Fertility and Acupuncture

what can we do

Research

ACUPUNCTURE & IVF

Acupuncture & IVF

Reduce uterine artery resistance

Modulate immune response

Relaxation prior to surgical procedures

Acupuncture onDay of Transfer

Choong, 2008 (Cochrane Review) –13 RCTs reviewed in meta-analysis

Acupuncture on Day of TransferChoong, 2008 (Cochrane Review) –13 RCTs reviewed in meta-analysis

Acupuncture Control

Clinical pregnancy rate1022 women

39%201/518

30%150/504

Ongoing pregnancy rate769 women

Live Birth Rate 542 women

Acupuncture on Day of TransferChoong, 2008 (Cochrane Review) –13 RCTs reviewed in meta-analysis

Acupuncture Control

Clinical pregnancy rate1022 women

39%201/518

30%150/504

Ongoing pregnancy rate769 women

32%126/384

21%81/385

Live Birth Rate 542 women

Acupuncture on Day of TransferChoong, 2008 (Cochrane Review) –13 RCTs reviewed in meta-analysis

Acupuncture Control

Clinical pregnancy rate1022 women

39%201/518

30%150/504

Ongoing pregnancy rate769 women

32%126/384

21%81/385

Live Birth Rate 542 women

35%95/275

22%59/267

Miscarriage rates- Acupuncture on day of transfer

Acupuncture Control

409 women 4%9/204

5%10/205

No statistical difference

Acupuncture before & after transfer + 2 days2 studies (Dieterle, 2006; Westergaard, 2006)

Acupuncture Control

Clinical pregnancy rate403 women

35%72/207

19%38/196

Ongoing pregnancy rate403 women

28%57/207

16%32/196

Live Birth Rate 403 women

28%57/207

17%34/196

Miscarriage rates- Acupuncture before & after transfer +2 days

Acupuncture Control

403 women 14%30/207

9%18/196

No statistical difference

Acupuncture around time of oocyte retrieval

Studies performed show no significant difference in quality or quantity of oocytes retrieved.

Better live birth rates if electro-acupuncture used as anesthetic rather that alfentanil

(28/75 acupuncture 19/74 alfentanil)

Acupuncture around time of oocyte retrieval

Clinically – too late

Beneficial to have acupuncture following day to help speed recovery after surgical procedure – swelling, pain, inflammation.

Ensure integrity of endometrium to allow for viable implantation.

Hypothalamic-Pituitary-Adrenal-Ovarian Axis (HPAO)

Stress and its role in unexplained infertility..?

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How does acupuncture affect the HPA?

affects plasma beta endorphin

affect the HPA by altering the release of hypothalamic gonadotrophin releasing hormone (GnRH) & pituitary gonadotrophin secretion.

Women

Ovulation induction

Increase microcirculation to reproductive organs

Regulate hypothalamic-pituitary-ovarian axis

Increase up-regulation of body’s own hormones

Acupuncture modulates immune factors

influences specific and nonspecific cellular and humoral immunities. activates cell proliferation, including blood, reticuloendothelial, and traumatised cells.activates leucocytosis, microbicidal activity, antibodies, globulin, complement, and interferon.modulates hypothalamic-pituitary control of the autonomic and neuroendocrine systems.

Rogers, 1992 Acupuncture for Immune-Mediated Disorders

Immune/ Inflammatory related disorders causing fertility problems

Immune

Endometriosis

Failure of embryo to implant & miscarriage

Thyroid disorders eg.Hashimotos

Inflammatory

High TNF alpha associated with repeated implantation failure in IVF

Treatment – men vs. women

www.flatrock.org.nz

Man

Increase sperm quality & quantity – morphology - motility

Increase semen quality

Faster results combining Chinese Herbal medicine with acupuncture

Questions?

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Moxa heat radiating down Stomach channel

Schlebusch, K. P., Maric-Oehler, W., & Schlebusch, K. P., Maric-Oehler, W., & Popp, F. A. (2005). Biophotonics in the Popp, F. A. (2005). Biophotonics in the infrared spectral range reveal acupuncture infrared spectral range reveal acupuncture meridian structure of the body. meridian structure of the body. J Altern J Altern Complement Med, 11Complement Med, 11(1), 171-173.(1), 171-173.

Propagated sensations along channels (PSCs/PSMs)

Reported PSCs during acupuncture correspond to EMG changes (Bensoussan, 1984)

PSCs follow pathways which closely correspond to channels (Ji, 1981)

PSCs travel at a slower rate than nerve conductionPSCs travel at 3.5 – 10 cm/sec (Bensoussan,1994)

A fibres conduct at 6.3 m/sec [630 cm/sec]C fibres conduct at 0.5 – 2 m/sec [50-200 cm/sec]

PSCs have been observed in many races (Deng, 1993)

PSCs are frequently associated with clinical efficacy of acupuncture (Deng, 1993)

PSCs can be blocked by mechanical pressure of more than 500 -1,00gm/mm2 (Ji, 1981)